Ayurveda & Complementary Systems

of Medicine



(Acupuncture, Alternative Medicine, Aromatherapy, Ayurveda, Complementary Medicine, Herbal Medicine, Homeopathy, Hypnotherapy, Magnetotherapy, Reflexology, Siddha & Traditional Medicine)



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3629. Aceves-Avila FJ.  Medina F.  Fraga A. Herbal therapies in rheumatology: the persistence of ancient medical practices. [see comments]. Clinical & Experimental Rheumatology.  19(2):177-83, 2001 Mar-Apr.


OBJECTIVE: To determine how frequently herbal remedies are employed as alternative therapies in rheumatic diseases, and the historical justification for their use. METHODS: We conducted a survey in 250 outpatients in the rheumatology clinic of a teaching hospital in México. We registered general demographic information and the previous use of herbal remedies for rheumatic conditions, how effective they were, and the presence of adverse effects during their use. We identified the herbs employed, and cross-checked them with medical texts from the 16th through the 18th centuries on the use of herbal remedies. RESULTS: Of 250 surveyed patients, 126 (51%) had used herbal remedies for their rheumatic conditions. 63% of all users reported them to be effective for the purpose they had been prescribed. 12% reported adverse effects, none of them life-threatening. Being a user had no relation with the patients' formal education. Three patients did not answer the survey. We were able to identify 67 plants. One third of these are either prescribed for rheumatic conditions in the consulted bibliography, or else were used for the same purpose by ancient Mexican cultures. CONCLUSION: Herbal remedies are frequently used for rheumatic conditions. Some of them have an historical antecedent for their use in rheumatic conditions. They deserve a cautious evaluation as adjunctive therapies in rheumatic diseases.

3630.      Ahmed MT.  Loutfy N.  Yousef Y. Contamination of medicinal herbs with organophosphorus insecticides. Bulletin of Environmental Contamination & Toxicology.  66(4):421-6, 2001 Apr.

3631.      Alferi SM.  Antoni MH.  Ironson G.  Kilbourn KM.  Carver CS. Factors predicting the use of complementary therapies in a multi-ethnic sample of early-stage breast cancer patients.  Journal of the American Medical Womens Association.  56(3):120-3, 126, 2001 Summer.


OBJECTIVES: to examine predictors of use of complementary therapies reported by women who had also received standard medical treatment for early-stage breast cancer. METHODS: A volunteer sample of 231 black, Hispanic, and non-Hispanic white patients with early-stage breast cancer (diagnosed within the preceding year) reported their use of complementary therapies. We examined predictors of the use of each therapy from among a set of demographic and quality of life measures. RESULTS: Most women reported using 1 complementary therapy or more, most commonly psychotherapy, support groups, meditation, and spiritual healing. Use of psychotherapy related to age, education, and elevated distress. Use of other complementary therapies was not related to distress. More black than Hispanic or non-Hispanic white patients used herbal therapies and spiritual healing. Use of complementary therapies did not relate to expectation of recurrence, dissatisfaction with medical care, or (among relevant patients) concerns about the consequences of chemotherapy. CONCLUSIONS: Use of healing therapies that do not replace medical treatment should be viewed as attempts to increase potential benefit and not as signs of distress or dissatisfaction. Use of complementary therapies also varies across racial and ethnic groups.

3632.      American College of Obstetricians and Gynecologists Committee on Practice Bulletins--Gynecology..  ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Use of botanicals for management of menopausal symptoms. [Review] [48 refs]  Obstetrics & Gynecology.  97(6):suppl 1-11, 2001 Jun.


  Lack of confidence in the espoused benefits of hormone replacement therapy (HRT) coupled with a significant array of side effects of HRT, results in fewer than 1 in 3 women choosing to take HRT. The use of alternatives to conventional HRT has become more accessible and acceptable to many women. As more women choose these alternatives, physicians are confronted with the challenges of how to advise patients about alternative medicine and how to determine which therapies may be safe and effective. This document will examine available scientific information on alternative therapies for treatment of menopausal symptoms and provide recommendations on efficacy and potential adverse consequences. [References: 48]

3633.       Anbar RD.  Self-hypnosis for management of chronic dyspnea in pediatric patients. Pediatrics.  107(2):E21, 2001 Feb.


  INTRODUCTION: Hypnotherapy can be useful in the management of anxiety, discomfort, and psychosomatic symptoms, all of which may contribute to a complaint of dyspnea. Therefore, instruction in self-hypnosis was offered to 17 children and adolescents with chronic dyspnea, which had not resolved despite medical therapy, and who were documented to have normal lung function at rest. This report documents the result of this intervention. METHODS: A retrospective chart review identified all patients followed by a single pediatric pulmonologist (R.D.A.), with a chief complaint of chronic dyspnea from April 1998 through December 1999. These patients had been evaluated and treated for medical diseases according to their history, physical examination, and laboratory investigations. The pulmonologist offered to teach self-hypnosis to all of these patients, who comprise the cohort in this report. Chronic dyspnea was defined as recurrent difficulty breathing or shortness of breath at rest or with exertion, which had existed for at least 1 month in patients who had not suffered within a month from an acute pulmonary illness. The pulmonologist was trained in hypnosis through his attendance at three 20-hour workshops. Hypnosis was taught to individual patients in 1 or two 15- to 45-minute sessions. Patients were taught hypnotic self-induction techniques and imagery to achieve relaxation. Additionally, imagery relating to dyspnea was developed by coaching patients to change their imagined lung appearance from a dyspneic to a healthy state. Patients were encouraged to practice self-hypnosis regularly and to use lung imagery to eliminate dyspnea if it occurred. RESULTS: Seventeen patients (13 males and 4 females) with chronic dyspnea were documented to have normal pulmonary function at rest. Their mean age was 13.4 years (range: 8-18 years). Twelve of the 17 previously were diagnosed with other conditions, such as allergies, asthma, and gastroesophageal reflux. Fifteen of the 17 manifested at least 1 other symptom associated with their dyspnea, including an anxious appearance (4 patients); chest tightness or pain (5); cough (4); wheeze (3); difficulty with inspiration (2); hyperventilation (1); inspiratory noise, such as stridor, gasping, rasping, or squeak (8); dizziness (1); feeling something is stuck in the throat (2); parasthesias (4); and tachycardia (3). Of the 17 patients, 2 complained of dyspnea at rest only, 13 complained of dyspnea with activity only, and 2 complained of dyspnea both at rest and with activity. Nine patients reported that they frequently needed to discontinue their physical activity because of dyspnea. The mean duration of their dyspnea before learning self-hypnosis was 2 years (range: 1 month to 5 years). The dyspnea was of <6 months duration for 4 of the patients. For 9 of the 17 patients a potential psychosocial association with their dyspnea was identified: 3 developed symptoms at school only; 2 with exercise during competitive races only; 3 after a major disagreement between their parents; and 1 developed symptoms each time his family moved to a new neighborhood. Before presentation, 7 of the 17 patients received chronic inhaled antiinflammatory therapy, and 3 were using inhaled albuterol, as needed. All 17 patients had normal physical examinations, with the exception of healed scars on the chest and abdomen of 1 patient, a repaired cleft palate in 1 patient, and rhinitis in another. Four of the 17 underwent pulmonary function testing before and after exercise, 6 had chest radiographs, and 3 had electrocardiograms. All of these tests were normal. A patient with a history of psychogenic cough declined to learn self-hypnosis. Thirteen of the remaining 16 patients were taught to use self-hypnosis in 1 session. A second session was provided to 3 patients within 2 months. Thirteen of the 16 patients reported their dyspnea and any associated symptoms had resolved within 1 month of their final hypnosis instruction session. Eleven believed that resolution of their dyspnea was attributable to hypnosis, because their symptoms cleared immediately after they received hypnosis instruction (5 patients) or with its regular use (6). Two did not attribute resolution of dyspnea to hypnosis because they did not use it at home. The remaining 3 reported that their dyspnea had improved. Patients were followed for a mean 9 months (range: 2-15 months) after their final hypnosis session. Ten of the 16 regularly used self-hypnosis at home for at least 1 month after the final hypnosis session. There was no recurrence of dyspnea, associated symptoms, or onset of new symptoms in patients in whom the dyspnea resolved. Under supervision of the pediatric pulmonologist, 2 of 7 patients discontinued their chronic antiinflammatory therapy when they became asymptomatic after hypnosis. Subsequently, their pulmonary function remained normal. DISCUSSION: (ABSTRACT TRUNCATED)

3634.      Anderson NR.  Gama R.  Kapadia S. Herbal remedy poisoning presenting with acute abdomen and raised urine porphyrins. Annals of Clinical Biochemistry.  38(Pt 4):408-10, 2001 Jul.


  We describe a case of lead poisoning due to herbal remedies, presenting with an acute abdomen, raised porphyrins and increased liver enzyme activities. We suggest that lead poisoning should be considered in the differential diagnosis of the 'acute abdomen', and that the presence of liver dysfunction points to the possibility of Asian herbal remedies as the source of the lead poisoning.

3635.      Ang-Lee MK.  Moss J.  Yuan CS. Herbal medicines and perioperative care. [Review] [122 refs] JAMA.  286(2):208-16, 2001 Jul 11.


  CONTEXT: Widespread use of herbal medications among the presurgical population may have a negative impact on perioperative patient care. OBJECTIVES: To review the literature on commonly used herbal medications in the context of the perioperative period and provide rational strategies for managing their preoperative use. DATA SOURCES: The MEDLINE and Cochrane Collaboration databases were searched for articles published between January 1966 and December 2000 using the search terms herbal medicine, phytotherapy, and alternative medicine and the names of the 16 most commonly used herbal medications. Additional data sources were obtained from manual searches of recent journal articles and textbooks. STUDY SELECTION: We selected studies, case reports, and reviews addressing the safety and pharmacology of 8 commonly used herbal medications for which safety information pertinent to the perioperative period was available. DATA EXTRACTION: We extracted safety, pharmacodynamic, and pharmacokinetic information from the selected literature and reached consensus about any discrepancies. DATA SYNTHESIS: Echinacea, ephedra, garlic, ginkgo, ginseng, kava, St John's wort, and valerian are commonly used herbal medications that may pose a concern during the perioperative period. Complications can arise from these herbs' direct and pharmacodynamic or pharmacokinetic effects. Direct effects include bleeding from garlic, ginkgo, and ginseng; cardiovascular instability from ephedra; and hypoglycemia from ginseng. Pharmacodynamic herb-drug interactions include potentiation of the sedative effect of anesthetics by kava and valerian. Pharmacokinetic herb-drug interactions include increased metabolism of many drugs used in the perioperative period by St John's wort. CONCLUSIONS: During the preoperative evaluation, physicians should explicitly elicit and document a history of herbal medication use. Physicians should be familiar with the potential perioperative effects of the commonly used herbal medications to prevent, recognize, and treat potentially serious problems associated with their use and discontinuation. [References: 122]

3636.      Anisimov VN.  Life span extension and cancer risk: myths and reality. [Review] [219 refs] Experimental Gerontology.  36(7):1101-36, 2001 Jul.


  A significant increase in the number of old people in the populations of developed countries was followed by an increase in morbidity and mortality resulting from main age-related diseases -- cardiovascular, cancer, neurodegenerative, diabetes mellitus, decrease in resistance to infections. Obviously, the development of the means of prevention of the premature aging of humans is crucial for the realization of this program. However, data available on such kind of means are rather scarce, contradictory and are often not reliable from the points of view of the adequacy of the experiments to current scientific requirements as well as the interpretation of the results and safety. Data available on the increase in life span and the adverse effects of the following geroprotectors were critically analyzed: antioxidants, chelate agents and lathyrogens, succinate, adaptogens and herbs, neurotropic drugs, inhibitors of monoamine oxidase, glucocorticoids, dehydroepiandrosterone, sex and growth hormones, melatonin, pineal peptide preparations, protein inhibitors, antidiabetic biguanides, thymic hormones and peptides, immunomodulators, enteroadsorbents, lypofuscin inhibitors, as well as calorie intake restriction and special diets. Most of the available results were insufficient and could not provide convincing evidence for the life span extension and the safety of the suggested geroprotectors. Drugs and means prolonging the life span could be subdivided into three groups: (a) geroprotectors prolonging the life span equally in all the members of the population: these postponed the beginning of the population's aging; (b) geroprotectors decreasing the mortality rate in a long-lived subpopulation, which raised their maximal life span: these slowed down the population's aging rate; (c) geroprotectors increasing the survival rate in a short-lived subpopulation without changes in the maximal life span: in this case, the aging rate increased. There was a high positive correlation between the type of geroprotector-induced aging delay and the pattern of tumour development in the same population of animals. The first type of geroprotectors did not influence the incidence of tumour but increased tumour latency. The second type of geroprotectors was effective both in the inhibition of spontaneous carcinogenesis and the increase in tumour latency. Certain drugs of the third type raised tumour incidence in the exposed populations. According to the multistage model, geroprotectors either inhibit or accelerate the passage of carcinogen-exposed cells form one stage to another. Thus, the efficacy of geroprotectors as preventive means of cancer development will decrease with respect to the age of exposure onset. Recommendations of the available drugs and means of life span increase should be carefully reconsidered under the international scientific control. [References: 219]



3637.      Anonymous. Early, aggressive treatment can boost arthritis outcomes. Clinical Resource Management.  2(6):87-91, 81, 2001 Jun.


  Those with osteoarthritis or rheumatoid arthritis can consider several new care strategies. They come with the risk of rare, though serious, side effects.

3638.       Atwood KC.  The efficacy of spiritual healing. Annals of Internal Medicine.  134(12):1150, 2001 Jun 19.

3639.      Au TK.  Lam TL.  Ng TB.  Fong WP.  Wan DC. A comparison of HIV-1 integrase inhibition by aqueous and methanol extracts of Chinese medicinal herbs. Life Sciences.  68(14):1687-94, 2001 Feb 23.


  The aqueous and methanol extracts of twenty herbs traditionally used in Chinese medicine were screened for anti-HIV-1 integrase activity in a non-radioactive ELISA-based HIV-1 integrase assay. The screening was performed at an herb extract concentration of 50 microg/ml. It was found that most of the aqueous and methanol herb extracts could elicit strong inhibition of HIV-I integrase activity. The inhibition was most likely due to tannins or polyphenolics in the herb extracts. In most of the herb extracts, 40-80% of the anti-HIV-1 integrase activity could be removed after passing through a minicolumn of polyamide resin. After removal of polyphenolic compounds, the methanol extract of Paeonia suffruticosa still exerted potent inhibition of HIV-1 integrase (EC50 = 15 microg/ml) and the aqueous extract of Prunella vulgaris caused moderate inhibition (EC50 = 45 microg/ml). The results support the view that herbs represent a rich source of anti-HIV compounds.

3640.      Banerji P.  Banerji P. Intracranial cysticercosis: an effective treatment with alternative medicines.  In Vivo.  15(2):181-4, 2001 Mar-Apr.


  The purpose of this study was to demonstrate the cysticidal activities of Ruta graveolens and calcium phosphate in fractional dilutions as a completely new approach for the treatment of neurocysticercosis in humans. These two homeopathic medicines when given to patients with neurocysticercosis have cured the infection in 25 subjects (69.4%) from a total of 36 patients. Our preliminary results indicate that Ruta graveolens in combination with calcium phosphate must be considered to be a potent cysticidal agent with very little or no side effects.

3641.      Bedoya LM.  Sanchez-Palomino S.  Abad MJ.  Bermejo P.  Alcami J. Anti-HIV activity of medicinal plant extracts. Journal of Ethnopharmacology.  77(1):113-6, 2001 Sep.


  As part of our screening of anti-AIDS agents from natural sources, ethanolic and aqueous extracts of 15 medicinal plants widely used in the folk medicine of the Iberian Peninsula were evaluated in vitro. Most of the extracts tested were relatively nontoxic to human lymphocytic MT-2 cells, but only the extracts of Tuberaria lignosa and Sanguisorba minor magnolii exhibited anti-HIV activity in an in vitro MTT assay. The aqueous extracts of these plants showed inhibitory effects against HIV-1 induced infections in MT-2 cells at concentrations ranging from 12.5 to 50 microg/ml and 50 microg/ml, respectively. Both extracts showed no appreciable cytotoxicity at these concentrations.

3642.      Bensoussan A.  Chang SW.  Menzies RG.  Talley NJ. Application of the general health status questionnaire SF36 to patients with gastrointestinal dysfunction: initial validation and validation as a measure of change. Australian & New Zealand Journal of Public Health.  25(1):71-7, 2001.


  OBJECTIVE: To determine whether the Short Form (SF36) Health Status Survey is a valid measure of health status and health change for patients with irritable bowel syndrome (IBS). METHODS: The SF36 was self-administered by 116 patients with IBS at the commencement and end of a controlled clinical trial. Patients were recruited through two Sydney teaching hospitals and through private gastroenterologists during 1997 and treated with Chinese herbal medicine. RESULTS: The SF36 health concepts demonstrated internal consistency, construct validity and concurrent validity when applied to patients with significant bowel dysfunction. Patient scores on two health scales of the SF36 (bodily pain, general health) correlated significantly with the bowel symptom scores recorded by patients and gastroenterologists at the beginning and end of the trial period. Actively treated patients significantly improved their scores in four out of eight of the health scales of the SF36 and reported overall improvement compared with inactively treated patients. CONCLUSIONS: The SF36 is a valid measure of general health status in IBS patients, is sensitive to the presence of IBS, and is adequately sensitive to gastrointestinal change in IBS patients. IMPLICATIONS: While the SF36 general health measure is used by the Australian Bureau of Statistics and widely overseas, until recently no data have been available on the sensitivity of the SF36 to gastrointestinal dysfunction or numerous other disorders. The SF36 is not only sensitive to the presence of IBS, it also provides a useful adjunct to current methods of evaluating treatment outcomes for IBS, and potentially other disorders.

3643.      Bhatt AD. Clinical research on ayurvedic therapeutics: myths, realities and challenges. [Review] [24 refs]  Journal of the Association of Physicians of India.  49:558-62, 2001 May.


  Globally there is an increasing interest in alternative routes to health such as ayurveda. There is a need to conduct globally acceptable clinical research in ayurvedic therapeutics (AT). Some of the issues in investigating AT in randomised clinical trials (CT) are: selection of appropriate AT, non-drug and/or drug AT, identification of objective outcomes, devising adequate placebo/positive controls, difficulties of blinding, guarding against bias, duration of trials, number of patients, dose optimisation, etc. There is also a need to establish reasonable safety of this therapy in CT. If AT has to complete with new chemical entities and biotechnology products, clinical research and development of AT should be focussed on unmet medical needs utilising principles and practices of modern CT approaches. [References: 24]

3644.      Bielory L. Complementary medicine for the allergist. [Review] [30 refs] Allergy & Asthma Proceedings.  22(1):33-7, 2001 Jan-Feb.


  The objective of this article is to provide a historical overview of the present state of complementary and alternative medicine (CAM) in the treatment of atopic disorders. The evolution of medicine in the United States has been in flux with the advent of newer technologies, new designs in managed care, and integrating the cultural differences into a complex multidisciplinary health care delivery process. There have been several herbal modalities that contain various anti-allergy and asthma components with effects on bronchodilation, congestion, pulmonary function tests, and antagonism of asthma mediators such as histamine and PAF, corticosteroid levels, and clearance of mucus. In the field of allergy, asthma, and immunology, the popularity of CAM is more widespread than other common chronic medical problems. Overall, CAM use has created a $15-billion-a-year industry in dietary supplements alone. This has been especially fueled by the deregulation of the "herbal" industry by the congressional passage of the Dietary Supplement Health and Education Act of 1994. It would appear that our specialty would clearly benefit from expanding its knowledge base about these entities because "allergies" are high on the list of patients seeking CAM. This will prepare us to better coordinate the future possibilities and to "doctor" (i.e., teach) our patients about the risks and benefits of these modalities. [References: 30]

3645.      Bivins R.  The needle and the lancet: acupuncture in Britain, 1683-2000. Acupuncture in Medicine.  19(1):2-14, 2001 Jun.


  Although commonly regarded as a late twentieth century phenomenon, acupuncture use in Britain has a surprisingly long history, beginning with its seventeenth century transmission from China and Japan. Acupuncture was in use in the great hospitals of Paris before a second stage of transmission and translation brought it to nineteenth century Britain. Acupuncture's first wave of popularity and its results in British medical practice can be examined through examples drawn from the Lancet, the BMJ and other medical periodicals. This historical transmission of acupuncture to the UK can be fruitfully compared to its modern analogue, and historical patterns of acupuncture use can be compared with those displayed in contemporary Britain.

3646.      Black P.  Brown C.  Morris M. Providing information on complementary and alternative therapies and practitioners by producing a directory of practitioners. Complementary Therapies in Medicine.  9(1):45-8, 2001 Mar.


  This article describes the experience of the authors in producing a booklet to provide information on complementary and alternative therapies (CAM) in their local area. The practical steps needed to produce a booklet are described, including ways of involving local general practitioners, meeting with local therapists, recruiting contact persons for each therapy, designing and producing a booklet and launching the final version. The feedback from general practitioners and CAM practitioners is reported.

3647.      Broide E.  Pintov S.  Portnoy S.  Barg J.  Klinowski E.  Scapa E. Effectiveness of acupuncture for treatment of childhood constipation. Digestive Diseases & Sciences.  46(6):1270-5, 2001 Jun.


  The aim of the present study was to examine the influence of acupuncture on chronic constipation in children and to investigate their basal plasma panopioid level and the changes of this treatment. Seventeen children constipated for at least six months were treated by five weekly placebo acupuncture sessions, followed by 10 weekly true acupuncture sessions. Their parents filled a bowel habit questionnaire. Panopioid activity was measured at time 0 and after 5, 10, and 15 acupuncture sessions. The frequency of bowel movements in males increased more gradually compared to females and reached a maximal improvement only after 10 true acupuncture sessions, from 1.4 +/- 0.6/week to 4.4 +/- 0.6/week and females from 1.4 +/- 0.3/week up to 5.6 +/- 1.2/week. The basal panopioid activity was lower in constipated children as compared to the control population and increased gradually up to control level after 10 true acupuncture sessions. This study is the first to describe a successful treatment by acupuncture of constipated children.

3648.      Campbell A. Definition of homeopathy. British Homoeopathic Journal.  90(3):175-6, 2001 Jul.

3649.      Cappuccio FP.  Duneclift SM.  Atkinson RW.  Cook DG. Use of alternative medicines in a multi-ethnic population. Ethnicity & Disease.  11(1):11-8, 2001 Winter.


  BACKGROUND: The prevalence and cost of regular use of non-prescribed alternative medicines are rising around the world, yet, little evidence is available that demonstrates the safety, efficacy, or effectiveness of specific alternative medicine interventions. It is of interest to understand how and why these practices have become so popular in different societies with different health care organizations and provisions, and which factors predict the regular use of alternative medicines. METHODS: We assessed the prevalence and the predictors of regular use of non-prescribed vitamin supplements, cod liver oil, primrose oil, and garlic in a cross-sectional population-based study in South London of 1,577 men and women, aged 40-59 years (883 women, 523 White, 549 of African origin and 505 of South Asian origin), when allowing for potential confounders. RESULTS: The prevalence of regular users of alternative medicines was 10.4% (164/1,577); 7.4% (116) made regular use of non-prescribed vitamin supplements, whereas 5.3% (84) used either cod liver oil, primrose oil, or garlic preparations. When adjusted for age, ethnicity and social class, women were more likely than men to use at least one alternative medicine (OR 2.09 [95% CI 1.45-3.00]). This was true both for vitamin supplements (1.98 [1.29-3.03]) and for oil or garlic supplements (1.91 [1.17-3.14]). The use of oil or garlic (P<.005) but not vitamin supplements (P=.32) varied by ethnic group. In particular, Black people of African origin were more likely to use alternative medicines than either Whites (1.78 [1.07-2.94]) or South Asians (1.66 [1.07-2.59]), the least common users. People in social classes IV and V were less likely to use alternative medicines (0.53 [0.31-0.90]) than those in social classes I and II, though this was due more to lesser use of non-prescribed vitamin supplements than of cod liver oil, primrose oil or garlic. These associations were not attenuated by further adjustment for body mass index, smoking, marital status and age at leaving full-time education. CONCLUSIONS: The regular users of alternative medicines in London are more likely to be women, of African origin, and of higher socioeconomic status. Given the lack of evidence of efficacy and safety of these alternative medicines, it is important to understand the cultural differences in values and beliefs about traditional medicine that may underlie these findings.

3650.      Chen HY.  Ma BY.  Grant A.  Research funds for complementary medicine. Lancet.  357(9272):1982, 2001 Jun 16.

3651.      Chung JG.  Hsia TC.  Kuo HM.  Li YC.  Lee YM.  Lin SS.  Hung CF. Inhibitory actions of luteolin on the growth and arylamine N-acetyltransferase activity in strains of Helicobacter pylori from ulcer patients. Toxicology in Vitro.  15(3):191-8, 2001 Jun.


  Helicobacter pylori is now recognized as an important cause of type B gastritis, which is strongly associated with gastric and duodenal ulcer disease. H. pylori may be a causative factor in patients with gastric cancer. The growth inhibition and N-acetylation of 2-Aminofluorene (AF) or P-aminobenzoic acid (PABA) by arylamine N-acetyltransferase (NAT) in H. pylori were inhibited by luteolin, a component in herbal medicine. The growth inhibition was based on the changes of optical density (OD) by using a spectrophotometer. The N-acetylation of AF or PABA by NAT from H. pylori were assayed by the amounts of acetylated and non-acetylated AF or PABA in cytosols and intact bacteria of H. pylori by using HPLC. An inhibition of growth on H. pylori demonstrated that luteolin elicited a dose-dependent growth inhibition in the H. pylori cultures. Cytosols and suspensions of H. pylori with or without specific concentrations of luteolin co-treatment showed different percentages of AF or PABA acetylation. The data indicated that there was decreased NAT activity associated with increased levels of luteolin in H. pylori cytosols and suspensions. Using standard steady-state kinetic analysis, it was demonstrated that luteolin was a possible uncompetitive inhibitor to NAT enzyme in H. pylori. This report is the first demonstration to show that luteolin can inhibit H. pylori growth and NAT activity.

3652.      Cohen KS. An indigenous perspective on "Medicine and story". Advances in Mind-Body Medicine.  17(2):87-9, 2001 Spring.

3653.      Cornbleet MA.  Ross CS. Research in complementary medicine is essential. BMJ.  322(7288):736-7, 2001 Mar 24.

3654.      Coutino-Rodriguez R.  Hernandez-Cruz P.  Giles-Rios H. Lectins in fruits having gastrointestinal activity: their participation in the hemagglutinating property of Escherichia coli O157:H7. Archives of Medical Research.  32(4):251-7, 2001 Jul-Aug.


  BACKGROUND: In fruits with therapeutic properties for antidiarrheal and laxative uses, the presence of lectins may be the bioactive properties that interfere with bacterial adhesion, thought to be competition for glycoside signal sites in the attachment. METHODS: This study identifies lectins in crude extracts from fruits such as Tamarindus indica (tamarind), Spontia vulgaris (plum), Psidium guava (guava), Mangifera indica (mango), Cydonia vulgaris (quince), and Crataegus mexicanus (tejocote). To verify the procedures, extracts from Ricinus communis (castor bean), Glycine max (soybean), Phaseolus vulgaris (beans), Vicia fava (fava bean), and Solanum tuberosum (potato) were used as controls for lectin activity. Both sources of lectins were analyzed to determine their participation in the host-parasite interaction, using as a model the hemagglutinating properties of Escherichia coli O157:H7 (EHA). RESULTS: All extracts showed hemagglutination to group O erythrocytes test (HA) with the exception of mango. Two new galactose-specific lectins were identified from tamarind and guava. When analyzed for participation in EHA, only guava lectins inhibited this, while soybean lectin induced hemolysis; as both lectins bind to galactose, it is probable that their recognition occurs in different domains. Sugars involved in the attachment between Escherichia coli O157:H7 and red cells were identified and again, galactose in addition to mannose was found to be related in EHA. On the other hand, guava lectins also agglutinated E. coli O157:H7, perhaps due to the same galactose-specific lectin or to another type of lectin. CONCLUSIONS: In summary, guava has a galactose-specific lectin that prevents adhesion of E. coli O157:H7 to red cells; this lectin is mediated by galactose. Prevention could also be due to their capacity of agglutinating E. coli by guava lectins. Soybean lectin induced hemolysis only when bacteria was present, but not with floating secretions. This finding showed that guava is a source of lectin that can be explored to prevent adhesion of E. coli to epithelial intestinal cells; contrariwise, soya must be studied to see its participation in the uremia caused during E. coli O157:H7 pathogenesis.

3655.      Cummings M.  Acupuncture and experimentally induced ishaemic pain (n=60). Acupuncture in Medicine.  19(1):61-2, 2001 Jun.

3656.      Cummings TM.  White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. [Review] [84 refs] Archives of Physical Medicine & Rehabilitation.  82(7):986-92, 2001 Jul.


  OBJECTIVE: To establish whether there is evidence for or against the efficacy of needling as a treatment approach for myofascial trigger point pain. DATA SOURCES: PubMed, Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, AMED, and CISCOM databases, searched from inception to July 999. STUDY SELECTION: Randomized, controlled trials in which some form of needling therapy was used to treat myofascial pain. DATA EXTRACTION: Two reviewers independently extracted data concerning trial methods, quality, and outcomes. DATA SYNTHESIS: Twenty-three papers were included. No trials were of sufficient quality or design to test the efficacy of any needling technique beyond placebo in the treatment of myofascial pain. Eight of the 10 trials comparing injection of different substances and all 7 higher quality trials found that the effect was independent of the injected substance. All 3 trials that compared dry needling with injection found no difference in effect. CONCLUSIONS: Direct needling of myofascial trigger points appears to be an effective treatment, but the hypothesis that needling therapies have efficacy beyond placebo is neither supported nor refuted by the evidence from clinical trials. Any effect of these therapies is likely because of the needle or placebo rather than the injection of either saline or active drug. Controlled trials are needed to investigate whether needling has an effect beyond placebo on myofascial trigger point pain. Copyright 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation [References: 84]

3657.      Dahl NV.  Herbs and supplements in dialysis patients: panacea or poison?. [Review] [69 refs] Seminars in Dialysis.  14(3):186-92, 2001 May-Jun.


  The safety of herbal remedies and supplement use is of particular concern in patients with renal disease, and reliable information is not always easy to find. Predialysis patients may be drawn to complementary and alternative medicine (CAM) because they believe it can help prevent the progression of their renal disease. The purpose of this series of articles on alternative medicine for nephrologists is to address concerns and issues specific to CAM use in dialysis patients and to provide a guide to reliable sources of information. This introductory article emphasizes safety issues with a focus primarily on herbal medicine. Lack of regulation means that patients may not actually be taking what they think they are. Independent laboratory analyses have shown a lack of stated label ingredients and many instances of supplements and traditional remedies being contaminated with pesticides, poisonous plants, heavy metals, or conventional drugs. While certain supplements are always unsafe (carcinogenic, hepatotoxic, glandular extracts), others are specifically contraindicated in renal disease. Supplement use may be especially hazardous in renal disease because of unpredictable pharmacokinetics, drug interactions, negative effects on kidney function, nephrotoxicity, hemodynamic alterations, unpredictable effects on blood pressure or blood glucose, or potentiation of electrolyte abnormalities. There are no data on potential dialyzability of either active compounds, or their potentially active or toxic metabolites. Many supplements contain metal ions and other minerals. Transplant recipients are also at risk from potential unpredictable effects on immune function. Recommendations and information resources are listed. [References: 69]


3658.      Davis SR.  Briganti EM.  Chen RQ.  Dalais FS.  Bailey M.  Burger HG. The effects of Chinese medicinal herbs on postmenopausal vasomotor symptoms of Australian women. A randomised controlled trial. [see comments]. Medical Journal of Australia.  174(2):68-71, 2001 Jan 15.


  OBJECTIVE: To evaluate the effects of a defined formula of Chinese medicinal herbs (CMH) on menopausal symptoms. DESIGN: A double-blind randomised placebo-controlled trial. METHODS: Between August 1998 and April 1999, 55 postmenopausal Australian women recruited from an urban population completed 12 weeks of intervention with either a defined formula of CMH (n = 28) or placebo (n = 27) taken twice daily as a beverage. MAIN OUTCOME MEASURES: The primary end-point was change in frequency of vasomotor events (hot flushes and night sweats). The secondary end-points were changes in score for the domains measured in the Menopause Specific Quality of Life (MENQOL) Questionnaire. RESULTS: There was a reduction in average weekly frequency of vasomotor events with CMH (-15%; 95% CI, -31% to +1%) and with placebo (-31%; 95% CI, -42% to -21%). The difference between groups favoured the use of placebo; however, this was not significant (P=0.09). Although significant reductions in scores for the various domains of the MENQOL Questionnaire were observed for both CMH and placebo, there were no significant differences between the two treatment groups for any domain. There was evidence for effect modification by previous use of natural therapies for the vasomotor, physical and sexual domains of the MENQOL Questionnaire: women with no prior use of natural therapies for their menopausal symptoms responded to therapy, whereas prior users did not. CONCLUSIONS: The defined formula of CMH was no more effective than placebo in reducing vasomotor episodes in Australian postmenopausal women, or in improving any of the four symptom domains in the MENQOL Questionnaire. Three of the MENQOL Questionnaire domains were modified by prior use of natural therapies. This finding has implications for future studies.

3659.      Derezic D.  Zurak N.  Marekovic Z. Tobacco extract used as a remedy for urinary retention 150 years ago by the native population of the Balkans. Journal of Ethnopharmacology.  76(1):133, 2001 Jun.

3660.      Doerr L. Using homeopathy for treating childhood asthma: understanding a family's choice.  Journal of Pediatric Nursing.  16(4):269-76, 2001 Aug.


  The incidence and severity of asthma are increasing despite concerted efforts in comprehensive management. Families may be expected to look to complementary or alternative therapies (CAM) for help in treating persistent childhood asthma. One such therapy is homeopathy, a system of medicine that uses specially prepared, highly dilute substances to induce the body's self-healing in a comprehensive manner. This article describes the contrasting experiences for a family who undergoes specialty consultations with an allergist and with a homeopath. The style of the interview and the diagnostic tools used vary, as well as the basic philosophies and goals. The advantages and limitations, as well as the regulatory framework of homeopathy are explained, as evidenced by the literature. For nurses and other clinicians caring for children and families who use nonconventional therapies, the clinical implications are that these professionals need to become knowledgeable about the various alternative therapies which can complement conventional care. Families who wish to try homeopathy along with conventional care need to have open lines of communication and cooperation between their providers, both conventional and homeopathic. The care of childhood asthma may prove to benefit from clinical trials in homeopathy. Copyright 2001 by W.B. Saunders Company

3661.      Dossey L. Surfing the Odornet: exploring the role of smell in life and healing. Alternative Therapies in Health & Medicine.  7(2):12-6, 100-8, 2001 Mar.

3662.      Ebell MH.  Beck E. How effective are complementary/alternative medicine (CAM) therapies for fibromyalgia?.  Journal of Family Practice.  50(5):400-1, 2001 May.

3663.       Eliopoulos C. Reclaiming our healing role through integrative care. Journal of Psychosocial Nursing & Mental Health Services.  39(4):6-7, 2001 Apr.

3664.      Ernst E.  Complementary medicine: its hidden risks. Diabetes Care.  24(8):1486-8, 2001 Aug.

3665.     Ernst E. Complementary therapies in palliative cancer care. [Review] [49 refs] Cancer.  91(11):2181-5, 2001 Jun 1.


  BACKGROUND: Complementary medicine has become an important aspect of palliative cancer care. This overview is primarily aimed at providing guidance to clinicians regarding some commonly used complementary therapies. METHODS: Several complementary therapies were identified as particularly relevant to palliative cancer care. Exemplary studies and, where available, systematic reviews are discussed. RESULTS: Promising results exist for some treatments, e.g. acupuncture, enzyme therapy, homeopathy, hypnotherapy, and relaxation techniques. Unfortunately, the author finds that the evidence is not compelling for any of these therapies. CONCLUSION: These results point to some potential for complementary medicine in palliative care. They also demonstrate an urgent need for more rigorous research into the value (or otherwise) of such treatments in palliative and supportive cancer care. Copyright 2001 American Cancer Society. [References: 49]

3666.      Fabricant DS.  Farnsworth NR. The value of plants used in traditional medicine for drug discovery. [Review] [98 refs] Environmental Health Perspectives.  109 Suppl 1:69-75, 2001 Mar.


 In this review we describe and discuss several approaches to selecting higher plants as candidates for drug development with the greatest possibility of success. We emphasize the role of information derived from various systems of traditional medicine (ethnomedicine) and its utility for drug discovery purposes. We have identified 122 compounds of defined structure, obtained from only 94 species of plants, that are used globally as drugs and demonstrate that 80% of these have had an ethnomedical use identical or related to the current use of the active elements of the plant. We identify and discuss advantages and disadvantages of using plants as starting points for drug development, specifically those used in traditional medicine. [References: 98]

3667.      Fetto J. Quackery no more: alternative medicine moves into the mainstream. American Demographics.  12(1):10-1, 2001 Jan.

3668.  Fink MG.  Wipperman B.  Gehrke A. Non-specific effects of traditional Chinese acupuncture in osteoarthritis of the hip. Complementary Therapies in Medicine.  9(2):82-9, 2001 Jun.


  OBJECTIVES: The effectiveness of acupuncture treatment in patients with osteoarthritis of the hip was tested. DESIGN: This is a prospective, randomized, controlled, patient- and investigator-blinded clinical trial. PATIENTS AND SETTING: The study was performed at a university department for physical medicine and rehabilitation. Sixty-seven patients were separated into two treatment groups. INTERVENTIONS: Group 1 (treatment) had traditional needle placement and manipulation, whereas in group 2 (control) needles were placed away from classic positions and not manipulated. In both groups needles were placed within the L2 to L5 dermatomes. Outcome parameters were: pain (VAS), functional impairment (hip score), activity in daily life (ADL) and overall satisfaction before treatment, and 2 weeks and 2 months after treatment. RESULTS: For all parameters there was a significant improvement versus baseline in both groups 2 weeks and 2 months following treatment, but no significant difference between the two treatment groups. CONCLUSIONS: We conclude from these results that needle placement in the area of the affected hip is associated with improvement in the symptoms of osteoarthritis. It appears to be less important to follow the rules of traditional acupuncture techniques.


3669.  Fiske J.  Dickinson C.  The role of acupuncture in controlling the gagging reflex using a review of ten cases. British Dental Journal.  190(11):611-3, 2001 Jun 9.


  The gagging reflex is a physiological reaction which safeguards the airway from foreign bodies. In some people this response is exaggerated to the extent that the acceptance/provision of dental treatment is not possible. The aim of this paper is to review the role of acupuncture in controlling gagging as a safe, cheap, quick and relatively non-invasive technique. METHOD: Ten people agreed to try ear acupuncture to control gagging during dental treatment. Prior to treatment the severity of gagging was assessed. Acupuncture needles were inserted into a specific anti-gagging point on each ear, manipulated briefly and left in situ. Dental treatment was then carried out and the effectiveness of the acupuncture in preventing gagging was assessed. After treatment, the needles were removed and the patient discharged. All acupuncture was carried out by a dentist trained in its use. RESULTS: Four people had a severe gag reflex which made treatment impossible and six had a very severe reflex which made treatment impossible and affected their dental attendance. Ear acupuncture completely controlled the gag reflex in eight cases (23 treatment episodes) and partially controlled the reflex in two cases (two treatment episodes). Dental treatment could be carried out in all cases and at all visits. The cost of materials was 0.2 pounds per person per visit. Additional clinical time was in the order of 2-3 minutes. There were no adverse reactions to the technique and, on all occasions, patients were fit to leave the surgery and travel home unaccompanied. CONCLUSIONS: Ear acupuncture was successful in controlling the gag reflex. It is a safe, quick, inexpensive and relatively noninvasive technique. A controlled clinical trial is required to investigate any placebo effect.

3670.      Fisken RA. Integrated medicine. Road to betrayal is short. BMJ.  322(7300):1486, 2001 Jun 16.

3671.      Gabius HJ.  Darro F.  Remmelink M.  Andre S.  Kopitz J.  Danguy A.  Gabius S.  Salmon I.  Kiss R. Evidence for stimulation of tumor proliferation in cell lines and histotypic cultures by clinically relevant low doses of the galactoside-binding mistletoe lectin, a component of proprietary extracts. Cancer Investigation.  19(2):114-26, 2001.


  The toxic galactoside-specific lectin from mistletoe, a component of proprietary extracts with unproven efficacy in oncology, exhibits capacity to trigger enhanced secretion of proinflammatory cytokines at low doses (ng/ml or ng/kg body weight) and reductions of cell viability with increasing concentrations. To infer any tumor selectivity of this activity, cytofluorimetric and cell growth assays with a variety of established human tumor cell lines were performed. Only quantitative changes were apparent, and the toxicity against tumor cells was within the range of that of the tested fibroblast preparations from 5 donors. No indication for any tumor selectivity was observed. In kinetic studies with 8 sarcoma and 4 melanoma lines, this evidence for quantitative variability of the response in interindividual comparison was further underscored. At 50 pg lectin/ml x 10(5) cells, even a growth-stimulatory impact was noted in 5 of 12 tested cases. To mimic in vivo conditions with presence of cytokine-secreting inflammatory and stromal cells, exposure to the lectin was extended to histotypic cultures established from 30 cases of surgically removed tumor. As salient result, 5 specimens from 4 of the 8 tested tumor classes responded with a significant increase of [3H]-thymidine incorporation relative to controls during the culture period of 72 hours, when the lectin was present at a concentration in the described immunomodulatory range (1 ng/ml). A relation of this activity to the extent of the actual proliferative status of the reactive samples could not be delineated. Therefore, a non-negligible percentage of the established tumor cell lines (e.g., 3 from 8 sarcoma lines) can be markedly stimulated by the lectin at a very low dose and with dependence on the cell type. Furthermore, the feasibility to elicit a significant growth enhancement is likewise documented for human tumor explants in 16.6% of the examined cases. In view of the uncontrolled application of lectin-containing extracts in alternative/complementary medicine, the presented results on unquestionably adverse lectin-dependent effects in two culture systems call for rigorous examination of the clinical safety of this unconventional, scientifically entirely experimental treatment modality.


3672.      Gao H.  Yan L.  Liu B.  Wang Y.  Wei X.  Sun L.  Cui H. Clinical study on treatment of senile vascular dementia by acupuncture. Journal of Traditional Chinese Medicine.  21(2):103-9, 2001 Jun.


  63 patients with senile vascular dementia were randomly divided into the treatment group (treated by acupuncture) and the control group (treated with piracetam). The authors observed the changes in the score of Hasegawa's dementia scale (HDS), p300, rheoencephalogram, topographic EEG, superoxide dismutase (SOD) activity in erythrocytes, and lipid peroxide (LPO) level in plasma before and after treatment. The statistical data showed that the total effective rate in the treatment group (80.6%) was significantly higher than that in the control group (25%), and the differences in the observed indexes before and after treatment were significant (P < 0.05 or P < 0.01) in the treatment group but not in the control group (P > 0.05), indicating that the acupuncture treatment was superior in immediate therapeutic effect on senile vascular dementia to drug treatment.

3673.      George Wong HC.  Adverse and allergic reactions in complementary and alternative medicine.  Journal of Allergy & Clinical Immunology.  108(1):149-50, 2001 Jul.

3674.      Goldhamer A.  Lisle D.  Parpia B.  Anderson SV.  Campbell TC. Medically supervised water-only fasting in the treatment of hypertension. Journal of Manipulative & Physiological Therapeutics.  24(5):335-9, 2001 Jun.


  BACKGROUND: Hypertension-related diseases are the leading cause of morbidity and mortality in industrially developed societies. Although antihypertensive drugs are extensively used, dietary and lifestyle modifications also are effective in the treatment of patients with hypertension. One such lifestyle intervention is the use of medically supervised, water-only fasting as a safe and effective means of normalizing blood pressure and initiating health-promoting behavioral changes. METHODS: One hundred seventy-four consecutive hypertensive patients with blood pressure in excess of 140 mm Hg systolic, 90 mm Hg diastolic (140/90 mm Hg), or both were treated in an inpatient setting under medical supervision. The treatment program consisted of a short prefasting period (approximately 2 to 3 days on average) during which food consumption was limited to fruits and vegetables, followed by medically supervised water-only fasting (approximately 10 to 11 days on average) and a refeeding period (approximately 6 to 7 days on average) introducing a low-fat, low-sodium, vegan diet. RESULTS: Almost 90% of the subjects achieved blood pressure less than 140/90 mm Hg by the end of the treatment program. The average reduction in blood pressure was 37/13 mm Hg, with the greatest decrease being observed for subjects with the most severe hypertension. Patients with stage 3 hypertension (those with systolic blood pressure greater than 180 mg Hg, diastolic blood pressure greater than 110 mg Hg, or both) had an average reduction of 60/17 mm Hg at the conclusion of treatment. All of the subjects who were taking antihypertensive medication at entry (6.3% of the total sample) successfully discontinued the use of medication. CONCLUSION: Medically supervised water-only fasting appears to be a safe and effective means of normalizing blood pressure and may assist in motivating health-promoting diet and lifestyle changes.


3675.      Graham-Pole J.  "Physician, heal thyself": how teaching holistic medicine differs from teaching CAM. Academic Medicine.  76(6):662-4, 2001 Jun.


  The term complementary and alternative medicine (CAM) has been adopted to describe a system of health care not generally recognized as part of mainstream medical practice. It is often conflated with an older term, holistic medicine, which can briefly be defined as the art and science of healing the whole person-body, mind, and spirit-in relation to that person's community and environment. Coursework in CAM is now offered in at least two thirds of U.S. medical schools. There is also a growing number of courses in the medical humanities and in spirituality and health. However, courses explicitly designed to introduce students to the principles and practices of holistic medicine are unusual. The author describes the fundamental differences between CAM and holistic medicine, highlighting holistic medicine's emphasis on the promotion of healthy lifestyles for practitioners and patients alike. He argues that offering physicians-to-be more coursework in holistic medicine could lay the groundwork for future physicians' adopting and modeling healthy lifestyles.

3676.      Grauds C. Clinical pharmacist talks to plants, too.  Alternative Therapies in Health & Medicine.  7(4):19-20, 2001 Jul-Aug.

3677.      Guajardo-Bernal G. The research agenda. British Homoeopathic Journal.  90(3):174-5, 2001 Jul.

3678.      Gupta K.  Horne R. The influence of health beliefs on the presentation and consultation outcome in patients with chemical sensitivities. Journal of Psychosomatic Research.  50(3):131-7, 2001 Mar.


  OBJECTIVE: This study was carried out to investigate the impact of the physical effects of a chemical exposure, health and chemical beliefs, and chemical sensitivities treatment preferences on the consultation outcome at a tertiary liaison clinic. METHOD: Eighty-five patients exposed to a range of chemicals were assessed at a joint medical toxicology and psychiatric clinic. Patient's beliefs about chemicals and health, chemical sensitivities and their treatment preferences were assessed using a 23-item questionnaire. RESULTS: Fifty-seven patients (69%) had suffered from a range of initial or delayed symptoms that were probably a clear physical consequence of the exposure (Group A), whereas 26 patients (31%) had not (Group B). There were no significant differences found between groups A and B in terms of their diagnosis and their beliefs about health, food, chemicals and chemical sensitivities treatment preferences. However, patients in Group A were significantly more likely to report moderate to severe symptoms in comparison to Group B. Consultation outcome too did not differ between the two groups. The only predictors of consultation outcome were the patients' chemical sensitivities treatment preferences. Patients who at the outset thought that their treatment should comprise of complete avoidance to chemicals, regular monitoring and the use of alternative rather than conventional medicine were significantly less likely to achieve a favourable consultation outcome. Patients' chemical sensitivities treatment preferences were related to the more general beliefs on health, food and the harmful nature of chemicals and were not related to the chemical exposure variables. CONCLUSION: These findings suggest that addressing patients' treatment preferences and the general beliefs on chemicals, food and health may enhance outcome and perhaps ought to be the target for intervention in context of such a liaison clinic.

3679.      Harnack LJ.  Rydell SA.  Stang J. Prevalence of use of herbal products by adults in the Minneapolis/St Paul, Minn, metropolitan area. Mayo Clinic Proceedings.  76(7):688-94, 2001 Jul.


  OBJECTIVES: To document the prevalence of use of herbal products among adults in a large metropolitan area and to examine issues surrounding such use. SUBJECTS AND METHODS: Of people aged 18 years and older residing in the Minneapolis/St Paul, Minn, metropolitan area, 752 were randomly selected from Minnesota Department of Public Safety Driver and Vehicle Service Division data tapes. Between June and August 1999, surveys were mailed to determine use of any herb and use of 13 specific herbs. Rationale for use, perceived efficacy, and source of product information were assessed for each of the specific herbs. RESULTS: Of the initial 752 persons, 580 were eligible, and 376 returned a completed survey, resulting in a response rate of 65%. When asked whether they had used an herb during the past 12 months, 230 respondents (61.2%) reported that they had. Prevalence of use of specific herbs ranged from 30.9% for ginseng to 3.0% for milk thistle. The most commonly reported reasons for using herbs varied by the type of herb, although for 5 of the herbs, the most frequently mentioned reason was to promote general health/well-being. For 11 of the 13 herbs, less than 60% of those who used the herb rated it as effective or very effective. Family, friends, and written materials were the leading sources of product information among those taking 9 of the 13 specific herbs. CONCLUSIONS: Herbs are used frequently to treat or prevent an array of health conditions. At present, people who use herbal products appear to rely predominantly on family and friends for information.


3680.      Houston EA.  Bork CE.  Price JH.  Jordan TR.  Dake JA. How physician assistants use and perceive complementary and alternative medicine. Jaapa/Journal of the American Academy of Physician Assistants.  14(1):29-30, 33-4, 39-40 passim, 2001 Jan.


  The use of complementary and alternative medicine (CAM) is growing in the United States. Patients and their health care providers are increasingly accepting of complementary and alternative therapies. The purpose of this study was to identify physician assistants' (PAs') attitudes, beliefs, knowledge, training, recommendations for, and personal use of CAM. A random sample of 500 practicing PAs was sent a four-page, 78-item survey investigating their personal use of, recommendations for, and perceptions of the efficacy and safety of complementary and alternative therapies. Of PAs eligible to complete the survey, 50% responded. Chi-square analyses found a significant relationship between knowledge level and recommendation for CAM; status of use and belief that CAM exerts a placebo effect; status of use and recommendation for CAM; and source of information on CAM and recommendation for CAM. With the increasing prevalence of use of CAM, PAs need to be informed regarding CAM therapies.

3681.      Hsieh JC.  Tu CH.  Chen FP.  Chen MC.  Yeh TC.  Cheng HC.  Wu YT.  Liu RS.  Ho LT. Activation of the hypothalamus characterizes the acupuncture stimulation at the analgesic point in human: a positron emission tomography study. Neuroscience Letters.  307(2):105-8, 2001 Jul 13.


  We performed a positron emission tomography study, using regional cerebral blood flow as the index of brain activity, to address the specificity of brain activation pattern by acupuncture stimulation of short duration at the classical analgesic point. Needling manipulation at 2 Hz was performed at a classical point of prominent analgesic efficacy (Li 4, Heku) and a near-by non-classical/non-analgesic point, respectively, in normal subjects. Regions activated by acupuncture stimulation at Li 4 included the hypothalamus with an extension to midbrain, the insula, the anterior cingulate cortex, and the cerebellum. Of note, it was only the stimulation at Li 4 that activated the hypothalamus under the similar psychophysical ratings of acupuncture sensation (deqi) as elicited by the stimulation at the two points, respectively. The data suggested that the hypothalamus might characterize the central expression of acupuncture stimulation at the classical analgesic point and serve as one key element in mediating analgesic efficacy of acupuncture stimulation.

3682.      Huang XX.  Yamashiki M.  Nakatani K.  Nobori T.  Mase A. Semi-quantitative analysis of cytokine mRNA expression induced by the herbal medicine Sho-saiko-to (TJ-9) using a Gel Doc system. Journal of Clinical Laboratory Analysis.  15(4):199-209, 2001.


  The RT-PCR method was employed to determine the cytokine mRNA expression of human peripheral lymphocytes induced by the Japanese herbal medicine Sho-saiko-to (TJ-9). The results showed that the mRNA expression of IL-12, IL-1beta, IL-10, TNF-alpha, G-CSF, and IFN-gamma increased after 6 hr in culture. This is the first reported finding that TJ-9 is an IFN-gamma inducer. Next, cytokine mRNA expression was semi-quantitatively measured using the Gel Doc system with a CCD camera and then statistically analyzed in order to determine which component of TJ-9 was the true cytokine inducer. The results showed that the scutellaria root is the main component inducing the cytokines, while the glycyrrhiza root is the secondary component. When the cytokine concentrations in the supernatants of cell cultures were measured by ELISA, the levels of IL-12, IL-1beta, IL-10, TNF-alpha, and G-CSF reflected mRNA expression levels in the cell fraction. However, the level of IFN-gamma was below the detectable limit. The effects of various reagents on many different kinds of cytokine mRNA expression could be analyzed objectively in a short time using the Gel Doc system. Many important findings could be demonstrated by this simple, easy, sensitive, and cheap method. After the clinical significance of cytokine analysis is confirmed, this method may become a useful clinical examination tool. Copyright 2001 Wiley-Liss, Inc.

3683.       (St George D). Integrated medicine. Integrated medicine means doctors will be in charge. BMJ.  322(7300):1484, 2001 Jun 16.

3684.      Irnich D.  Behrens N.  Molzen H.  Konig A.  Gleditsch J.  Krauss M.  Natalis M.  Senn E.  Beyer A.  Schops P. Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain.  BMJ.  322(7302):1574-8, 2001 Jun 30.


  OBJECTIVES: To compare the efficacy of acupuncture and conventional massage for the treatment of chronic neck pain. DESIGN: Prospective, randomised, placebo controlled trial. Setting: Three outpatient departments in Germany. PARTICIPANTS: 177 patients aged 18-85 years with chronic neck pain. Interventions: Patients were randomly allocated to five treatments over three weeks with acupuncture (56), massage (60), or "sham" laser acupuncture (61). MAIN OUTCOME MEASURES: Primary outcome measure: maximum pain related to motion (visual analogue scale) irrespective of direction of movement one week after treatment. Secondary outcome measures: range of motion (3D ultrasound real time motion analyser), pain related to movement in six directions (visual analogue scale), pressure pain threshold (pressure algometer), changes of spontaneous pain, motion related pain, global complaints (seven point scale), and quality of life (SF-36). Assessments were performed before, during, and one week and three months after treatment. Patients' beliefs in treatment were assessed. RESULTS: One week after five treatments the acupuncture group showed a significantly greater improvement in motion related pain compared with massage (difference 24.22 (95% confidence interval 16.5 to 31.9), P=0.0052) but not compared with sham laser (17.28 (10.0 to 24.6), P=0.327). Differences between acupuncture and massage or sham laser were greater in the subgroup who had had pain for longer than five years (n=75) and in patients with myofascial pain syndrome (n=129). The acupuncture group had the best results in most secondary outcome measures. There were no differences in patients' beliefs in treatment. CONCLUSIONS: Acupuncture is an effective short term treatment for patients with chronic neck pain, but there is only limited evidence for long term effects after five treatments.

3685.      Jackson C. Surfing the odornet: a reflective response.  Alternative Therapies in Health & Medicine.  7(4):22, 2001 Jul-Aug.

3686.       Jonas WB. The evidence house: how to build an inclusive base for complementary medicine.  Western Journal of Medicine.  175(2):79-80, 2001 Aug.

3687.      Joshi BS.  Kaul PN.  Alternative medicine: herbal drugs and their critical appraisal--Part I. [Review] [315 refs] Progress in Drug Research.  56:1-76, 2001.


  Among alternative therapeutic approaches that have shown global popularity during the past decades, herbal medicine stands out as a major concern in the countries where allopathic medicine prevails. The sales of herbal products as health care adjuvants in these countries have increased exponentially. Lack of quality control, commercial profiteering and exploitation leading to adulterations, lack of proper knowledge about the herbs and their contents that may exhibit drug-drug interactions and other adverse side-effects, and inappropriate usage of the herbal products have become a cause for concern in the health care professions, particularly in the United States. This review provides an incisive description of the known chemical, pharmacological, clinical and toxicological profiles of four of the most widely used herbal products. [References: 315]

3688.      Kaboli PJ.  Doebbeling BN.  Saag KG.  Rosenthal GE. Use of complementary and alternative medicine by older patients with arthritis: a population-based study. Arthritis & Rheumatism.  45(4):398-403, 2001 Aug.


  OBJECTIVE: To determine the prevalence of complementary and alternative medicine (CAM) use and to identify factors associated with its use in older patients with arthritis. METHODS: A population-based telephone survey of 480 elderly patients with arthritis was conducted to determine demographics, comorbidities, health status, arthritis symptoms, and the use of CAM and traditional providers and treatments for arthritis. RESULTS: CAM provider use was reported by 28% of respondents, and 66% reported using one or more CAM treatments. Factors independently related to CAM provider use (P < 0.05) included podiatrist or orthotist use, physician visits for arthritis, and fair or poor self-reported health. For CAM treatments, independent associations were found with physical or occupational therapist use, physician visits for arthritis, chronic obstructive pulmonary disease, and alcohol abstinence. Rural residence, age, income, education, and health insurance type were unrelated to CAM use. CONCLUSION: Many older patients with arthritis reported seeing CAM providers, and most used CAM treatments. The use of CAM for arthritis was most common among those with poorer self-assessed health and higher use of traditional health care resources.

3689.      Kaddu S.  Kerl H.  Wolf P. Accidental bullous phototoxic reactions to bergamot aromatherapy oil. Journal of the American Academy of Dermatology.  45(3):458-61, 2001 Sep.


  Oil of bergamot is an extract from the rind of bergamot orange (Citrus aurantium ssp bergamia) that has a pleasant, refreshing scent; until a few years ago it had been widely used as an ingredient in cosmetics but was restricted or banned in most countries because of certain adverse effects. More recently, oil of bergamot preparations have been gaining renewed popularity in aromatherapy. Oil of bergamot possesses photosensitive and melanogenic properties because of the presence of furocoumarins, primarily bergapten (5-methoxypsoralen [5-MOP]). However, 5-MOP is also potentially phototoxic and photomutagenic. Despite its increasing application, there are only a few recent reports of phototoxic reactions to bergamot aromatherapy oil. We describe two patients with localized and disseminated bullous phototoxic skin reactions developing within 48 to 72 hours after exposure to bergamot aromatherapy oil and subsequent ultraviolet exposure. One patient (case 2) had no history of direct contact with aromatherapy oil but developed bullous skin lesions after exposure to aerosolized (evaporated) aromatherapy oil in a sauna and subsequent UVA radiation in a tanning salon. This report highlights the potential health hazard related to the increasing use of psoralen-containing aromatherapy oils.

3690.      Kalauokalani D.  Cherkin DC.  Sherman KJ.  Koepsell TD.  Deyo RA. Lessons from a trial of acupuncture and massage for low back pain: patient expectations and treatment effects.  Spine.  26(13):1418-24, 2001 Jul 1.


  STUDY DESIGN: A subanalysis of data derived from a randomized clinical trial was performed. OBJECTIVE: To evaluate the association of a patient's expectation for benefit from a specific treatment with improved functional outcome. SUMMARY OF BACKGROUND DATA: Psychosocial factors, ambiguous diagnoses, and lack of a clearly superior treatment have complicated the management of patients with chronic low back pain. The authors hypothesized that patient expectation for benefit from a specific treatment is associated with improved functional outcomes when that treatment is administered. METHODS: In a randomized trial, 135 patients with chronic low back pain who received acupuncture or massage were studied. Before randomization, study participants were asked to describe their expectations regarding the helpfulness of each treatment on a scale of 0 to 10. The primary outcome was level of function at 10 weeks as measured by the modified Roland Disability scale. RESULTS: After adjustment for baseline characteristics, improved function was observed for 86% of the participants with higher expectations for the treatment they received, as compared with 68% of those with lower expectations (P = 0.01). Furthermore, patients who expected greater benefit from massage than from acupuncture were more likely to experience better outcomes with massage than with acupuncture, and vice versa (P = 0.03). CONCLUSIONS: The results of this study suggest that patient expectations may influence clinical outcome independently of the treatment itself. In contrast, general optimism about treatment, divorced from a specific treatment, is not strongly associated with outcome. These results may have important implications for clinical trial design and recruitment, and may help to explain the apparent success of some conventional and alternative therapies in trials that do not control for patient expectations. The findings also may be important for therapy choices made in the clinical setting.

3691.      Kaptchuk TJ.  Eisenberg DM. Varieties of healing. 2: a taxonomy of unconventional healing practices. [see comments]. Annals of Internal Medicine.  135(3):196-204, 2001 Aug 7.


  The first of two essays in this issue demonstrated that the United States has had a rich history of medical pluralism. This essay seeks to present an overview of contemporary unconventional medical practices in the United States. No clear definition of "alternative medicine" is offered because it is a residual category composed of heterogeneous healing methods. A descriptive taxonomy of contemporary unconventional healing could be more helpful. Two broad categories of unconventional medicine are described here: a more prominent, "mainstream" complementary and alternative medicine (CAM) and a more culture-bound, "parochial" unconventional medicine. The CAM component can be divided into professional groups, layperson-initiated popular health reform movements, New Age healing, alternative psychological therapies, and non-normative scientific enterprises. The parochial category can be divided into ethno-medicine, religious healing, and folk medicine. A topologic examination of U.S. health care can provide an important conceptual framework through which health care providers can understand the current situation in U.S. medical pluralism.

3692.      Kemper KJ.  Dietary supplements for attention-deficit/hyperactivity disorder--a fishy business? [letter; comment]. Journal of Pediatrics.  139(2):173-4, 2001 Aug.

3693.       Kiong HN. Article: gynaecomastia and the herbal tonic 'Dong Quai". Singapore Medical Journal.  42(6):286-7, 2001 Jun.

3694.      Krivoy N.  Pavlotzky E.  Chrubasik S.  Eisenberg E.  Brook G. Effect of salicis cortex extract on human platelet aggregation. Planta Medica.  67(3):209-12, 2001 Apr.


  The bark of Salix species contains several prodrugs of salicylate, mainly salicin. The aim of this study was to investigate if during pain treatment with Salicis cortex extract platelet aggregation was affected. A total of 51 patients were enrolled in the study. Thirty-five patients suffering from acute exacerbations of chronic low back pain received randomly and double-blind either Salicis cortex extract with 240 mg salicin/day (n = 19) or placebo (n = 16). Further sixteen patients with stable chronic ischemic heart disease were given 100 mg acetylsalicylate per day. Platelet aggregation was studied using an aggregometer. As aggregating agents, arachidonic acid (500 micrograms/ml), adenosine di-phosphate (2 x 10(-5) M) and collagen (0.18 microgram/ml) were used. The mean maximal arachidonic acid induced platelet aggregation was 61%, 78% and 13% in the Salicis cortex extract, placebo and acetylsalicylate groups. Acetylsalicylate had a significant inhibitory effect on platelet aggregation compared to Salicis cortex extract (p = 0.001) and placebo (p = 0.001). There was also a significant difference between the placebo and the willow bark-treated groups in the maximal platelet aggregation induced by arachidonic acid (p = 0.04) and ADP (p = 0.01). No statistical difference was found between the groups when collagen was applied to the human platelets. Daily consumption of Salicis cortex extract with 240 mg salicin per day affects platelet aggregation to a far lesser extent than acetylsalicylate. Further investigation needs to clarify if this finding is of clinical relevance in patients with impaired thrombocyte function.

3695.      Kshirsagar RD.  Singh NP. Some less known ethnomedicinal uses from Mysore and Coorg districts, Karnataka state, India. Journal of Ethnopharmacology.  75(2-3):231-8, 2001 May.


  Present communication deals with 76 ethnomedicinal plants being used traditionally in Karnataka, India. These plants are reported to have 78 less known ethnomedicinal uses for curing various skin diseases, cuts, stomach disorders, gynaecological complaints and snakebites.

3696.      Lamarine RJ. Alternative medicine: more than a harmless option. Journal of School Health.  71(3):114-6, 2001 Mar.

3697.      Larkin M. Alternative medicine centre aims for mainstream status. Lancet.  358(9281):566, 2001 Aug 18.

3698.      Levinson A.  Chinn J.  Lead poisoning from complementary and alternative medicine in multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry.  71(2):281-2, 2001 Aug.

3699.      Lewis CJ. Comment: regulatory environment for dietary supplements and botanicals targeted to weight loss. [letter; comment]. Critical Reviews in Food Science & Nutrition.  41(1):43-4, 2001 Jan.

3700.      Long L.  Soeken K.  Ernst E. Herbal medicines for the treatment of osteoarthritis: a systematic review. [Review] [46 refs] Rheumatology (Oxford).  40(7):779-93, 2001 Jul.


  OBJECTIVE: Limitations in the conventional medical management of osteoarthritis indicate a real need for safe and effective treatment of osteoarthritis patients. Herbal medicines may provide a solution to this problem. The aim of this article was to review systematically all randomized controlled trials on the effectiveness of herbal medicines in the treatment of osteoarthritis. METHODS: Computerized literature searches were carried out on five electronic databases. Trial data were extracted in a standardized, predefined manner and assessed independently. RESULTS: Twelve trials and two systematic reviews fulfilled the inclusion criteria. The authors found promising evidence for the effective use of some herbal preparations in the treatment of osteoarthritis. In addition, evidence suggesting that some herbal preparations reduce consumption of non-steroidal anti-inflammatory drugs was found. The reviewed herbal medicines appear relatively safe. CONCLUSIONS: Some herbal medicines may offer a much-needed alternative for patients with osteoarthritis. [References: 46]

3701.      Low J. Alternative, complementary or concurrent health care? A critical analysis of the use of the concept of complementary therapy. Complementary Therapies in Medicine.  9(2):105-10, 2001 Jun.


  In this paper I critically address what is becoming the wholesale adoption of the concept of complementary medicine in researchers' analyses of lay participation in alternative therapies. This paper emerged out of a qualitative study of 21 Canadians who use and/or practice alternative therapies. I found that only seven informants used the term 'complementary' in describing their use of alternative therapies. Of those seven who did, five were alternative practitioners. I discuss the variability of meaning of the concept of 'complementary' and I argue that alternative practitioners have a professional interest in using the concept to avoid seeming in competition with medical professionals and to reduce the likelihood of being labelled 'quacks'. I conclude with a plea for researchers to define their terms in analyses of individuals' use of alternative and/or their dual use of alternative and allopathic health care. Copyright 2001 Harcourt Publishers Ltd.


3702.      Lusu T.  Buhlungu N.  Grant H. The attitudes of parents to traditional medicine and the surgeon. South African Medical Journal.  91(4):270-1, 2001 Apr.

3703.      MacPherson H. Workshop report "Acupuncture and science: fundamental contradiction or creative tension" March 5(th)2001. Complementary Therapies in Medicine.  9(2):122, 2001 Jun.

3704.      Malhotra S.  Bhatia GS.  Pandhi P.  Patterns of use of unconventional therapies in the medical outpatient department of a tertiary care hospital in India. Journal of Ethnopharmacology.  75(2-3):71-5, 2001 May.


  Unconventional, alternative or unorthodox systems of treatment have become increasingly popular in recent years. We interviewed patients visiting the Internal Medicine outpatient department (OPD) for a period of 6 months regarding their use of unconventional therapies. Overall 76% of patients visiting the OPD had used one or more of the unconventional therapies in the past 1 year. Homeopathy was found to be the most frequently used alternative therapy (38.6%). A large number of patients used more than one unconventional therapy. Digestive problems, backache, joint pains and bronchial asthma were the most frequent conditions for which alternative therapies were used. Most patients who used alternative therapies used them on their own, without actually visiting a provider of such therapies. Because of the widespread use of alternative systems of medicine, efforts to enhance understanding about these forms of treatment have to be made.

3705.      Mazur LJ.  De Ybarrondo L.  Miller J.  Colasurdo G.  Use of alternative and complementary therapies for pediatric asthma. Texas Medicine.  97(6):64-8, 2001 Jun.


  This survey of 48 multicultural parents of children with asthma identifies and compares alternative and complementary treatments used for asthma, and compares any potentially effective or harmful effects. Thirty-nine (81%) of the parents used at least one form of alternative or complementary therapy to treat their child's asthma. Nontraditional therapies included prayer, over-the-counter medications, herbal teas, vitamins, and massage. African-American parents were more likely to rely on prayer, and Hispanic parents were more likely to use herbal and massage therapies. Use of over-the-counter medications and vitamins was similar among groups. Three herbal remedies were potentially toxic: lobelia, possible pennyroyal mint, and tree tea oil. Medical histories for all patients should include inquiries into the use of alternative therapies.

3706.      McIntosh P. Government-industry collaborations explored for alternative medicine. Journal of the National Cancer Institute.  93(15):1129-31, 2001 Aug 1.

3707.      Mendelson G. A primer of complementary and alternative medicine commonly used by cancer patients. Medical Journal of Australia.  174(11):611-2, 2001 Jun 4.

3708.      Mendelson G. Ezzo et al.: Is acupuncture effective for the treatment of chronic pain? A systematic review, PAIN 86(2000)217-225. Pain.  93(2):198-200, 2001 Aug.

3709.      Mensor LL.  Menezes FS.  Leitao GG.  Reis AS.  dos Santos TC.  Coube CS.  Leitao SG. Screening of Brazilian plant extracts for antioxidant activity by the use of DPPH free radical method. Phytotherapy Research.  15(2):127-30, 2001 Mar.


  Brazilian plant extracts belonging to 16 species of 5 different families (71 extracts) were tested against the stable DPPH (2,2-diphenyl-1-picryl-hydrazyl-hydrate) free-radical. The ability to scavenge DPPH radical was measured in these experiments by the discoloration of the solution. Ginkgo biloba and rutin, commonly used as antioxidants for medical purposes, were used as standards. Based on our results, we can say that as a general rule the ethanol extracts of plants belonging to the Verbenaceae family showed lower EC(50) values than the other plant extracts. Among the partitions, the more polar ones (ethyl acetate and n-butanol) are those that generally have higher antioxidant activity (AA). Copyright 2001 John Wiley & Sons, Ltd.

3710.      Monkman D. Using the Web to find information on complementary and alternative medicine. Complementary Therapies in Medicine.  9(2):127, 2001 Jun.

3711.      Morris HJ. Stevia adds sweetness, but don't call it a sweetener. US News & World Report.  131(5):50, 2001 Aug 6.

3712.      Muzi G.  Dell'omo M.  Madeo G.  Abbritti G.  Caroli S. Arsenic poisoning caused by Indian ethnic remedies. Journal of Pediatrics.  139(1):169, 2001 Jul.

3713.       Orlando CW. On breasts and beyond. Alternative Therapies in Health & Medicine.  7(4):20, 21, 2001 Jul-Aug.

3714.      Osborn CE.  Barlas P.  Baxter GD.  Barlow JH. Aromatherapy: a survey of current practice in the management of rheumatic disease symptoms. Complementary Therapies in Medicine.  9(2):62-7, 2001 Jun.

3715.      Paterson JK. Learning from complementary medicine. British Journal of General Practice.  51(462):65-6, 2001 Jan.

3716.      Perez-Garcia F.  Marin E.  Adzet T.  Canigueral S. Activity of plant extracts on the respiratory burst and the stress protein synthesis. Phytomedicine.  8(1):31-8, 2001 Jan.


  Aqueous, methanol and dichloromethane extracts from Artemisia copa, Baccharis grisebachii, Baccharis incarum, Baccharis latifolia, Mutisia kurtzii and Pluchea sagittalis, plants used in the Traditional Medicine of South America, are studied for activity on the respiratory burst and the inducible heat shock protein of 72 kD (hsp72) synthesis. Activity on the production of reactive oxygen species (ROS) and reactive nitrogen species (RNS), as well as on hsp72 synthesis was measured by flow cytometry in human neutrophils. Cells were stimulated using hydrogen peroxide, phorbol-12-myristate-13-acetate (PMA) or formyl-methionyl-leucyl-phenylalanine (FMLP) for ROS generation, and sodium nitroprusside (SNP) or PMA in the presence of calmodulin inhibitor W-13 for RNS. The production of hsp72 was induced by heat, PMA, H2O2 and SNP. The best inhibitory activity was shown by the dichloromethane extracts of Baccharis grisebachii and Pluchea sagittalis that were active in all the assays. The aqueous extract of Pluchea sagittalis was also active in most assays. The aqueous extract from Mutisia kurtzii caused a clear increase of the hsp72 production and showed prooxidant activity.

3717.      Petry JJ.  Hadley SK. Medicinal herbs: answers and advice, part 1. [Review] [9 refs] Hospital Practice (Office Edition).  36(7):57-60, 2001 Jul 15.


  Many herbal medicines have been used for centuries but have only recently been subjected to rigorous scientific scrutiny. Fever-few, milk thistle, tea tree oil, and valerian are considered safe for use by most patients. All four appear to provide some benefits in treating or preventing illness, but the supporting evidence is inconclusive in some cases. [References: 9]

3718.      Popat A.  Shear NH.  Malkiewicz I.  Stewart MJ.  Steenkamp V.  Thomson S.  Neuman MG. The toxicity of Callilepis laureola, a South African traditional herbal medicine. [Review] [78 refs] Clinical Biochemistry.  34(3):229-36, 2001 May.


  OBJECTIVES: To review the literature on the toxicity of Callilepis laureola, and to assess the cytotoxicity of C. laureola in human hepatoblastoma Hep G2 cells in vitro. DESIGN AND METHODS: Cells were incubated for up to 48 h in the presence of increasing concentrations of an aqueous extract of C. laureola (0.3-13.3 mg/mL). Cytotoxicity was quantitated spectrophotometrically by the metabolism of the tetrazolium dye MTT. Cytoviability of the control cells was considered to be 100%. RESULTS: C. laureola produced cytotoxicity in a concentration-dependent manner. Cytotoxicity was significant at all concentrations tested (0.3-2.5 mg/mL, p < 0.05 vs. controls and 3.3-13.3 mg/mL, p < 0.0001 vs. controls). After 6 h, 100% toxicity was observed at a concentration of 6.7 mg/mL. CONCLUSION: C. laureola causes significant cytotoxicity in Hep G2 cells in vitro. These findings are in accordance with the observed hepatotoxicity in clinical cases of C. laureola poisoning. [References: 78]

3719.      Pribitkin  ED.  Boger G. Herbal therapy: what every facial plastic surgeon must know. [Review] [76 refs] Archives of Facial Plastic Surgery.  3(2):127-32, 2001 Apr-Jun.


  Herbal medicine (phytomedicine) uses remedies possessing significant pharmacological activity and, consequently, potential adverse effects and drug interactions. The explosion in sales of herbal therapies has brought many products to the marketplace that do not conform to the standards of safety and efficacy that physicians and patients expect. Unfortunately, few surgeons question patients regarding their use of herbal medicines, and 70% of patients do not reveal their use of herbal medicines to their physicians and pharmacists. All surgeons should question patients about the use of the following common herbal remedies, which may increase the risk of bleeding during surgical procedures: feverfew, garlic, ginger, ginkgo, and Asian ginseng. Physicians should exercise caution in prescribing retinoids or advising skin resurfacing in patients using St John's wort, which poses a risk of photosensitivity reaction. Several herbal medicines, such as aloe vera gel, contain pharmacologically active ingredients that may aid in wound healing. Practitioners who wish to recommend herbal medicines to patients should counsel them that products labeled as supplements have not been evaluated by the US Food and Drug Administration and that no guarantee of product quality can be made. [References: 76]

3720.      Pyevich D.  Bogenschutz MP.  Herbal diuretics and lithium toxicity. American Journal of Psychiatry.  158(8):1329, 2001 Aug.

3721.      Ramey D. Integrated medicine. Medicine can't be everything to everyone. BMJ.  322(7300):1485, 2001 Jun 16.

3722.      Ramsey SD.  Spencer AC.  Topolski TD.  Belza B.  Patrick DL. Use of alternative therapies by older adults with osteoarthritis. Arthritis & Rheumatism.  45(3):222-7, 2001 Jun.


  OBJECTIVE: To examine the rates of use and expenditures on alternative therapies by adults with osteoarthritis (OA). METHODS: Adults with OA recruited from the community to participate in a randomized clinical trial recorded alternative and traditional health care use on postcard diaries. General and arthritis-specific quality of life was assessed by questionnaires. RESULTS: More than 47% of participants reported using at least one type of alternative care during the 20-week intervention period. Among alternative care consumers, the most commonly used treatments were massage therapy (57%), chiropractic services (20.7%), and nonprescribed alternative medications (17.2%). Four percent of subjects reported using only alternative care during the study period. Expenditures for alternative therapy averaged $1,127 per year, compared with $1,148 for traditional therapies. CONCLUSION: Use of and expenditures for alternative care were high among this cohort of older adults with OA. Clinicians may want to inquire about use of these therapies before recommending treatments for this condition.

3723.      Read N.  Czauderna J. Integrated medicine. Finding the time is most important. BMJ.  322(7300):1484-5, 2001 Jun 16.

3724.      Roen DT. Another call for scientific evidence of alternative medicine. Journal of the American Veterinary Medical Association.  218(4):505, 2001 Feb 15.

3725.      Rosted P.  Griffiths PA.  Bacon P.  Gravill N. Is there an effect of acupuncture on the resting EEG?. Complementary Therapies in Medicine.  9(2):77-81, 2001 Jun.


  OBJECTIVE: To investigate if acupuncture has a measurable effect on the resting electron EEG. SUBJECTS: 14 healthy volunteers with no neurological condition took part in the study. METHODS: Using a digital storage EEG recorder and quantitative frequency analysis techniques data were obtained before, during and after acupuncture stimulation. To minimize the effect of artefacts all data were collected with the subject alert, but with eyes closed. Manual stimulation of the LI 4 acupuncture site was undertaken for periods of 0.5, 1.0 and 2.0 min. Frequency analysis of the EEG data from each acupuncture event was compared to the baseline data to show any significant changes over the bandwidth 0.3 to 30 Hz. Only changes greater than 2 standard deviations were considered significant. RESULTS: In 10 subjects the frequency spectra remained unchanged during acupuncture, but in three significant increases were recorded in the amplitude of very low frequencies between 0.5 and 2 Hz and in one subject there was an increase in the amplitude of the alpha band during acupuncture. All spectra returned to their baseline values immediately after acupuncture. Outcome: The changes recorded in the delta band of individuals during acupuncture were large but highly variable. They arose at a frequency that is on the limit of the recording equipment and where recording and physiological artefacts are known to occur, although there was no evidence of artefactual contamination of the data. The one case in which there was an increase in the alpha band is attributed to suppression of the dominant rhythm initially brought about by anxiety concerning the procedure which subsequently disappeared during acupuncture as the subject relaxed. CONCLUSION: It is clear that there are no changes brought about by acupuncture in the resting EEG in the frequency range 2-30 Hz and no evidence to attribute changes below 2Hz to a direct affect of acupuncture.

3726.      Ryan EA.  Pick ME.  Marceau C. Use of alternative medicines in diabetes mellitus. Diabetic Medicine.  18(3):242-5, 2001 Mar.


  AIMS: Enormous advances have been made in medical care but more people are still using herbal or alternative remedies. In chronic conditions such as diabetes patients may turn to alternative remedies that have been purported to improve glycaemic control. This study surveyed diabetic and control subjects about their use of all prescribed medication, over-the-counter supplements, and alternative medications. METHODS: Subjects were prospectively contacted in person or by telephone. Five hundred and two diabetic subjects and 201 control subjects were asked to provide details about themselves, their diabetes (for the diabetic subjects) and their use of prescribed medication, over-the-counter supplements and alternative medications. Subjects were asked to rank their assessment of the effectiveness of each medication. Costs were calculated on a per month basis from average prices obtained from five alternative health stores and five chemist shops. RESULTS: Of the diabetic subjects, 78% were taking prescribed medication for their diabetes, 44% were taking over-the-counter supplements and 31% were taking alternative medications. Of the control subjects, 63% were taking prescribed medication, 51% were taking over-the-counter supplements, and 37% were taking alternative medications. Multivitamins, vitamin E, vitamin C, calcium and aspirin were the most commonly used over the counter supplements. Garlic, echinacea, herbal mixtures, glucosamine were the most commonly used alternative medications. Chromium was used only by diabetic subjects and then only rarely. Subjects rated the effectiveness of the alternative medications significantly lower than for prescribed medications but still thought them efficacious. Alternative medications purported to have some hypoglycaemic effect were little used by diabetic subjects. Diabetic subjects spent almost as much money on over-the-counter supplements and alternative medications together as they did on their diabetic medications. CONCLUSIONS: One-third of diabetic patients are taking alternative medications that they consider efficacious but this is no more than in the control group. The money spent on alternative and non-prescription supplements nearly equals that spent on prescription medications. In view of the money spent in this area the time is past due to evaluate these remedies and to establish what merit they have.

3727.      Salmenpera L.  Suominen T.  Lauri S.  Puukka P. Attitudes of patients with breast and prostate cancer toward complementary therapies in Finland. Cancer Nursing.  24(4):328-34, 2001 Aug.


  This study aimed to describe the attitudes of patients with breast cancer and those with prostate cancer toward complementary therapies. The data were collected with a postal questionnaire administered to 216 patients with breast cancer (response rate, 55.4%) and 1 90 patients with prostate cancer (response rate, 54.9%) in southern and southwestern Finland. The questionnaire was composed of 44 Likert-type statements, which were analyzed using descriptive statistics, chi2 tests, t tests, and two-way analyses of variance. More than half (54%) of the patients with breast cancer and 45% of the patients with prostate cancer believed that people with cancer may benefit from complementary therapies, although they did not think these therapies actually could cure cancer. More than half of the respondents were dubious about using complementary therapies as long as there was no solid scientific evidence. Most believed that complementary therapies were used because they gave people hope (women, 88%; men, 72%) or "something to cling to" (women, 83%; men, 76%). The respondents believed most in dietary therapies and least in healing. There was much confusion and uncertainty about the professional competencies and expertise of the people who provided complementary therapies. Approximately one fourth of the respondents had spoken to their physician about complementary therapies. Only a few had talked about the matter with nursing staff. About half of the respondents thought that physicians and nurses took a negative attitude toward complementary therapies. In both groups, patients who had talked with their physician about complementary therapies tended to show a more positive attitude.

3728.      Samiulla DS.  Prashanth D.  Amit A. Mast cell stabilising activity of Bacopa monnieri. Fitoterapia.  72(3):284-5, 2001 Mar.


  Successive petroleum ether, chloroform, methanol and water extracts of Bacopa monnieri were tested (in vitro) for mast cell stabilising effect. The methanolic fraction exhibited potent activity comparable to disodium cromoglycate, a known mast cell stabiliser.

3729.      Santa Ana CF. The adoption of complementary and alternative medicine by hospitals: a framework for decision making. Journal of Healthcare Management.  46(4):250-60, 2001 Jul-Aug.


  As a result of increased consumer awareness, personal preference, and limitations of conventional medicine, many individuals are turning to complementary and alternative medicine (CAM). In response to this movement, many community hospitals are striving to be innovative providers. Society is leaning toward a more comprehensive style of healing that incorporates all aspects of wellness. During the last three decades, the public has increasingly used CAM. Arnold (1999) cited a study published in the Journal of the American Medical Association that reported that 39 million people sought either advice or treatment from a CAM provider and 42 percent of Americans used some form of alternative therapy. With the population becoming increasingly educated, aware, and proactive about wellness, many Americans see CAM as an effective alternative to traditional medicine. Healthcare organizations have responded, although slowly, to this trend, as new alternative medicine clinics, hospital departments, and research centers emerge throughout the United States. Although alternative medical practices are being used by an increasing number of people, there is still limited understanding of what CAM includes and how it influences health services organizations. Understanding this new market and its implementation in the healthcare setting is of interest to healthcare administrators. This article defines CAM, discusses its rising popularity, identifies its adoption in today's hospitals, and depicts barriers to its implementation. Finally, an analytical framework developed by the author is used to suggest factors for jadministrators to consider in CAM implementation in their organizations.

3732.      Shang W.  Cheng H. Advances in TCM research of insulin resistance. [Review] [25 refs] Journal of Traditional Chinese Medicine.  21(2):141-6, 2001 Jun.


3733.      Sistenich V. East and west see eye to eye--an elective report. Acupuncture in Medicine.  19(1):66-8, 2001 Jun.


  A summary of personal experiences encountered as a medical student on elective at an eye hospital in China. It bears witness to the possibility of seamless combination of western and traditional Chinese medical practices in the field of ophthalmology. Included are also the acupuncture points used in the treatment of optic atrophy at this particular eye hospital. Address of eye hospital: Zhongshan Ophthalmic Center 54 South Xianlie Road Guangzhou 510060 China Period of elective: 5th January 2001-11th March 2001.

3734.       Sohn RS. Re: "Acute intracranial hemorrhage caused by acupuncture" (Choo DC, Yue G. Headache. 2000;40:397-398.). Headache.  41(3):328-9, 2001 Mar.

3735.       St George D. Integrated medicine. Integrated medicine means doctors will be in charge. BMJ.  322(7300):1484, 2001 Jun 16.

3736.      Sterne JA.  Egger M.  Smith GD. Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis. [Review] [46 refs] BMJ.  323(7304):101-5, 2001 Jul 14.

3737.      Stevinson C.  Ernst E. Complementary/alternative therapies for premenstrual syndrome: a systematic review of randomized controlled trials. [Review] [61 refs] American Journal of Obstetrics & Gynecology.  185(1):227-35, 2001 Jul.


  Complementary/alternative therapies are popular with women who have premenstrual syndrome. This systematic review was designed to determine whether use of such therapies is supported by evidence of effectiveness from rigorous clinical trials. Trials were located through searching 7 databases and checking the reference lists of articles. Randomized controlled trials investigating a complementary/alternative therapy in women with premenstrual syndrome published in the peer-reviewed literature were included in the review. Twenty-seven trials were included investigating herbal medicine (7 trials), homeopathy (1), dietary supplements (13), relaxation (1), massage (1), reflexology (1) chiropractic (1), and biofeedback (2). Despite some positive findings, the evidence was not compelling for any of these therapies, with most trials suffering from various methodological limitations. On the basis of current evidence, no complementary/alternative therapy can be recommended as a treatment for premenstrual syndrome. [References: 61]

3738.       Stoneham L. Teaching to heal. Part 2: Asking the right questions.  Texas Medicine.  97(4):54-7, 2001 Apr.

3739.       Tamaki K.  Okuda S. Chinese herbs nephropathy: a variant form in Japan. [letter; comment]. [Review] [15 refs] Internal Medicine.  40(4):267-8, 2001 Apr.

3740.      Thomas P.  Homeopathy in the USA. British Homoeopathic Journal.  90(2):99-103, 2001 Apr.


  Homeopathy was introduced into the USA by Hans Burch Gram in 1825. It developed largely through immigration of German homeopaths. The first homeopathic medical college was established in Allentown, PA in 1835. The American institute of Homeopathy (AIH) was founded in 1844. The American Medical Association was founded in 1847 and pursued policies hostile to homeopathy from the outset. Eclectic medicine was widespread in nineteenth century medicine, one of the greatest homeopaths, JT Kent had originally been an eclectic. The International Hahnemannian Association split from the AIH in 1880. The Flexner Report of 1910 resulted in many homeopathic medical colleges being closed down. Homeopathy in the USA was in steep decline from the 1920s to the 1960s but has had a strong recovery since the 1970s.

3741.      Thompson T. Regulating the practice of CAM--the view from the Web. Complementary Therapies in Medicine.  9(2):120-1, 2001 Jun.

3742.      Tomassoni AJ.  Simone K. Herbal medicines for children: an illusion of safety?. [Review] [51 refs] Current Opinion in Pediatrics.  13(2):162-9, 2001 Apr.


  Herbal medicaments are in common use. In general, the judicious use of carefully selected and prepared herbal medications seems to cause few adverse effects and may be beneficial. However, toxic effects of these products have been reported with increasing frequency. Infants and children may be even more susceptible to some of the adverse effects and toxicity of these products because of differences in physiology, immature metabolic enzyme systems, and dose per body weight. Although information promoting the use of herbal medicine is widespread, true evidence-based information about the efficacy and safety of herbal medications is limited. Although the most conservative approach is to recommend against use of herbal medicine until such evidence is available, some patients are not receptive to this approach. A reasonable approach for health care providers may be to follow such use closely, assist in herbal therapeutic decisions, and monitor for adverse effects and interactions. This manuscript discusses general concepts about herbal medicines, public health implications, and a framework for mechanisms of adverse effects from the use of botanicals. Adverse effects and toxicity of selected herbal products, including Chinese herbal medicines, are presented. The authors propose a risk reduction approach in which physicians actively seek information about the use of complementary or alternative medicine while taking medical histories. [References: 51]

3743.       Trotter RT 2nd. Curanderismo: a picture of Mexican-American folk healing. Journal of Alternative & Complementary Medicine.  7(2):129-31, 2001 Apr.

3744.       Tsuruoka Y.  Tsuruoka K.  Kajii E. What can general practice learn from complementary medicine?. British Journal of General Practice.  51(465):319, 2001 Apr.

3745.      Tuzlaci E.  Aymaz PE. Turkish folk medicinal plants, Part IV: Gönen (Balikesir). Fitoterapia.  72(4):323-43, 2001 May.


  Eighty-four folk medicinal plants from Gönen (Turkey) are reported. Among them 73 species are wild and 11 species are cultivated plants. The folk medicinal plants are mostly used for the treatment of hemorrhoids, rheumatism, stomach and kidney ailments.

3746.      Upton R. Valeriana officinalis. Journal of Alternative & Complementary Medicine.  7(1):15-7, 2001 Feb.

3747.       Vickers A.  Zollman C.  Lee R. Herbal medicine. Western Journal of Medicine.  175(2):125-8, 2001 Aug.

3748.       Vickers A. The general practitioners' complementary medicine versus evidence-based medicine. Complementary Therapies in Medicine.  9(2):127-8, 2001 Jun.

3749.       Vincent C. The safety of acupuncture. [letter; comment].  BMJ.  323(7311):467-8, 2001 Sep 1.

3750.      Voelker R.  CAM Research attempts to separate wheat from chaff. JAMA.  286(2):156-8, 2001 Jul 11.

3751.       Waddell DL.  Hummel ME.  Sumners AD. Three herbs you should get to know. [Review] [24 refs] American Journal of Nursing.  101(4):48-53; quiz 54, 2001 Apr.

3752.       Weil A.  Andrew Weil, MD on integrative medicine and the nature of reality. Interview by Bonnie Horrigan.  Alternative Therapies in Health & Medicine.  7(4):96-104, 2001 Jul-Aug.

3753.      Westfall RE. Herbal medicine in pregnancy and childbirth. [Review] [57 refs] Advances in Therapy.  18(1):47-55, 2001 Jan-Feb.


  Pregnant women often use medicinal herbs in an effort to maintain good health and reduce the need for medical intervention. A survey of the scientific and popular literature identified a number of therapeutic herbs used in North America. Three categories are discussed: tonics, herbs for preventing miscarriage, and herbs for inducing labor. Some of these preparations may address women's needs in ways that biomedicine has failed to do. Purported merits and hazards of these medications are discussed. [References: 57]

3754.       White A.  Hayhoe S.  Hart A.  Ernst E. Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. [see comments]. BMJ.  323(7311):485-6, 2001 Sep 1.

3755.       White A. Quality criticism required. Complementary Therapies in Medicine.  9(2):61, 2001 Jun.

3756.      Wong V.  Sun JG.  Wong W. Traditional Chinese medicine (tongue acupuncture) in children with drooling problems. Pediatric Neurology.  25(1):47-54, 2001 Jul.


  Tongue acupuncture is an innovative technique in traditional Chinese medicine. We have demonstrated that specific tongue acupoints are related to various functional domains. This study aimed to assess the efficacy of tongue acupuncture in children with neurologic disability who had severe drooling problems. We conducted an intent-to-treat study in a cohort of 10 children. A continuous course of tongue acupuncture was performed daily to five acupoints in the tongue for a total of 30 sessions. Standardized outcome measures of drooling were evaluated by a blinded assessor to study the efficacy at baseline and after a course of treatment. Statistically significant improvement was noted in the following outcome measures: (1) mean visual analog scale (VAS) decreased from 6.6 (pre-TAC) to 4.67 (post-TAC) (P = 0.002); (2) mean drooling quotient (DQ) decreased from 14.016% (pre-TAC) to 8.335% (post-TAC) (P = 0.0078); and (3) mean drooling score (DS) decreased from 7.4 (pre-TAC) to 4.4 (post-TAC) (P = 0.002). This study demonstrated the efficacy of tongue acupuncture as an adjunctive or alternative treatment for patients with drooling problems and can be integrated as part of the oromotor stimulation program, drooling program, and behavioral modification program before subjecting the patient to invasive surgical procedures on the salivary glands.

3757.      Woo PC.  Li JH.  Tang W.  Yuen K. Acupuncture mycobacteriosis.  New England Journal of Medicine.  345(11):842-3, 2001 Sep 13.

3758.       Wootton JC.  Sparber A. Surveys of complementary and alternative medicine: part I. General trends and demographic groups. [Review] [32 refs]  Journal of Alternative & Complementary Medicine.  7(2):195-208, 2001 Apr.


  Data from the surveys of the Harvard team, led by David Eisenberg, M.D., are frequently used as a summary first paragraph introduction to the status of complementary and alternative medicine (CAM) in the United States. However, there is now a substantial body of literature on various facets of CAM use. Six national surveys to date are briefly discussed and summarized in a table. Some surveys have been conducted at a regional level. Three are summarized but there are too few data yet to draw any conclusions. Eighteen more exploratory surveys of specific subpopulations are presented to help draw a clearer picture of income, ethnic, and age groups. The search strategy is provided. The changing terminology in the field, the development of the CAM survey, and some common shortcomings are also addressed. [References: 32]

3759.      Yakir M.  Kreitler S.  Brzezinski A.  Vithoulkas G.  Oberbaum M.  Bentwich Z. Effects of homeopathic treatment in women with premenstrual syndrome: a pilot study.  British Homoeopathic Journal.  90(3):148-53, 2001 Jul.


  Alternative therapies in general, and homeopathy in particular, lack clear scientific evaluation of efficacy. Controlled clinical trials are urgently needed, especially for conditions that are not helped by conventional methods. The objective of this work was to assess the efficacy of homeopathic treatment in relieving symptoms associated with premenstrual syndrome (PMS). It was a randomised controlled double-blind clinical trial. Two months baseline assessment with post-intervention follow-up for 3 months was conducted at Hadassah Hospital outpatient gynaecology clinic in Jerusalem in Israel 1992-1994. The subjects were 20 women, aged 20-48, suffering from PMS. Homeopathic intervention was chosen individually for each patient, according to a model of symptom clusters. Recruited volunteers with PMS were treated randomly with one oral dose of a homeopathic medication or placebo. The main outcome measure was scores of a daily menstrual distress questionnaire (MDQ) before and after treatment. Psychological tests for suggestibility were used to examine the possible effects of suggestion. Mean MDQ scores fell from 0.44 to 0.13 (P<0.05) with active treatment, and from 0.38 to 0.34 with placebo (NS). (Between group P=0.057). Improvement >30% was observed in 90% of patients receiving active treatment and 37.5% receiving placebo (P=0.048). Homeopathic treatment was found to be effective in alleviating the symptoms of PMS in comparison to placebo. The use of symptom clusters in this trial may offer a novel approach that will facilitate clinical trials in homeopathy. Further research is in progress.

3760.        Yeap JS.  Anbanandan S.  Yeap JK.  Borhan Tan M.  Harwant S. 'Thermal reflex therapy' a danger for diabetic feet.  Medical Journal of Malaysia.  56(1):102-3, 2001 Mar.

3761.       Zhang G. Maximizing the effectiveness of acupuncture: prospects from clinical studies. [letter; comment]. Alternative Therapies in Health & Medicine.  7(4):42-4, 2001 Jul-Aug.

 Zipes DP. President's page: Complementary and alternative medicine: ignore at doctors' and patients' peril. Journal of the American College of Cardiology.  37(8):2166-9, 2001 Jun 15.


Apr 02


4357.      Aasgaard T. An ecology of love: aspects of music therapy in the pediatric oncology environment. J Palliat Care  2001 Autumn;17(3):177-81


This paper explores how music therapy can assist patients and relatives in the processes of making friendship and love audible in a child cancer ward. Four short patient histories are presented to illustrate a health-oriented, ecological music therapy practice. Two histories describe how texts, made by patients, become songs, and how the songs are performed and used. Another two histories deal with musical communication with dying children and their parents. The paper indicates that these interventions may involve more than palliation (making a disease less severe and unpleasant without removing its cause). Not least, such activities can make it possible for the sick child to expand from being "just a patient" into playing, if only for a moment, a more active social role. The processes of artistic interplay, in- and outside the sickroom, influence various relationships in the child's social environment.


4358.      Adelakun EA, Finbar EA, Agina SE, Makinde AA. Antimicrobial activity of Boswellia dalziellii stem bark. Fitoterapia. 2001 Nov;72(7):822-4.


The methanol and aqueous extracts of Boswellia dalziellii stem bark showed broad spectrum inhibiting activity against bacteria, both Gram-positive and Gram-negative, and fungi.

4359.      Aggarwal A, Ades PA. Interactions of herbal remedies with prescription cardiovascular medications. Coron Artery Dis. 2001 Nov;12(7):581-4. Review. No abstract.

4360.      Akhondzadeh S, Kashani L, Mobaseri M, Hosseini SH, Nikzad S, Khani M Passionflower in the treatment of opiates withdrawal: a double-blind randomized controlled trial. J Clin Pharm Ther  2001 Oct;26(5):369-73


OBJECTIVE: Clonidine-based therapies have been utilized as the main protocol for opiate detoxification for several years. However, detoxification with clonidine has its limitations, including lack of efficacy for mental symptoms. Accumulating evidence shows the efficacy of Passiflora incarnata extract in the management of anxiety. In our continuing study of traditional medicines, which have neurotropic effects, this plant had an anxiolytic effect, which may be used as an adjuvant agent in the detoxification of opiates by clonidine. We present the results of a double-blind randomized controlled trial of clonidine plus passiflora extract vs. clonidine plus placebo in the outpatient detoxification of 65 opiates addicts. METHODS: A total of 65 opiates addicts were assigned randomly to treatment with passiflora extract plus clonidine tablet or clonidine tablet plus placebo drop during a 14-day double-blind clinical trial. All patients met the DSM IV criteria for opioid dependence. The fixed daily dose was 60 drops of passiflora extract and a maximum daily dose of 0.8 mg of clonidine administered in three divided doses. The severity of the opiate withdrawal syndrome was measured on days 0, 1, 2, 3, 4, 7 and 14 using the Short Opiate Withdrawal Scale (SOWS). CONCLUSION: Both protocols were equally effective in treating the physical symptoms of withdrawal syndromes. However, the passiflora plus clonidine group showed a significant superiority over clonidine alone in the management of mental symptoms. These results suggested that passiflora extract may be an effective adjuvant agent in the management of opiate withdrawal. However, a larger study to confirm our results is warranted.

4361.      Altman RD, Marcussen KC. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum. 2001 Nov;44(11):2531-8. No abstract.

4362.      Asres K, Bucar F, Knauder E, Yardley V, Kendrick H, Croft SL. In vitro antiprotozoal activity of extract and compounds from the stem bark of Combretum molle. Phytother Res  2001 Nov;15(7):613-7


The antiprotozoal activity of the Ethiopian medicinal plant Combretum molle (R. Br. ex G. Don.) Engl & Diels (Combretaceae) was evaluated by in vitro testing against Plasmodium falciparum, Trypanosoma brucei rhodesiense, Trypanosoma cruzi and Leishmania donovani. The acetone fraction of the stem bark of this plant prepared by soxhlet extraction was inactive against the intracellular amastigotes of L. donovani and T. cruzi in murine peritoneal macrophages but showed significant activity against extracellular T. b. rhodesiense blood stream form trypomastigotes and trophozoites of P. falciparum with IC(50) values of 2.19 and 8.17 microg/mL, respectively. Phytochemical examination of the bioactive fraction resulted in the isolation of two tannins and two oleanane-type pentacyclic triterpene glycosides. One of the tannins was identified as the ellagitannin, punicalagin, whilst the structure of the other (CM-A) has not yet been fully elucidated. The saponins that were characterized as arjunglucoside (also called 4-epi-sericoside) and sericoside displayed no activity against any of the four species of protozoa tested. On the other hand, punicalagin and CM-A had IC(50) values of 1.75 and 1.50 microM, respectively, against T. b. rhodesiense and were relatively less toxic to KB cells (cytotoxic/antiprotozoal ratios of 70 and 48, respectively). The tannins also showed intermediate activity against P. falciparum, although their selectivity against these parasites was less favourable than the above. It appears that our findings are the first report of hydrolysable tannins exhibiting antitrypanosomal and antiplasmodial activities. Copyright 2001 John Wiley & Sons, Ltd.

4363.      Audera C, Patulny RV, Sander BH, Douglass RM. Effect of a specific preparation of Chinese herbs ("clear the way") on duration and severity of the common cold. Med J Aust. 2001 Oct 1;175(7):389. No abstract.

4364.      Aviles JM, Whelan SE, Hernke DA, Williams BA, Kenny KE, O'Fallon WM, Kopecky SL. Intercessory prayer and cardiovascular disease progression in a coronary care unit population: a randomized controlled trial. Mayo Clin Proc  2001 Dec;76(12):1192-8

OBJECTIVE: To determine the effect of intercessory prayer, a widely practiced complementary therapy, on cardiovascular disease progression after hospital discharge. PATIENTS AND METHODS: In this randomized controlled trial conducted between 1997 and 1999, a total of 799 coronary care unit patients were randomized at hospital discharge to the intercessory prayer group or to the control group. Intercessory prayer, ie, prayer by 1 or more persons on behalf of another, was administered at least once a week for 26 weeks by 5 intercessors per patient. The primary end point after 26 weeks was any of the following: death, cardiac arrest, rehospitalization for cardiovascular disease, coronary revascularization, or an emergency department visit for cardiovascular disease. Patients were divided into a high-risk group based on the presence of any of 5 risk factors (age = or >70 years, diabetes mellitus, prior myocardial infarction, cerebrovascular disease, or peripheral vascular disease) or a low-risk group (absence of risk factors) for subsequent primary events. RESULTS: At 26 weeks, a primary end point had occurred in 25.6% of the intercessory prayer group and 29.3% of the control group (odds ratio [OR], 0.83 [95% confidence interval (CI), 0.60-1.14]; P=.25). Among high-risk patients, 31.0% in the prayer group vs 33.3% in the control group (OR, 0.90 [95% CI, 0.60-1.34]; P=.60) experienced a primary end point. Among low-risk patients, a primary end point occurred in 17.0% in the prayer group vs 24.1% in the control group (OR, 0.65 [95% CI, 0.20-1.36]; P=.12). CONCLUSIONS: As delivered in this study, intercessory prayer had no significant effect on medical outcomes after hospitalization in a coronary care unit.

4365.      Bakshu LM, Jeevan Ram A, Venkata Raju R. Antimicrobial activity of Securinega leucopyrus. Fitoterapia  2001 Dec;72(8):930-3 No abstract.

4366.      Barnes VA, Treiber FA, Davis H. Impact of Transcendental Meditation on cardiovascular function at rest and during acute stress in adolescents with high normal blood pressure. J Psychosom Res  2001 Oct;51(4):597-605


OBJECTIVE: This study examined the impact of the Transcendental Meditation (TM) program on cardiovascular (CV) reactivity in adolescents with high normal BP. METHOD: Thirty-five adolescents [34 African Americans (AAs), 1 Caucasian American (CA); ages 15-18 years] with resting systolic blood pressure (SBP) between the 85th and 95th percentile for their age and gender on three consecutive occasions, were randomly assigned to either TM (n=17) or health education control (CTL, n=18) groups. The TM group engaged in 15-min meditation twice each day for 2 months including sessions during school lunch break. Primary CV outcome measures were changes in blood pressure (BP), heart rate (HR), and cardiac output (CO) at rest and in response to two laboratory stressors, a simulated car driving stressor and an interpersonal social stressor interview. RESULTS: The TM group exhibited greater decreases in resting SBP (P<.03) from pre- to postintervention, compared to the CTL group. The TM group exhibited greater decreases from pre- to postintervention in SBP, HR, and CO reactivity (P's<.03) to the simulated car driving stressor, and in SBP reactivity (P<.03) to the social stressor interview. CONCLUSION: The TM program appears to have a beneficial impact upon CV functioning at rest and during acute laboratory stress in adolescents at-risk for hypertension.



4367.      Bernardi L, Sleight P, Bandinelli G, Cencetti S, Fattorini L, Wdowczyc-Szulc J, Lagi A. Effect of rosary prayer and yoga mantras on autonomic cardiovascular rhythms: comparative study. BMJ  2001 Dec 22-29;323(7327):1446-9


OBJECTIVE: To test whether rhythmic formulas such as the rosary and yoga mantras can synchronise and reinforce inherent cardiovascular rhythms and modify baroreflex sensitivity. DESIGN: Comparison of effects of recitation of the Ave Maria (in Latin) or of a mantra, during spontaneous and metronome controlled breathing, on breathing rate and on spontaneous oscillations in RR interval, and on blood pressure and cerebral circulation. SETTING: Florence and Pavia, Italy. PARTICIPANTS: 23 healthy adults. MAIN OUTCOME MEASURES: Breathing rate, regularity of breathing, baroreflex sensitivity, frequency of cardiovascular oscillations. RESULTS: Both prayer and mantra caused striking, powerful, and synchronous increases in existing cardiovascular rhythms when recited six times a minute. Baroreflex sensitivity also increased significantly, from 9.5 (SD 4.6) to 11.5 (4.9) ms/mm Hg, P<0.05. CONCLUSION: Rhythm formulas that involve breathing at six breaths per minute induce favourable psychological and possibly physiological effects.

4368.      Betz JM. Use of herbal medications before surgery. JAMA. 2001 Nov 28;286(20):2542; discussion 2543-4.  No abstract.

4369.      Bhat GP, Surolia N. In vitro antimalarial activity of extracts of three plants used in the traditional medicine of India. Am J Trop Med Hyg. 2001 Oct;65(4):304-8.


In an attempt to search for new antimalarial drugs, we studied plants used by traditional healers of southwest India to treat malaria. Aqueous and organic solvent extracts obtained from specific parts of the plants Swertia chirata, Carica papaya, and Citrus sinensis were tested on malaria strain Plasmodium falciparum FCK 2 in vitro. The temperatures of extraction were the same as that used by the traditional healers in their plant preparations. Visual evaluation of the antimalarial activity of the plant extracts on thin blood smears was followed by quantification of the activity by use of [35S]-methionine incorporation into parasite proteins to determine the value that inhibits 50% (IC50). Among the 3 plants tested, 2 had significant inhibitory effect on P. falciparum in vitro.

4370.      Bhigjee AI. Use of alternative medicine by patients with neurological disease. S Afr Med J  2001 Oct;91(10):850-1 No abstract.

4371.      Blanc PD, Trupin L, Earnest G, Katz PP, Yelin EH, Eisner MD. Alternative therapies among adults with a reported diagnosis of asthma or rhinosinusitis : data from a population-based survey. Chest. 2001 Nov;120(5):1461-7.


BACKGROUND: Asthma and rhinosinusitis are common medical conditions among adults. Alternative treatments could have important impacts on health status among those individuals with these conditions, but specific prevalence data for these treatments are limited. OBJECTIVE: To estimate the prevalence of specific alternative treatment modalities, including herbal agents, ingestion of caffeinated beverages, homeopathy, acupuncture, and massage therapies. DESIGN: Random population telephone sample. SETTING: Northern California. PARTICIPANTS: Three hundred adults aged 18 to 50 years with self-report of a physician diagnosis of asthma (n = 125) or rhinosinusitis without concomitant asthma (n = 175). MEASUREMENTS: Structured telephone interviews covering demographics and clinical variables, including the following alternative treatments used in the previous 12 months: herbal agents; caffeine-containing products; homeopathy; acupuncture; aromatherapy; reflexology; and massage. RESULTS: Any alternative practice was reported by 127 subjects (42%; 95% confidence interval [CI], 36 to 48%). Of these, 33 subjects (26%; 95% CI, 21 to 31%) were not current prescription medication users. Herbal use was reported by 72 subjects (24%), caffeine treatment by 54 subjects (18%), and other alternative treatments by 66 subjects (22%). Taking into account demographic variables, subjects with asthma were more likely than those with rhinitis alone to report caffeine self-treatment for their condition (odds ratio, 2.5; 95% CI, 1.4 to 4.8%), but herbal use and other alternative treatments did not differ significantly by condition group. CONCLUSION: Alternative treatments are frequent among adults with asthma or rhinosinusitis and should be taken into account by health-care providers and public health and policy analysts.


4372.      Bloom BS. What is this nonsense that complementary and alternative medicine is not amenable to controlled investigation of population effects? Acad Med  2001 Dec;76(12):1221-3  No abstract.

4373.      Bolton B. Intercessory prayer. Ann Intern Med. 2001 Dec 18;135(12):1094. No abstract.

4374.      Borneman JP. Blackie Memorial Lecture 2001. Homeopathy: progress and promise, a critical perspective. Br Homeopath J  2001 Oct;90(4):204-13


This lecture attempts to analyse the progress made by homeopathy in recent years, by analysing consumer awareness, sales and distribution trends of homeopathic products, and research publications. Sales of homeopathic medicines are growing rapidly, but remain a very small fraction of the total pharmaceutical market. The proportion of combination to single medicines varies widely between countries. The market is concentrated in a relatively small number of the available medicines; many available homeopathic medicines are never used. Regulation of homeopathic practitioners and medicines is problematic, the legal position varies between countries. The volume of research is growing steadily. A series of recommendations is made, including modernisation of the terminology of homeopathy, training of more practitioners, a defined research agenda and integration into the medical system.

4375.      Brown WA. Use of alternative medicine. Am J Psychiatry  2001 Oct;158(10):1744 No abstract.

4376.      Burke J. Stroke and complementary medicine. Hawaii Med J  2001 Oct;60(10):261 No abstract.

4377.      Callahan RJ. Raising and lowering of heart rate variability: some clinical findings of Thought Field Therapy. J Clin Psychol  2001 Oct;57(10):1175-86

This clinical report presents some of the findings in Thought Field Therapy (TFT) that show both raising and lowering of heart rate variability (HRV). TFT algorithms are effective, but the specificity of diagnosed treatment gives results that are superior to algorithms. Some TFT treatments take only seconds to yield improved results on HRV. Toxins can undo a cured problem and lower HRV. TFT can overturn the effect of some toxins. It is hypothesized that TFT works by inputting a specific code that addresses and effects the healing system. HRV may be a measure of general physical and mental health. Copyright 2001 John Wiley & Sons, Inc.

4378.      Carlsson M, Arman M, Backman M, Hamrin E. Perceived quality of life and coping for Swedish women with breast cancer who choose complementary medicine. Cancer Nurs  2001 Oct;24(5):395-401


The aim of the present study, which is part of a major clinical controlled study of the life situation of women with breast cancer, was to compare two groups of women concerning perceived quality of life and coping. The women were treated in two different cancer treatment programs: complementary treatment, which included anthroposophic therapy, and conventional cancer treatment. A total of 120 women were included, 60 women treated with anthroposophic medicine, and 60 individually matched women treated with conventional medicine only. Quality of life was measured by the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Core 30, and the Life Satisfaction Questionnaire. Coping was measured by the Mental Adjustment to Cancer scale. The results showed that the women who chose anthroposophic therapy perceived their quality of life to be lower on admission to the hospital and showed more anxious preoccupation than the women in conventional medicine. It can be concluded that, due to the careful matching procedure, the women in the two groups are comparable in a medical sense but not from the perspective of quality of life and coping.

4379.      Choi SW, Son BW, Son YS, Park YI, Lee SK, Chung MH. The wound-healing effect of a glycoprotein fraction isolated from aloe vera. Br J Dermatol  2001 Oct;145(4):535-45


BACKGROUND: Aloe vera has been used as a family medicine for promoting wound healing, but it is not known which component of the plant is effective for this purpose. OBJECTIVES: To isolate and characterize the component effective in wound healing. METHODS: Chromatography, electrophoresis and spectroscopic methods were used. The cell-proliferation activity of each component isolated was measured by a [3H]thymidine uptake assay. The cell-proliferation activity of the effective component was tested on a three-dimensional raft culture cell culture technique by which artificial epidermis is made from keratinocytes). The effect of the active component on cell migration and wound healing was observed on a monolayer of human keratinocytes and in hairless mice. RESULTS: A glycoprotein fraction was isolated and named G1G1M1DI2. It showed a single band on sodium dodecyl sulphate-polyacrylamide gel electrophoresis, with an apparent molecular weight of about 5.5 kDa. It exhibited significant [3H]thymidine uptake in squamous cell carcinoma cells. The effect of G1G1M1DI2 on cell migration was confirmed by accelerated wound healing on a monolayer of human keratinocytes. When this fraction was tested on a raft culture, it stimulated the formation of epidermal tissue. Furthermore, proliferation markers (epidermal growth factor receptor, fibronectin receptor, fibronectin, keratin 5/14 and keratin 1/10) were markedly expressed at the immunohistochemical level. The glycoprotein fraction enhanced wound healing in hairless mice by day 8 after injury, with significant cell proliferation. CONCLUSIONS: It is considered that this glycoprotein fraction is involved in the wound-healing effect of aloe vera via cell proliferation and migration.

4380.      Colloca CJ, Keller TS. Stiffness and neuromuscular reflex response of the human spine to posteroanterior manipulative thrusts in patients with low back pain. J Manipulative Physiol Ther  2001 Oct;24(8):489-500


BACKGROUND: Studies investigating posteroanterior (PA) forces in spinal stiffness assessment have shown relationships to spinal level, body type, and lumbar extensor muscle activity. Such measures may be important determinants in discriminating between patients who are asymptomatic and those who have low back pain. However, little objective evidence is available concerning variations in PA stiffness and their clinical significance. Moreover, although several studies have assessed only load input in relation to stiffness, a more complete assessment based on dynamic stiffness measurements (force/velocity) and concomitant neuromuscular response may offer more information concerning mechanical properties of the low back. OBJECTIVE: To determine the stiffness and neuromuscular characteristics of the symptomatic low back. STUDY DESIGN: This study is a prospective clinical study investigating the in vivo mechanical and muscular behavior of human lumbar spinal segments to high loading rate PA manipulative thrusts in research subjects with low back pain (LBP). METHODS: Twelve men and 10 women, aged 15 to 73 years (mean age of 42.8 +/- 17.5 years) underwent physical examination and completed outcome assessment instruments, including Visual Analog Scale, Oswestry Low Back Disability Index, and SF-36 health status questionnaires. Clinical categorization was made on the basis of symptom frequency and LBP history. A hand-held spinal manipulation device, equipped with a preload control frame and impedance head, was used to deliver high-rate (<0.1 millisecond) PA manipulative thrusts (190 N) to several common spinal landmarks, including the ilium, sacral base, and L5, L4, L2, T12, and T8 spinous and transverse processes. Surface, linear-enveloped, electromyographic (sEMG) recordings were obtained from electrodes (8 leads) located over the L3 and L5 paraspinal musculature to monitor the bilateral neuromuscular activity of the erector spinae group during the PA thrusts. Maximal-effort isometric trunk extensions were performed by the research subjects before and immediately after the testing protocol to normalize sEMG data. The accelerance or stiffness index (peak acceleration/peak force, kg-1) and composite sEMG neuromuscular reflex response were calculated for each of the thrusts. RESULTS: Posteroanterior stiffness obtained at the sacroiliac joints, transverse processes, or spinous processes was not different for subjects grouped according to LBP chronicity. However, in those with frequent or constant LBP symptoms, there was a significantly increased spinous process (SP) stiffness index (7.0 kg-1) (P <.05) in comparison with SP stiffness index (6.5 kg-1) of subjects with only occasional or no LBP symptoms. Subjects with frequent or constant LBP symptoms also reported significantly greater scores on the visual analog scale (P=.001), Oswestry (P =.001), and perceived health status (P =.03) assessments. The average SP stiffness index was 6.6% greater (P <.05) and 19.1% greater (P <.001) than the average sacroiliac stiffness index and average transverse process stiffness index, respectively. CONCLUSIONS: This study is the first to assess erector spinae neuromuscular reflex responses simultaneously during spinal stiffness examination. This study demonstrated increased spinal stiffness index and positive neuromuscular reflex responses in subjects with frequent or constant LBP as compared with those reporting intermittent or no LBP.

4381.      Davies P, Levy S, Pahari A, Martinez D.  Acute nicotine poisoning associated with a traditional remedy for eczema. Arch Dis Child. 2001 Dec;85(6):500-2.


We present a case of severe acute nicotine poisoning in an 8 year old boy with moderate eczema after topical application of a traditional remedy from a book published in Bangladesh. Symptoms consistent with nicotine poisoning developed within 30 minutes of application of the remedy. The child subsequently improved with supportive care and was discharged after five days with no neurological sequelae. Diagnosis of nicotine poisoning was not initially made due to difficulty in obtaining an accurate history via an interpreter from the parents who did not speak English. Samples taken 12 hours after application of the remedy showed a serum nicotine of 89 microgram/l, serum cotinine of 1430 microgram/l, urine nicotine of 1120 microgram/l, and a urine cotinine of 6960 microgram/l confirming acute nicotine poisoning.

4382.      Deale A, Husain K, Chalder T, Wessely S. Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: a 5-year follow-up study. Am J Psychiatry. 2001 Dec;158(12):2038-42.


OBJECTIVE: This study evaluated the long-term outcome of cognitive behavior therapy versus relaxation therapy for patients with chronic fatigue syndrome. METHOD: Sixty patients who participated in a randomized controlled trial of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome were invited to complete self-rated measures and participate in a 5-year follow-up interview with an assessor who was blind to treatment type. RESULTS: Fifty-three patients (88%) participated in the follow-up study: 25 received cognitive behavior therapy and 28 received relaxation therapy. A total of 68% of the patients who received cognitive behavior therapy and 36% who received relaxation therapy rated themselves as "much improved" or "very much improved" at the 5-year follow-up. Significantly more patients receiving cognitive behavior therapy, in relation to those in relaxation therapy, met criteria for complete recovery, were free of relapse, and experienced symptoms that had steadily improved or were consistently mild or absent since treatment ended. Similar proportions were employed, but patients in the cognitive behavior therapy group worked significantly more mean hours per week. Few patients crossed the threshold for "normal" fatigue, despite achieving a good outcome on other measures. Cognitive behavior therapy was positively evaluated and was still used by over 80% of the patients. CONCLUSIONS: Cognitive behavior therapy for chronic fatigue syndrome can produce some lasting benefits but is not a cure. Once therapy ends, some patients have difficulty making further improvements. In the future, attention should be directed toward ensuring that gains are maintained and extended after regular treatment ends.



4383.      Ernst E, Coon JT. Heavy metals in traditional Chinese medicines: a systematic review. Clin Pharmacol Ther. 2001 Dec;70(6):497-504. Review.  No abstract.

4384.      Ernst E. "Alternative" therapies for asthma : reason for concern? Chest  2001 Nov;120(5):1433-4  No abstract.

4385.      Ernst E. Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination. Vaccine  2001 Oct 15;20 Suppl 1:S90-3; discussion S89


Complementary and alternative medicine (CAM) has become a popular form of healthcare and the predictions are that, it will increase further. The reasons for this level of popularity are highly diverse, and much of the motivation to turn to CAM pertains to a deeply felt criticism of mainstream medicine – many people (are led to) believe that conventional interventions, including immunisation, are associated with the potential to do more harm than good. Thus, it is hardly surprising that CAM also lends support to the "anti-vaccination movement". In particular, sections of the chiropractors, the (non-medically trained) homoeopaths and naturopaths tend to advise their clients against immunisation. The reasons for this attitude are complex and lie, at least in part in the early philosophies which form the basis of these professions. The negative attitude of some providers of CAM towards immunisation constitutes an important example of indirect risks associated with this form of healthcare. The best way forward, it seems, would be a campaign to clarify the risk-benefit profile of immunisations for both users and providers of CAM.

4386.      Gossart RM.  "Mind" and "Brain". Am J Psychiatry. 2001 Nov;158(11):1938-9; discussion 1939-40. No abstract.

4387.      Hudson K, Brady E, Rapp D. What you and your patients should know about herbal medicines. JAAPA. 2001 Nov;14(11):27-9, 32-4. Review. No abstract.

4388.      Johnson C, Shala M, Sejdijaj X, Odell R, Dabishevci K. Thought Field Therapy soothing the bad moments of Kosovo. J Clin Psychol. 2001 Oct;57(10):1237-40.


Trauma in Kosovo was treated with Thought Field Therapy (TFT) during five separate trips by members of the Global Institute of Thought Field Therapy, in the year 2000. Clinicians from Sweden, the United Kingdom, and the United States were joined in Kosovo by four physicians who transported them to remote war-torn villages where patients with severe trauma were treated. Treatment was given to 105 patients with 249 separate traumas. Total relief was reported by 103 of the patients, and for 247 of the separate traumas. Follow-up data averaging five months revealed no instance of relapse. Copyright 2001 John Wiley & Sons, Inc.

4389.      Keller KB, Lemberg L. Herbal or complementary medicine: fact or fiction? Am J Crit Care. 2001 Nov;10(6):438-43.


Although herbal medications have been used in medical therapy since the dawn of civilization, they have not undergone careful scientific assessment. Some herbal derivations are exceptional and have become standard therapy in cardiovascular disease; eg, digitalis, reserpine, and aspirin. The high prevalence of herbal use around the world and in the United States today may have a negative impact on patient care when herbal preparations are used in combination with medications ordered by healthcare providers who are not advised of the patient's use of herbs. Healthcare providers need to be familiar with all herbal medications in order to prevent potentially serious reactions between conventional and herbal medications. They should be asking patients about herbal use when first obtaining a medical history. Patients who use alternative therapies do not tell their healthcare providers about such use.

4390.      Kost'alova D, Kardosova A, Hajnicka V. Effect of Mahonia aquifolium stem bark crude extract and one of its polysaccharide components on production of IL-8. Fitoterapia  2001 Nov;72(7):802-6


The crude hydroalcoholic extract of Mahonia aquifolium stem bark and a polysaccharide isolated from the extract were tested for their activity on interleukin-8 (IL-8) production by human monocytic cell line THP-1. The crude extract partly inhibited the IL-8 spontaneous production after 48-h treatment of the cells, while the polysaccharide was found to be a potent inducer of IL-8 production.


4391.      Krout RE. The effects of single-session music therapy interventions on the observed and self-reported levels of pain control, physical comfort, and relaxation of hospice patients. Am J Hosp Palliat Care  2001 Nov-Dec;18(6):383-90


This article describes the process and results of a three-month music therapy clinical effectiveness study conducted with terminally ill patients. The purpose of this study was to quantify and evaluate the effectiveness of single-session music therapy interventions with hospice patients in three patient problem areas: pain control; physical comfort; and relaxation. Data from a total of 90 sessions conducted with a total of 80 subjects served by Hospice of Palm Beach County, Florida, were included in the study. Music therapy services were provided by five board-certified music therapists and one music therapist eligible for board certification. The subjects in this study were receiving regularly scheduled music therapy services from the hospice organization. The study used both behavioral observation and subject's self-reporting as methods of data reporting and recording. Subjects were observed for, or self-reported, their levels of pain control, physical comfort, and relaxation, both before and after each music therapy session. The subjects were served in the environments where music therapy services would normally be delivered (i.e., home, hospital, nursing home, or inpatient acute-care unit of the hospice organization). Music therapy services included live active and passive music-based experiences. These were designed to build and to establish rapport with patient or family, to facilitate family interaction and patient control, to provide support and comfort, to facilitate relaxation, to enable reminiscence and life review, to provide a frame-work for spiritual exploration and validation, and to encourage the identification and expression of feelings of anticipatory mourning and grief. A total of six hypotheses stated that there would be significant pre- to postsession differences in each of the three variables: pain control, physical comfort, and relaxation, as measured during two different session and data collection scenarios. These scenarios included the independent observation and recording of the three subject variables and the subject's self-report of each variable. Reliability correlation coefficients were calculated for each of the different session and data-collection scenarios to help assess the correlation between primary and reliability observers. Pearson product moment correlations indicated reliability agreement coefficients of r = .85 and r = .90. One-tailed t-tests were performed on the collected data for subject pain control, physical comfort, and relaxation. Results of the t-tests were significant at the p < or = .001 (for observed pain control, physical comfort, and relaxation) and p < or = 005 (for self-reported pain control, physical comfort, and relaxation) levels. These results suggest that single-session music therapy interventions appear to be effective in increasing subject pain control, physical comfort, and relaxation during both data collection scenarios. Based on the results of these tests of the analyzed data, the hypotheses were all accepted. Tables illustrate pre- to post-session changes in levels of all three variables from both session and data-collection scenarios. Copies of the data-collection forms are also included in the Appendix. The discussion section addresses limitations of this study and suggestions for future studies.


4392.      Lee D, Bhat KP, Fong HH, Farnsworth NR, Pezzuto JM, Kinghorn AD. Aromatase inhibitors from Broussonetia papyrifera. J Nat Prod. 2001 Oct;64(10):1286-93. No abstract.

4393.      Lepage C, Drolet P, Girard M, Grenier Y, DeGagne R. Music decreases sedative requirements during spinal anesthesia. Anesth Analg  2001 Oct;93(4):912-6


Ambulatory surgery can create significant anxiety. This prospective study measured whether music can influence anxiety and perioperative sedative requirements in outpatients undergoing surgery with spinal anesthesia. We also evaluated the correlation between two anxiety measures, the State-Trait Anxiety Inventory test (STAI) and the 0- to 10-cm visual analog scale (VAS 0-10), with 0 meaning complete relaxation and 10 the worst feeling of anxiety possible. Fifty unpremedicated patients were randomly assigned to listen to music of their choice via headset during the perioperative period (Group I) or to have no music (Group II). All participants used patient-controlled IV midazolam sedation and underwent repeated evaluations of their anxiety level with the STAI and the VAS 0-10. Midazolam requirements during surgery (Group I, 0.6 +/- 0.7 versus Group II, 1.3 +/- 1.1 mg; P < 0.05) and for the whole perioperative period (Group I, 1.2 +/- 1.3 versus Group II, 2.5 +/- 2.0 mg; P < 0.05) were smaller in patients listening to music. Anxiety levels, measured with STAI or VAS 0-10, were similar in both groups. The Spearman's coefficient values between STAI and VAS 0-10 ranged from 0.532 to 0.687. We conclude that patients listening to music require less midazolam to achieve a similar degree of relaxation as controls and that measures of anxiety obtained from the STAI and the VAS 0-10 are positively, but only moderately, correlated. IMPLICATIONS: It is possible to decrease sedative requirements during surgery under spinal anesthesia by allowing patients to listen to music to reduce their anxiety.

4394.      Logan AC, Wong C. Chronic fatigue syndrome: oxidative stress and dietary modifications. Altern Med Rev. 2001 Oct;6(5):450-9. Review.


Chronic fatigue syndrome (CFS) is an illness characterized by persistent and relapsing fatigue, often accompanied by numerous symptoms involving various body systems. The etiology of CFS remains unclear; however, a number of recent studies have shown oxidative stress may be involved in its pathogenesis. The role of oxidative stress in CFS is an important area for current and future research as it suggests the use of antioxidants in the management of CFS. Specifically, the dietary supplements glutathione, N-acetylcysteine, alpha-lipoic acid, oligomeric proanthocyanidins, Ginkgo biloba, and Vaccinium myrtillus (bilberry) may be beneficial. In addition, research on food intolerance is discussed, since food intolerance may be involved in CFS symptom presentation and in oxidation via cytokine induction. Finally, recent evidence suggests celiac disease can present with neurological symptoms in the absence of gastrointestinal symptoms; therefore, celiac disease should be included in the differential diagnosis of CFS.

4395.      Magill L. The use of music therapy to address the suffering in advanced cancer pain. J Palliat Care  2001 Autumn;17(3):167-72


Pain associated with advanced cancer is multifaceted and complex, and is influenced by physiological, psychological, social, and spiritual phenomena. Suffering may be identified in patients when pain is associated with impending loss, increased dependency, and an altered understanding of one's existential purpose. Comprehensive pain management aims to address problematic symptoms in order to improve comfort, peace of mind, and quality of life. Music therapy is a treatment modality of great diversity that can offer a range of benefits to patients with advanced cancer pain and symptoms of suffering. Music therapists perform comprehensive assessments that include reviews of social, cultural, and medical history; current medical status; and the ways in which emotions are affecting the pain. A variety of music therapy techniques may be used, including vocal techniques, listening, and instrumental techniques. These techniques provide opportunities for exploration of the feelings and issues compounding the pain experience. Case examples are presented to demonstrate the "lifting", "transporting", and "bringing of peace" qualities of music that offer patients moments of release, reflection, and renewal.

4396.      Marcus DM, Suarez-Almazor ME.  Is there a role for ginger in the treatment of osteoarthritis? Arthritis Rheum. 2001 Nov;44(11):2461-2. No abstract.

4397.      Matsumoto M, Smith JC. Progressive muscle relaxation, breathing exercises, and ABC relaxation theory. J Clin Psychol. 2001 Dec;57(12):1551-7.


This study compared the psychological effects of Progressive Muscle Relaxation (PMR) and breathing exercises. Forty-two students were divided randomly into two groups and taught PMR or breathing exercises. Both groups practiced for five weeks and were given the Smith Relaxation States Inventory before and after each session. As hypothesized, PMR practitioners displayed greater increments in relaxation states (R-States) Physical Relaxation and Disengagement, while breathing practitioners displayed higher levels of R-State Strength and Awareness. Slight differences emerged at Weeks 1 and 2; major differences emerged at Weeks 4 and 5. A delayed and potentially reinforcing aftereffect emerged for PMR only after five weeks of training--increased levels of Mental Quiet and Joy. Clinical and theoretical implications are discussed. Copyright 2001 John Wiley & Sons, Inc.

4398.      Mazumder UK, Gupta M, Manikandan L, Bhattacharya S. Antibacterial activity of Urena lobata root. Fitoterapia. 2001 Dec;72(8):927-9. No abstract.

4399.      Mudur G. Indian doctors decry proposal to teach traditional medicine. BMJ. 2001 Nov 10;323(7321):1090.  No abstract.

4400.      Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: implications for clinical practice. Mayo Clin Proc  2001 Dec;76(12):1225-35


Surveys suggest that most patients have a spiritual life and regard their spiritual health and physical health as equally important. Furthermore, people may have greater spiritual needs during illness. We reviewed published studies, meta-analyses, systematic reviews, and subject reviews that examined the association between religious involvement and spirituality and physical health, mental health, health-related quality of life, and other health outcomes. We also reviewed articles that provided suggestions on how clinicians might assess and support the spiritual needs of patients. Most studies have shown that religious involvement and spirituality are associated with better health outcomes, including greater longevity, coping skills, and health-related quality of life (even during terminal illness) and less anxiety, depression, and suicide. Several studies have shown that addressing the spiritual needs of the patient may enhance recovery from illness. Discerning, acknowledging, and supporting the spiritual needs of patients can be done in a straightforward and noncontroversial manner. Furthermore, many sources of spiritual care (e.g., chaplains) are available to clinicians to address the spiritual needs of patients.

4401.      Mukherjee AK, Basu S, Sarkar N, Ghosh AC. Advances in cancer therapy with plant based natural products. Curr Med Chem  2001 Oct;8(12):1467-86


Natural Products have long been a fertile source of cure for cancer, which is projected to become the major causes of death in this century. However, there is a continuing need for development of new anticancer drugs, drug combinations and chemotherapy strategies, by methodical and scientific exploration of enormous pool of synthetic, biological and natural products. There are at least 250,000 species of plants out of which more than one thousand plants have been found to possess significant anticancer properties. While many molecules obtained from nature have shown wonders, there are a huge number of molecules that still either remains to be trapped or studied in details by the medicinal chemists. The article reviews many such structures and their related chemistry along with the recent advances in understanding mechanism of action and structure-function relationships of nature derived anti-cancer agents at the molecular, cellular and physiological levels. Taxol, one of the most outstanding agents, has been found beneficial in treatment of refractory ovarian, breast and other cancers. Another prominent molecule includes Podophyllotoxin. Synthetic modification of this molecule led to the development of Etoposide, known to be effective for small cell cancers of the lungs and testes. Camptothecin isolated from Camptotheca acuminata also have been extensively studied. Other important molecules discussed include Vincristine, Vinblastine, Colchicine, Ellipticine and Lepachol along with Flavopiridol, a semi-synthetic analogue of the chromone alkaloid Rohitukine from India, a pyridoindole alkaloid from leaves of Ochrosia species and many more. The review also deals with the lesser-known plants of sub-Himalayan region.


4402.      Neinstein LS. The treatment of adolescents with a chronic illness: physicians must go beyond the medical model. West J Med. 2001 Nov;175(5):293-5.  No abstract.

4403.      Nestel P, Cehun M, Pomeroy S, Abbey M, Weldon G. Cholesterol-lowering effects of plant sterol esters and non-esterified stanols in margarine, butter and low-fat foods. Eur J Clin Nutr  2001 Dec;55(12):1084-90


OBJECTIVES: To determine the efficacy on plasma cholesterol-lowering of plant sterol esters or non-esterified stanols eaten within low-fat foods as well as margarine. DESIGN: Randomised, controlled, single-blind study with sterol esters and non-esterified plant stanols provided in breakfast cereal, bread and spreads. Study 1 comprised 12 weeks during which sterol esters (2.4 g) and stanol (2.4 g)-containing foods were eaten during 4 week test periods of cross-over design following a 4 week control food period. In Study 2, in a random order cross-over design, a 50% dairy fat spread with or without 2.4 g sterol esters daily was tested. SUBJECTS: Hypercholesterolaemic subjects; 22 in study 1 and 15 in study 2. MAIN OUTCOME MEASURES: Plasma lipids, plasma sterols, plasma carotenoids and tocopherols. RESULTS: Study 1-median LDL cholesterol was reduced by the sterol esters (-13.6%; P<0.001 by ANOVA on ranks; P<0.05 by pairwise comparison) and by stanols (-8.3%; P=0.003, ANOVA and <0.05 pairwise comparison). With sterol esters plasma plant sterol levels rose (35% for sitosterol, 51% for campesterol; P<0.001); plasma lathosterol rose 20% (P=0.03), indicating compensatory increased cholesterol synthesis. With stanols, plasma sitosterol fell 22% (P=0.004), indicating less cholesterol absorption. None of the four carotenoids measured in plasma changed significantly. In study 2, median LDL cholesterol rose 6.5% with dairy spread and fell 12.2% with the sitosterol ester fortified spread (P=0.03 ANOVA and <5% pairwise comparison). CONCLUSION: 1. Plant sterol esters and non-esterified stanols, two-thirds of which were incorporated into low-fat foods, contributed effectively to LDL cholesterol lowering, extending the range of potential foods. 2. The LDL cholesterol-raising effect of butter fat could be countered by including sterol esters. 3. Plasma carotenoids and tocopherols were not reduced in this study. SPONSORSHIP: Meadow Lea Foods, Australia.


4404.      Nicholl DS, Daniels HM, Ira Thabrew M, Grayer RJ, Simmonds MS, Hughes RD. In vitro studies on the immunomodulatory effects of extracts of Osbeckia aspera. J Ethnopharmacol. 2001 Nov;78(1):39-44. No abstract.

4405.      Patavino T, Brady DM. Natural medicine and nutritional therapy as an alternative treatment in systemic lupus erythematosus. Altern Med Rev  2001 Oct;6(5):460-71


Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder without a known cure. Conventional medicine typically approaches the disease with a treatment plan that includes the use of corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), antimalarial drugs, and chemotherapeutic agents. The results vary and safety is questionable. Conservative treatment methods, such as the use of vitamins, minerals, and fatty acids, have been shown to have an impact on the activity of the disease. Alternative medicine treatments, including the use of dehydroepiandrosterone (DHEA) and Chinese medicines, such as Tripterygium wilfordii Hook F (TwHF), have gained a growing interest recently and may prove to be viable treatment options in the future. The elimination of possible associated factors, such as food allergens and SLE-symptom eliciting foods like alfalfa seeds, have also been shown to affect disease activity. Conservative alternative medicine approaches have been shown to provide some benefit in SLE studies; however, the evidence is limited, and the overall effectiveness and long-term safety have not been established. More research must be conducted in this area to further establish firm treatment protocols which provide maximum therapeutic benefit and minimum treatment-related side effects.


4406.      Polisson R.  Innovative therapies in osteoarthritis. Curr Rheumatol Rep. 2001 Dec;3(6):489-95. Review. No abstract.

4407.      Schmidt K, Pittler MH, Ernst E.  Bias in alternative medicine is still rife but is diminishing. BMJ. 2001 Nov 3;323(7320):1071.  No abstract.

4408.      Sharma DC.  India to promote integration of traditional and modern medicine. Lancet. 2001 Nov 3;358(9292):1524. No abstract.

4409.      Sharma DC. India to regulate indigenous medicine sector. Lancet. 2001 Oct 13;358(9289):1249. No abstract.

4410.      Shintani TT.  Integrative medicine approach to obesity and diabetes. Hawaii Med J. 2001 Oct;60(10):262-3. Review.  No abstract.

4411.      Simpson N, Roman K.  Complementary medicine use in children: extent and reasons. A population-based study. Br J Gen Pract. 2001 Nov;51(472):914-6.


This study used a cross-sectional population survey to determine the prevalence of complementary medicine use in children. Some form of complementary medicine had been used by 17.9% of children at least once, and 6.9% had visited a complementary medicine practitioner. Homoeopathy, aromatherapy, and herbal medicine were most frequently used, most commonly for ear; nose, and throat; dermatology; musculoskeletal; infant; respiratory; and emotional/behavioural health problems. Complementary medicine was used mainly because of word-of-mouth recommendation, dissatisfaction with conventional medicine, and fear of side-effects of conventional treatments. Complementary medicine use is widespread in children; professionals should be aware of this, be alert for possible side-effects/interactions, and encourage adherence to effective conventional treatments where important.


4412.      Sun A, Chiang CP. Levamisole and/or Chinese medicinal herbs can modulate the serum level of squamous cell carcinoma associated antigen in patients with erosive oral lichen planus. J Oral Pathol Med  2001 Oct;30(9):542-8


The serum levels of squamous cell carcinoma associated antigen (SCCA) were determined by a microparticle enzyme immunoassay in a group of patients with stage I oral squamous cell carcinoma (OSCC), major or minor type erosive oral lichen planus (EOLP), recurrent aphthous stomatitis (RAS), Behcet's disease (BD), oral leukoplakia (OL), or oral submucous fibrosis (OSF), and in normal control subjects. About 97% of the normal control subjects and the patients with minor type EOLP, RAS, BD, OL or OSF had a serum level of SCCA within the normal limit of 1.2 ng/ml. However, 6 of the 12 (50%) patients with stage I OSCC and 14 of the 31 (45.2%) patients with major type EOLP had a serum level of SCCA greater than 1.2 ng/ml. The mean serum level of SCCA in stage I OSCC patients (1.38+/-1.16 ng/ml) or in major type EOLP patients (1.32+/-1.23 ng/ml) was significantly higher than that in normal control subjects (P<0.001) and that in the patients with minor type EOLP (P<0.001), RAS (P<0.001), BD (P<0.05), OL (P<0.05), or OSF (P<0.05). Either major or minor type EOLP patients could obtain a significant mean reduction of the serum SCCA level of 0.34-0.63 ng/ml after treatment with levamisole and/or Chinese medicinal herbs for 1-30 months. Combination therapy with levamisole plus Chinese medicinal herbs could achieve a shorter duration of treatment to get complete remission than the single therapy with either levamisole only or Chinese medicinal herbs only. We conclude that levamisole and/or Chinese medicinal herbs can modulate the serum SCCA level in EOLP patients. SCCA may be a useful marker in evaluating therapeutic effects and in monitoring the disease status of EOLP. For EOLP patients, the combination therapy is superior to the single therapy of levamisole or of Chinese medicinal herbs.

4413.      Tonelli MR, Callahan TC. Why alternative medicine cannot be evidence-based. Acad Med. 2001 Dec;76(12):1213-20. Review.


The concept of evidence-based medicine (EBM) has been widely adopted by orthodox Western medicine. Proponents of EBM have argued that complementary and alternative medicine (CAM) modalities ought to be subjected to rigorous, controlled clinical trials in order to assess their efficacy. However, this does not represent a scientific necessity, but rather is a philosophical demand: promoters of EBM seek to establish their particular epistemology as the primary arbiter of all medical knowledge. This claim is problematic. The methods for obtaining knowledge in a healing art must be coherent with that art's underlying understanding and theory of illness. Thus, the method of EBM and the knowledge gained from population-based studies may not be the best way to assess certain CAM practices, which view illness and healing within the context of a particular individual only. In addition, many alternative approaches center on the  notion of non-measurable but perceptible aspects of illness and health (e.g., Qi) that preclude study within the current framework of controlled clinical trials. Still, the methods of developing knowledge within CAM currently have limitations and are subject to bias and varied interpretation. CAM must develop and defend a rational and coherent method for assessing causality and efficacy, though not necessarily one based on the results of controlled clinical trials. Orthodox medicine should consider abandoning demands that CAM become evidence-based, at least as "evidence" is currently narrowly defined, but insist instead upon a more complete and coherent description and defense of the alternative epistemic methods and tools of these disciplines.



4414.      Vickers A, Zollman C, Payne DK. Hypnosis and relaxation therapies. West J Med. 2001 Oct;175(4):269-72.  No abstract.

4415.      Yawar A.  Spirituality in medicine: what is to be done? J R Soc Med. 2001 Oct;94(10):529-33. Review.  No abstract.

4416.      Yun-Choi HS, Pyo MK, Park KM, Chang KC, Lee DH. Anti-thrombotic effects of higenamine. Planta Med. 2001 Oct;67(7):619-22.


The anti-platelet and anti-thrombotic effects of higenamine, a benzyltetrahydroisoquinoline alkaloid of the roots of Aconitum japonicum (Ranunculaceae), were investigated. The degree of platelet aggregation was measured with platelet rich plasma (PRP). An acute thrombotic condition was induced in mice by the injection of the mixture of collagen and epinephrine. The thrombus formation was induced inside the arterio-venous shunt tube installed between an abdominal aorta and the renal vein of rats. Higenamine showed inhibitory activities to both human and rat platelet aggregation induced by ADP, collagen and epinephrine. It was more inhibitory to epinephrine induced aggregation (IC(50); 19 and 7.2 microM to human and rat platelets respectively) than ADP- or collagen-induced aggregation. The anti-thrombotic effects of higenamine were also observed in both mouse acute thrombosis model and rat arterio-venous shunt (AV-shunt) models. The oral administration of higenamine (50 or 100 mg/kg) increased the recovery rates from the acute thrombotic challenge in mice and lowered the weight of thrombus formed inside the AV-shunt tube in rats.

July 02


4991.      Abdullaev FI.  Cancer chemopreventive and tumoricidal properties of saffron (Crocus sativus L.). Exp Biol Med (Maywood). 2002 Jan;227(1):20-5. Review.


Since cancer is the most common cause of death in the world population, the possibility that readily available natural substances from plants, vegetables,herbs, and spices may be beneficial in the prevention of cancer warrants closer examination. Saffron in filaments is the dried, dark red stigmata of Crocus sativus L. flowers and it is used as a spice, food colorant, and a drug in medicine. A growing body of research has demonstrated that saffron extract itself and its main constituents, the carotenoids, possess chemopreventive properties against cancer. This review discusses recent literature data and our results on the cancer chemopreventive activities of saffron and its main ingredients.


4992.      Ai AL, Bolling SF.  The use of complementary and alternative therapies among middle-aged and older cardiac patients. Am J Med Qual. 2002 Jan-Feb;17(1):21-7.


This study investigated the prevalence, pattern, perceived benefits, andpredictors of the use of complementary and alternative therapies (CAM) among middle-aged and older patients prior to cardiac surgery. Comprehensive information of 246 patients who came for preoperative medical assessment was obtained through face-to-face interviews. CAM utility of 225 was obtained by telephone the day before surgery. A computerized STS Adult Cardiac Database of Cardiac Surgery provided patients' medical information. One hundred eighty-two patients (80.9%) confirmed CAM use, including relaxation techniques, lifestyle-diet modification, spiritual healing, megavitamin therapy, massage, herbs or folk remedies, and imagery. Education, functional status, the number of non-cardiac chronic conditions, status as former cigarette smoker, public religiosity, and congestive heart failure predicted greater CAM utility, whereas cerebrovascular diseases and arrhythmia tended to predict less use. Findings suggest that there is considerable CAM use in this cardiac sample. Physicians and other health providers should investigate patients' CAM utility and promote collaborative medical care.


4993.      Al-Windi A, Dag E, Kurt S.  The influence of perceived well-being and reported symptoms on health care utilization: a population-based study. J Clin Epidemiol. 2002 Jan;55(1):60-6.


The aim of this study was to evaluate the influence of reported well-being and symptoms on the utilization of health care, including alternative medicine. A random, age-stratified sample was drawn from the general population of Habo, a municipality in mid-Sweden. Of the 1312 subjects sampled, 827 responded to a postal questionnaire, providing information on health care utilization during the previous year, on a number of well-being variables and on perceived symptoms during the past 3 months. Subjects who reported low scores for perceived health and sleep had significantly more appointments with a physician than subjects reporting high scores. These results remained when the influence of age, sex, marital status, household size, educational level, occupational status and presence of chronic disease, shown to affect health care utilization in a previous report, was taken into account. In addition, multi-symptom reporters had higher odds for appointments with physicians or providers of alternative medicine than those with few symptoms when account was taken of potential confounders. The effect of perceived health was independent of symptom reporting on health care utilization, indicating that there is probably no simple chain of causation involved. Health care consumption, especially out-patient care, appears to be linked to perceived bad health and the multi-symptom reporting, factors that together with other known predictors perhaps might be used to estimate future health care needs.



4994.      Bausell RB, Berman BM.  Commentary: alternative medicine: is it a reflection of the continued emergence of the biopsychosocial paradigm? Am J Med Qual. 2002 Jan-Feb;17(1):28-32.


The possibility is presented that the current collaborative versus conventional medical debate may be a consumer-driven continuation of the biomedical versus biopsychosocial controversy first proposed by George Engel 25 years ago. If true, we may all be actors in a genuine Kuhnian paradigmatic shift destined to occur whether we appreciate our roles therein or approve of the ultimate outcome. At the very least, however, it is important to recognize the evidence that at least some patients suffering from chronic conditions may be choosing collaborative therapies for different reasons than for those for which they seek conventional medical care. For these patients, at least, it is important that the quality of the collaborative care they receive be judged on outcomes capable of reflecting these alternative objectives. Finally, whether we are in the midst of a paradigmatic shift in medicine or not, it is essential that we all, as providers of clinical care or as investigators of clinical efficacy, adopt a collaborative role to ensure the provision of both good medicine and good science.


4995.      Bedi MK, Shenefelt PD.  Herbal therapy in dermatology. Arch Dermatol. 2002 Feb;138(2):232-42. Review.


Herbal therapy is becoming increasingly popular among patients and physicians. Many herbal preparations are marketed to the public for various ailments including those of the skin. Herbal therapies have been used successfully in treating dermatologic disorders for thousands of years in Europe and Asia. In Germany, a regulatory commission oversees herbal preparations and recommended uses. In Asia, herbal treatments that have been used for centuries are now being studied scientifically. Currently, the United States does not regulate herbal products, as they are considered dietary supplements. Therefore, there is no standardization of active ingredients, purity, or concentration. There are also no regulations governing which herbs can be marketed for various ailments. This has made learning about and using these treatments challenging. Information compiled in a practical fashion may enable more patients to benefit from these treatments currently used worldwide. We reviewed the herbal medications that show scientific evidence of clinical efficacy, as well as the more common herbs shown to be useful in the treatment of dermatologic disorders. The safety of each herb has been addressed to better enable the physician to know which herbal therapies they may want to begin to use in practice. Common drug interactions and side effects of herbal medicines that may be seen in the dermatologic setting were also studied.


4996.      Benor DJ.  Prayer study: what about expectancy effects among the researchers themselves? Altern Ther Health Med. 2002 Jan-Feb;8(1):20-1.

No Abstract


4997.      Bernardi L, Porta C, Spicuzza L, Bellwon J, Spadacini G, Frey AW, Yeung LY, Sanderson JE, Pedretti R, Tramarin R.  Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation. 2002 Jan 15;105(2):143-5.


    BACKGROUND: It is well established that a depressed baroreflex sensitivity may adversely influence the prognosis in patients with chronic heart failure (CHF) and in those with previous myocardial infarction. METHODS AND RESULTS: We tested whether a slow breathing rate (6 breaths/min) could modify the baroreflex sensitivity in 81 patients with stable (2 weeks) CHF (age, 58+/-1 years; NYHA classes I [6 patients], II [33], III [27], and IV [15]) and in 21 controls. Slow breathing induced highly significant increases in baroreflex sensitivity, both in controls (from 9.4+/-0.7 to 13.8+/-1.0 ms/mm Hg, P<0.0025) and in CHF patients (from 5.0+/-0.3 to 6.1+/-0.5 ms/mm Hg, P<0.0025), which correlated with the value obtained during spontaneous breathing (r=+0.202, P=0.047). In addition, systolic and diastolic blood pressure decreased in CHF patients (systolic, from 117+/-3 to 110+/-4 mm Hg, P=0.009; diastolic, from 62+/-1 to 59+/-1 mm Hg, P=0.02). CONCLUSIONS: These data suggest that in patients with CHF, slow breathing, in addition to improving oxygen saturation and exercise tolerance as has been previously shown, may be beneficial by increasing baroreflex sensitivity.


4998.      Bhatt D C, Mitaliya K D, Maheta D P, Prajapati M M.  Preventive herbal medicine against malaria. Adv Pl Sci 2001, 14(1), 7-10.


 Preventive herbal medicine play an important role to remain healthy. Different parts of some herbs are of medicinal use and used for theraputic purposes. In this treatise 28 plants have been listed that are used successfully to prevent malaria.


4999.      Bielory L.  Adverse reactions to complementary and alternative medicine: ragweed's cousin, the coneflower (echinacea), is "a problem more than a sneeze". Ann Allergy Asthma Immunol. 2002 Jan;88(1):7-9.

     No Abstract


5000.      Brue AW, Oakland TD.  Alternative treatments for attention-deficit/hyperactivity disorder: does evidence support their use? Altern Ther Health Med. 2002 Jan-Feb;8(1):68-70, 72-4. Review.


Attention-deficit/hyperactivity disorder (ADHD) affects approximately 2 to 3 million children in the United States. Stimulant medication is one of the most common treatments for ADHD; however, adverse reactions from its use cause many parents to seek complementary or alternative treatments. Many individuals use complementary and alternative medicine (CAM) because they are attracted to CAM philosophies and health beliefs, dissatisfied with the process or results of their conventional care, or concerned about adverse effects of stimulants. The success of CAM in treating children with ADHD varies, and parents typically use a trial-and-error method when evaluating CAM. Alternative treatments often include neurofeedback, homeopathy, herbal medicines, iron supplements, and dietary modifications or supplements. Although anecdotal and empirical evidence is surfacing to support the efficacy of these alternatives, further research is needed before they can be regarded as effective, reliable treatments for ADHD. Therefore, the use of more conventional treatments should be considered if alternative interventions prove unsuccessful.


5001.      Buckle J.  Aromatherapy for health professionals. Beginnings. 2002 Jan Feb;22(1):7.

No Abstract


5002.      Buske L.  Popularity of alternative health care providers continues to grow. CMAJ. 2002 Feb 5;166(3):366.

     No Abstract

5003.      Carlson LK.  Reimbursement of complementary and alternative medicine in the context of the future of healthcare. Altern Ther Health Med. 2002 Jan-Feb;8(1):36

5004.      Chilton K.  The Ommani Center: an integrative model of healthcare. Altern Ther Health Med. 2002 Jan-Feb;8(1):102-3.

      No Abstract

5005.      Chopra A, Doiphode VV.  Ayurvedic medicine. Core concept, therapeutic principles, and current relevance. Med Clin North Am. 2002 Jan;86(1):75-89, vii. Review.

In the prebiblical Ayurvedic origins, every creation inclusive of a human being is a model of the universe. In this model, the basic matter and the dynamic forces (Dosha) of the nature determine health and disease, and the medicinal value of any substance (plant and mineral). The Ayurvedic practices (chiefly that of diet, life style, and the Panchkarama) aim to maintain the Dosha equilibrium. Despite a holistic approach aimed to cure disease, therapy is customized to the individual's constitution (Prakruti). Numerous Ayurvedic medicines (plant derived in particular) have been tested for their biological (especially immunomodulation) and clinical potential using modern ethnovalidation, and thereby setting an interface with modern medicine. To understand Ayurvedic medicine, it would be necessary to first understand the origin, basic concept and principles of Ayurveda.


5006.      Cocks M, Moller V.  Use of indigenous and indigenised medicines to enhance personal well-being: a South African case study. Soc Sci Med. 2002 Feb;54(3):387-97.

An estimated 27 million South Africans use indigenous medicines (Mander, 1997,Medicinal plant marketing and strategies for sustaining the plant supply in the Bushbuckridge area and Mpumalanga Province. Institute for Natural Resources, University of Natal. Pietermaritzburg, South Africa). Although herbal remedies are freely available in amayeza stores, or Xhosa chemists, for self-medication, little is known about the motivations of consumers. According to African belief systems, good health is holistic and extends to the person's social environment. The paper makes a distinction between traditional medicines which are used to enhance personal well-being generally and for cultural purposes, on the one hand, and medicines used to treat physical conditions only, on the other. Drawing on an eight-month study of Xhosa chemists in Eastern Cape Province, South Africa, in 1996, the paper identifies 90 medicines in stock which are used to enhance personal well-being. Just under one-third of all purchases were of medicines to enhance well-being. Remedies particularly popular included medicines believed to ward off evil spirits and bring good luck. The protection of infants with medicines which repel evil spirits is a common practice. Consumer behaviours indicate that the range of medicines available is increased by indigenisation of manufactured traditional medicines and cross-cultural borrowing. Case studies confirm that self- and infant medication with indigenous remedies augmented by indigenised medicines plays an important role in primary, health care by allaying the fears and anxieties of everyday life within the Xhosa belief system. thereby promoting personal well-being.


5007.      Crowe S, Fitzpatrick G, Jamaluddin MF.  Use of herbal medicines in ambulatory surgical patients. Anaesthesia. 2002 Feb;57(2):203-4.

No Abstract

5008.      Davis MM, Jones DW. The role of lifestyle management in the overall treatment plan for prevention and management of hypertension. Semin Nephrol. 2002 Jan;22(1):35-43. Review.


Hypertension is the most common cardiovascular risk factor in the U.S. population, and hypertensive nephrosclerosis is a common cause of progressive renal disease. Dietary and lifestyle modifications have shown promise in enhancing the effectiveness of blood pressure (BP) management. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNCVI) includes recommendations for prevention and management of hypertension. Recommendations include reducing sodium intake, increasing potassium, calcium, and magnesium intake, controlling obesity, and avoiding heavy alcohol intake, along with aggressive BP control. JNCVI guidelines provide a reasonable approach to lifestyle interventions, the benefits of which would outweigh the antihypertensive effects. The data suggest that such guidelines would benefit normotensive people as well. Copyright 2002 by W.B. Saunders Company


5009.      de Lemos M.  Phytoestrogens and menopause. Pharmacological attributes of plant based drugs should be discussed widely. BMJ. 2002 Jan 5;324(7328):52.

No Abstract


5010.      Del M, Glasziou PP, Spinks AB, Sanders SL.  Natural remedies for osteoporosis in postmenopausal women. Med J Aust. 2002 Feb 18;176(4):182-3.

No Abstract


5011.      du PA.  Accomplishing the impossible: talking about body and soul and mind during a medical visit. Health Commun. 2002;14(1):1-21.

No Abstract

5012.      Ernst E, Pittler MH.  Herbal medicine. Med Clin North Am. 2002 Jan;86(1):149-61. Review.


Generalized statements about herbal medicines are nonsensical, and each remedy has to be evaluated on its own merits. Some herbal treatments can be shown to have  favorable risk-benefit profile, but for most herbal medicines the data are insufficient to determine whether they do more good than harm. The research required to fill the gaps in present knowledge should have a high priority.


5013.      Ernst E. Complementary and alternative medicine for pain management in rheumatic disease. Curr Opin Rheumatol. 2002 Jan;14(1):58-62. Review.


Complementary and alternative medicine has become immensely popular. This review summarizes the recent literature on complementary and alternative medicine for rheumatic conditions. Research has emerged in the following areas: acupuncture, herbal remedies, homeopathy, magnetic fields, massage therapy, spiritual healing, and supplements. Positive evidence was found in relation to glucosamine, chondroitin, some herbal remedies, and acupuncture. Generally speaking, complementary and alternative medicine is grossly underresearched. Because of the popularity of complementary and alternative medicine, adequately defining risk-benefit relationships is an urgent matter.


5014.      Feder G, Katz T.  Randomised controlled trials for homoeopathy. BMJ. 2002 Mar 2;324(7336):498-9.

No Abstract

5015.      Field T.  Massage therapy. Med Clin North Am. 2002 Jan;86(1):163-71. Review.


The author and other investigators have documented improvement in several medical and psychiatric conditions after massage therapy, including growth in preterm infants, depression and addictive problems, pain syndromes, and immune and autoimmune conditions. Although some potential underlying mechanisms have been explored for the massage therapy-improved clinical condition relationship, including decreased stress (and decreased cortisol), improved sleep patterns, and enhanced immune function, further research is needed in this area.


5016.      Frenkel M, Hermoni D.  Effects of homeopathic intervention on medication consumption in atopic and allergic disorders. Altern Ther Health Med. 2002 Jan-Feb;8(1):76-9.


CONTEXT: Allergies are the most common immunologic diseases among the general population. Increasing evidence suggests that the incidence of allergic disorders is rising dramatically. Conventional medicine provides only limited relief and does not offer a complete cure to this health problem. Consequently, patients seek additional approaches and therapies to integrate into their healthcare. Homeopathy is one of the leading complementary modalities used to treat this health problem. OBJECTIVE: This preliminary study assessed the effect of integrating homeopathic treatment in allergic diseases on conventional medication consumption in a health maintenance organization. DESIGN: Retrospective outcome study designed as a before-after trial. SETTING: Patients were studied in a complementary medicine clinic affiliated with an Israeli health maintenance organization. PARTICIPANTS: Forty-eight patients were treated for allergic diseases with homeopathic remedies and conventional medications. MAIN OUTCOME MEASURES: A computerized medication chart for each patient was evaluated for conventional medication consumption 3 months before and 3 months after the homeopathic intervention. Each patient served as his or her own control. RESULTS: Fifty-six percent of patients in this study reduced their use of conventional medication following the homeopathic intervention. Patients who used conventional medications for their allergic disorders reduced their medication expense by an average of 60%, with an average savings of $24 per patient in the 3-month period following the homeopathic intervention. CONCLUSIONS: This retrospective outcome study demonstrates cost savings for an Israeli health maintenance organization. The homeopathic intervention led to a modest but significant reduction in the use of medications commonly used to treat allergic conditions and their complications. Largerr controlled studies are needed to verify these findings.


5017.      Gershen BJ.  An alternative view of complementary and alternative medicine. Md Med. 2002 Winter;3(1):29-31.

      No abstract


5018.      Gutierrez-M O. Biodiversity and new drugs. Trends Pharmacol Sci. 2002 Jan;23(1):8.

No Abstract

5019.      Hepner DL, Harnett M, Segal S, Camann W, Bader AM, Tsen LC.  Herbal medicine use in parturients. Anesth Analg. 2002 Mar;94(3):690-3;


Alternative medicine use has increased dramatically over the last decade. Recently a 22% incidence of herbal medicine use in presurgical patients was reported. Of concern is the potential for these medications to cause adverse drug-herb interactions or other effects such as bleeding complications. We sought to determine the prevalence and pattern of use of herbal remedies in parturients. A one-page questionnaire examining the use of all prescription and nonprescription medications, including herbal remedies, was sent to parturients expected to deliver within 20 wk who had preregistered with the hospital's admissions office. Sixty-one percent of the parturients responded to the survey, with 7.1% of parturients reporting the use of herbal remedies. Only 14.6% of users considered them to be medications. Parturients in the 41--50 yr age bracket (5.6% of parturients) were the most likely to use herbal remedies (17.1% rate of use in this age group). Many parturients who took herbal remedies (46%) did so on the recommendation of their health care provider. IMPLICATIONS: Herbal medicine use may be less prevalent in the parturient population, however, some health care providers may be promoting their use during pregnancy.


5020.      Husband AJ.  Phytoestrogens and menopause. Published evidence supports a role for phytoestrogens in menopause. BMJ. 2002 Jan 5;324(7328):52.

No Abstract

5021.      Khaitan BK, Prasad HR.  Complementary and alternative medicine: how safe is it?  Natl Med J India. 2002 Jan-Feb;15(1):32-3.

No Abstract

5022.      Koopman BG, Blasband RA.  Distant healing revisited: time for a new epistemology. Altern Ther Health Med. 2002 Jan-Feb;8(1):100-1.


As distant healing becomes a valid object of scientific scrutiny, state-of-the-art statistical techniques point to outcomes clearly outside the realm of chance. Accordingly, a variety of experimental designs have come into play that highlight the many challenges and hazards of trying to objectify conscious intention. Our survey pinpoints some landmark studies geared toward relatively modest, short-term healing through the application of multiple modalities. In view of the transient and modest results of the distant healing reported, we suggest that the full range of its potential and its longitudinal effects have yet to be uncovered. To this end, we believe that broader, nonlinear thought processes would better serve us in fathoming the mysterious leap from mind to living matter.


5023.      Lampert N, Xu Y.  Chinese herbal nephropathy. Lancet. 2002 Mar 2;359(9308):796-7. No Abstract

5024.      Le Bars PL, Velasco FM, Ferguson JM, Dessain EC, Kieser M, Hoerr R.  Influence of the severity of cognitive impairment on the effect of the Gnkgo biloba extract EGb 761 in Alzheimer's disease. Neuropsychobiology. 2002;45(1):19-26.


OBJECTIVE: To explore the treatment effect of EGb 761((R)) (EGb) in Alzheimer's disease depending on baseline severity. METHODS: We applied stratification to the intent-to-treat data set collected during a 52-week, randomized, double-blind, placebo-controlled, parallel-group, multicenter study with 120 mg of EGb, using cutoff points of 23 and 14 for the Mini-Mental State Examination (MMSE) score. Outcome measures used were the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog) and the Geriatric Evaluation by Relative's Rating Instrument (GERRI). RESULTS: In the severity stratum 1 (MMSE >23), the placebo group did not show significant changes, while the EGb group improved significantly by 1.7 points on the ADAS-Cog and by 0.09 points on the GERRI. In the severity stratum 2 (MMSE <24), the placebo group worsened by 4.1 points on the ADAS-Cog and 0.18 points on the GERRI, whereas the EGb group showed 60% less decline on the ADAS-Cog (treatment difference of 2.5 points) and no change on the GERRI (treatment difference of 0.25 points). The most severely impaired subgroup (MMSE <15) showed slightly more pronounced worsening for both treatment groups. However, in comparison to placebo, EGb induced virtually the same magnitude of effect as was observed in the entire stratum 2. CONCLUSIONS: The results of this retrospective analysis indicated that a treatment effect favorable to EGb could be observed with respect to cognitive performance (p = 0.02) and social functioning (p = 0.001) regardless of the stage of dementia, whether mild or moderately severe. However, the relative changes from baseline measured at endpoint depended heavily on the severity at baseline. Improvement was observed in the group of patients with very mild to mild cognitive impairment, while in more severe dementia, the mean EGb effect should be considered more in terms of stabilization or slowing down of worsening, as compared to the greater deterioration observed with placebo. Copyright 2002 S.

Karger AG, Basel


5025.      Ludvik BH, Mahdjoobian K, Waldhaeusl W, Hofer A, Prager R, Kautzky-Willer A, Pacini G.  The effect of Ipomoea batatas (Caiapo) on glucose metabolism and serum cholesterol in patients with type 2 diabetes: a randomized study. Diabetes Care. 2002 Jan;25(1):239-40.

No Abstract

5026.      Morse JM.  Qualitative health research: challenges for the 21st century. Qual Health Res. 2002 Jan;12(1):116-29.


To understand complex human phenomena, it is necessary to triangulate the results of multiple separate projects that use diverse methods. Using the example of suffering, a research program emerging from studies exploring comfort was initiated. A model of enduring and emotional suffering (or releasing) was developed, and, using this model as a scaffold, eight subsequent projects explored the interaction of enduring and emotional suffering in various contexts and with different populations. Although there remains much to learn, the researcher argues that using this programmatic approach to explore new areas is an efficient and effective way to gain understanding of complex human phenomena.


5027.      Moura VL, Warber SL, James SA.  CAM providers' messages to conventional medicine: a qualitative study. Am J Med Qual. 2002 Jan-Feb;17(1):10-4.


Between 30 and 50% of patients use complementary and alternative medicine (CAM). There is little research on the interaction between CAM and conventional providers. We investigated what messages CAM practitioners would convey to conventional medicine (CM). Thirty-four CAM practitioners participated in audiotaped interviews. A coherent message was constructed from the identified themes. CAM practitioners see CAM supporting CM rather than replacing it. Blending of CAM with CM benefits patients and CM providers. CAM reintroduces the concept of healing that technology and time pressures have reduced. The basis of healing is connection, being present in the moment, and seeing patients as whole human beings. Research validating CAM effectiveness will foster integration, as will inclusion of CAM theory and practice in the medical curricula. The messages from CAM practitioners to CM coincide with current views of integrative medicine. Collaboration in research, education, and practice can foster a high-quality health care system.


5028.      Nestler G.  Traditional Chinese medicine. Med Clin North Am. 2002 Jan;86(1):63-73. Review.


According to an article by Wald in the November 2000 issue of Strategic Healthcare Marketing, through physician education, integrated medicine shall continue to be adopted by conventional medical establishments in the United States. With many leading medical schools now adding courses on alternative medicine and hospital administrators recognizing this growing trend, responding to the patients' needs and demands remains paramount. According to a study of 3200 physicians conducted by Health Products Research, physicians expect to offer and embrace therapeutic alternatives outside of the traditional pharmaceutical realm. Greater than 50% will begin or increase using alternative

medicine in the next 12 months. Physicians also believe that patient acceptance is greater for alternative therapies, resulting in therapeutic compliance. Most physicians continue to be skeptical about certain treatments, citing a lack of clinical information. With these factors understood, more clinical research to be completed in a teaching hospital environment becomes paramount.

5029.      Newton SM, Lau C, Gurcha SS, Besra GS, Wright CW.  The evaluation of forty-three plant species for in vitro antimycobacterial activities; isolation of active constituents from Psoralea corylifolia and Sanguinaria canadensis. J Ethnopharmacol. 2002 Jan;79(1):57-67. Review.


Extracts from forty-three plant species were selected on account of reported traditional uses for the treatment of TB and/or leprosy. These were assayed for antimycobacterial activities. A simple in vitro screening assay was employed using two model species of mycobacteria, M. aurum and M. smegmatis. Crude methanolic extracts from three of the plants, C. mukul, P. corylifolia and S. canadensis, were found to have significant antimycobacterial activity against M. aurum only (MIC=62.5 microg/ml). Bioassay guided fractionation led to the isolation of two known benzophenanthridine alkaloids, sanguinarine (1) and chelerythrine (2), from the roots S. canadensis and the known phenolic meroterpene, bakuchiol (3) from the seeds of P. corylifolia. The fractionation of the resin of C. mukul lead to a decrease in antimycobacterial activity and hence further work was not pursued. Compound (2) was the most active against M. aurum and M. smegmatis (IC(50)=7.30 microg/ml [19.02 microM] and 29.0 microg/ml [75.56 microM], respectively). M. aurum was the most susceptible organism to all three compounds. No significant difference in antimycobacterial activity was observed when the two alkaloids were tested for activity in media of differing pH values. The activities of the pure compounds against M. aurum were comparable with those against M. bovis BCG with compound (2) being the most active (M. bovis BCG, IC(50)=14.3 microg/ml [37.3 microM]). These results support the use of these plants in traditional medicine.

5030.      O'Hara DP.  Is there a role for prayer and spirituality in health care? Med Clin North Am. 2002 Jan;86(1):33-46, vi. Review.


While most people will turn to prayer during serious illness or impending death, our healthcare system has tended to relegate prayer and spirituality to the periphery of medical care, if it is tolerated at all. Despite recent research that seemingly demonstrates a relationship between prayerful practices and health benefits, the integration of spirituality into the practice of medicine remains elusive. The research that purports to demonstrate the link between prayer and health is examined in an exploration of the place prayer and  spirituality might have in the health care system.


5031.      Ott MJ, Lynch M.  Integrating complementary and conventional symptom management in a cancer center. Oncol Nurs Forum. 2002 Jan-Feb;29(1):25-7.


One goal of oncology nursing is to help patients achieve the best possible quality of life. In the conventional care perspective, quality of life has four aspects: physical, emotional, social, and spiritual. From the complementary care perspective, it is defined as harmony of body, mind, and spirit. Integrating these perspectives of quality of life allows us to have a fuller and richer view of the patient, accentuating the core of his or her being: values, beliefs, and goals. The Pain and Symptom Management Service has embraced this integrated view and, by doing so, has improved symptom management outcomes for patients and their families.


5032.      Pappas S, Perlman A.  Complementary and alternative medicine. The importance of doctor-patient communication. Med Clin North Am. 2002 Jan;86(1):1-10. Review.


The foundation of good medical care is a comfortable and evolving relationship between the patient and the physician. Since the dawn of medicine with Hippocrates and later Plato, this relationship was regarded as the foundation of the art of medicine. This bidirectional relationship has evolved over time from a benign physician paternalism to one of patient autonomy. It is hoped that by communicating about CAM, patients and physicians can reach a state of shared comfort, described by Balint as the mutual investment company. To begin this process, physicians must understand the complex and important role CAM plays in modern society. Its increasing prevalence and efficacy benefit (actual and perceived) are difficult points to argue with. Patients need to understand they can turn to physicians to receive constructive feedback with regards to the safety and efficacy of these modalities in an unbiased fashion. Physicians can do no less for their patients. As Peabody said in 1927, "...the secret of the care of the patient is caring for the patient."


5033.      Richardson MA.  Complementary and alternative therapy use in gynecologic oncology: implications for clinical practice. Gynecol Oncol. 2002 Mar;84(3):360-2.

No Abstract

5034.      Rossiter-Thornton JF.  Prayer in your practice. Complement Ther Nurs Midwifery. 2002 Feb;8(1):21-8. Review.


This article is intended for anyone interested in introducing prayer into his or her practice. It outlines the reasons for using prayer and addresses some of the objections put forward by certain professionals. The paper then describes The Prayer Wheel, a practical non-denominational way to pray and provides instructions on how to present it as an adjunct in health care.

5035.      Rui H.  Recent progress of traditional Chinese medicine and herbal medicine for the treatment and prevention of cancer. Gan To Kagaku Ryoho. 2002 Feb;29 Suppl 1:67-75.

5036.      Shepherd JE.  Hormone replacement therapy: separating fact from fallacy. J Am Pharm Assoc (Wash). 2002 Jan-Feb;42(1):122-3. Review.

No Abstract

5037.      Silversides A.  More provinces protecting MDs who practise alternative medicine. CMAJ. 2002 Feb 5;166(3):367.

No Abstract

5038.      Smith MJ, Logan AC.  Naturopathy. Med Clin North Am. 2002 Jan;86(1):173-84. Review.


Naturopathic medicine is an eclectic form of primary health care that encompasses many complementary modalities in the treatment and prevention of disease. Treatment protocols are integrative in nature, combining the most suitable therapies to address the individual patient's needs. Although naturopathic physicians often are referred to as general practitioners of complementary medicine, practitioners share a common philosophical belief in the profession's founding principles. Naturopathic physicians have started to contribute to research and incorporate modern scientific methods into clinical practice, which has served to develop and validate the profession further. In contrast to many other forms of complementary medicine, naturopathic medicine is regulated partially by law. Legislation of naturopathic medicine has worked well in jurisdictions where it is legislated and has led to uniform standards of education and practice. In addition, regulation has helped with integration and naturopathic cooperation with all other branches of medical science. Within licensed jurisdictions, patients receiving naturopathic care can expect the practitioner to be held to high standards, established by state or provincial law. As alternative therapies become more integrated in nature, conventional medicine will face new challenges. Licensed naturopathic physicians are trained sufficiently to play an active role in this new primary health care team. Although the exact role has yet to be determined, the eclectic approach taken by naturopathic physicians may be of benefit in this evolutionary process.

5039.      Snyderman R, Weil AT. Integrative medicine: bringing medicine back to its roots. Arch Intern Med. 2002 Feb 25;162(4):395-7.

No Abstract

5040.      Soliman N.  Homeopathy: the other medicine. Md Med. 2002 Winter; 3(1):23-5. Review.

No Abstract

5041.      Swisher EM, Cohn DE, Goff BA, Parham J, Herzog TJ, Rader JS, Mutch DG.  Use of complementary and alternative medicine among women with gynecologic cancers. Gynecol Oncol. 2002 Mar;84(3):363-7.


OBJECTIVE: The aim of this study was to determine the prevalence and types of complementary and alternative medicine (CAM) usage by women with gynecologic cancer in an outpatient midwestern university practice. METHODS: Any patient with a gynecologic cancer seen in the outpatient clinic of the gynecologic oncology division at Washington University over a 3-month period was eligible, excluding those patients with a new cancer diagnosis. Subjects completed a questionnaire anonymously. Two by two comparisons were made using the Fisher exact test and P was considered significant at P < 0.05. RESULTS: Nearly half (49.6%) of 113 respondents had used CAM since being diagnosed with cancer. Characteristics significantly associated with CAM use include annual income greater than $30,000, cancer site of origin other than the cervix, and use of CAM prior to cancer diagnosis. Users with annual incomes greater than $30,000 were significantly more likely to use CAM in the "other" category that included acupuncture, reflexology, and electromagnetic therapy. Fewer than 25% of CAM users received information regarding CAM from a physician, nurse, or practitioner of CAM. Women used CAM in hopes of achieving a wide range of potential benefits including both improved well-being and anti-cancer effects. The most common actual benefit these women perceived was an improvement in psychosocial well-being, including increased hope or optimism. CONCLUSIONS: American patients with gynecologic cancer frequently use CAM in addition to standard medical therapy. Oncologists caring for women with gynecologic cancer should initiate a dialogue about usage of CAM, discussing the potential adverse effects of CAM and the patient's therapeutic goals.

5042.      Torpy JM.  Integrating complementary therapy into care. JAMA. 2002 Jan 16;287(3):306-7. No Abstract

5043.      Wolsko PM, Eisenberg DM, Davis RB, Ettner SL, Phillips RS.  Insurance coverage, medical conditions, and visits to alternative medicine providers: results of a national survey. Arch Intern Med. 2002 Feb 11;162(3):281-7.


BACKGROUND: In 1997, patients made an estimated 629 million visits to complementary and alternative medicine (CAM) providers; however, little is known about factors associated with visits to CAM providers. OBJECTIVE: To examine the effect of insurance coverage on frequency of use of CAM providers. METHODS: We conducted a nationally representative, random household telephone survey of 2055 adults. MAIN OUTCOME MEASURE: The number of visits made to CAM providers. RESULTS: An estimated 44% of the US population used at least 1 CAM therapy in 1997. Of those using CAM, 52% had seen at least 1 CAM provider in the last year. Among those who used a CAM therapy, factors independently associated with seeing a provider were having been in the upper quartile of visits to conventional providers in the last year (adjusted odds ratio [AOR], 2.00; 95% confidence interval [CI], 1.33-3.01), female sex (AOR, 1.67; 95% CI, 1.17-2.38), and having used the therapy to treat diabetes (AOR, 5.20; 95% CI, 1.40-19.40), cancer (AOR, 2.99; 95% CI, 1.04-8.62), or back or neck problems (AOR, 1.51; 95% CI, 1.02-2.23). Factors independently associated with frequent use (. or = 8 visits per year) of a CAM provider were full insurance coverage of the CAM provider (AOR, 5.06; 95% CI, 2.45-10.47), partial insurance coverage (AOR, 3.26; 95% CI, 1.72-6.19), having used the therapy for wellness (AOR, 2.85; 95% CI, 1.63-4.98), and having seen the provider for back or neckk problems (AOR, 2.26; 95% CI 1.29-3.94). Conservative extrapolation to national estimates suggests that 8.9% of the population (17.5 million adults) accounted for more than 75% of the 629 million visits made to CAM providers in 1997. CONCLUSIONS: A small minority of persons accounted for more than 75% of visits to CAM providers. Extent of insurance coverage for CAM providers and use for wellness are strong correlates of frequent use of CAM providers.


5044.      Yarnell E, Abascal K, Greenfield RH, Romm A, Sudberg S.  Credentialing of practitioners of botanical medicine. Am J Med Qual. 2002 Jan-Feb;17(1):15-20.


This article discusses how practitioners, regardless of other professional licenses they may hold, could be credentialed in botanical medicine. The article reviews the field of clinical botanical medicine and the history and modern status of botanical medicine, as well as organizations currently involved in botanical medicine credentialing. Many different types of professionals prescribe botanical medicines, and the potential for collaboration among them is great. The current trend treats botanical medicine as a narrow subdivision of allopathic medicine and does not acknowledge the breadth, depth, and diversity of botanical medicine and ultimately will not provide maximum benefits for patients. An alternative approach that instead credentials practitioners skilled in the use of a wide variety of botanical medicines in a responsible, scientific fashion is presented.


Oct 02


5772.      Boehler M, Mitterschiffthaler G, Schlager A. Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery. Anesth Analg  2002 Apr;94(4):872-5.


To investigate the effectiveness of prophylactic Korean hand acupressure in the prevention of postoperative vomiting in women scheduled for minor gynecological laparoscopic surgery, we conducted a double-blinded, randomized, placebo-controlled study. In one group (n = 40), acupressure was performed 30 min before the induction of anesthesia by using special acupressure seeds, which were fixed onto the Korean hand acupuncture point K-K9 and remained there for at least 24 h. The second group (n = 40) functioned as the Placebo group. The treatment groups did not differ with regard to demographics, surgical procedure, or anesthetic administered. In the Acupressure group, the incidence of nausea and vomiting was significantly less (40% and 22.5%) than in the Placebo group (70% and 50%). We conclude that Korean hand acupressure of the acupuncture point K-K9 is an effective method for reducing postoperative nausea and vomiting in women after minor gynecological laparoscopic surgery. IMPLICATIONS: This randomized study was performed to investigate the antiemetic effect of the Korean hand acupuncture point K-K9. Acupressure of K-K9 reduces the incidence of postoperative nausea and vomiting in female patients after minor gynecological laparoscopic surgery.


5773.      Frank BL. Acupuncture for the treatment of cocaine addiction. JAMA  2002 Apr 10;287(14):1800-1; discussion 1801-2  No abstract.

5774.      Hawkes S. Human immunodeficiency virus and hepatitis in Bangladesh – widespead or targeted prevention strategies. Int. J Epidemiol. 2001; 30(4), 85-6. No abstract.

5775.      Johnstone PA, Polston GR, Niemtzow RC, Martin PJ. Integration of acupuncture into the oncology clinic. Palliat Med  2002 May;16(3):235-9


PURPOSE/OBJECTIVE: Patients with cancer or symptoms referable to cancer therapy were offered acupuncture as potential palliation of their symptoms. This paper describes the physical integration of the discipline into the Oncology Clinic, and patient perspectives on its availability and efficacy. PATIENTS AND METHODS: Between August 1999 and May 2000, 123 patients with varying symptoms received acupuncture in our Center's Radiation and Medical Oncology Clinics and Breast Health Center. These patients had 823 visits during this time period. A practice outcome analysis was performed on patients receiving therapy between 1 January 2024 and 30 April 2000. The 89 patients treated during this interval had 444 total visits. In June and July 2000, a questionnaire was administered by phone to 79 of these patients (89%). Standard allopathic care continued while patients were receiving acupuncture. RESULTS: Major reasons for referral included pain (53%), xerostomia (32%), hot flashes (6%) and nausea/loss of appetite (6%). Patients had a mean of five acupuncture visits (range 1-9). Most patients (60%) showed at least 30% improvement in their symptoms. About one-third of patients had no change in severity of symptoms. There were no untoward effects reported related to the acupuncture. When analysed by diagnosis, these values persist. Irrespective of response to therapy, 86% of respondents considered it 'very important' that we continue to provide acupuncture services. CONCLUSION: Acupuncture may contribute to control of symptoms for cancer patients. Expansion of providers, continued patient follow-up, optimization of techniques and prospective objective measurement of response continue in our clinic.

5776.      Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow JA, Fox JR, Krag MH. Evidence of connective tissue involvement in acupuncture. FASEB J  2002 Jun;16(8):872-4


Acupuncture needle manipulation gives rise to "needle grasp," a biomechanical phenomenon characterized by an increase in the force necessary to pull the needle out of the tissue (pullout force). This study investigates the hypothesis that winding of connective tissue, rather than muscle contraction, is the mechanism responsible for needle grasp. We performed 1) measurements of pullout force in humans with and without needle penetration of muscle; 2) measurements of pullout force in anesthetized rats, with and without needle rotation, followed by measurements of connective tissue volume surrounding the needle; 3) imaging of rat abdominal wall explants, with and without needle rotation, using ultrasound scanning acoustic microscopy. We found 1) no evidence that increased penetration of muscle results in greater pullout force than increased penetration of subcutaneous tissue; 2) that both pullout force and subcutaneous tissue volume were increased by needle rotation; 3) that increased periodic architectural order was present in subcutaneous tissue with rotation, compared with no rotation. These data support connective tissue winding as the mechanism responsible for the increase in pullout force induced by needle rotation. Winding may allow needle movements to deliver a mechanical signal into the tissue and may be key to acupuncture's therapeutic mechanism.


5777.      Newman RG. Acupuncture for the trreatment of cocaine addiction JAMA  2002 Apr 10;287(14):1801; discussion 1801-2  No abstract.

5778.      Shapira MY, Berkman N, Ben-David G, Avital A, Bardach E, Breuer R. Short-term acupuncture therapy is of no benefit in patients with moderate persistent asthma. Chest  2002 May;121(5):1396-400


STUDY OBJECTIVES: Acupuncture traditionally has been used to treat asthma. Nevertheless, only a few controlled studies have been performed to determine the efficacy of this treatment. Our study aimed to determine the efficacy of acupuncture in patients with moderate persistent asthma. METHODS: Twenty-three patients with moderate persistent asthma who had been treated only with inhaled beta(2)-agonists were randomly assigned to receive four sessions of real acupuncture (RA) or sham acupuncture (SA) in a blinded manner. After a washout period of 3 weeks, the patients were crossed over. Monitoring included FEV(1), methacholine challenge, daily peak flow (PF) variability, and the keeping of an asthma diary. RESULTS: Twenty of 23 patients completed the study. There was no significant change in FEV(1) following treatment. The mean (+/- SE) FEV(1) values before and after the RA were 73 +/- 4% and 73 +/- 3%, respectively (not significant [NS]). FEV(1) values before and after SA were 70 +/- 3% and 70 +/- 3%, respectively (NS). There was also no change in provocative methacholine concentration causing a 20% fall in FEV(1) (PC(20)) before and after treatment. The mean PC(20) values before and after RA were 0.92 +/- 0.42 mg/mL and 1.16 +/- 0.51 mg/mL, respectively (p = 0.71), while the PC(20) values before and after SA were 1.47 +/- 0.83 mg/mL and 1.11 +/- 0.79 mg/mL, respectively (p = 0.59). There was no change in the mean PF variability before and after the RA (1.6 +/- 3.1% and 1.8 +/- 2.3%, respectively [NS]). The PF variability before and after SA were 3.6 +/- 2.8% and 2.8 +/- 3.4%, respectively (NS). No significant difference was demonstrated for symptom scores or for the use of beta(2)-agonist inhalers (RA, 6.7 +/- 3.4; SA, 8.1 +/- 3.6; p = 0.58). CONCLUSION: In patients with moderate persistent asthma, a short course of acupuncture treatment resulted in no change in lung functions, bronchial hyperreactivity, or patient symptoms.

5779.      Varon J, Fromm RE Jr, Marik PE. Acupuncture for asthma: fact or fiction? Chest  2002 May;121(5):1387-8  No abstract.

Alternative Medicine:

5780.      Ackermann RT, Williams JW Jr. Rational treatment choices for non-major depressions in primary care: an evidence-based review. J Gen Intern Med. 2002 Apr;17(4):293-301. Review.


OBJECTIVE: This review synthesizes available evidence for managing clinically significant dysphoric symptoms encountered in primary care, when formal criteria for major depression or dysthymia are not met. Discussion is focused on premenstrual dysphoric disorder (PMDD) and minor depression because of their significant prevalence in the primary care setting and the lack of clear practice guidelines for addressing each illness. DESIGN: English language literature from prior systematic reviews was supplemented by searching medline, embase, the Cochrane Controlled Trials Registry, the Agency for Healthcare Research and Quality National Guideline Clearinghouse, and bibliographies of selected papers. Studies addressing the natural history or treatment of minor depression or PMDD were selected for review. Data were abstracted by 1 of 2 independent reviewers and studies were synthesized qualitatively. RESULTS: Five individual studies that compared antidepressant or psychological treatments to placebo in patients with minor depression suggest short-term improvements in depressive symptoms with paroxetine, problem-solving therapy, and cognitive behavioral therapy, but not with amitryptiline. Modest benefits on mental health function were reported with paroxetine and with problem-solving therapy, but only in patients with severe functional impairment at baseline. Twenty-four controlled trials were identified that compared antidepressant or psychological treatments to placebo in patients with premenstrual dysphoric disorder. Pooled results from a recent systematic review of 15 randomized controlled trials and one additional trial abstract provide strong evidence for a significantly greater improvement in physical and psychological symptoms with serotonin-selective reuptake inhibitor medications when compared with placebo. Individual trials also suggest significantly greater improvements in symptom scores with venlafaxine, but not with tricyclic antidepressants. CONCLUSIONS: The limited evidence base for minor depression provides only mixed support for a small to moderate benefit for few antidepressant medications and psychological treatments tested. For the treatment of severe psychological or physical symptoms causing functional impairment in patients with PMDD, sertraline and fluoxetine are clearly beneficial in carefully selected patients.


5781.      Anaya CJ. Religion and health. Mayo Clin Proc. 2002 Jun;77(6):600; discussion 600-1.  No abstract.

5782.      Berger LS. The mind-body problem. Am J Psychiatry. 2002 May;159(5):879-80; discussion 880-1. No abstract.

5783.      Berman BM, Bausell RB, Lee WL. Use and referral patterns for 22 complementary and alternative medical therapies by members of the American College of Rheumatology: results of a national survey. Arch Intern Med. 2002 Apr 8;162(7):766-70.


BACKGROUND: This study was designed to determine rheumatologists' self-reported knowledge, perceptions of legitimacy, referral patterns, and use in practice of 22 complementary and alternative medicine (CAM) therapies. METHODS: A survey was mailed to a random sample of 2000 physician members of the American College of Rheumatology asking respondents which (if any) CAM therapies they (1) knew enough about to discuss with patients, (2) considered part of "legitimate medical practice," and (3) "personally administered" to patients, or "referred patients to someone else" to administer. The response rate was 47%. RESULTS: On average, the respondents reported knowing enough to discuss 10 of the therapies with patients, considered 9 to be part of legitimate medical practice, and had referred patients to someone else for 8 of the 22 therapies. Correlates of use and/or referral included sex, age, belief in the legitimacy of the therapies, and self-reported knowledge. CONCLUSIONS: These results provide potentially important preliminary data regarding rheumatologists' responses to dramatic increases in the use of CAM therapies among their patients.

5784.      Block B. NCCAM reaches out to scientists and general public. National Center for Complementary and Alternative Medicine. Altern Ther Health Med. 2002 May-Jun;8(3):24-6.  No abstract.

5785.      Borckardt JJ, Nash MR. How practitioners (and others) can make scientifically viable contributions to clinical-outcome research using the single-case time-series design. Int J Clin Exp Hypn. 2002 Apr;50(2):114-48.


Although clinicians typically possess considerable interest in research, especially about which interventions do and do not work, all too often they dismiss the notion that they themselves can make viable scientific contributions to the outcome literature. This derives from an unfortunate assumption that the only true experiment is a between-groups experiment. There is another form of true experiment that is perfectly compatible with real-world clinical practice: the single-case time-series design. Intensive and systematic tracking of one or a few patients over time can yield viable inferences about efficacy, effectiveness, and, under some circumstances, mechanism of change. This paper describes how clinicians working with hypnosis can carry out such research. The rationale and essential features of time-series studies are outlined; each design is illustrated with actual studies from the hypnosis literature; and new methods of statistical analysis, well within the statistical competence of practitioners, are described.

5786.      Borowitz SM, Cox DJ, Sutphen JL, Kovatchev B. Treatment of childhood encopresis: a randomized trial comparing three treatment protocols. J Pediatr Gastroenterol Nutr. 2002 Apr;34(4):378-84.


OBJECTIVES: To compare short- and long-term effectiveness of three additive treatment protocols in children experiencing chronic encopresis. METHODS: Children, 6 to 15 years of age, who experienced at least weekly fecal soiling for 6 months or longer were eligible for the study. Children were randomly assigned to a group that received intensive medical therapy (IMT), a group that received intensive medical therapy plus a behavior management program called enhanced toilet training (ETT), or a group that received intensive medical therapy with enhanced toilet training and external anal sphincter electromyographic biofeedback (BF). Data concerning toileting habits were collected for 14 consecutive days before an initial visit, and at 3, 6, and 12 months after initiation of therapy. All data were collected using a computerized voice-mail system that telephoned the families each day. At 12 months, children were classified as significantly improved (reduction in soiling, P < 0.001) or cured (<one fecal accident in 2 weeks). RESULTS: Eighty-seven children participated in the study, 72 boys and 15 girls. Mean age at enrollment was 8.6 +/- 2.0 years, and mean duration of symptoms was 58.2 +/- 38.5 months. At 12 months, the cure rates for the IMM, ETT, and BF groups were 36, 48, and 39, respectively (not significant). The improvement rates for these three groups were 45, 78, and 54, respectively (P < 0.05). These results were very stable over time (r > 0.90, P < 0.001 in each case). Response to treatment during the first 2 weeks of therapy was highly predictive of outcome at 3, 6, and 12 months (P < 0.0001). Children in the ETT group used less laxative medication (P < 0.04) and required fewer treatment contacts (P = 0.08) than children in the IMM group. All three treatments resulted in significant increases in daily bowel movements passed in the toilet and self-initiated toileting, and resulted in decreases in average daily soiling at 3, 6, and 12 months (P < 0.05). CONCLUSIONS: Enhanced toilet training is somewhat more effective in treating childhood encopresis than either intensive medical therapy or anal sphincter biofeedback therapy. Although similar total cure rates at 1 year can be expected with these three forms of therapy, enhanced toilet training results in statistically significant decreases in the daily frequency of soiling for the greatest number of children.

5787.      Catane R. Defining alternative medicine. Isr Med Assoc J. 2002 Apr;4(4):314. No abstract.

5788.      Chliaoutakis JE, Drakou I, Gnardellis C, Galariotou S, Carra H, Chliaoutaki M.  Greek Christian Orthodox Ecclesiastical lifestyle: could it become a pattern of health-related behavior? Prev Med. 2002 Apr;34(4):428-35.


BACKGROUND: Although past research has globally supported the salutary impact of religion on health and health-related behaviors, it has not extensively examined the impact of the Christian Orthodox Church's way of living on people's health and health-related behavior. METHODS: Semistructured personal interviews were used to investigate a stratified sample of 20- to 65-year-old individuals in the greater Athens area. Constructs were compared to single items and indices, which varied across data sets. RESULTS: Multiple-regression analysis specify that persons adopting the Christian Orthodox Church's lifestyle were more likely to behave in ways that enhance their health (e.g., relaxation, life satisfaction, healthful nutrition, personal hygiene, and physical activity), after controlling for a set of socio-demographic factors and their current health status. CONCLUSION: These results suggest that the Christian Orthodox Church's lifestyle constitutes a pattern of health-related behavior. (C)2002 Elsevier Science (USA).

5789.      Chung OM. MRI confirmed cervical cord injury caused by spinal manipulation in a Chinese patient. Spinal Cord. 2002 Apr;40(4):196-9.


OBJECTIVE: To report a rare case of cervical cord injury caused by spinal manipulation in a Chinese patient. METHOD: A 46-year-old man suffered from acute tetraplegia immediately after spinal manipulation by a bonesetter. There was nothing abnormal in the plain X-ray but Magnetic Resonance Imaging (MRI) of his cervical spine demonstrated cervical cord oedema at the level of C1/2. RESULT: The patient was treated with high doses of methylprednisolone. Coupled with intensive rehabilitation, the patient made a nearly complete recovery 6 months after injury. Repeated MRI demonstrated syrinx formation at the previous location of cervical cord oedema. CONCLUSION: Spinal manipulation may cause cervical cord injury. MRI is useful in the documentation of this injury and exclusion of other pathology.


5790.      Cohen RJ, Ek K, Pan CX. Complementary and alternative medicine (CAM) use by older adults: a comparison of self-report and physician chart documentation. J Gerontol A Biol Sci Med Sci. 2002 Apr;57(4):M223-7.


BACKGROUND: Older adults are increasingly using complementary and alternative medicine (CAM) dietary supplements and herbal remedies, but may not discuss this with their physicians. When patients do report using CAM, their physicians may not record this information in patient charts. METHODS: This cross-sectional analysis compared results of a convenience sample survey with medical charts. Participants were older than 65 and from an urban academic hospital's ambulatory geriatrics practice. We measured (i) prevalence of CAM use; (ii) proportion of CAM supplements and herbs (CAMsh) reported by patients and documented in patients' charts; (iii) percentage of patients reporting taking CAMsh with anticoagulant activity (ginger, ginkgo, garlic, and vitamin E) while concomitantly taking prescribed anticoagulant medications, as per chart; and (iv) percentages of those patients for whom the CAM anticoagulant was or was not documented in the chart. RESULTS: We surveyed 212 patients; of those, 182 had available charts. Prevalence of CAM use was 64%. Only 35% of all self-reported supplements were documented in the charts. Of 182 patients, 84 (46%) reported taking CAM with anticoagulant properties: of these, 52% took a prescribed anticoagulant (per chart), while 48% took CAM but not prescribed anticoagulants. CONCLUSION: CAM use is highly prevalent among older adults. Physicians do not consistently record the use of CAMsh on patients' charts. This may lead to unrecognized, potentially harmful drug-herb/drug-supplement interactions. Physicians should elicit and document information on CAM use from older adult patients, both to provide sound medical care and to advance knowledge about drug-herb/drug-supplement interactions.


5791.      Corbin Winslow L, Shapiro H. Physicians want education about complementary and alternative medicine to enhance communication with their patients. Arch Intern Med. 2002 May 27;162(10):1176-81.


BACKGROUND: More than one third of patients in the United States use complementary and alternative medicine (CAM); most also visit conventional physicians. There is little information about how physicians and patients discuss CAM. We hypothesized that physicians frequently fielded questions about CAM treatments but felt uncomfortable discussing them owing to a lack of education. OBJECTIVES: To survey physicians to see how they discussed CAM with their patients and what factors influenced discussions and referrals. METHODS: A total of 751 physicians in the Denver, Colo, area were asked about their experience with CAM and communication about CAM with patients. Analyses were conducted using the SAS system (version 6, 1989; SAS Institute Inc, Cary, NC). RESULTS: Of the 705 deliverable surveys, 302 (43%) were returned: 76% of physicians reported having patients using CAM; 59% had been asked about specific CAM treatments; 48% had recommended CAM to a patient; and 24% had personally used CAM. Physician recommendation of CAM was most strongly associated with physician self-use (odds ratio, 6.98; P<.001). Few physicians felt comfortable discussing CAM with their patients, and the overwhelming majority (84%) thought they needed to learn more about CAM to adequately address patient concerns. CONCLUSIONS: Education about CAM modalities is a significant unmet need among Denver physicians, and education may help alleviate the discomfort physicians have when answering patients' questions about CAM. Physicians who use CAM treatments themselves are much more likely to recommend CAM for their patients than physicians who do not.

5792.      Davies B, Brenner P, Orloff S, Sumner L, Worden W. Addressing spirituality in pediatric hospice and palliative care. J Palliat Care. 2002 Spring;18(1):59-67. Review.


Hospice and palliative care principles mandate clinicIans to provide "total" care to patients and their families. Such care incorporates not only physical, emotional, and psychosocial care, but spiritual care as well. Even though considerable attention has been directed to spiritual issues for adult patients in hospice and palliative care, spirituality in pediatric palliative care has been virtually neglected. The need for guidelines to assess spirituality in this population was identified as a priority issue by members of a subcommittee of the Children's International Project on Children's Palliative/Hospice Services, created under the auspices of the National Hospice Organization. Committee members, based on their clinical, research, and personal experiences, identified several aspects relevant to spirituality in general, and to spirituality in pediatric palliative care in particular, and developed guidelines for clinicians in pediatric palliative care. The purpose of this paper is to share the results of this committee's work and, in particular, to present their guidelines for addressing spiritual issues in children and families in pediatric hospice and palliative care.

5793.      Dusek JA, Sherwood JB, Friedman R, Myers P, Bethea CF, Levitsky S, Hill PC, Jain MK, Kopecky SL, Mueller PS, Lam P, Benson H, Hibberd PL. Study of the Therapeutic Effects of Intercessory Prayer (STEP): study design and research methods. Am Heart J. 2002 Apr;143(4):577-84.


BACKGROUND: The effect of intercessory prayer (IP) on outcome in cardiac cases has been evaluated previously, but results are controversial. The goals of the Study of the Therapeutic Effects of Intercessory Prayer (STEP) are to evaluate the effects of receipt of additional study IP and awareness of receipt of additional study IP on outcomes in patients undergoing coronary artery bypass graft surgery. STEP is not designed to determine whether God exists or whether God does or does not respond to IP. METHODS: STEP is a multicenter, controlled trial of 1802 patients in 6 US hospitals, randomized to 1 of 3 groups. Two groups were informed that they may or may not receive 14 consecutive days of additional IP starting the night before coronary artery bypass graft surgery; Group 1 received IP, Group 2 did not. A third group (Group 3) was informed that they would receive additional IP and did so. Three mainstream religious sites provided daily IP for patients assigned to receive IP. At each hospital, research nurses blinded to patient group assignment reviewed medical records to determine whether complications occurred, on the basis of the Society for Thoracic Surgeons definitions. A blinded nurse auditor from the Coordinating  Center reviewed every study patient's data against the medical record before release of study forms. RESULTS: The STEP Data and Safety Monitoring Board reviewed patient safety and outcomes in the first 900 study patients. Patients were enrolled in STEP from January 1998 to November 2000.

5794.      Ernst E. Manipulation of the cervical spine: a systematic review of case reports of serious adverse events, 1995-2001. Med J Aust. 2002 Apr 15;176(8):376-80. Review.


OBJECTIVE: To summarise recent evidence from case reports (published January 1995-September 2001) of adverse events after cervical spine manipulation. DATA SOURCES: Five computerised literature searches (MEDLINE-Pubmed; EMBASE, the Cochrane Library, AMED [Allied and Complementary Medicine Database], and CISCOM [Centralised Information Service for Complementary Medicine] were performed. No language restrictions were applied. STUDY SELECTION: All case reports containing original data of adverse events after cervical spine manipulation were included. DATA EXTRACTION: All articles were evaluated and key data extracted according to pre-defined criteria: patient's age, sex and diagnosis; type of therapist; type of treatment; nature of adverse event; method of diagnosis; and clinical outcome. DATA SYNTHESIS: Thirty-one case reports (42 individual cases) were found. The patients were equally distributed between the sexes (21 male, 20 female, one unknown) and mostly middle-aged (range, 3 months to 87 years). Most were treated by chiropractors. Arterial dissection causing stroke was reported in at least 18 cases. CONCLUSIONS: Serious adverse events after cervical spine manipulation continue to be reported. As the incidence of these events is unknown, large and rigorous prospective studies of cervical spine manipulation are needed to accurately define the risks.

5795.      Ferber SG, Kuint J, Weller A, Feldman R, Dollberg S, Arbel E, Kohelet D. Massage therapy by mothers and trained professionals enhances weight gain in preterm infants. Early Hum Dev. 2002 Apr;67(1-2):37-45.


BACKGROUND: The method of "massage therapy" has consistently shown increased weight gain in preterm infants. The weight gain was apparent during massages administered by professionals. AIMS: To replicate the results of increased weight gain in the course of "massage therapy" in preterm infants, and utilize a new, cost-effective application of this method by comparing maternal to nonmaternal administration of the therapy. STUDY DESIGN: Random cluster design. SUBJECTS: The study comprised 57 healthy, preterm infants assigned to three groups: two treatment groups--one in which the mothers performed the massage, and the other in which a professional female figure unrelated to the infant administered the treatment. Both these groups were compared to a control group. RESULTS: Over the 10-day study period, the two treatment groups gained significantly more weight compared to the control group (291.3 and 311.3 vs. 225.5 g, respectively). Calorie intake/kg did not differ between groups. CONCLUSIONS: Mothers are able to achieve the same effect size as that of trained professionals, allowing cost-effective application of the treatment within the neonatal intensive care unit.

5796.      Frischenschlager O, Pucher I. Psychological management of pain. Disabil Rehabil. 2002 May 20;24(8):416-22. Review.


PURPOSE: In this article an overview is given on the attempts of understanding and treating chronic pain from the psychodynamic view and the perspective of behavioural medicine. ISSUE: Pain cannot be reliably measured. Assessment of pain depends on verbal description, nonverbal expressions, specific tests and our empathy. From this perspective pain is a matter of subjective experience and communication. Several phenomena (e.g. phantom limb pain, stress analgesia, the pain-relieving effects of relaxation, hypnosis, placebo, etc., pain in spite of  a non-existing injury) obviously show that psychological factors like distraction, relaxation, fear, depression, former pain experiences as well as family and cultural influences modulate the way pain is experienced. Different parts of the CNS are involved in the modulation of pain-experience. Referring to cognitive and emotional processes, the importance of the the neocortex and and the limbic system are to be underlined. CONCLUSION: Chronic pain (as a category of ICD-10) presupposes a continuous, torturing pain, which sometimes even cannot be explained sufficiently by an organic damage. Psychosocial problems such as emotional conflicts, misleading thoughts, etc. are recognizable and can be brought into connection with the pain the patient experiences.


5797.      Gordon JS. New White House report. Commission supports scientific research on CAM. Health Forum J. 2002 May-Jun;45(3):33.  No abstract.

5798.      Gordon JS. The White House Commission on Complementary and Alternative Medicine Policy: final report and next steps. Altern Ther Health Med. 2002 May-Jun;8(3):28-31.  No abstract.

5799.      Gorman C. The science of anxiety. Why do we worry ourselves sick? Because the brain is hardwired for fear, and sometimes it short-circuits. Time. 2002 Jun 10;159(23):46-54.  No abstract.

5800.      Hayashi N, Tanabe Y, Nakagawa S, Noguchi M, Iwata C, Koubuchi Y, Watanabe M, Okui M, Takagi K, Sugita K, Horiuchi K, Sasaki A, Koike I.  Effects of group musical therapy on inpatients with chronic psychoses: a controlled study. Psychiatry Clin Neurosci. 2002 Apr;56(2):187-93.


The objective of the present study was to examine the efficacy of group musical therapy for inpatients with DSM-IV schizophrenia or schizoaffective psychosis. Thirty-four therapy group subjects in a ward for long-stay female patients received 15 group musical therapy sessions over 4 months, while 32 waiting group subjects from another ward with the same function were to wait for the sessions until the studied course was completed. The assessment included measures of psychotic symptoms, objective quality of life and subjective musical experiences. Comparison of the groups indicated that significant advantages in the therapy group subjects were detected in some measures concerning personal relations and a subjective sense of participation in a chorus activity. However, the follow-up evaluation suggested that the improvement might not be durable. These findings suggested that the musical therapy had some, but possibly only short-lived, effects on personal relations and musical experiences of chronic psychotic patients.

5801.      Henley E, Chang L, Hollander S. Treatment of hyperlipidemia. J Fam Pract. 2002 Apr;51(4):370-6. Review.


In 1995 and 1996, US adults made more than 18 million office visits for the evaluation and treatment of hyperlipidemia, including 3.4% of all visits to family physicians. Among visits to family physicians, 4.1% included measurement of cholesterol levels.(1) Overall, mean cholesterol levels decreased from 220 in 1960-1962 to 203 in 1988-1994. During the same time period, the proportion of adults with elevated total cholesterol levels (> 240) decreased from 32% to 19%.(2) Despite this progress, the availability of more effective drugs, guidelines advocating increasingly aggressive treatment, and population-wide goals established in Healthy People 2010 will continue to increase the number of patients seen by family physicians for screening, diagnosis, and treatment of hyperlipidemia.

5802.      Herskowitz I. Regulating natural health products. Science. 2002 Apr 5;296(5565):46-7.  No abstract.

5803.      Hsieh CY, Adams AH, Tobis J, Hong CZ, Danielson C, Platt K, Hoehler F, Reinsch S, Rubel A. Effectiveness of four conservative treatments for subacute low back pain: a randomized clinical trial. Spine. 2002 Jun 1;27(11):1142-8.


STUDY DESIGN: A randomized, assessor-blinded clinical trial was conducted. OBJECTIVE: To investigate the relative effectiveness of three manual treatments and back school for patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: Literature comparing the relative effectiveness of specific therapies for low back pain is limited. METHODS: Among the 5925 inquiries, 206 patients met the specific admission criteria, and 200 patients randomly received one of four treatments for 3 weeks: back school, joint manipulation, myofascial therapy, and combined joint manipulation and myofascial therapy. These patients received assessments at baseline, after 3 weeks of therapy, and 6 months after the completion of therapy. The primary outcomes were evaluated using visual analog pain scales and Roland-Morris activity scales. RESULTS: All four groups showed significant improvement in pain and activity scores after 3 weeks of care, but did not show further significant improvement at the 6-month follow-up assessment. No statistically significant between-group differences were found either at the 3-week or 6-month reassessments. CONCLUSIONS: For subacute low back pain, combined joint manipulation and myofascial therapy was as effective as joint manipulation or myofascial therapy alone. Additionally, back school was as effective as three manual treatments.

5804.      Jacobsen PB, Meade CD, Stein KD, Chirikos TN, Small BJ, Ruckdeschel JC. Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. J Clin Oncol. 2002 Jun 15;20(12):2851-62.


PURPOSE: Professionally administered psychosocial interventions have been shown to improve the quality of life of cancer patients undergoing chemotherapy. The present study sought to improve access to psychosocial interventions during chemotherapy treatment by evaluating the efficacy and costs of a patient self-administered form of stress management training that requires limited professional time or experience to deliver. PATIENTS AND METHODS: Four hundred eleven patients about to start chemotherapy were randomly assigned to receive usual psychosocial care only, a professionally administered form of stress management training, or a patient self-administered form of stress management training. Quality-of-life assessments were conducted before randomization and before the second, third, and fourth treatment cycles. Intervention costs were estimated from both payer and societal perspectives. RESULTS: Compared with patients who received usual care only, patients receiving the self-administered intervention reported significantly (P < or = .05) better physical functioning, greater vitality, fewer role limitations because of emotional problems, and better mental health. In contrast, patients who received the professionally administered intervention fared no better in terms of quality of life than patients receiving usual care only. Costs of the self-administered intervention were estimated to be 66% (from a payer perspective) to 68% (from a societal perspective) less than the average costs of professionally administered psychosocial interventions for patients starting chemotherapy. CONCLUSION: Evidence regarding the efficacy and favorable costs of self-administered stress management training suggests that this intervention has the potential to greatly improve patient access to psychosocial intervention during chemotherapy treatment.

5805.      Jorm AF, Christensen H, Griffiths KM, Rodgers B. Effectiveness of complementary and self-help treatments for depression. Med J Aust. 2002 May 20;176 Suppl:S84-96. Review.


OBJECTIVES: To review the evidence for the effectiveness of complementary and self-help treatments for depression. DATA SOURCES: Systematic literature search using PubMed, PsycLit, the Cochrane Library and previous review papers. DATA SYNTHESIS: Thirty-seven treatments were identified and grouped under the categories of medicines, physical treatments, lifestyle, and dietary changes. We give a description of each treatment, the rationale behind the treatment, a review of studies on effectiveness, and the level of evidence for the effectiveness studies. RESULTS: The treatments with the best evidence of effectiveness are St John's wort, exercise, bibliotherapy involving cognitive behaviour therapy and light therapy (for winter depression). There is some limited evidence to support the effectiveness of acupuncture, light therapy (for non-seasonal depression), massage therapy, negative air ionisation (for winter depression), relaxation therapy, S-adenosylmethionine, folate and yoga breathing exercises. CONCLUSION: Although none of the treatments reviewed is as well supported by evidence as standard treatments such as antidepressants and cognitive behaviour therapy, many warrant further research.


5806.      Kaptchuk TJ. The placebo effect in alternative medicine: can the performance of a healing ritual have clinical significance? Ann Intern Med. 2002 Jun 4;136(11):817-25. Review.


In alternative medicine, the main question regarding placebo has been whether a given therapy has more than a placebo effect. Just as mainstream medicine ignores the clinical significance of its own placebo effect, the placebo effect of unconventional medicine is disregarded except for polemics. This essay looks at the placebo effect of alternative medicine as a distinct entity. This is done by reviewing current knowledge about the placebo effect and how it may pertain to alternative medicine. The term placebo effect is taken to mean not only the narrow effect of a dummy intervention but also the broad array of nonspecific effects in the patient-physician relationship, including attention; compassionate care; and the modulation of expectations, anxiety, and self-awareness. Five components of the placebo effect--patient, practitioner, patient-practitioner interaction, nature of the illness, and treatment and setting--are examined. Therapeutic patterns that heighten placebo effects are especially prominent in unconventional healing, and it seems possible that the unique drama of this realm may have "enhanced" placebo effects in particular conditions. Ultimately, only prospective trials directly comparing the placebo effects of unconventional and mainstream medicine can provide reliable evidence to support such claims. Nonetheless, the possibility of enhanced placebo effects raises complex conundrums. Can an alternative ritual with only nonspecific psychosocial effects have more positive health outcomes than a proven, specific conventional treatment? What makes therapy legitimate, positive clinical outcomes or culturally acceptable methods of attainment? Who decides?

5807.      Keefer L, Blanchard EB. A one year follow-up of relaxation response meditation as a treatment for irritable bowel syndrome. Behav Res Ther. 2002 May;40(5):541-6.


Ten of thirteen original participants with Irritable Bowel Syndrome (IBS) participated in a one year follow-up study to determine whether the effects of Relaxation Response Meditation (RRM) on IBS symptom reduction were maintained over the long-term. From pre-treatment to one-year follow-up, significant reductions were noted for the symptoms of abdominal pain (p = 0.017), diarrhea (p = 0.045), flatulence (p = 0.030), and bloating (p = 0.018). When we examined changes from the original three month follow-up point to the one year follow-up, we noted significant additional reductions in pain (p = 0.03) and bloating (p = 0.04), which tended to be the most distressing symptoms of IBS. It appears that: (1) continued use of meditation is particularly effective in reducing the symptoms of pain and bloating; and (2) RRM is a beneficial treatment for IBS in the both short- and the long-term.


5808.      Koppe H. Wellbeing. Part 1--what is it? Aust Fam Physician. 2002 Apr;31(4):374-5.

This is the first in a series of articles which will explore the nondisease focused model of medicine--the notion of promoting wellness. The primary intention is to encourage the reader to reflect on their own wellbeing, and to gain some strategies to assist them in improving it where necessary. However, all the principles outlined here can also be used to help our patients in achieving similar outcomes.

5809.      Lee R, Balick MJ. Snakebite, shamanism, and modern medicine: exploring the power of the mind-body relationship in healing. Altern Ther Health Med. 2002 May-Jun;8(3):118-21. No abstract.

5810.      McCarthy M. US panel calls for more support of alternative medicine. Lancet. 2002 Apr 6;359(9313):1213.  No abstract.

5811.      Mender D. The mind-body problem. Am J Psychiatry. 2002 May;159(5):880; discussion 880-1.  No abstract.

5812.      Mitchell M, Doyle M. Complementary therapies in the midwifery curriculum. 2: Development and evaluation of a CT module. Pract Midwife. 2002 Apr;5(4):39. No abstract.

5813.      Reynolds T. White House report on alternative medicine draws criticism. J Natl Cancer Inst. 2002 May 1;94(9):646-8.  No abstract.

5814.      Shapiro J. How do physicians teach empathy in the primary care setting? Acad Med. 2002 Apr;77(4):323-8.


To explore how primary care clinician-teachers actually attempt to convey empathy to medical students and residents, the author carried out a qualitative study in 1999-2000 in which 12 primary care physicians reflected on their views of empathy, how they demonstrated empathy to patients, and how they went about teaching empathy to learners. Interview data were triangulated with observations of actual teaching sessions and informal questioning of students and residents who had been taught by the faculty participants. Grounded theory was used to interpret the data. The faculty had clear conceptualizations of what empathy meant in clinical practice, but differed as to whether it was primarily a measurable, behavioral skill or a global attitude. Respondents stressed the centrality of role modeling in teaching, and most used debriefing strategies, as well as both learner- and patient-centered approaches, in instructing learners about empathy. Findings suggest that limiting the teaching of empathy to a skill-based approach does not reflect the richness of what actually occurs in the clinical setting, and that it is important to teach empathy comprehensively, acknowledging both behavioral and attitudinal tools.

5815.      Siegal M, Varley R. Neural systems involved in "theory of mind". Nat Rev Neurosci. 2002 Jun;3(6):463-71. Review.


What is the nature of our ability to understand and reason about the beliefs of others--the possession of a "theory of mind", or ToM? Here, we review findings from imaging and lesion studies indicating that ToM reasoning is supported by a widely distributed neural system. Some functional components of this system, such as language-related regions of the left hemisphere, the frontal lobes and the right temporal parietal cortex, are not solely dedicated to the computation of mental states. However, the system also includes a core, domain-specific component that is centred on the amygdala circuitry. We provide a framework in which impairments of ToM can be viewed in terms of abnormalities of the core system, the failure of a co-opted system that is necessary for performance on a particular set of tasks, or the absence of an experiential trigger for the emergence of ToM.

5816.      Solberg S. Will your way to better health. Posit Living. 2002 Apr-May;11(3):28-30. No abstract.

5817.      Ting W, Gross M, Oz MC. The Internet as a research tool in complementary and alternative medicine: a pilot study. Altern Ther Health Med. 2002 May-Jun;8(3):84-6.


Information on the use of complementary and alternative medical (CAM) therapies is sometimes difficult to obtain from consumers. The purpose of this study was to evaluate the Internet as a research tool in CAM to obtain information from these consumers about the use of psychotropic herbs and drugs. A survey on psychotropic herb and drug usage was posted on 138 mental-health newsgroups on the Internet. After 38 days, 72 (71%) of the 102 respondents reported usage of psychotropic medication and 68 (67%) reported usage of psychotropic herbs during the preceding 12 months. The Internet is a potential tool to reach consumers of CAM for research purposes. The study design requires modification, and the findings need cautious interpretation for further research using the Internet as a venue.

5818.      Van Niel CW, Feudtner C, Garrison MM, Christakis DA. Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics. 2002 Apr;109(4):678-84.


OBJECTIVE: Childhood diarrhea accounts for substantial morbidity and mortality worldwide. Multiple studies in children have shown that Lactobacillus, administered orally, may have antidiarrheal properties. We conducted a meta-analysis of randomized, controlled studies to assess whether treatment with Lactobacillus improves clinical outcomes in children with acute infectious diarrhea. METHODS: Studies were sought in bibliographic databases of traditional biomedical as well as complementary and alternative medicine literature published from 1966 to 2000. Search terms were "competitive inhibition," "diarrhea," "gastroenteritis," "Lactobacillus," "probiotic," "rotavirus," and "yog(h)urt." We included studies that were adequately randomized, blinded, controlled trials in which the treatment group received Lactobacillus and the control group received an adequate placebo and that reported clinical outcome measures of diarrhea intensity. These inclusion criteria were applied by blind review and consensus. The original search yielded 26 studies, 9 of which met the criteria. Multiple observers independently extracted study characteristics and clinical outcomes. Data sufficient to perform meta-analysis of the effect of Lactobacillus on diarrhea duration and diarrhea frequency on day 2 were contained in 7 and 3 of the included studies, respectively. RESULTS: Summary point estimates indicate a reduction in diarrhea duration of 0.7 days (95% confidence interval: 0.3-1.2 days) and a reduction in diarrhea frequency of 1.6 stools on day 2 of treatment (95% confidence interval: 0.7-2.6 fewer stools) in the participants who received Lactobacillus compared with those who received placebo. Details of treatment protocols varied among the studies. A preplanned subanalysis suggests a dose-effect relationship. CONCLUSION: The results of this meta-analysis suggest that Lactobacillus is safe and effective as a treatment for children with acute infectious diarrhea.

5819.      Waterman GS, Schwartz RJ. The mind-body problem. Am J Psychiatry. 2002 May;159(5):878-9; discussion 880-1. No abstract.

5820.      Yu YM, Chang WC, Chang CT, Hsieh CL, Tsai CE. Effects of young barley leaf extract and antioxidative vitamins on LDL oxidation and free radical scavenging activities in type 2 diabetes. Diabetes Metab. 2002 Apr;28(2):107-14.


BACKGROUND: The effects of supplementation of young barley leaf extract (BL) and/or antioxidative vitamins C and E on different low-density lipoprotein (LDL) subfractions susceptibility to oxidation and free radical scavenging activities in patients with type 2 diabetes were evaluated. METHODS: Thirty-six type 2 diabetic patients were enrolled in this study. The subjects received one of the following supplements daily for 4 weeks: 15 g BL, 200 mg vitamin C and 200 mg vitamin E (CE), or BL plus CE (BL + CE). RESULTS: The lucigenin-chemiluminescence (CL) and luminol-CL levels in blood were significantly reduced in all groups. Vitamin E content of LDL subfractions increased significantly following supplements, especially for BL + CE group. The percent increase of lag times in the BL + CE was significantly higher than those in the BL or CE group. The antioxidative effect of BL + CE was the greatest for small, dense LDL (Sd-LDL) with further increases in percentage of lag times 4 folds compared to BL alone. CONCLUSION: Our results indicate that supplementation with BL may help to scavenge oxygen free radicals, save the LDL-vitamin E content, and inhibit LDL oxidation. Furthermore, the addition of vitamins C and E to BL can inhibit the Sd-LDL oxidation more effectively, which may protect against vascular diseases in type 2 diabetic patients.


5821.      Holmes C, Hopkins V, Hensford C, MacLaughlin V, Wilkinson D, Rosenvinge H. Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study. Int J Geriatr Psychiatry  2002 Apr;17(4):305-8


OBJECTIVE: To determine whether aromatherapy with lavender oil is effective in the treatment of agitated behaviour in patients with severe dementia. DESIGN: A placebo controlled trial with blinded observer rater. SETTING: A long-stay psychogeriatric ward. PATIENTS: Fifteen patients meeting ICD-10 diagnostic criteria for severe dementia and suffering from agitated behaviour defined as a minimum score of three points on the Pittsburgh Agitation Scale (PAS). INTERVENTION: A 2% lavender oil aromatherapy stream was administered on the ward for a two hour period alternated with placebo (water) every other day for a total of ten treatment sessions. ASSESSMENTS: For each subject 10 total PAS scores were obtained. Five during treatment and five during placebo periods. RESULTS: Nine patients (60%) showed an improvement, five (33%) showed no change and one patient (7%) showed a worsening of agitated behaviour during aromatherapy compared with placebo. A comparison of the group median PAS scores during aromatherapy showed a significant improvement in agitated behaviour during aromatherapy compared with placebo (median PAS scores 3 c.f. 4; Wilcoxon Signed-Ranks test p = 0.016 (one-tailed)). CONCLUSIONS: Lavender oil administered in an aroma stream shows modest efficacy in the treatment of agitated behaviour in patients with severe dementia. Copyright 2002 John Wiley & Sons, Ltd.

5822.      Jardine M. Aromatherapy. Introduction into a maternity service. Pract Midwife  2002 Apr;5(4):14-5    No abstract.




5823.           Buwa S, Patil S, Kulkarni PH, Kanase A. Hepatoprotective action of abhrak bhasma, as ayurvedic drug in albino rats against hepatitis induced by CCL4. Indian J expl Biol. 2001; 39(10), 1022-7. Abhrak bhasma is a commonly used ayurvedic drug against many diseases including hepatitis. It is tested in albino rats using a model of hepatitis induced by a single dose of CCl4 (3 ml/kg body wt.). Different doses of abharak bhasma (10,20,30 and 40 mg/kg body wt) were tested to decide the dose related hepatoprotective efficacy. The centrolobular necrosis induced by single dose of CCl4 was reduced significantly by abhrak bhasma (10 mg) and liver history was also protected by 20 mg dose. Liver acid lipase activities were evaluated due to treatment of single dose of CCl4. Abhrak bhasma counteracted the action of CCl4 on liver lioplytic enzymes. CCl4 did not alter the kidney histologically. Activities of three lipase of rat kidney (acid, alkaline and lipoprotein lipase) were reduced by CCl4 treatment and were reversed by administration of abhrak bhasma. Acid lipase activity of rat adipose tissue was reduced by CCl4 treatment. On the contrary alkaline, lipoprotein and hormone sensitive lipases were enhanced after 24 hr of administration of CCl4. Acid lipase activity was raised by administration of deffrent doses of abhrak bhasma concurrent with CCl4. Abhrak bhasma treatment along with CCl4 enhanced alkaline lipase activity at 10 and 20 mg sode and later it was resuced at 30 and 40 mg doses and came to normal.

5824.           Goel RK; Sairam K. Anti-ulcer drugs from indigenous sources with emphasis on musa sapientum, tamarabhasma, asparagus racemosus and zingiber officinale Indian Journal of Pharmacology. 2002 Apr; 34(2): 100-10.


ABSTRACT: Sula, Parinamasula and Amlapitta are clinical entities recognized by ayurveda, akin to peptic ulcer and functional dyspepsia. Many indigenous drugs have been advocated in ayurveda for treatment of dyspepsia. Our laboratory has been engaged in screening of various indigenous herbal and metallic drugs for their potential use in peptic ulcer diseases , taking lead from Ayurveda and have reported anti-ulcer and ulcer-healing properties of Tectona grandis (lapachol), Rhamnus procumbens (kaempferol), Rhamnus triquerta (emodin), Withania somnifera (acylsteryl glycoside), Shilajit (fulvic acid and carboxymethoxybiphenyl), Datura fastuosa (withafastuosin E), Fluggea microcarpa and Aegle marmelos (pyrano-and iso-coumarins) etc., along with their mechanism of action. The present article includes the detailed exploration of ulcer protective and healing effects of unripe plantain banana, tambrabhasma and Asparagus racemosus on various models of experimental gastroduodenal ulceration and patients with peptic ulcer. Their effects on mucin secretion, mucosal cell shedding, cell proliferation, anti-oxidant activity, glycoproteins, and PG synthesis have been reported. Clinical trials of these drugs for evaluating their potential ulcer healing effects in peptic ulcer patients have been done. Their potential ulcer protective effects both, experimental and clinical seemed to be due to their predominant effects on various mucosal defensive factors rather than on the offensive acid-pepsin secretion. Thus, the above herbal/herbo-mineral drugs do have potential usefulness for treatment of peptic ulcer diseases.


5825.           Sharma DC, Jha J, Sharma P. Evaluation  of safety and efficacy of a gold containing ayurvedic drug. Indian J expl Biol.  2001; 39(9): 892-6
Gold containing Ayurvedic preparation, Swarna Vasant Malti, was given to 20 male persons in a dose of 100 mg twice a day for 40 days under supervision in a dose of 100 mg twice a day for 40 days under supervision of Ayurvedic physicians. The total cumulative intake of 160 mg of gold at the rate of 4 mg per day in this form did not have any toxic effect on human body as evidence by clinical examination, unaltered body weight, absence of urinary pathology and by 30 sensitive biochemical and enzymatic tests. The gold from this Ayurvedic preparation was found in plasma and erythrocytes, excreted partly in urine and was present in semen. Gold binding to albumin and haemoglobin slightly increased their electrophoretic mobility towards anode. This gold preparation seemed to increase sperm motility and prostatic activity.


Complementary Medicine:

5826.      Cohen MH, Eisenberg DM. Potential physician malpractice liability associated with complementary and integrative medical therapies. Ann Intern Med. 2002 Apr 16;136(8):596-603. Review.


Physicians are increasingly grappling with medical liability issues as complementary and integrative health care practices are made available in conventional medical settings. This article proposes a framework in which physicians can assess potential malpractice liability issues in counseling patients about complementary and integrative therapies. The framework classifies complementary and integrative therapies according to whether the evidence reported in the medical and scientific literature supports both safety and efficacy; supports safety, but evidence regarding efficacy is inconclusive; supports efficacy, but evidence regarding safety is inconclusive; or indicates either serious risk or inefficacy. Clinical examples in each category help guide the clinician on how to counsel patients regarding use of complementary and alternative medical therapies in a given clinical situation. Specific strategies to reduce the risk for potential malpractice liability include the following: 1) determine the clinical risk level; 2) document the literature supporting the therapeutic choice; 3) provide adequate informed consent; 4) continue to monitor the patient conventionally; and 5) for referrals, inquire about the competence of the complementary and alternative medicine provider. This framework provides a basis for clinical decisions involving complementary and integrative care.

5827.      Ernst E. Intangible principles of good research in complementary and alternative medicine. Altern Ther Health Med. 2002 May-Jun;8(3):22.  No abstract.

5828.      Kim YH, Lichtenstein G, Waalen J. Distinguishing complementary medicine from alternative medicine. Arch Intern Med. 2002 Apr 22;162(8):943; discussion 944.  No abstract.

5829.      Moyad MA. Complementary/alternative therapies for reducing hot flashes in prostate cancer patients: reevaluating the existing indirect data from studies of breast cancer and postmenopausal women. Urology. 2002 Apr;59(4 Suppl 1):20-33. Review.


Vasomotor hot flashes are a common problem in women who are postmenopausal or receiving antiestrogen treatment for breast cancer. Hot flashes are also a common problem after orchiectomy/luteinizing hormone-releasing hormone therapy, occurring generally in 50% to 66% of these men. Prescribed treatments for hot flashes for men on hormonal ablation treatment for prostate cancer are well documented. These conventional agents have shown good results, but their long-term efficacy, safety, and cost are still questioned. Therefore, the search for other viable agents, including nontraditional treatments, continues. Complementary/alternative treatments to alleviate hot flashes in women have generated an enormous amount of interest. However, these options have received little attention in men with hot flashes. Research with vitamin E, soy, black cohosh, red clover, and numerous other alternative treatments in women may provide some indirect but valuable insight on their potential effectiveness in men. Many of these alternatives have been a disappointment in recent randomized trials of women, and it is likely that there will be similar results with men. However, numerous supplements have yet to be tested in a clinical trial against a placebo, and clinicians should become aware of this ever-increasing list. Patients should be made aware of the primary importance of lifestyle interventions that could partially affect hot flashes and immediately affect overall health, especially during the period of androgen suppression, when it is not uncommon to observe accelerated weight changes and insulin insensitivity. Otherwise, recent research with older and newer conventional agents, such as antidepressants or estrogen/progesterone, should be emphasized at this time for moderate-to-severe hot flashes that profoundly affect daily activities and/or sleep. Antidepressant supplements (St. John's wort) or acupuncture could also be an attractive option in future investigations. Low-dose estrogen seems particularly attractive, because it is inexpensive and may simultaneously reduce hot flashes and the risk of osteoporosis in men receiving long-term androgen suppression therapy; however, the potential for cardiovascular complications must be further investigated. Ultimately, adequate research (vs placebo) should determine the fate of the alternative supplements proposed for hot flash reduction.



5830.      Moyad MA. Complementary therapies for reducing the risk of osteoporosis in patients receiving luteinizing hormone-releasing hormone treatment/orchiectomy for prostate cancer: a review and assessment of the need for more research. Urology. 2002 Apr;59(4 Suppl 1):34-40. Review.


Osteoporosis in women has received a substantial amount of attention, but its impact in men is also significant and noteworthy. Those men who benefit from treatment for prostate cancer with androgen deprivation therapy (ADT) may also be at a higher risk for osteoporosis. Pharmacologic approaches to reduce this risk have received some attention. For example, agents such as bisphosphonates, estrogen receptor-binding drugs (diethylstilbestrol, tamoxifen, and raloxifene), calcitonin, and fluoride are some of the more promising interventions that have been previously outlined. In addition, statin drugs, or hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, have recently been hypothesized to lower osteoporosis risk. However, complementary therapies, which may also have an impact on reducing osteoporosis risk, have not received attention. Dietary and supplemental calcium and vitamin D have been shown, in some preliminary investigations, to maintain bone density in women and men. Numerous healthy and affordable dietary sources of this mineral and vitamin exist, and large intakes can be realistically achieved through proper education. Similarly, the supplemental dosages required to impact risk have been moderate, appear to be safe, are of low cost, and thus may provide an additional route for reducing risk, especially if these interventions are initiated at the start of medical treatment. More studies in men receiving ADT are needed because the existing work has mostly focused on men without castrate levels of male hormone. Additionally, many studies with conventional and nonconventional agents have only focused on individuals with baseline osteoporosis, rather than normal bone mineral densities or osteopenia. Other promising complementary therapies, such as weight-bearing exercise and abstaining from smoking, may also be of benefit. Newer estrogenic-type supplements (eg, ipriflavone) appear interesting and have some preliminary data, but more research is desperately required to determine their actual impact and potential for adverse effects (such as lymphocytopenia from a recent trial). Simple, inexpensive, and potentially effective dietary and supplemental approaches to reduce the risk of osteoporosis in men exist, and they should be discussed with patients. Whether these approaches effectively reduce the risk of osteoporosis in men receiving androgen ablation remains to be determined. The possibility is intriguing, and future research is needed. In the meantime, it is important to keep in mind that these complementary approaches are, at the very least, an integral part of the conventional options used today to the reduce the risk of osteoporosis in men and women.

5831.      Newell SA, Sanson-Fisher RW, Savolainen NJ. Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J Natl Cancer Inst. 2002 Apr 17;94(8):558-84.


Many cancer patients use psychological therapies because they expect them to cure their cancer or to improve their recovery. Despite these high expectations, both patients and oncologists report being moderately to very satisfied with the results of psychological therapies. Previous reviews of the literature have concluded that psychological therapies may help cancer patients in various ways, ranging from reducing the side effects of cancer treatments to improving patients' immune function and longevity. However, because those reviews lacked methodologic rigor, we critically and systematically reviewed all identifiable publications about psychological therapies used by cancer patients to provide an objective and scientific evaluation of nontraditional therapies. We identified 627 relevant papers that reported on 329 intervention trials by searching MEDLINE, Healthplan, Psychlit, and Allied and Complementary Medicine databases and in the bibliographies of the papers identified. Despite increased use of randomized, controlled trial designs over time, the methodologic quality of the intervention trials, on 10 internal validity indicators, was generally suboptimal, with only one trial achieving a quality rating of "good" for its methodology. Using effectiveness results from 34 trials with psychosocial outcomes, 28 trials with side effect outcomes, 10 trials with conditioned side-effect outcomes, and 10 trials with survival or immune outcomes, we make only tentative recommendations about the effectiveness of psychological therapies for improving cancer patients' outcomes. Nevertheless, by exploring the relative effectiveness of the different intervention strategies for each outcome and follow-up period, we suggest the specific therapies that should be considered for further investigation. In addition, we suggest how future trials can maximize their internal validity by describing the minimal reporting standards that should be required in this field.


5832.      Ni H, Simile C, Hardy AM. Utilization of complementary and alternative medicine by United States adults: results from the 1999 national health interview survey. Med Care. 2002 Apr;40(4):353-8.


OBJECTIVE: To measure utilization of complementary and alternative medicine (CAM) by US adults. METHODS: We analyzed data from the 1999 National Health Interview Survey (NHIS), which covers the noninstitutionalized civilian US population. Information on 12 types of CAM use in the past 12 months was obtained from 30,801 respondents aged 18 years and older. Statistical analyses were performed using the SUDAAN software package to account for the complex sample design of the NHIS. RESULTS: An estimated 28.9% of US adults used at least one CAM therapy in the past year. The three most commonly used therapies were spiritual healing or prayer (13.7%), herbal medicine (9.6%), and chiropractic therapies (7.6%). The use of CAM was most prevalent among women, persons aged 35 to 54 years, and persons with an educational attainment of > or =16 years. The overall CAM use was higher for white non-Hispanic persons (30.8%) than for Hispanic (19.9%) and black non-Hispanic persons (24.1%). Although the use was higher for persons who had health insurance than for those who did not, the difference was not statistically significant after adjusting for age, gender and educational attainment. Compared with nonusers, CAM users were more likely to use conventional medical services. CONCLUSIONS: Estimates of CAM use in this nationally representative sample were considerably lower than have been reported in previous surveys. Most CAM therapies are used by US adults in conjunction with conventional medical services.


Herbal Medicine:

5833.           Babu MR; Rao RVK; Annapurna A; Babu DRK. Immunostimulant profile of a polyherbal formulation rv08 Indian Journal of Pharmacology. 2001 Dec; 33(6): 454-5  No abstract.

5834.           Baruah A, Sarma D, Saud J, Singh RS. In vitro regeneration  of Hypercium patulum Thumb.- a medicinal plant. Indian J expl Biol. 2001; 39(9), 947-9.
Protocol was developed for high frequency plant regeneration in Hypericum patulum by shoot-tips culture. Hypericum patulum plants were collected from a wild source growing at high altitude in the eastern Himalayas. Multiple buds were initiated from shoot-tips cultured on Murashige and Skoog’s medium supplemented with BAP, kinetin. Addition of thiamine HCl, Ca – pantothenate and biotin enhanced multiple shoot formation. Upon transfer to phytohormone free liquid medium following f brief exposure to auxin, root formation occurred from the micro shoots. Rooted plants were hardened and transferred to soil. Regeneration potentiality was found to be constant throughout the year in long term cultures.

5835.           Bhattacharya HK, Ahmed FA, Barua PM, Nath KC. Effect of Sajani, a herbal medicine on post-partum anostrus in crossbred cattle of Assam. Indian Vet J. 2001; 78(12), 1160-1.  No abstract.

5836.           Bisht MS. Biodiversity Characterization of some medicinal and forest plants at landscape level in the hill tract of Nainital district. School of Life Sciences, Jawaharlal Nehru University of: New Delhi, 2001. No abstract.

5837.           Chatterjee S; Das SN. Anti-arthritic and anti-inflammatory effect of a poly-herbal drug(ease):its mechanism of action. Indian Journal of Pharmacology. 1996 Jun; 28(2): 116-9  No abstract.

5838.           Chauhan NS. Genetic-diversity of medicinal and aromatic plants of Himalayan region (Himachal Pradesh) and its conversation. Indian J Pl Genet Resour. 2001; 14(2), 318-22. No abstract.

5839.           Chauhan SK; Singh BP; Kimothi GP; Agarwal S.  Determination of glycyrrhizin inn Glycyrrhiza glabra and its extract by HPTLC. Indian Journal of Pharmaceutical Sciences. 1998 July; 60(4): 251-2

ABSTRACT: A simple reproducible HPTLC method for the determination of glycyrrhizin in Glycyrrhiza glabra and its extract was developed and is described. The sensitivity was found to be linear in the range of 0.2 10 1.0 ug. The prposed method being precise, sensitive and reproducible can be used for detection, monitoring and quantification of glycyrrhizin in G. glabra and its extract.

5840.           Dey A; Ghosh TK Effect of livol as a growth promoter in kids. Indian Journal of Indigenous Medicine. 1992 Mar; 9(1 and 2): 73-6  No abstract.

5841.           Dikshit N, Pani D, Singh A. Potential medicinal plants of Eastern Ghats (Orissa). Indian J Pl Genet Resour. 2001; 14(2), 138-41. No abstract.


5842.           Ghosal S; Mukherjee B; Bhattacharya SK. Shilajit comparative study of the ancient and the modern scientific findings. Indian Journal of Indigenous Medicine. 1995 Apr-Sep; 17(1): 1-10


ABSTRACT: Comparison of the findings on the origin, chemical characters, purification, formulation, odour, and mechanism of biological actions of Shilajit (synonymous with Shilajatu;shila,rock,jatu, what adheres to) of the ancient Ayurvedic texts (ca. 1000yr B.C. to 14th Century A.D.) and by modern scientific research, reveals several remarkable similarities not projected before. This review of the ancient Ayurvedic texts also brings forth a number of major deficiencies in the hitherto reported Hindi and English versions of the ancient literatures (in Sanskrit) on shilajit. The more important parallel findings of the ancient and the modern research bear directly on the purification (sodhana) and formulation (bhavana) of shilajit, and the ability of shilajit as a carrier (yogabaha) of other drug molecules. The biological effects of shilajit revealed by modern research lend credence to its anti-aging and rejuvenating properties as claimed in Ayurveda.


5843.           Ghosal S; Mukhopdhyay B; Muruganandam V. Ayurvedic herbo-mineral vitalizers : ancient and modern perspectives. Indian Journal of Indigenous Medicine. 1995 Oct; 17(2): 1-12.

ABSTRACT: Comparative study has been made of the Ayurvedic herbo-mineral vitalizers(rasayanas)in the perspectives of the ancient and the modern scientific tenets. The herbal (polyphenolic/humic)ingredients, by complexation with the ions of transitional metals (Fe, Cu, Mn) and those of fixed valency states become thermostable and water-soluble. These assemblies become readily available to living cells as sources of micronutrients and of energy. The herbal ingredients in the assemblies also act as reductants and backing pump for regeneration of the metal ions into their lower valency states. The total assembly acts as biocatalyst, for biological energy conservation and for signal transduction.

5844.           Ghoshal S, Mukhopadhyay MJ, Mukherjee A. Clastogenic effect of dietary supplement – spirullia alga, and some medicinal plant products from  Boswellia serrata. Indian J Biol. 2001; 39(10): 1068 – 70. Pretreatment of aqueous extracts of Zyrulina (Spirulina), Aswagandha (Withania) and Nopane (Bosewellia) on colchicines induced chromosome damage showed weakness of clastogenic activity in Swiss albino mice. None of the treatments increased significantly the number of chromosome aberrations.

5845.           Ghule ST, manjare MR, Karade VM. Rakhtrohida (Tecomella undulata) – a medicinal plant. Indian J. Arecanut Spices Medicinal Pl. 2001; 3(2): 60-1. no abstract.

5846.           Gupta V, Srinivasan K, Saksena S. Effect of various physico-chemical treatments in breaking hardseedness in Mucuna pruriens. Indian J Pl  Genete Resour. 2001; 14(2): 323-4. No abstract.

5847.           Handique PJ, Bora P. In vitro regeneration of a medicinal plant-Houttuynia cordata Thunb. from nodal explants. Curr Sci. 1999; 76(9): 1245-7. No abstract.

5848.      Hold KM, Sirisoma NS, Sparks SE, Casida JE. Metabolism and mode of action of cis- and trans-3-pinanones (the active ingredients of hyssop oil). Xenobiotica  2002 Apr;32(4):251-65


1. Hyssop oil is an important food additive and herbal medicine and the principal active ingredients are (-)-cis- and (-)-trans-3-pinanones. No information is available on their metabolism or specific mode of action. 2. The metabolites of cis- and trans-3-pinanones were examined from mouse and human liver microsomes and human recombinant P4503A4 with NADPH and on administration to mouse by gas chromatography/chemical ionization mass spectrometry comparison with standards from synthesis. 3. The major metabolite of cis-3-pinanone in each P450 system and in brain of the i.p.-treated mouse in quantitative studies was 2-hydroxy-cis-3-pinanone, and two minor metabolites were hydroxypinanones other than 2-hydroxy-trans-3-pinanone and 4S-hydroxy-cis-3-pinanone. The urine from oral cis-3-pinanone treatment examined on a qualitative basis contained conjugates of metabolites observed in the microsomal systems plus 2,10-dehydro-3-pinanone. 4. Trans-3-pinanone was metabolized more slowly than the cis-isomer in each system to give hydroxy derivatives different than those derived from cis-3-pinanone. 5. Cis- and trans-3-pinanones and hyssop oil act as gamma-aminobutyric acid type A (GABAA) receptor antagonists based on inhibition of 4'-ethynyl-4-n-[2,3-(3)H(2)]propylbicycloorthobenzoate ([(3)H]EBOB) binding in mouse brain membranes (IC(50) of 35-64 microM) and supported by tonic/clonic convulsions in mouse (i.p. LD(50) 175 to >250 mg kg(-1)) alleviated by diazepam. The cis-3-pinanone metabolites 2-hydroxy-cis-3-pinanone and 2,10-dehydro-3-pinanone exhibit reduced toxicity and potency for inhibition of [(3)H]EBOB binding.

5849.           Karoshi VR, Hegde GV. Vegatitive propagation of Gymnema sylvestre, an important medicinal plant – a research report. Indian For. 2001; 127(9), 1067-8. No abstract.

5850.           Mahapatra PBK; Maity LN; Marjit B. An experimental study on the role of some indigenous herbs in chronic alcohol induced gastritis. Indian Journal of Physiology and Allied Sciences. 1997 Jul.; 51(3): 144-8


ABSTRACT: The effect of a combined mixture of three indigenous herbs i.e., Daruharidra (Berberis aristata), Jatamansi (Nardostachys jatamansi) and Palta (Trichosanthes dioica) has been studied experimentally over chronic alcohol induced gastritis of albino rats. It has been established that this mixture has a significant cytoprotective and curative effects against alcohol induced gastric mucosal injury of experimental animals.

5851.           Mathur AK. Envin . Multicentre clinical evaluation of "eazmov plus" a polyherbal formulation in arthritic patients JK Practitioner. 2000 Apr-Jun; 7(2): 149-52


ABSTRACT: A multicentre Clinical Observation and Monitoring Project (COMP) was carried out in 60 patients of Arthritis comprising Osteoarthritis (OA), Rheumatoid arthritis (RA) and Non-specific Arthritis (NSA), ranging in age from 32 to 70 years. This trial was designed as a prospective observational study to monitor the safety and efficacy profile of "EazMov Plus" a polyherbal formulation for treatment of Arthritis. It involved 10 physicians from different parts of Northern India who recruited arthritic patients and no maximum limit of patients per physician. Thus this COMP ensured the use of the product in "Real Life Situation", as seen in day to day clinical practice. The Clinical profile of all patients was carefully recorded in a clinical examination form at the beginning of treatment and "EazMov Plus" Capsules were given in dose of 1 capsule twice a day after meals for 3 weeks. Clinical signs were again recorded at the end of week 1, 2 and 3 respectively on a scale as absent, mild, moderate and severe. Patient compliance, the presence of side effects, and overall response to treatment were carefully observed and noted. Significant reduction in the severity of symptoms as compared to the baseline was seen, with improvement in joint mobility and reduction of stiffness. The incidence of drug related adverse events was minimal 3 percent and did not require discontinuation of treatment. It would be interesting to compare the results of this real life COMP with a double blind activedrug/placebo controlled trial in a monitored clinical environment.

5852.           Max D; Martina G; Gerhard KW.  Effect of herbal preparactions in feed on commercial turkey production. Indian Journal of Indigenous Medicine. 1997 Apr-Sep; 19(1): 1-6

ABSTRACT: A trial was conducted to determine the effects of inclusion of certain herbal preparations in the feed used in commercial turkey production. The test group birds (those fed diets containing Indian Herbs products) performed better than the control group birds, this despite the test birds being given a diet contaminated with Vomitoxin at a level in excess of 5000 ppb for two weeks longer than the control birds. Also the test bird house experienced certain unforseenable accidents during the trial period that adversely affected performance and livability of the test birds when compared to the Control birds. The financial advantage of the test birds was between GB Pound 1.42 to 1.56 per bird over the Control birds at slaughter. The additional cost of including the herbal products in the test bird rations amounted to approximately 30 pence per bird.

5853.      McRae CA, Agarwal K, Mutimer D, Bassendine MF. Hepatitis associated with Chinese herbs. Eur J Gastroenterol Hepatol  2002 May;14(5):559-62


Traditional Chinese herbal medicines are widely available in Western society and are popular as a form of 'natural' alternative medicine. Their use is increasing, as they are perceived to be free of side effects, but they remain largely unregulated. We describe two patients who suffered severe hepatitis, one of whom died, after taking Chinese herbal remedies for minor complaints. We also review the English-language literature on hepatitis associated with Chinese herbs. Two products appear to be implicated frequently: Jin bu huan was taken by 11 patients, and Dictamnus dasycarpus was taken by six patients, including both fatal cases. It is difficult to provide conclusive evidence of what caused hepatitis, as these products are mixtures that may contain adulterants. These cases highlight not only the potential dangers of these products to consumers but also the need for greater control of their manufacture and use.

5854.           Melookunnel S. Managing common ailments with simple herbs Health Administrator. 1996 Jul & 1997 Dec; 7 & 8(1 & 2): 225-8  No abstract.

5855.           Pethkar AV, Gaikaiwari RP, Paknikar KM. Biosorptive removal of contaminating heavy metals from plant extracts of medicinal value. Curr Sci 2001; 80(9): 1216-9. 2441 Granulated Cladosporium cladosporioides * 2 biosorbent removed lead and cadmium from aqueous extracts of Nordostachys jatamansi and Vitis vinifera with high efficiency. Different proporties of the extracts such as pH, Uv-visible spectra and total dissolved solids were unaltered after biosorption, indicating that none of the components of the extracts were removed and the biosorbent itself did not transfer its components to the extracts. These findings open up new avenues for the application of metal biosorption technology.


5856.           Rajiv Kumar, Rajiv S, Gupta H, Garg S, Gupta A. study of herbal treatment in mental retardation. J. natn Integrat med Ass. 2001; 43(9), 7-10. No abstract.

5857.           Ram P, Birendra Kumar, Patra NK, Garg SN, Negi MS, Naqvi AA. Tagetes nimuta L. – effect post harvest storage of herb on oil under tarai conditions of Uttaranchal. Indian Perfumer. 2001; 45(3), 153-7.
Stored seven biomass samples, in general, showed high upgradations in oil quality in exchange of reductions in oil recovery. The samples stored for the shortest period (one day), besides showing significant improvement in oil quality due to increase in less important alcoholic fraction (ipsenol), registered small (5%) reduction  in oil recovery. Allowing post harvest storage for one day appeared as an effective and essential prelude to assuring ideal oil extraction in T. minuta.

5858.           Ray J. Some common medicinal plants of Birbhum, district. Int. J. Mendel 2001; 18(4), 141-2.
Information regarding the availability and use of some medicinal plants of Birbhum district of West Bengal has been studied. More than one hundred species of medicinal value are distributed in different regions of the district of which the most common are used for traditional health care. Further studies could be taken for search of new germplasm.

5859.    Riel MA, Kyle DE, Milhous WK. Efficacy of scopadulcic acid A against Plasmodium falciparum in vitro. J Nat Prod  2002 Apr;65(4):614-5
Scoparia dulcis is a perennial herb widely distributed in many tropical countries. It is used as an herbal remedy for gastrointestinal and many other ailments, and in Nicaragua extracts are used to treat malaria. Phytochemical screening has shown that scopadulcic acid A (SDA), scopadulcic acid B (SDB), and semisynthetic analogues are pharmacologically active compounds from S. dulcis. SDB has antiviral activity against Herpes simplex virus type 1, antitumor activity in various human cell lines, and direct inhibitory activity against porcine gastric H(+), K(+)-ATPase. A methyl ester of scopadulcic acid B showed the most potent inhibitory activity against gastric proton pumps of 30 compounds tested in one study. Compounds with antiviral, antifungal, and antitumor activity often show activity against Plasmodium falciparum. In P. falciparum, the plasma membrane and food vacuole have H(+)-ATPases and the acidocalcisome has an H(+)-Ppase. These proton pumps are potential targets for antimalarial therapy and may have their function disrupted by compounds known to inhibit gastric proton pumps. We tested pure SDA and found in vitro activity against P. falciparum with an IC(50) of 27 and 19 microM against the D6 and W2 clones, respectively. The IC(50) against the multidrug-resistant isolate, TM91C235, was 23 microM.


5860.      Sadava D, Ahn J, Zhan M, Pang ML, Ding J, Kane SE. Effects of four Chinese herbal extracts on drug-sensitive and multidrug-resistant small-cell lung carcinoma cells. Cancer Chemother Pharmacol  2002 Apr;49(4):261-6
PURPOSE: We examined the pharmacology, cell biology and molecular biology of small-cell lung carcinoma cells treated with four extracts of Chinese herbal medicines. Many cancer patients take these medicines, but their effects at the cellular level are largely unknown. We were especially interested in the effects on drug-resistant cells, as resistance is a significant clinical problem in lung cancer. METHODS: Drug-sensitive (H69), multidrug-resistant (H69VP) and normal lung epithelial cells (BEAS-2) were exposed to extracts from two plants used in Chinese herbal medicine for lung cancer: Glycorrhiza glabra (GLYC) and Olenandria diffusa (OLEN), and to extracts of two commercially available combinations of Chinese herbal medicines, SPES (15 herbs) and PC-SPES (8 herbs). Cytotoxicity was measured in terms of cell growth inhibition (IC(50)). The kinetics of DNA fragmentation after exposure to the herbal extracts was measured by BudR labeling followed by ELISA. Apoptosis was measured by the TUNEL assay followed by flow cytometry. Expression of apoptosis- and cell cycle-related genes was measured by reverse transcription of mRNA followed by filter hybridization to arrays of probes and detection by chemiluminescence. RESULTS: In each case, the four herbal extracts were equally cytotoxic to H69 and H69VP and less cytotoxic to BEAS-2. All four extracts induced DNA fragmentation in the lung carcinoma cells. The kinetics showed DNA fragments released to the medium (an indication of necrosis) in GLYC-exposed cultures, but inside the cells (an indication of apoptosis) in OLEN-, SPES- and PC-SPES-exposed cultures. TUNEL analysis confirmed that exposure to the latter three extracts, but not to GLYC, led to apoptosis. Compared to untreated and GLYC-treated cells, H69 and H69VP cells treated with OLEN, SPES and PC-SPES showed elevated expression of a number of genes involved in the apoptotic cascade, similar to cells treated with etoposide and vincristine. CONCLUSION: The Chinese herbal medicine extracts OLEN, SPES and PC-SPES are cytotoxic to both drug-resistant and drug-sensitive lung cancer cells, show some tumor cell specificity compared to their effect on normal cells, and are proapoptotic as measured by DNA breaks and gene expression. The reaction of the tumor cells to these extracts was similar to their reaction to conventional chemotherapeutic drugs.

5861.      Seetharam YN, Murthy NS, Vijay. Screening for phenols from few medicinal plants. Asian J Chem. 2001; 13(2), 768-70.
Phenols are very important, biologically active constituents, known for their antifungal and antiallergic properties. In the study well known medicinal plants used in various systems of medicine to cure different ailments wee screened qualitatively by using  chromatographic method and estimated quantitatively by spectrophotometric studies.

5862.      Sehrawat AR, Uppal S, Punai A. In vitro culture and multiplication of  Rauwolfia serpentina – a threatened medicinal plant. Crop Res. 2001; 22(1), 68-71.
Effects of different combinations of plant growth regulators on callus induction and formation of multiple shoots from various explants of Rauwolfia serpentina were studied. Maximum callus induction (91.66%) was found on MS basal medium containing 2, 4-D (2.0 mg/l) and BAP (0.2 mg/l) when leaf was the explant. Callus growth could be improved with adequate concentrations of auxin and cytokinin to MS medium without the addition of casein hydrolysate, coconut milk and yeast extract. Multiple shoots (2-4) were induced from the shoot apices and nodal segmetns on MS medium supplemented with BAP and NAA. A substantial positive correlation between biomass and crude alkaloid fraction (CAF) indicated an increase in alkaloid accumulation. Medium optimization may thus lead to enhancement of tissue culture response and alkaloid contents of sarpagandha.


5863.           Sehrawata A R, Uppal S, Punai A. In vitro culture and multiplication of Rauwolfia serpentia-a threatened medicinal plant. Crop Res. 2001; 22(1), 68-71.
Effects of different combinations of plant growth regulators on callus induction and formation of multiple shoots from various explains of Rauwolfia serpentina were studied. Maximum callus induction (91.66%) was found on MS basal medium containing 2, 4-D (2.0 mg/l) and BAP (0.2 mg/l) when leaf was the explant. Callus growth could be improved with adequate concentration of auxin and cytokinin to MS medium without the addition of casein hydrolysate, coconut milk and yeast extract. Multiple shoots (2-4) were induced from the shoot apices and nodal segments on MS medium supplemented with BAP and NAA. A  substantial positive correlation between biomass and crude alkaloid fraction (CAF) indicated an increase in alkaloid accumulation. Medium optimisation may thus lead to enhanced of tissue culture response and alkaloid contents of sarpagandha.

5864.           Shah L P; Patil S P; Patil J. Observations on Clinical evaluation of indigenous herbal drugs in the treatment of mental illnesses. Indian Journal of Pharmacology. 1997 Oct; 29(5): 347-9
ABSTRACT: Ayurvedic literature describes psychotropic properties of many herbs. In recent years they have been evaluated for efficacy and safety by using modern methods of human pharmacological investigations. The article describes the observations of the authors while conducting clinical trials of some of the compounds claimed to have psychotropic properties.

5865.           Shiva KN, Nair SA, Sharma TVRS. Scope of intercropping of commercially viable medicinal plants with coconut for higher ecnomic returns at Andamans. Indian J. Arecanut Spices Medicinal Pl. 2001; 3(2), 62-3. No abstract.

5866.           Singh PK, Khan SN. Mycoflora and mycotoxins in medicinal fruit/seed of forestry origin. Indian For. 2001; 127(7), 770-6.
Fruit/seed of seven medicinal plants namely Aegel marmelos, Azadirachta indica, Emblica of officinalis, Plantago ovata, Terminalia bellirica, T. chebula and Vitex negundowere examined for their susceptibility to mould invasion and elaboration of mycotoxins. Fifteen fungi were found associated with seed samples. 23-40% of the isolated fungi were species of Aspergillus, Fusarium and Penicillium. The strains of A. flavus thus obtained were screened for aflatoxin producing potential. It was found that almost 30% of these isolated elaborated aflatoxin. Natural occurrence of aflatoxin contamination was also determined in these medicinal seeds. Aegle marmelos was found to be most suitable substrate for elaboration of aflatoxins whereas no traces of aflatoxin were detected in P. ovata.

5867.           Singh RB, Singh Y. Preliminary observations on the ethnomedicinal plants on Indo-Nepal border (Champaran), Bihar. Mendel 2001; 18(3):87-9.
Ethnomedicinal study was made among tribals of Indo-Nepal border (Champaron), Bihar. The investigators collected informations from various tribal communities about their medical practices. Vernacular name, botanical name, family, plant parts of medicinal use and methods of administration

5868.           Singh Y; Muruganandam AV; Das SN; Rao AT; Agrawala SK. Reno-protective action of a herbal formulation (ELKP-1) in cisplatin-induced nephrotoxicity Phytomedica. 1999 Mar; 20(1&2): 37-41


ABSTRACT: ELKP-1, a polyherbal formulation manufactured by Indian Herbs, Saharanpur, is recommended for the treatment of renal disorders. In the present study, effect of ELKP-1 on cisplatin-induced nephrotoxicity was evaluated in rats. ELKP-1 (50 mg/kg, p.o. five days treatment) showed significant nephroprotection against cisplatin-induced nephrotoxicity as evidenced by decreased levels of blood urea nitrogen (BUN) and creatinine in ELKP-1 treated rats in comparison to only cisplatin treated control rats. Histopathological studies also confirmed the renoprotective action of ELKP-1 against cisplatin-induced renal damage. Cisplatin-induced nephrodegenerative signs, viz., ischaemia, vacuolar appearance, swelling and pyknotic nuclei of glomeruli were not observed in the ELKP-1 treated rats. Nephroprotective action of ELKP-1 with a wide safety margin and without any side effects merits its use in the renal disorders.

5869.           Sudha CG, Seeni S. Establishment and snalysis of fast-growing normal root culture of decalepis arayalpathra, a rare endemic medicinal plant. Curr Sci. 2001; 81(4), 371-4.
Fast growing normal root culture of Decalepis arayalpathra, a rare endemic medicinal plant was establish from leaf and inter nodal explants of in vitro-raised shoot cultures in Murashige and Skoog (MS) medium containing 2.5 mg/l 6-benzyladenine (BA), 0.5 mg/l 2-isopentenylademine (2-ip) and 0.5 mg/l a-napthaleneacetic acid (NAA). Shoot cultures were maintained on MS agar medium supplemented with 0.5 mg/l BA and 0.05 mg/l 2-ip or and 0.05 mg/l NAA and subcultured in  at 5-week interval. Leaf explants incubated in total darkness in half strength MS medium supplemented with 0.5 mg/l IBA and 0.2 mg/l NAA favoured induction of roots in 89% of the cultures with highest biomess of roots (5.820 g). A 100 mg fresh root tissue cultured in 80 ml  half-strength MS liquid medium supplemented with 0.2 mg/l IBA and ) 0.1 mg/l NAA, under continuous agitation (80 rpm), yielded 3.433 g and 0.734 g fresh and dry weight of roots, respectively. Root grown in this optimal medium produced maximum compound, 2-hydroxy-4-methoxy benzaldehyde (0.16%) after 6 week of culture. The root culture were maintained up to the 7th passage without decline of growth.

5870.           Vaishnav R. an example of the toxic potential of traditional eye cosmetics. Indian J Pharmac. 2001; 33(1), 46-8. no abstract.

5871.           Vyhnalek J; Hera. Efficacy of neblon powder : an antidiarrhoeal herbal preparation. Indian Journal of Indigenous Medicine. 1994 Mar; 10(2): 21-5


ABSTRACT: NEBLON powder, an exclusively herbal product of INDIAN HERBS, India was evaluated in three different experiments. It was therapeutically applied to 150 calves and kids with clinical signs of ailments of the gastrointestinal tract only, and in a smaller number of cases accompanied with problems of the respiratory system. For prevention of regular incidence of post-weaning diarrhoea, NEBLON was used on 60 piglets at the time of weaning. In both the preventive and therapeutic applications, very good results were achieved with NEBLON in gastrointestinal tract ailments. The rare instances of failure were caused by unsuccessful treatment of complications due to aliments of respiratory system. Animals willingly ingested NEBLON in both individual as well as mass applications. Because the use of NEBLON does not require a withdrawal period, this product has all the qualities necessary for successful use in regular farm work and even for ecological farming.


5872.      Kirby BJ. Safety of homeopathic products. J R Soc Med  2002 May;95(5):221-2 No abstract.

5873.      Thompson EA, Reillly D. The homeopathic approach to symptom control in the cancer patient: a prospective observational study. Palliat Med  2002 May;16(3):227-33 

The aims of this study were to describe a population of patients with cancer referred for complementary therapies to an NHS homeopathic hospital, and to explore the homeopathic approach to symptom control and its impact on mood disturbance and quality of life. One hundred consecutive patients attending a designated research cancer clinic were seen for a consultation, lasting up to 60 min, and prescription of a homeopathic remedy. A maximum of three symptoms were identified and rated by the patient as a problem, using a numerical self-rating scale. The effect these symptoms have on daily life and overall sense of well being were recorded using similar scales. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the European Organization for Research and Treatment in Cancer--Quality of Life Questionnaire--Core 30 (EORTC QLQ-30) at the initial consultation and at four to six consultations later. After this time, the patients completed a final assessment questionnaire asking about satisfaction with the homeopathic approach, how helpful they had found the approach for the targeted symptoms and what factors they felt may have contributed to the changes perceived. One hundred patients were entered into the study. Thirty-nine patients had metastatic disease. Nine patients were refusing conventional cancer treatments. The most common symptoms were pain, fatigue and hot flushes. Symptom scores for fatigue and hot flushes improved significantly over the study period but not for pain scores. Side effects included a transient worsening of symptoms in a few cases, which settled on stopping the remedy. Fifty-two patients completed the study, and in those patients satisfaction was high, and 75% (n=38) rated the approach as helpful or very helpful for their symptoms. Results suggest that further research is warranted to explore the management of hot flushes in women with breast cancer and fatigue in the cancer diagnosis.



5874.      Gonsalkorale WM, Houghton LA, Whorwell PJ. Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness. Am J Gastroenterol  2002 Apr;97(4):954-61.


OBJECTIVES: Hypnotherapy has been shown to be effective in the treatment of irritable bowel syndrome in a number of previous research studies. This has led to the establishment of the first unit in the United Kingdom staffed by six therapists that provides this treatment as a clinical service. This study presents an audit on the first 250 unselected patients treated, and these large numbers have also allowed analysis of data in terms of a variety of other factors, such as gender and bowel habit type, that might affect outcome. METHODS: Patients underwent 12 sessions of hypnotherapy over a 3-month period and were required to practice techniques in between sessions. At the beginning and end of the course of treatment, patients completed questionnaires to score bowel and extracolonic symptoms, quality of life, and anxiety and depression, allowing comparisons to be made. RESULTS: Marked improvement was seen in all symptom measures, quality of life, and anxiety and depression (all ps < 0.001), in keeping with previous studies. All subgroups of patients appeared to do equally well, with the notable exception of males with diarrhea, who improved far less than other patients (p < 0.001). No factors, such as anxiety and depression or other prehypnotherapy variables, could explain this lack of improvement. CONCLUSIONS: This study clearly demonstrates that hypnotherapy remains an extremely effective treatment for irritable bowel syndrome and should prove more cost-effective as new, more expensive drugs come on to the market. It may be less useful in males with diarrhea-predominant bowel habit, a finding that may have pathophysiological implications.



5875.      Quittan M. Management of back pain. Disabil Rehabil 2002 May 20;24(8):423-34


PURPOSE: Low back pain (LBP) constitutes one of the most difficult and costly medical problems in industrial countries, with a prevalence of 25 to 30% in an adult lifetime span and an incidence of about 5% per year. METHOD: Based on risk factors cited in the pertinent literature, the evaluation, diagnosis and therapeutic options for LBP are outlined. Especially the latter can be highlighted on the basis of a large number of systematic reviews. RESULTS: Bed rest is no longer regarded as an effective treatment for episodes of acute LBP, except when the patient has evident clinical signs of nerve root compression. Exercise therapy comprises a wide range of concepts and underlying physiological principles. Different concepts are discussed. Evidence suggests no specific effects of exercise therapy in acute LBP. In chronic LBP, exercise as well as combined treatment with several modalities appear to be superior to conventional medical care. In the past decade, reconditioning of the paraspinal muscles is being given increasing importance in research. Several studies indicate the effectiveness of vigorous strengthening of paraspinal and trunk muscles on pain and even disc surgery. Different underlying pathologies seem to respond equally well to this concept. Back school concepts are not proven to have long-term effects on LBP. The literature on electrotherapy and massage in LBP is generally sparse. Nevertheless, some studies suggest the effectiveness of electrotherapy on pain reduction at least in the short term. Spinal mobilization seems to be effective in reducing pain. CONCLUSION: Based on these evidence-based conclusions, the patient's medical history, the investigation and the diagnosis the clinician has to devise an individual treatment plan that takes the deficiencies and requirements of the patient into account.


5876.           Anoop A; Jegadeesan M; Subramaniam S. Toxicological studies of lingha chendooram-1; a siddha drug Indian Journal of Pharmaceutical Sciences. 2002 Jan-Feb; 64(1): 53-8


ABSTRACT: Lingha chendooram-1, a widely used Siddha drug was evaluated for acute, sub-acute and chronic toxicity in rats with reference to histopathological, haematological, parameters and detection of mercury from the tissues of liver and kidney. The drug showed acute toxicity from 100 mg onwards. But it produced sub-acute and chronic toxic effects from 50 mg onwards and elevation in blood urea level. Feed and water intake failed to reveal any marked changes in sub-acute and chronic toxicity studies. Mercury was detected from 75 mg with concurrent increase in dose in both sub-acute and chronic toxicity studies. The histopathological lesions were non-specific when compared to microscopic changes along with the drug dosages. In the present study the drug possessed no toxic effect below 20 mg.

Traditional Medicine:

5877.      Fields JZ, Walton KG, Schneider RH, Nidich S, Pomerantz R, Suchdev P, Castillo-Richmond A, Payne K, Clark ET, Rainforth M. Effect of a multimodality natural medicine program on carotid atherosclerosis in older subjects: a pilot trial of Maharishi Vedic Medicine. Am J Cardiol 2002 Apr 15;89(8):952-8


Although the onset and progression of coronary heart disease (CHD) involve multiple risk factors, few intervention studies have attempted to modify these factors simultaneously. This pilot study tested the effect of a multimodality intervention involving dietary, exercise, herbal food supplement, and stress reduction approaches from a traditional system of natural medicine, Maharishi Vedic Medicine (MVM). The primary outcome measure was carotid intima-media thickness (IMT), a noninvasive measure of peripheral atherosclerosis and surrogate measure of coronary atherosclerosis. Comparison groups included modern medicine (conventional dietary, exercise, and multivitamin approaches) and usual care (no added intervention). Of 57 healthy seniors (mean age 74 years) randomized to the 3 treatment groups, 46 completed IMT post-testing. Carotid IMT was determined by B-mode ultrasound before and after 1 year of treatment. IMT decreased in a larger fraction of MVM subjects (16 of 20) than in the modern (5 of 9) and usual care (7 of 14) groups combined (i.e., 12 of 23; odds ratio 3.7, p = 0.05). For subjects with multiple CHD risk factors ("high-risk" subjects, n = 15), IMT decreased more in the MVM (-0.32 +/- 0.23 mm, mean +/- SD) than in the usual care (+0.022 +/- 0.085; p = 0.009) or modern (-0.082 +/- 0.095, p = 0.10) groups. Within-group reductions in IMT were significant for all MVM subjects (-0.15 +/- 0.21, n = 20, p = 0.004) and for high-risk MVM subjects (n = 6, p = 0.01). These results show that this multimodality traditional approach can attenuate atherosclerosis in older subjects, particularly those with marked CHD risk.

5878.      Niagia SF. Traditional medicine gets healthy recognition. Lancet  2002 May 18;359(9319):1760  No abstract.

5879.      Tang W. Recent advances in antineoplastic principles of Traditional Chinese Medicine. Pharmazie  2002 Apr;57(4):223-32 No abstract.



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