Complementary Systems of Medicine

(Acupressure, Acupuncture, Alternative Medicine, Aroma therapy, Ayurveda, Complementary Medicine, Herbal Medicine, Homeopathy, Hypnotherapy, Magnetotherapy, Naturopathy, Pranic Healing, Reflexology, Reiki, Siddha, Traditional Medicine, Unani, Yoga & Meditation)


             Selected Abstracts

1.                  Arandelovic M, Stankovic I, Nikolic M. Swimming and persons with mild persistant asthma. ScientificWorldJournal. 2007 Aug 17;7:1182-8.

            Faculty of Medicine, University of Nis, Serbia. amima@eunet.yu

            The aim of our study was to analyze the effect of recreational swimming on lung function and bronchial hyperresponsiveness (BHR) in patients with mild persistent asthma. This study included 65 patients with mild persistent asthma, who were divided into two groups: experimental group A (n = 45) and control group B (n = 20). Patients from both groups were treated with low doses of inhaled corticosteroids (ICS) and short-acting beta2 agonists salbutamol as needed. Our program for patients in group A was combined asthma education with swimming (twice a week on a 1-h basis for the following 6 months). At the end of the study, in Group A, we found a statistically significant increase of lung function parameters FEV1 (forced expiratory volume in 1 sec) (3.55 vs. 3.65) (p < 0.01), FVC (forced vital capacity) (4.27 vs. 4.37) (p < 0.05), PEF (peak expiratory flow) (7.08 vs. 7.46) (p < 0.01), and statistically significant decrease of BHR (PD20 0.58 vs. 2.01) (p < 0.001). In Group B, there was a statistically significant improvement of FEV1 3.29 vs. 3.33 (p < 0.05) and although FVC, FEV1/FVC, and PEF were improved, it was not significant. When Groups A and B were compared at the end of the study, there was a statistically significant difference of FVC (4.01 vs. 4.37), FEV1 (3.33 vs. 3.55), PEF (6.79 vs.7.46), and variability (p < 0.001), and statistically significantly decreased BHR in Group A (2.01 vs. 1.75) (p < 0.001). Engagement of patients with mild persistent asthma in recreational swimming in nonchlorinated pools, combined with regular medical treatment and education, leads to better improvement of their parameters of lung function and also to more significant decrease of their airway hyperresponsiveness compared to patients treated with traditional medicine.

2.                  Booth-LaForce C, Thurston RC, Taylor MR. A pilot study of a Hatha yoga treatment for menopausal symptoms. Maturitas. 2007 Jul 20;57(3):286-95.

            University of Washington, United States.

            OBJECTIVE: To assess the feasibility and efficacy of a yoga treatment for menopausal symptoms. Both physiologic and self-reported measures of hot flashes were included. METHODS: A prospective within-group pilot study was conducted. Participants were 12 peri- and post-menopausal women experiencing at least 4 menopausal hot flashes per day, at least 4 days per week. Assessments were administered before and after completion of a 10-week yoga program. Pre- and post-treatment measures included: Severity of questionnaire-rated menopausal symptoms (Wiklund Symptom Check List), frequency, duration, and severity of hot flashes (24-h ambulatory skin-conductance monitoring; hot-flash diary), interference of hot flashes with daily life (Hot Flash Related Daily Interference Scale), and subjective sleep quality (Pittsburgh Sleep Quality Index). Yoga classes included breathing techniques, postures, and relaxation poses designed specifically for menopausal symptoms. Participants were asked to practice at home 15 min each day in addition to weekly classes. RESULTS: Eleven women completed the study and attended a mean of 7.45 (S.D. 1.63) classes. Significant pre- to post-treatment improvements were found for severity of questionnaire-rated total menopausal symptoms, hot-flash daily interference; and sleep efficiency, disturbances, and quality. Neither 24-h monitoring nor accompanying diaries yielded significant changes in hot flashes. CONCLUSIONS: The yoga treatment and study procedures were feasible for midlife women. Improvement in symptom perceptions and well being warrant further study of yoga for menopausal symptoms, with a larger number of women and including a control group.

3.                  Brefczynski-Lewis JA, Lutz A, Schaefer HS, Levinson DB, Davidson RJ. Neural correlates of attentional expertise in long-term meditation practitioners. Proc Natl Acad Sci U S A. 2007 Jul 3;104(27):11483-8.

            W.M. Keck Laboratory for Functional Brain Imaging and Behavior, Medical College of Wisconsin, University of Wisconsin, Madison, WI 53226, USA.

            Meditation refers to a family of mental training practices that are designed to familiarize the practitioner with specific types of mental processes. One of the most basic forms of meditation is concentration meditation, in which sustained attention is focused on an object such as a small visual stimulus or the breath. In age-matched participants, using functional MRI, we found that activation in a network of brain regions typically involved in sustained attention showed an inverted u-shaped curve in which expert meditators (EMs) with an average of 19,000 h of practice had more activation than novices, but EMs with an average of 44,000 h had less activation. In response to distracter sounds used to probe the meditation, EMs vs. novices had less brain activation in regions related to discursive thoughts and emotions and more activation in regions related to response inhibition and attention. Correlation with hours of practice suggests possible plasticity in these mechanisms.

4.                  Brockhoff A, Behrens M, Massarotti A, Appendino G, Meyerhof W. Broad tuning of the human bitter taste receptor hTAS2R46 to various sesquiterpene lactones, clerodane and labdane diterpenoids, strychnine, and denatonium. J Agric Food Chem. 2007 Jul 25;55(15):6236-43.

            Department of Molecular Genetics, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.

            Sesquiterpene lactones are a major class of natural bitter compounds occurring in vegetables and culinary herbs as well as in aromatic and medicinal plants, where they often represent the main gustatory and pharmacologically active component. Investigations on sesquiterpene lactones have mainly focused on their bioactive potential rather than on their sensory properties. In the present study, we report about the stimulation of heterologously expressed human bitter taste receptors, hTAS2Rs, by the bitter sesquiterpene lactone herbolide D. A specific response to herbolide D was observed i.a. for hTAS2R46, a so far orphan bitter taste receptor without any known ligand. By further investigation of its agonist pattern, we characterized hTAS2R46 as a bitter receptor broadly tuned to sesquiterpene lactones and to clerodane and labdane diterpenoids as well as to the unrelated bitter substances strychnine and denatonium.

5.                  Caplan RL. Chiropractic and the changing US health care marketplace: where we are going and  what needs to be done.  J Manipulative Physiol Ther. 2007 Jul-Aug;30(6):401-6. Review.

            This editorial reviews the current health care marketplace in the United States as it relates to chiropractic and the complementary and alternative medicine community. A 4-part strategy of research, education, alliance-building, and politics, is offered to address current obstacles.

6.                  Chan WK, Law HK, Lin ZB, Lau YL, Chan GC. Response of human dendritic cells to different immunomodulatory polysaccharides derived from mushroom and barley. Int Immunol. 2007 Jul;19(7):891-9.

                        Department of Paediatrics and Adolescent Medicine, Hong Kong Jockey Club Clinical Research Center, Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China.

            Polysaccharides derived from fungi and plants have been increasingly used as dietary supplement with therapeutic intention for cancer. However, whether these polysaccharides from different sources and structures can elicit similar immunological effects remain unknown. This study aims to investigate and compare the effects of selected groups of purified and crude polysaccharides on human dendritic cells (DCs), the most potent antigen-presenting cells. The selected polysaccharides were from Ganoderma lucidum [(GL) Lingzhi, Reishi], a medicinal mushroom commonly used by oriental; and barley glucan, a purified polysaccharide with known in vivo immunomodulating effect. We found that purified polysaccharides from GL mycelium could induce human PBMC proliferation and phenotypic and functional maturation of DCs with significant IL-12 and IL-10 production. Polysaccharides of GL spore and barley were both rather weak immunostimulator in vitro. In general, all these polysaccharides did not polarize T cells into either T(h)1 or T(h)2 or regulatory T cells, except for crude spore polysaccharides-treated DCs which could suppress T cell proliferation with IL-10 production. This study revealed the polysaccharides of different sources have different immune potency and effect on human immune cells including DCs. Our study also provides a reproducible biological platform for comparing the potential therapeutic effects of different herbal-derived polysaccharides in the future.

7.                  Chrubasik JE, Roufogalis BD, Chrubasik S. Evidence of effectiveness of herbal antiinflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain. Phytother Res. 2007 Jul;21(7):675-83. Review.

            Institute of Forensic Medicine, University of Freiburg im Breisgau, Albertstr. 9 79104 Freiburg im Breisgau, Germany.

            Treatment with herbal medicines is very popular in Europe. In order to get information on the evidence of effectiveness of oral herbal medicines in the treatment of pain in the joints or lower back, OVID(MEDLINE), PUBMED and COCHRANE COLLABORATION LIBRARY were searched back to 1985 for systematic reviews. The level of evidence of effectiveness was defined as strong - at least two confirmatory studies demonstrating a clinical relevant effect, moderate - one confirmatory study with a clinical relevant effect and/or multiple exploratory studies of good quality; otherwise the evidence was insufficient or conflicting in the case of inconsistent findings. Fifteen systematic reviews were identified. The evidence of effectiveness was strong for a proprietary unsaponifiable avocado soybean fraction and Harpagophytum preparations containing > 50 mg harpagoside in the daily dosage, moderate for ginger and a proprietary rose hip and seed powder, insufficient for Boswellia serrata gum resin and other herbal preparations and inconsistent for a proprietary willow bark extract. Further rigorous studies are required to confirm the usefulness of herbal medicines in the treatment of osteoarthritic complaints and chronic low back pain in order to enable acceptance of the herbal medicines into the treatment guidelines. Copyright 2007 John Wiley & Sons, Ltd.

8.                  Cook DA, Gelula MH, Lee MC, Bauer BA, Dupras DM, Schwartz A. A web-based course on complementary medicine for medical students and residents improves knowledge and changes attitudes. Teach Learn Med. 2007 Summer;19(3):230-8.

            Department of Medicine, Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.

            BACKGROUND: There is a growing need to educate physicians about complementary and alternative medicine (CAM). Few introductory courses in CAM have been described. PURPOSE: To develop and evaluate an introductory course in CAM for medical students and residents. METHOD: We conducted a controlled study evaluating a case-based, Web-based course in CAM, making comparison to no intervention. Participants were 123 internal medicine residents, family medicine residents, and 3rd- and 4th-year medical students at academic residency programs in internal medicine and family medicine and two U.S. medical schools. Outcomes included knowledge of CAM, attitudes toward CAM, and course evaluation information. RESULTS: Eighty-nine learners completed the course. Test scores among a subset of these (n = 57) were higher (M +/- SD = 78.7 +/- 10.1) than scores (50.9 +/- 8.5, p < .001) among a no-intervention control group (n = 34), and remained higher (64.9 +/- 11.4) 3 months later. After the course participants felt more comfortable discussing CAM with patients, recognized a greater role for CAM, and knew better where to find information on CAM (ps < .001 compared to baseline). Course ratings were high, although 26% of learners desired greater feedback. CONCLUSIONS: This brief course in CAM improved knowledge, changed attitudes, and was well received.

9.                  Creswell JD, Way BM, Eisenberger NI, Lieberman MD. Neural correlates of dispositional mindfulness during affect labeling. Psychosom Med. 2007 Jul-Aug;69(6):560-5.

            Department of Psychology, University of California, Los Angeles, CA 90095-1563, USA.

            OBJECTIVE: Mindfulness is a process whereby one is aware and receptive to present moment experiences. Although mindfulness-enhancing interventions reduce pathological mental and physical health symptoms across a wide variety of conditions and diseases, the mechanisms underlying these effects remain unknown. Converging evidence from the mindfulness and neuroscience literature suggests that labeling affect may be one mechanism for these effects. METHODS: Participants (n = 27) indicated trait levels of mindfulness and then completed an affect labeling task while undergoing functional magnetic resonance imaging. The labeling task consisted of matching facial expressions to appropriate affect words (affect labeling) or to gender-appropriate names (gender labeling control task). RESULTS: After controlling for multiple individual difference measures, dispositional mindfulness was associated with greater widespread prefrontal cortical activation, and reduced bilateral amygdala activity during affect labeling, compared with the gender labeling control task. Further, strong negative associations were found between areas of prefrontal cortex and right amygdala responses in participants high in mindfulness but not in participants low in mindfulness. CONCLUSIONS: The present findings with a dispositional measure of mindfulness suggest one potential neurocognitive mechanism for understanding how mindfulness meditation interventions reduce negative affect and improve health outcomes, showing that mindfulness is associated with enhanced prefrontal cortical regulation of affect through labeling of negative affective stimuli.

10.               Duraiswamy G, Thirthalli J, Nagendra HR, Gangadhar BN. Yoga therapy as an add-on treatment in the management of patients with schizophrenia--a randomized controlled trial. Acta Psychiatr Scand. 2007 Sep;116(3):226-32.

            Department of Psychiatry, National Institute of Mental Health and NeuroSciences, Bangalore 560029, India.

            OBJECTIVE: Treatment of schizophrenia has remained unsatisfactory despite the availability of antipsychotics. This study examined the efficacy of yoga therapy (YT) as an add-on treatment to the ongoing antipsychotic treatment. METHOD: Sixty-one moderately ill schizophrenia patients were randomly assigned to YT (n = 31) and physical exercise therapy (PT; n = 30) for 4 months. They were assessed at baseline and 4 months after the start of intervention, by a rater who was blind to their group status. RESULTS: Forty-one subjects (YT = 21; PT = 20) were available at the end of 4 months for assessment. Subjects in the YT group had significantly less psychopathology than those in the PT group at the end of 4 months. They also had significantly greater social and occupational functioning and quality of life. CONCLUSION: Both non-pharmacological interventions contribute to reduction in symptoms, with YT having better efficacy.

111.                 Ganbhire S, PR More, MI Queshi, SR Rajurkar. Studies on hypolipidemic properties of Murraya koenigii Spreng. Aryavaidyan 2007 Nov, 21(2), 108-112.

Murraya koenigii Spreng, belongs to the family Rutaceae, is one of the most widely cultivated plant throughout the country, commonly known as Curry leaf tree in English, karhinimb or karhipatta in Hindi. The powdered leaf powder was experimented in normal and alloxan induced diabetic rats to explore its effect on serum cholesterol, triglyceride, blood urea nitrogen (BUN) and alanine transaminase (ALT) level. The result indicated significant reduction in the serum cholesterol and serum triglyceride level in the treated group.

12.               Hillesund E, Skranes J, Trygg KU, Bohmer T. Micronutrient status in children with cerebral palsy. Acta Paediatr. 2007 Aug;96(8):1195-8.

            Department of Pediatrics, Sorlandet Hospital, Arendal, Norway.

            AIM: To investigate micronutrient status in a group of children with cerebral palsy (CP). METHODS: Thirty-six children with CP, aged 1.5-17 years, completed a 4-day food diary, underwent anthropometric measurements and delivered blood for analysis of micronutrient concentrations. RESULTS: Low intake of iron, folate, niacin, calcium, vitamin E and vitamin D was common, even among those who were receiving nutritional supplements. Laboratory tests revealed low serum concentration of folate in eight children, alpha-tocopherol in six children, ferritin in five children and pyridoxal-5-phosphate in three children. Two participants were low in zinc and one was low in selenium. Severely disabled children received nutrition supplements more frequently than those with less severe disability (71% vs.16%, p = 0.01). Tube feeding and use of nutrition supplements was reflected in higher concentrations of micronutrients in blood and serum. CONCLUSION: Low intake of micronutrients as well as low micronutrient concentrations was common in this heterogenic group of children with CP. Children with neurological disabilities should have their nutritional status evaluated in order to ascertain sufficient intake of micronutrients.

13.               Kamau-Mbuthia E, Elmadfa I. Diet quality of pregnant women attending an antenatal clinic in Nakuru, Kenya. Ann Nutr Metab. 2007;51(4):324-30.

            Department of Nutritional Sciences, University of Vienna, Vienna, Austria.

            BACKGROUND/AIMS: To determine diet quality and common food sources of various nutrients of pregnant Kenyan women. METHODS: Cross-sectional study of 716 pregnant women attending the antenatal clinic at the Provincial General Hospital, Nakuru, Kenya. Nutrient intake was estimated using the 24-hour dietary recall method. RESULTS: Inadequate nutrient intake was found for energy, total folic acid, calcium, iron and zinc. Adequate intake was found for protein, fat, PUFA, carbohydrate, dietary fiber, vitamins A and C. Diet quality was poor as evidenced from the food sources of various nutrients. Maize flour was the most common source of the following nutrients: energy, protein, total folic acid, iron and zinc. Young women and those of low socio-economic status were at risk of inadequate intake of some of the nutrients. CONCLUSION: The results of this study indicate poor-quality diets of pregnant women attending the antenatal clinic, low in multiple micronutrients. Nutrient education for dietary diversification and nutrient supplementation should be explored as interventions for improving nutrient intake among pregnant women. Copyright (c) 2007 S. Karger AG, Basel.

14.               Li XM. Traditional Chinese herbal remedies for asthma and food allergy. J Allergy Clin Immunol. 2007 Jul;120(1):25-31.

            Department of Pediatrics, Mount Sinai School of Medicine, New York, NY 10029, USA.

            The increasing prevalence of allergic diseases in Westernized countries is a significant health problem. Curative therapies for these diseases are not available. There are also significant concerns regarding the potential side effects from the chronic use of conventional drugs such as corticosteroids, especially in children. Many patients with chronic allergic conditions seek complementary and alternative medicine therapies including traditional Chinese medicines. This trend has begun to attract interest from mainstream health care providers and scientific investigators and has stimulated government agencies in the United States to provide support and guidance for the scientific investigation of complementary and alternative medicine. This effort may lead to improved therapies and better health care/patient outcomes. This review presents an update on the most promising Chinese herbal remedies for asthma and food allergy.

15.               Moadel AB, Shah C, Wylie-Rosett J, Harris MS, Patel SR, Hall CB, Sparano JA. Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. J Clin Oncol. 2007 Oct 1;25(28):4387-95.

            Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY 10461, USA.

            PURPOSE: This study examines the impact of yoga, including physical poses, breathing, and meditation exercises, on quality of life (QOL), fatigue, distressed mood, and spiritual well-being among a multiethnic sample of breast cancer patients. PATIENTS AND METHODS: One hundred twenty-eight patients (42% African American, 31% Hispanic) recruited from an urban cancer center were randomly assigned (2:1 ratio) to a 12-week yoga intervention (n = 84) or a 12-week waitlist control group (n = 44). Changes in QOL (eg, Functional Assessment of Cancer Therapy) from before random assignment (T1) to the 3-month follow-up (T3) were examined; predictors of adherence were also assessed. Nearly half of all patients were receiving medical treatment. RESULTS: Regression analyses indicated that the control group had a greater decrease in social well-being compared with the intervention group after controlling for baseline social well-being and covariates (P < .0001). Secondary analyses of 71 patients not receiving chemotherapy during the intervention period indicated favorable outcomes for the intervention group compared with the control group in overall QOL (P < .008), emotional well-being (P < .015), social well-being (P < .004), spiritual well-being (P < .009), and distressed mood (P < .031). Sixty-nine percent of intervention participants attended classes (mean number of classes attended by active class participants = 7.00 +/- 3.80), with lower adherence associated with increased fatigue (P < .001), radiotherapy (P < .0001), younger age (P < .008), and no antiestrogen therapy (P < .02). CONCLUSION: Despite limited adherence, this intent-to-treat analysis suggests that yoga is associated with beneficial effects on social functioning among a medically diverse sample of breast cancer survivors. Among patients not receiving chemotherapy, yoga appears to enhance emotional well-being and mood and may serve to buffer deterioration in both overall and specific domains of QOL.

16.               Son DJ, Lee JW, Lee YH, Song HS, Lee CK, Hong JT. Therapeutic application of anti-arthritis, pain-releasing, and anti-cancer effects of bee venom and its constituent compounds. Pharmacol Ther. 2007 Aug;115(2):246-70.

            College of Pharmacy and CBITRC, Chungbuk National University, 48 Gaesin-dong, Heungduk-gu, Cheongju, Chungbuk 361-763, Korea.

           Bee venom (BV) therapy (BVT), the therapeutic application of BV, has been used in traditional medicine to treat diseases, such as arthritis, rheumatism, pain, cancerous tumors, and skin diseases. BV contains a variety of peptides, including melittin, apamin, adolapin, the mast-cell-degranulating (MCD) peptide, enzymes (i.e., phospholipase [PL] A(2)), biologically active amines (i.e., histamine and epinephrine), and nonpeptide components which have a variety of pharmaceutical properties. BV has been reported to have anti-arthritis effects in several arthritis models. Melittin, a major peptide component of BV, has anti-inflammatory and anti-arthritis properties, and its inhibitory activity on nuclear factor kappaB (NF-kappaB) may be essential for the effects of BV. The anti-nociceptive effects of BV have also been demonstrated in thermal, visceral, and inflammatory pain models. Apcupoint stimulation (apipuncture) therapy into subcutaneous region may be important in the BV-induced anti-nociceptive effects. Multiple mechanisms, such as activation of the central and spinal opiod receptor, and alpha(2)-adrenergic activity, as well as activation of the descending serotonergic pathway have been suggested. The inhibition of c-Fos expression in the spinal cord by BV apipuncture in several nociceptive models is also reported to be a possible mechanism. BV also has anti-cancer activity. The cell cytotoxic effects through the activation of PLA(2) by melittin have been suggested to be the critical mechanism for the anti-cancer activity of BV. The conjugation of cell lytic peptide (melittin) with hormone receptors and gene therapy carrying melittin can be useful as a novel targeted therapy for some types of cancer, such as prostate and breast cancer.

17.               Weber W, Taylor JA, McCarty RL, Johnson-Grass A. Frequency and characteristics of pediatric and adolescent visits in naturopathic  medical practice. Pediatrics. 2007 Jul;120(1):e142-6.

            School of Naturopathic Medicine, Bastyr University, 14500 Juanita Dr NE, Kenmore, WA 98028, USA.

            OBJECTIVES: This work sought to identify naturopathic physicians in Washington State who frequently provide pediatric care and to describe the conditions treated and therapies recommended for children. PATIENTS AND METHODS: A mailed survey of licensed naturopathic physicians residing in Washington State collected demographic information and practice descriptions. For naturopathic physicians treating > or = 5 pediatric patients per week, data were collected on the conditions seen and treatments provided to children during a 2-week period. RESULTS: Of 499 surveys delivered to providers, 251 surveys were returned (response rate: 50.3%). Among the 204 naturopathic physicians currently practicing, only 31 (15%) saw > or = 5 children per week. For these pediatric naturopathic physicians, pediatric visits constituted 28% of their office practice. Pediatric naturopathic physicians were more likely to be licensed midwives (19.4% vs 0.6%) and treated significantly more patients per week (41.6 vs 20.2) than naturopathic physicians who provided less pediatric care. Eighteen of the 31 pediatric naturopathic physicians returned data on 354 pediatric visits; 30.5% of the visits were by children < 2 years old, and 58.5% were by those < 6 years old. The most common purpose for presentation included health supervision visits (27.4%), infectious disease (20.6%), and mental health conditions (12.7%). Pediatric naturopathic physicians provided immunizations during 18.6% of health supervision visits by children < 2 years old and 27.3% of visits by children between the ages of 2 and 5 years. CONCLUSIONS: Although most naturopathic physicians in Washington treat few children, a group of naturopathic physicians provide pediatric care as a substantial part of their practice. Based on the ages of children seen and the conditions treated, pediatric naturopathic physicians may provide the majority of care for some children. Efforts should be made to enhance collaboration between naturopathic physicians and conventional providers so that optimal care can be provided to children.

18.               Yurtkuran M, Alp A, Yurtkuran M, Dilek K.  A modified yoga-based exercise program in hemodialysis patients: a randomized controlled study. Complement Ther Med. 2007 Sep;15(3):164-71.

            Uludag University Medical Faculty, Physical Therapy and Rehabilitation Department, Atatürk Balneotherapy and Rehabilitation Center, PK 16080 Kükürtlü, Bursa, Turkey.

            AIM: To evaluate the effects of a yoga-based exercise program on pain, fatigue, sleep disturbance, and biochemical markers in hemodialysis patients. MATERIALS AND METHODS: In 2004 a randomized controlled trial was carried out in the outpatient hemodialysis unit of the Nephrology Department, Uludag University Faculty of Medicine. Clinically stable hemodialysis patients (n=37) were included and followed in two groups: the modified yoga-based exercise group (n=19) and the control group (n=18). Yoga-based exercises were done in groups for 30 min/day twice a week for 3 months. All of the patients in the yoga and control groups were given an active range of motion exercises to do for 10 min at home. The main outcome measures were pain intensity (measured by the visual analogue scale, VAS), fatigue (VAS), sleep disturbance (VAS), and grip strength (mmHg); biochemical variables-- urea, creatinine, calcium, alkaline phosphatase, phosphorus, cholesterol, HDL-cholesterol, triglyceride, erythrocyte, hematocrit--were evaluated. RESULTS: After a 12-week intervention, significant improvements were seen in the variables: pain -37%, fatigue -55%, sleep disturbance -25%, grip strength +15%, urea -29%, creatinine -14%, alkaline phosphatase -15%, cholesterol -15%, erythrocyte +11%, and hematocrit count +13%; no side-effects were seen. Improvement of the variables in the yoga-based exercise program was found to be superior to that in the control group for all the variables except calcium, phosphorus, HDL-cholesterol and triglyceride levels. CONCLUSION: A simplified yoga-based rehabilitation program is a complementary, safe and effective clinical treatment modality in patients with end-stage renal disease.

19.               Ziegelstein RC. Acute emotional stress and cardiac arrhythmias. JAMA. 2007 Jul 18;298(3):324-9.

            Department of Medicine, Johns Hopkins University School of Medicine and Division of Cardiology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224-2780, USA.

            Episodes of acute emotional stress can have significant adverse effects on the heart. Acute emotional stress can produce left ventricular contractile dysfunction, myocardial ischemia, or disturbances of cardiac rhythm. Although these abnormalities are often only transient, their consequences can be gravely damaging and sometimes fatal. Despite the many descriptions of catastrophic cardiovascular events in the setting of acute emotional stress, the anatomical substrate and physiological pathways by which emotional stress triggers cardiovascular events are only now being characterized, aided by the advent of functional neuroimaging. Recent evidence indicates that asymmetric brain activity is particularly important in making the heart more susceptible to ventricular arrhythmias. Lateralization of cerebral activity during emotional stress may stimulate the heart asymmetrically and produce areas of inhomogeneous repolarization that create electrical instability and facilitate the development of cardiac arrhythmias. Patients with ischemic heart disease who survive an episode of sudden cardiac death in the setting of acute emotional stress should receive a beta-blocker. Nonpharmacological approaches to manage emotional stress in patients with and without coronary artery disease, including social support, relaxation therapy, yoga, meditation, controlled slow breathing, and biofeedback, are also appropriate to consider and merit additional investigation in randomized trials.


17008.    Akihisa T, Higo N, Tokuda H, Ukiya M, Akazawa H, Tochigi Y, Kimura Y, Suzuki T, Nishino H. Cucurbitane-type triterpenoids from the fruits of Momordica charantia and their cancer chemopreventive effects. J Nat Prod. 2007 Aug;70(8):1233-9.

17009.    Alkhalaf M. Resveratrol-induced growth inhibition in MDA-MB-231 breast cancer cells is associated with mitogen-activated protein kinase signaling and protein translation. Eur J Cancer Prev. 2007 Aug;16(4):334-41.

17010.    Antoshechkin A, Olalde J, Magarici M, Muhammad A, Salom A, Suarez J, Amendola  F. Analysis of effects of the herbal preparation Circulat on gene expression levels in cultured human fibroblasts. Phytother Res. 2007 Aug;21(8):777-89.

17011. Arisawa M. Development of environmentally benign organometallic catalysis for drug discovery
and its application. Chem Pharm Bull (Tokyo). 2007 Aug;55(8):1099-118. Review.

17012. Birden H, Page S. 21st century medical education. Aust Health Rev. 2007 Aug;31(3):341-50.


17013.    Bliwise DL, Ansari FP. Insomnia associated with valerian and melatonin usage in the 2002 National Health Interview Survey. Sleep. 2007 Jul 1;30(7):881-4.

17014.    Blumenthal JA, Babyak MA, Ironson G, Thoresen C, Powell L, Czajkowski S, Burg M, Keefe FJ, Steffen P, Catellier D; for the ENRICHD Investigators. Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction. Psychosom Med. 2007 Jul-Aug;69(6):501-8.

17015.    Braga FC, Serra CP, Viana NS Jr, Oliveira AB, Cortes SF, Lombardi JA. Angiotensin-converting enzyme inhibition by Brazilian plants. Fitoterapia. 2007 Jul;78(5):353-8.

17016.    Capko J. Alternative medicine goes mainstream. J Med Pract Manage. 2007 Jul-Aug;23(1):64-5.

17017.    Chandeying V, Lamlertkittikul S. Challenges in the conduct of Thai herbal scientific study: efficacy and safety of phytoestrogen, pueraria mirifica (Kwao Keur Kao), phase I, in the alleviation of climacteric symptoms in perimenopausal women. J Med Assoc Thai. 2007 Jul;90(7):1274-80.

17018.    Cheng TO. Acupuncture treatment for musculoskeletal chest pain. Int J Cardiol. 2007 Sep 14;121(1):95-6.

17019.    Choochote W, Chaithong U, Kamsuk K, Jitpakdi A, Tippawangkosol P, Tuetun B, Champakaew D, Pitasawat B. Repellent activity of selected essential oils against Aedes aegypti. Fitoterapia. 2007 Jul;78(5):359-64.

17020.    Cigolle CT, Langa KM, Kabeto MU, Tian Z, Blaum CS. Geriatric conditions and disability: the Health and Retirement Study. Ann Intern Med. 2007 Aug 7;147(3):156-64.

17021.    Clark LG, Upshur CC. Family medicine physicians' views of how to improve chronic pain management. J Am Board Fam Med. 2007 Sep-Oct;20(5):479-82.

17022.    Cloninger CR. Spirituality and the science of feeling good. South Med J. 2007 Jul;100(7):740-3.

17023.    Coelho HF, Pittler MH, Ernst E. An investigation of the contents of complementary and alternative medicine journals. Altern Ther Health Med. 2007 Jul-Aug;13(4):40-4.

17024.    Cruccu G, Aziz TZ, Garcia-Larrea L, Hansson P, Jensen TS, Lefaucheur JP, Simpson BA, Taylor RS. EFNS guidelines on neurostimulation therapy for neuropathic pain. Eur J Neurol. 2007 Sep;14(9):952-70.

17025.    Dangour AD, Albala C, Aedo C, Elbourne D, Grundy E, Walker D, Uauy R. A factorial-design cluster randomised controlled trial investigating the cost-effectiveness of a nutrition supplement and an exercise programme on pneumonia incidence, walking capacity and body mass index in older people living in Santiago, Chile: the CENEX study protocol. Nutr J. 2007 Jul 5;6:14.

17026.    Davidson JE, Bloomberg D, Burnell L. Scope creep: when nursing practice moves beyond traditional boundaries: an evidence-based example using procedural sedation. Crit Care Nurs

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