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1.
Factors determining the use of hormonal therapy and phytotherapy in Spanish postmenopausal women.
Mendoza, N, Hernández, C, Cornellana, MJ, Carballo, A, Llaneza, P, Harvey, X, Palacios, S, ,
Climacteric : the journal of the International Menopause Society. 2016;(4):375-80
Abstract
OBJECTIVE To identify women's sociodemographic and variables related to health care with the prescription of hormonal therapy (HT) and phytotherapy (PT) in Spanish postmenopausal women. METHOD The survey consisted of a multicenter, observational, cross-sectional, questionnaire-based investigation and was conducted among 3022 postmenopausal women. RESULTS Of all the women, 31.8% reported the use of systemic HT or PT sometime in their lives. Hot flushes and information received about menopause were the most important variables that influence HT and PT use, although far more intense symptoms were observed in those who were inclined to use HT. The use of HT or PT was more frequently reported among women with high levels of education, who came from private clinics and lived in urban areas. Women who had primary ovarian insufficiency or surgical menopause were inclined to use HT. CONCLUSION Hot flushes and information received about menopause are the most important variables that influence HT and PT use.
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2.
Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience.
Waissengrin, B, Urban, D, Leshem, Y, Garty, M, Wolf, I
Journal of pain and symptom management. 2015;(2):223-30
Abstract
CONTEXT The use of the cannabis plant (Cannabis sativa L.) for the palliative treatment of cancer patients has been legalized in multiple jurisdictions including Israel. Yet, not much is currently known regarding the efficacy and patterns of use of cannabis in this setting. OBJECTIVES To analyze the indications for the administration of cannabis among adult Israeli cancer patients and evaluate its efficacy. METHODS Efficacy and patterns of use of cannabis were evaluated using physician-completed application forms, medical files, and a detailed questionnaire in adult cancer patients treated at a single institution. RESULTS Of approximately 17,000 cancer patients seen, 279 (<1.7%) received a permit for cannabis from an authorized institutional oncologist. The median age of cannabis users was 60 years (range 19-93 years), 160 (57%) were female, and 234 (84%) had metastatic disease. Of 151 (54%) patients alive at six months, 70 (46%) renewed their cannabis permit. Renewal was more common among younger patients and those with metastatic disease. Of 113 patients alive and using cannabis at one month, 69 (61%) responded to the detailed questionnaire. Improvement in pain, general well-being, appetite, and nausea were reported by 70%, 70%, 60%, and 50%, respectively. Side effects were mild and consisted mostly of fatigue and dizziness. CONCLUSION Cannabis use is perceived as highly effective by some patients with advanced cancer and its administration can be regulated, even by local authorities. Additional studies are required to evaluate the efficacy of cannabis as part of the palliative treatment of cancer patients.
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3.
Hypericum perforatum and neem oil for the management of acute skin toxicity in head and neck cancer patients undergoing radiation or chemo-radiation: a single-arm prospective observational study.
Franco, P, Potenza, I, Moretto, F, Segantin, M, Grosso, M, Lombardo, A, Taricco, D, Vallario, P, Filippi, AR, Rampino, M, et al
Radiation oncology (London, England). 2014;:297
Abstract
BACKGROUND Radiation dermatitis is common in patients treated with combined radiotherapy and chemotherapy for head and neck malignancies. Its timely and adequate management is of uttermost importance for both oncological outcomes and global quality of life. We prospectively evaluated the role of hypericum perforatum and neem oil (Holoil®; RIMOS srl, Mirandola, Italy) in the treatment of acute skin toxicity for patients undergoing radiotherapy or chemo-radiotherapy for head and neck cancer. METHODS A consecutive series of 28 head and neck cancer patients submitted to radiotherapy (RT) was enrolled onto this mono-institutional single-arm prospective observational study. Patients undergoing both definitive or post-operative radiotherapy were allowed, either as exclusive modality or combined with (concomitant or induction) chemotherapy. We started Holoil treatment whenever bright erythema, moderate oedema or patchy moist desquamation were observed. Holoil® was used during all RT course and during follow up time, until acute skin toxicity recovery. RESULTS The maximum detected acute skin toxicity was Grade 1 in 7% of patients, Grade 2 in 68%, Grade 3 in 25%, while at the end of RT was Grade 0 in 3.5%, Grade 1 in 32%, Grade 2 in 61%, Grade 3 in 3.5%. For patients having G2 acute skin toxicity, it mainly started at weeks 4-5; for those having G3, it began during weeks 5-6. Median times spent with G2 or G3 toxicity were 17.5 and 11 days. Patients having G2 acute skin toxicity had a dermatitis worsening in 27% of case (median occurrence time: 7 days). G3 events were reconverted to a G2 profile in all patients (median time: 7 days). Those experiencing a G2 skin event were converted to a G1 score in 23% of cases (median time: 14 days). Time between maximum acute skin toxicity and complete skin recovery after RT was 27 days. CONCLUSIONS Holoil® proved to be a safe and active option in the management of acute skin toxicity in head and neck cancer patients submitted to RT or chemo-radiotherapy. A prophylactic effect in the prevention of moist desquamation may be hypothesized for hypericum and neem oil and need to be tested within a prospective controlled study.
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4.
Traditional Chinese medicine for idiopathic precocious puberty: A hospital-based retrospective observational study.
Yu, CH, Liu, PH, Van, YH, Lien, AS, Huang, TP, Yen, HR
Complementary therapies in medicine. 2014;(2):258-65
Abstract
OBJECTIVES To characterize the application of traditional Chinese medicine (TCM) among children with idiopathic precocious puberty (IPP). DESIGN AND SETTING This study examined data sets from patients diagnosed with IPP at Chang Gung Memorial Hospital between 2010 and 2012. The patients were allocated into three groups according their voluntary choice of treatment modalities: TCM users (received TCM treatment only), Western medicine (WM) users (received WM treatment only), and "no treatment" group (received no medical treatment at all). MAIN OUTCOME MEASURES The demographic data of children with IPP were characterized. The prescription patterns and frequencies of TCM for IPP patients were analyzed. The patients' bone maturation rates and the change of predicted height after different approaches were measured as outcomes. RESULTS There were 3390 patients enrolled in the study. Zhi-Bai-Di-Huang-Wan (70.62%) was the most common herbal formula and Mai-Ya (Hordei Fructus Germinatus) (51.58%) was the most common single herb prescribed for IPP in all of the 2784 prescriptions. The bone maturation rates of TCM users (0.95±0.20) and WM users (0.69±0.05) were both decelerated but the "no treatment" group had an accelerated bone maturation rate of 1.33±0.04. TCM and WM users also had higher predicted height after treatment (1.15±1.19cm versus 1.73±0.29cm), while the "no treatment" group had a decreased predicted height (-0.52±0.23cm). CONCLUSIONS Our study revealed a comprehensive list of TCM prescriptions for IPP patients. Future well-designed, randomized, double-blinded, and placebo-controlled clinical trials are warranted to evaluate the efficacy and safety of TCM for precocity.
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5.
A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain.
Conrozier, T, Mathieu, P, Bonjean, M, Marc, JF, Renevier, JL, Balblanc, JC
Alternative therapies in health and medicine. 2014;:32-7
Abstract
BACKGROUND Devil's claw (Harpagophytum procumbens), turmeric (Curcuma longa), and bromelain are nutraceuticals that have demonstrated anti-inflammatory and analgesic properties and may be potential solutions in the treatment of acute or chronic joint pain. Their analgesic effect, however, is generally considered mild to moderate, and the relevance of their clinical use remains subject to discussion. OBJECTIVES The aim of the study was to evaluate the clinical relevance of the efficacy of a marketed complex of 3 plant extracts-H procumbens, C longa, and bromelain (AINAT, 650 mg)-in the treatment of degenerative joint pain. METHODS A multicenter, observational, prospective, open-label survey was conducted in 8 rheumatology centers. The study included 2 groups, 1 group with participants suffering from chronic osteoarthritis (OA) pain and 1 group suffering from acute OA pain. SETTING The research team carried out the study under daily practice conditions. PARTICIPANTS A total of 42 patients (36 women; mean age = 67 y) suffering from acute or chronic, degenerative spine or joint pain participated. INTERVENTION Two 650-mg capsules of AINAT were administered 3 ×/d to patients with acute pain and 2 ×/d to patients with chronic pain. OUTCOME MEASURES At baseline, and during a follow-up visit at 15 d for the acute pain group and 60 d for the chronic pain group, the research team obtained each participant's global assessment (PGA) and each rheumatologist's global assessment (RGA), as well as each participant's pain score, using for each of them a 100-mm visual analogue scale (VAS). The clinical relevance of the efficacy was evaluated by comparing the outcome measures at endpoint to the values defining the patient acceptable symptom state (PASS) and by comparing the variations (in mm and %) between baseline and endpoint to those defining the minimal clinically important improvement (MCII). Tolerance was also assessed by collecting adverse events at each visit and by using a 4-point scale (very good to bad) at the endpoint. RESULTS At baseline, the VAS pain score (standard deviation) was 69.1 mm (15.4) and 68.0 mm (18.2) for patients with acute and chronic pain, respectively. At the endpoint, the scores decreased to 42.1 mm (21.1) and 37.8 mm (25.9), respectively. This reduction of pain, as a percentage as well as an absolute value, corresponds to the required definition of MCII, particularly in patients with chronic joint pain. At the endpoint, most of the patients in both groups reached the level of pain defined as the PASS. No withdrawals occurred due to treatment side effects. CONCLUSION The improvement of joint pain was clinically relevant in patients treated with AINAT for both acute and chronic OA pain. Considering its excellent tolerance profile, the tested complex of 3 plant extracts with antiinflammatory properties may be a valuable and safe alternative to NSAIDs in patients suffering from degenerative joint diseases.
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6.
An 84-month observational study of the changes in CD4 T-lymphocyte cell count of 110 HIV/AIDS patients treated with traditional Chinese medicine.
Wang, J, Liang, B, Zhang, X, Xu, L, Deng, X, Li, X, Fang, L, Tan, X, Mao, Y, Zhang, G, et al
Frontiers of medicine. 2014;(3):362-7
Abstract
This study aimed to evaluate the therapeutic effect of traditional Chinese medicine (TCM) by observing the changes in CD4 T-lymphocyte cell count of 110 cases with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) treated continuously with TCM for 84 months. Information of 110 HIV/AIDS patients from 19 provinces and cities treated with TCM from 2004 to 2013 was collected. Changes in the indexes of CD4 counts ( ≤ 200, 201-350, 351-500 and > 500 cells/mm(3)) at five time points (0, 12, 36, 60 and 84 months) and different treatments [TCM and TCM plus antiretroviral therapy (ART)] were compared. Repeated measures test indicated no interaction between group and time (P > 0.05). Degrees of increasing and decreasing CD4 count of the two groups at four different frames were statistically significant compared with the baseline. The CD4 count between the two groups was not statistically significant. For CD4 count of ≤ 200 cells/mm(3), the mean CD4 count changes were 21 and 28 cells/mm(3) per year for the TCM group and TCM plus ART group, respectively. For CD4 count of 201-350 cells/mm(3), the mean CD4 count changes were 6 and 25 cells/mm(3) per year for the TCM group and TCM plus ART group, respectively. For CD4 count of 351-500 cells/mm(3), the mean CD4 count changes were -13 and -7 cells/mm(3) per year for the TCM group and TCM plus ART group, respectively. For CD4 count of > 500 cells/mm(3), the mean CD4 count changes were -34 and -17 cells/mm(3) per year for the TCM group and TCM plus ART group, respectively. Long-term use of TCM could maintain or slow the pace of declining CD4 counts in patients with HIV/AIDS, and may achieve lasting effectiveness.
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7.
Ayahuasca-assisted therapy for addiction: results from a preliminary observational study in Canada.
Thomas, G, Lucas, P, Capler, NR, Tupper, KW, Martin, G
Current drug abuse reviews. 2013;(1):30-42
Abstract
INTRODUCTION This paper reports results from a preliminary observational study of ayahuasca-assisted treatment for problematic substance use and stress delivered in a rural First Nations community in British Columbia, Canada. METHODS The "Working with Addiction and Stress" retreats combined four days of group counselling with two expert-led ayahuasca ceremonies. This study collected pre-treatment and six months follow-up data from 12 participants on several psychological and behavioral factors related to problematic substance use, and qualitative data assessing the personal experiences of the participants six months after the retreat. FINDINGS Statistically significant (p < 0.05) improvements were demonstrated for scales assessing hopefulness, empowerment, mindfulness, and quality of life meaning and outlook subscales. Self-reported alcohol, tobacco and cocaine use declined, although cannabis and opiate use did not; reported reductions in problematic cocaine use were statistically significant. All study participants reported positive and lasting changes from participating in the retreats. CONCLUSIONS This form of ayahuasca-assisted therapy appears to be associated with statistically significant improvements in several factors related to problematic substance use among a rural aboriginal population. These findings suggest participants may have experienced positive psychological and behavioral changes in response to this therapeutic approach, and that more rigorous research of ayahuasca-assisted therapy for problematic substance use is warranted.