Description

The journal includes observational and analytical reports on treatments outside the realm of allopathic medicine which are gaining interest and warranting research to assess their therapeutic value. It includes current concepts in clinical care, including case reports that will be valuable for health care professionals and scientists who are seeking to evaluate and integrate these therapies into patient care protocols and research strategies.

Publisher details

Mary Ann Liebert

Publications in this journal

• Decontextualized Versus Lived Worlds: Critical Thoughts on the Intersection of Evidence, Lifeworld, and Values.

  Authors: Jeff Flatt

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Background: Numerous studies and trials are conducted under the evidence-based complementary and alternative medicine (EBCAM) paradigm. Some individuals view the results generated by thisAbstract Background: Numerous studies and trials are conducted under the evidence-based complementary and alternative medicine (EBCAM) paradigm. Some individuals view the results generated by this approach as symbolic evidential proof of complementary medicine, and as representative of practice. Such evaluations are made even though the ability to capture and reflect clinical reality by the methods used is questioned. The effect of this type of research on complementary medicine researchers and practitioners has received minimal consideration, and this article explores this subject by critically reviewing the literature and theorizing the effects on the lifeworld and values of those embodied by EBCAM. Methods: This review accesses the discourse of various disciplines involved with, and commenting on, complementary medicine research. Collected literature is collated within specified limits, subjected to argumentation analysis, and synthesized within a critical theory methodology. Emergent themes are examined, and the effects of EBCAM on holistic researcher and practitioner lifeworld and values are theorized via the colonization framework of critical social theorist Jürgen Habermas. Results: The use of an evidence-based medicine research model to investigate complementary medicine practice is not well regarded by those who critically examine its use. Within a critical theory framework, the generation and application of research resulting from EBCAM is viewed as a philosophically incongruent process arising from a dominative discourse that can colonize lifeworld. This can result in a variety of pathological symptoms that may have a detrimental effect. Conclusions: The application of EBCAM has the theoretical potential to damage complementary medicine culture, profession, and practice. Its ongoing use requires thought, attention, and careful revision, taking into account the lifeworld and values of researchers and practitioners. If this inclusive view can occur, knowledge generation with relevance to the whole of the professions could proceed.

• Portrayal of Complementary and Alternative Medicine for Cancer by Top Online News Sites.

  Authors: Alexandra Price, Victor R Grann

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Background: Medical research news provided through the World Wide Web is easily accessible to the general public. Thus, it is necessary to understand how research findings released fromAbstract Background: Medical research news provided through the World Wide Web is easily accessible to the general public. Thus, it is necessary to understand how research findings released from online news sources are portrayed. Methods: The sample includes articles (n=205) published between January 1, 2010 and June 18, 2010 in top online news sites with competitive traffic rankings in the United States as determined by Alexa.com . Google Reader was used to find health-related news articles corresponding to the relevant news sources. Data analysis was performed using SPSS with two-tailed significance values of the χ(2) statistic. Results: A content analysis (n=205 stories) revealed that the majority of complementary and alternative medicine (CAM) modalities for cancer discussed in top online news sources are classified as nutritional therapeutics, and the cancer topic that appeared most frequently was that of prevention. General oncology was the most frequently cited cancer type that was discussed with regard to CAM. Medical journals were the most frequently cited source in CAM/cancer news articles. The majority of news stories on CAM/cancer were neutral in tone, and the relationship between tone and evidence type reported was statistically significant. Observational studies rather than randomized controlled trials were the predominant form of evidence provided for research findings. Conclusions: Overall, the quality of how online news sources report research findings on complementary and alternative medicine therapies for cancer is fairly high. However, certain top online media sources are more reliable and informative than others when it comes to reporting about CAM remedies for cancer.

• The Mismatch Between Personal Experience of Healing (in Patient or Therapist) and Currently Accepted Forms of Evidence.

  Authors: Thomas Whitmarsh

  Journal of alternative and complementary medicine (New York, N.Y.).

• Utilization of Group-Based, Community Acupuncture Clinics: A Comparative Study with a Nationally Representative Sample of Acupuncture Users.

  Authors: Maria T Chao, Kimberly M Tippens, Erin Connelly

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: Acupuncture utilization in the United States has increased in recent years, but is less common among racial/ethnic minorities and those of low socioeconomic status. Group-based,Abstract Objectives: Acupuncture utilization in the United States has increased in recent years, but is less common among racial/ethnic minorities and those of low socioeconomic status. Group-based, community acupuncture is a delivery model gaining in popularity around the United States, due in part to low-cost treatments provided on a sliding-fee scale. Affordable, community-based acupuncture may increase access to health care at a time when increasing numbers of people are uninsured. To assess the population using local community acupuncture clinics, sociodemographic factors, health status, and utilization patterns compared to national acupuncture users were examined. Design: Data were employed from (1) a cross-sectional survey of 478 clients of two community acupuncture clinics in Portland, Oregon and (2) a nationally representative sample of acupuncture users from the 2007 National Health Interview Survey. Results: Portland community acupuncture clients were more homogeneous racially, had higher educational attainment, lower household income, and were more likely to receive 10 or more treatments in the past 12 months (odds ratio=5.39, 95% confidence interval=3.54, 8.22), compared to a nationally representative sample of U.S. acupuncture users. Self-reported health status and medical reasons for seeking acupuncture treatment were similar in both groups. Back pain (21%), joint pain (17%), and depression (13%) were the most common conditions for seeking treatment at community acupuncture clinics. Conclusions: Study findings suggest that local community acupuncture clinics reach individuals of a broad socioeconomic spectrum and may allow for increased frequency of treatment. Limited racial diversity among community acupuncture clients may reflect local demographics of Portland. In addition, exposure to and knowledge about acupuncture is likely to vary by race and ethnicity. Future studies should examine access, patient satisfaction, frequency of treatment, and clinical outcomes of group-based models of community acupuncture clinics located in racially and socioeconomically diverse communities.

• Anti-Inflammatory Effect of Keigai-rengyo-to Extract and Acupuncture in Male Patients with Acne Vulgaris: A Randomized Controlled Pilot Trial.

  Authors: Kyu Seok Kim, Yoon-Bum Kim

  Journal of alternative and complementary medicine (New York, N.Y.). 18(5):501-8.

  Abstract Objectives: The objectives of this study were to evaluate the efficacy and interaction of Keigai-rengyo-to extract (KRTE) and acupuncture in male patients with acne and the feasibility of aAbstract Objectives: The objectives of this study were to evaluate the efficacy and interaction of Keigai-rengyo-to extract (KRTE) and acupuncture in male patients with acne and the feasibility of a large clinical trial. Design: A randomized, assessor single-blinded, 2×2 factorial trial was conducted. The trial is registered with the Clinical Research Information Service, Republic of Korea: KCT0000071. Subjects: Forty-four (44) participants with acne vulgaris were randomized into one of four groups: waiting list group (WL), KRTE only group (KO), acupuncture only group (AO), and KRTE and acupuncture combined treatment group (KA). Intervention: After randomization, patients in the AO and KA groups underwent eight sessions of acupuncture treatment, twice per week. Patients in the KO and KA groups were prescribed KRTE 3 times daily, 7.4 g each dose, after meals, for 4 weeks. Outcome measures: The following outcome measurements were used in examination of subjects: mean percentage change and the count change of inflammatory and noninflammatory acne lesions, Skindex 29, investigator global assessment from baseline to end of trial, and proportion of dropouts and compliance with KRTE. Results: A significant interaction of KRTE and acupuncture was evident according to mean percent change of inflammatory acne lesions, but not of noninflammatory acne lesions from baseline to the end of the study. Statistically significant differences were observed in the primary effect on mean percent change of noninflammatory acne lesions, not by acupuncture, but by KRTE. Adjusted Skindex 29 score changes indicated no statistically significant reduction within groups and between groups. The improvement rate in patients with KRTE and acupuncture treatment was not significant, compared to patients with no KRTE and acupuncture treatment. The proportion of dropouts was 22.7% and rate of compliance with KRTE was 92.3%. Conclusions: For treatment of acne vulgaris, use of KRTE combined with acupuncture is recommended for inflammatory lesions and KRTE only is recommended for noninflammatory lesions. Further large-scale trials assuming a higher dropout rate and aimed at confirming the ability of KRTE and acupuncture to improve inflammatory and noninflammatory lesions in patients with acne are needed.

• Multiweek resting EEG cordance change patterns from repeated olfactory activation with two constitutionally salient homeopathic remedies in healthy young adults.

  Authors: Iris R Bell, Amy Howerter, Nicholas Jackson, Audrey J Brooks, Gary E Schwartz

  Journal of alternative and complementary medicine (New York, N.Y.). 18(5):445-53.

  Abstract Objectives: Electroencephalography (EEG) offers psychophysiologic tools to improve sensitivity for detecting objective effects in complementary and alternative medicine. This currentAbstract Objectives: Electroencephalography (EEG) offers psychophysiologic tools to improve sensitivity for detecting objective effects in complementary and alternative medicine. This current investigation extended prior clinical research studies to evaluate effects of one of two different homeopathic remedies on resting EEG cordance after an olfactory activation protocol on healthy young adults with remedy-relevant, self-perceived characteristics. Methods: Ninety-seven (7) young adults (N=97, mean age 19 years, 55% women) with good self-rated global health and screened for homeopathic constitutional types consistent with one of two remedies (either Sulphur or Pulsatilla) underwent three weekly laboratory sessions. At each visit, subjects had 5-minute resting, eyes-closed EEG recordings before and after a placebo-controlled olfactory activation task with their constitutionally relevant verum remedy. One remedy potency (6c, 12c, or 30c) used per week, was presented in a randomized order over the 3 sessions. Prefrontal resting EEG cordance values at Fp1 and Fp2 were computed from artifact-free 2-minute EEG samples from the presniffing and postsniffing rest periods. Cordance derives from an algorithm that incorporates absolute and relative EEG values. Results: The data showed significant two-way oscillatory interactions of remedy by time for ß, α, θ, and δ cordance, controlling for gender and chemical sensitivity. Conclusions: EEG cordance provided a minimally invasive technique for assessing objective nonlinear physiologic effects of two different homeopathic remedies salient to the individuals who received them. Time factors modulated the direction of effects. Given previous evidence of correlations between cordance and single-photon emission computed tomography, these findings encourage additional neuroimaging research on nonlinear psychophysiologic effects of specific homeopathic remedies.

• Effects of Acupuncture on the Outcomes of In Vitro Fertilization: A Systematic Review and Meta-Analysis.

  Authors: Fan Qu, Jue Zhou, Ru-Xiang Ren

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: The objective of this article was to conduct a systematic review with meta-analysis of the trials of acupuncture during in vitro fertilization (IVF) or intracytoplasmic spermAbstract Objectives: The objective of this article was to conduct a systematic review with meta-analysis of the trials of acupuncture during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment on the outcomes of clinical pregnancy, biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, and miscarriage. Search strategy: The search was conducted by using MEDLINE(®), SCISEARCH, the Cochrane Menstrual Disorders and Subfertility Group trials register, AMED, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Wanfang Database, China Academic Journal Electronic full text Database in China National Knowledge Infrastructure, Index to Chinese Periodical Literature, ISI Proceedings for conference abstracts, and ISRCTN Register and Meta-register for randomized controlled trials. Data collection and analysis: Study selection, quality appraisal, and data extraction were performed independently and in duplicate. The measures of treatment effect were the pooled relative risks (RR) of achieving clinical pregnancy, biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, or miscarriage for women in the acupuncture group compared with women in the control group. Results: Using the random-effects model, pooling of the effect estimates from all of the 17 trials showed no significant difference in the clinical pregnancy outcome between the acupuncture and the control groups (RR=1.09, 95% confidence interval (CI) 0.94-1.26, p=0.25). No significant differences in the biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, or miscarriage outcomes were found between the acupuncture and the control groups (biochemical pregnancy: RR=1.01, 95% CI 0.84-1.20, p=0.95; ongoing pregnancy: RR=1.20, 95% CI 0.93-1.56, p=0.16; implantation rate: RR=1.22, 95% CI 0.93-1.62, p=0.16; live birth: RR=1.42, 95% CI 0.92-2.20, p=0.11; miscarriage outcomes: RR=0.94, 95% CI 0.67-1.33, p=0.74). Conclusions: No significant benefits of acupuncture are found to improve the outcomes of IVF or ICSI.

• Zingiber officinale (Ginger) as an Anti-Emetic in Cancer Chemotherapy: A Review.

  Authors: Raghavendra Haniadka, Antappa Govindaraju Rajeev, Princy L Palatty, Rajesh Arora, Manjeshwar S Baliga

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Despite significant advances and development of novel anti-emetics, nausea and vomiting (emesis) is a major side-effect of cancer chemotherapy. At times, severe nausea and vomiting may alsoAbstract Despite significant advances and development of novel anti-emetics, nausea and vomiting (emesis) is a major side-effect of cancer chemotherapy. At times, severe nausea and vomiting may also lead to reduction in adherence to the treatment regimen, and this will concomitantly affect the patient's survival. The rhizome of Zingiber officinale, commonly known as ginger, is globally an important spice. It has been used for centuries in the Indian, Chinese, Arabic, Tibetan, Unani, and Siddha systems of traditional medicine to treat nausea and vomiting induced by different stimuli. Preclinical studies with experimental animals (dogs and rats) have shown that the various extracts of ginger and the ginger juice possess anti-emetic effects against chemotherapy-induced nausea and vomiting. Gingerol, the active principle, is also shown to possess anti-emetic effects in minks. However, with regard to humans, while most studies have been supportive of the preclinical observations, a few have been contradictory. The exact mechanism responsible for the anti-emetic effects of ginger is unknown; however, the ginger phytochemicals, especially 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol, may function as a 5-hydroxytryptamine (5-HT3) antagonist, NK1 antagonist, antihistaminic, and possess prokinetic effects. The present review for the first time attempts to address the anti-emetic observations and the variability in response of the anti-emetic effects of ginger in cancer chemotherapy. An attempt is also made to address the lacunae in the published studies and emphasize aspects that need further investigations for ginger to be of use in clinics as an anti-emetic agent in the future.

• Effects of Physical Therapy on Pain and Mood in Patients with Terminal Cancer: A Pilot Randomized Clinical Trial.

  Authors: Nuria López-Sendín, Francisco Alburquerque-Sendín, Joshua A Cleland, César Fernández-de-Las-Peñas

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: The objective of this study was to determine the effects of physical therapy, including massage and exercise, on pain and mood in patients with advanced terminal cancer. Design:Abstract Objectives: The objective of this study was to determine the effects of physical therapy, including massage and exercise, on pain and mood in patients with advanced terminal cancer. Design: The design was a randomized controlled pilot study. Subjects: Twenty-four (24) patients with terminal cancer were randomly assigned to one of two treatment groups. Interventions: Group A received a physiotherapy intervention consisting of several massage techniques, mobilizations, and local and global exercises. Group B received a simple hand contact/touch to areas of pain (cervical area, shoulder, interscapular area, heels, and gastrocnemius), which was maintained for the same period of time as the intervention group. All patients received six sessions of 30-35 minutes in duration over a 2-week period. Outcomes: Outcomes were collected at baseline, at 1 week, and at a 2-week follow-up (after treatment completion) by an assessor blinded to the treatment allocation of the participants. Outcomes included the Brief Pain Inventory (BPI, 0-10 scale), Memorial Pain Assessment Card (0-10 scale), and Memorial Symptom Assessment Scale (MSAS Physical, Psychological, 0-4 scale). Baseline between-group differences were assessed with an independent t-test. A two-way repeated-measures analysis of variance was used to examine the effects of the intervention. Results: There were no significant between-group baseline differences (p>0.2). A significant group×time interaction with greater improvements in group A was found for BPI worst pain (F=3.5, p=0.036), BPI pain right now (F=3.94, p=0.027), and BPI index (F=13.2, p<0.001), for MSAS Psychological (F=8.480, p=0.001). Conclusions: The combination of massage and exercises can reduce pain and improve mood in patients with terminal cancer. A sustained effect on pain and psychologic distress existed; however, parameters such as physical distress and the least pain were no greater in the intervention group as compared to the sham.

• The Effect of Qigong on Menopausal Symptoms and Quality of Sleep for Perimenopausal Women: A Preliminary Observational Study.

  Authors: Shu-Chuan Jennifer Yeh, Mei-Ying Chang

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: The study objectives were to examine the effect of a 12-week 30-minute-a-day Ping Shuai Qigong exercise program on climacteric symptoms and sleep quality in perimenopausal women.Abstract Objectives: The study objectives were to examine the effect of a 12-week 30-minute-a-day Ping Shuai Qigong exercise program on climacteric symptoms and sleep quality in perimenopausal women. Design: This was a prospective observational study. Settings/location: The subjects (N=70) from two communities were women aged 45 years and above who were experiencing menopausal symptoms. Subjects: Thirty-five (35) women from one community were assigned to a Ping Shuai Qigong intervention group, while 35 women from the other community were assigned to the control group. Interventions: This was a 12-week, 30-minute-a-day Ping Shuai Qigong program. Outcome measures: The Greene Climacteric Symptom scale and the Pittsburgh Sleep Quality Index were the outcome measures. Methods: Descriptive analysis and repeated-measures analysis of variance were used. Results: Pretest scores at baseline found no significant group differences in climacteric symptoms or sleep quality. Significant improvements in climacteric symptoms were found at 6 weeks and 12 weeks (t=4.07, p<0.001 and t=11.83, p<0.001) in the intervention group. They were also found to have significant improvements in sleep quality in those times (t=5.93, p<0.001 and t=10.58, p<0.001, respectively). Conclusions: Ping Shuai Qigong improved climacteric symptoms and sleep quality in perimenopausal women at 6 weeks and 12 weeks. The longer a person practiced this form of meditative exercise, the greater the improvement in sleeping quality and climacteric symptoms.

• A Case of Unilateral Pleural Effusion Secondary to Congestive Heart Failure Successfully Treated with Traditional Chinese Herbal Formulas.

  Authors: Han-Dao Lee, Hsien-Hsueh Elley Chiu

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: A case is presented that illustrates the potential effect of traditional Chinese medicine (TCM) herbal formulas on treatment for unilateral pleural effusion secondary toAbstract Objectives: A case is presented that illustrates the potential effect of traditional Chinese medicine (TCM) herbal formulas on treatment for unilateral pleural effusion secondary to congestive heart failure (CHF). Subject: A 79-year-old woman experienced episodic dyspnea with unilateral pleural effusion for 2 years. Thoracocentesis with pleural fluid analysis revealed no infection, tuberculosis, or malignancy. She had received conventional treatment for CHF but the symptoms persisted. Therefore, she visited the authors' TCM clinic for help. Interventions and outcome: This patient was treated with TCM herbal granules including Shengmaisan, Xiebaisan, and Tinglizi, 3 times a day for 4 weeks. The daily dosage was adjusted on the basis of the patient's clinical response and her follow-up chest x-ray studies. After 8 months of treatment, her symptoms improved and the pleural effusion showed significant regression. Conclusions: It is suggested that TCM herbal formulas could play an important role in preventing the progression of unilateral pleural effusion secondary to CHF, in case of poor response to conservative treatment. Additional studies about the mechanism of action of the medication involved are warranted.

• Review of The Medical War Against Chiropractors: The Untold Story from Persecution to Vindication.

  Authors: By James C Smith, Reviewed By Steve Agocs

  Journal of alternative and complementary medicine (New York, N.Y.).

• Effects of an Integrated Approach of Hatha Yoga Therapy on Functional Disability, Pain, and Flexibility in Osteoarthritis of the Knee Joint: A Randomized Controlled Study.

  Authors: John Ebnezar, Raghuram Nagarathna, Bali Yogitha, Hongasandra Ramarao Nagendra

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: The study objectives were to evaluate the efficacy of integrating hatha yoga therapy with therapeutic exercises for osteoarthritis (OA) of the knee joints. Design: This was aAbstract Objectives: The study objectives were to evaluate the efficacy of integrating hatha yoga therapy with therapeutic exercises for osteoarthritis (OA) of the knee joints. Design: This was a prospective, randomized, active controlled trial. Two hundred and fifty (250) participants who had OA knees and who were between 35 and 80 years (yoga 59.56±9.54) and (control 59.42±10.66) from the outpatient department of Ebnezar Orthopedic Center, Bengaluru, were randomly assigned to receive hatha yoga therapy or therapeutic exercises after transcutaneous electrical stimulation and ultrasound treatment (20 minutes per day). Both of the groups practiced supervised interventions (40 minutes per day) for 3 months. One hundred and eighteen (118) (yoga) and 117 (control) subjects were available for the final analysis. Results: There were significant differences within (Wilcoxon's, p<0.001) and between the groups (Mann-Whitney U, p<0.001) on all the variables, with better improvements in the yoga than the control groups. Walking pain in the yoga (37.3%, 64.9%) and control (24.9%, 42%), knee disability in the yoga (59.7%, 83%) and control (32.7%, 53.6%), range of knee flexion in yoga (12.7%, 26.5% right, 13.5%, 28% left) and control (6.9%, 13.3% right, 5.6%, 11.5% left), joint tenderness in yoga (52.3%, 86.1%) and control (28%, 57.1%), swelling in yoga (55.4%, 85.9%) and control (32.1%, 60%), crepitus in yoga (44.0%, 79.9%) and control (27.0%, 47.8%) and walking time in yoga (26.6%, 52.8%) and control (9.3%, 21.6%), all improved more in the yoga than the control groups on the 15th and 90th day, respectively. Conclusions: An integrated approach of hatha yoga therapy is better than therapeutic exercises as an adjunct to transcutaneous electrical stimulation and ultrasound treatment in improving walking pain, range of knee flexion, walking time, tenderness, swelling, crepitus, and knee disability in patients with OA knees.

• Effects of Transcutaneous Electrical Nerve Stimulation on Motion Sickness Induced by Rotary Chair: A Crossover Study.

  Authors: Hsin Chu, Min-Hui Li, Szu-Hsuan Juan, Wen-Yao Chiou

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: Motion sickness (MS) is evoked by the conflict among somatosensory, visual, and vestibular input. Some of the MS symptoms and signs are mediated by activation of the autonomicAbstract Objectives: Motion sickness (MS) is evoked by the conflict among somatosensory, visual, and vestibular input. Some of the MS symptoms and signs are mediated by activation of the autonomic nervous system (ANS). Transcutaneous electrical nerve stimulation (TENS), a maneuver used for pain control, was found to influence cardiovascular responses through ANS reflex, and to enhance motor function, visuospatial abilities, postural control, and cognitive function. The purpose of the present study is to investigate the effects of TENS on MS. Subjects and design: Fifteen (15) healthy young men participated in a within-subjects crossover study. Each completed four test sessions (control, rotation, TENS, TENS+rotation) in randomized order. Rotary chair (120°/s) combined with pitch movement of the subject's head was used as a model to provoke MS. Whole rotation protocol consisted of 5 1-minute rotations, each separated by a 1-minute rest period. TENS protocol involved simultaneous electrical stimulation of posterior neck and Zusanli acupoint. Outcome measures: Motion sickness susceptibility was rated on a standardized questionnaire (Motion Sickness Susceptibility Questionnaire). Motion sickness symptoms, blood pressure (BP), skin temperature, heart rate (HR), and heart rate variability (HRV) were measured. Saliva samples were collected to analyze the level of stress markers. Cognitive function was evaluated with d2 test prior to and after MS provocation. Results: Spinning by itself significantly decreased task response speed and contraction. MS symptom scores, BP, as well as the sympathetic parameter of HRV increased progressively with MS provocation (p<0.05), but skin temperature decreased (p=0.023). Severity of MS symptoms significantly decreased with TENS intervention (p<0.05). After TENS treatment, subjects were able to concentrate better and showed fewer errors in a cognitive test. Salivary cortisol concentration significant decreased after TENS treatment. Conclusions: Sympathetic activity increased but parasympathetic activity decreased during MS. TENS was effective in reducing MS symptoms as well as alleviating cognitive impairment.

• A Comparative Pilot Study of Litholytic Properties of Celosia argental (Sitivaraka) Versus Potassium Citrate in Renal Calculus Disease.

  Authors: Rana G Singh, Takhellambam Brojen Singh, Rakesh Kumar, Udal S Dwivedi, Kanupuri N Moorthy, Neeraj Kumar

  Journal of alternative and complementary medicine (New York, N.Y.).

• Implementation and Acceptability of Mindful Awareness in Body-Oriented Therapy in Women's Substance Use Disorder Treatment.

  Authors: Cynthia J Price, Elizabeth A Wells, Dennis M Donovan, Marissa Brooks

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: The purpose of this study was to examine the implementation and acceptability of Mindful Awareness in Body-oriented Therapy (MABT), a novel adjunctive approach to substance useAbstract Objectives: The purpose of this study was to examine the implementation and acceptability of Mindful Awareness in Body-oriented Therapy (MABT), a novel adjunctive approach to substance use disorder (SUD) treatment. The primary aims of the study were to examine implementation of MABT as an adjunct to addiction treatment, and MABT acceptability to study participants and treatment staff. Methods: MABT was delivered to participants randomly assigned to the intervention in a larger ongoing trial. This study focuses only on the implementation and acceptability of the intervention, as outcomes are not yet available. MABT was delivered once weekly for 8 weeks (1.5-hour sessions) and spanned inpatient and outpatient programs at a women-only treatment facility. Descriptive statistics were used to examine participant recruitment and retention to the intervention. To measure MABT acceptability, survey and written questionnaires were administered; analysis involved descriptive statistics and content analysis using Atlas.ti software. Results: Thirty-one (31) of the women enrolled in the study were randomized to MABT. Eighteen (18) participants completed 75%-100% of the MABT sessions. Intervention implementation required flexibility on the part of both the researchers and the clinic staff, and minor changes were made to successfully implement MABT as an adjunct to usual care. MABT was perceived to increase emotional awareness and provide new tools to cope with stress, and to positively influence SUD treatment by facilitating emotion regulation. Conclusions: It was feasible to implement MABT and to recruit and retain women to MABT in women's chemical-dependency treatment. MABT acceptability and perceived benefit was high.

• Yoga Breathing for Cancer Chemotherapy-Associated Symptoms and Quality of Life: Results of a Pilot Randomized Controlled Trial.

  Authors: Anand Dhruva, Christine Miaskowski, Donald Abrams, Michael Acree, Bruce Cooper, Steffanie Goodman, Frederick M Hecht

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Background: Many debilitating symptoms arise from cancer and its treatment that are often unrelieved by established methods. Pranayama, a series of yogic breathing techniques, may improveAbstract Background: Many debilitating symptoms arise from cancer and its treatment that are often unrelieved by established methods. Pranayama, a series of yogic breathing techniques, may improve cancer-related symptoms and quality of life, but it has not been studied for this purpose. Objectives: A pilot study was performed to evaluate feasibility and to test the effects of pranayama on cancer-associated symptoms and quality of life. Design: This was a randomized controlled clinical trial comparing pranayama to usual care. Setting: The study was conducted at a university medical center. Subjects: Patients receiving cancer chemotherapy were randomized to receive pranayama immediately or after a waiting period (control group). Interventions: The pranayama intervention consisted of four breathing techniques taught in weekly classes and practiced at home. The treatment group received pranayama during two consecutive cycles of chemotherapy. The control group received usual care during their first cycle, and received pranayama during their second cycle of chemotherapy. Outcome measures: Feasibility, cancer-associated symptoms (fatigue, sleep disturbance, anxiety, depression, stress), and quality of life were the outcomes. Results: Class attendance was nearly 100% in both groups. Sixteen (16) participants were included in the final intent-to-treat analyses. The repeated-measures analyses demonstrated that any increase in pranayama dose, with dose measured in the number of hours practiced in class or at home, resulted in improved symptom and quality-of-life scores. Several of these associations-sleep disturbance (p=0.04), anxiety (p=0.04), and mental quality of life (p=0.05)-reached or approached statistical significance. Conclusions: Yoga breathing was a feasible intervention among patients with cancer receiving chemotherapy. Pranayama may improve sleep disturbance, anxiety, and mental quality of life. A dose-response relationship was found between pranayama use and improvements in chemotherapy-associated symptoms and quality of life. These findings need to be confirmed in a larger study.

• Low-Back Pain, Leg Pain, and Chronic Idiopathic Testicular Pain Treated with Chiropractic Care.

  Authors: Robert M Rowell, Steven J Rylander

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: The purpose of this article is to report the case of a patient who had low-back pain, leg pain, and idiopathic chronic testicular pain and who sought chiropractic care for hisAbstract Objectives: The purpose of this article is to report the case of a patient who had low-back pain, leg pain, and idiopathic chronic testicular pain and who sought chiropractic care for his low-back and leg pain and received pain relief including his testicular pain. Subject: A 36-year-old male patient had low-back pain, right leg pain, and testicular pain that was worsening. All had been present for 5 years. He had been seen by several medical physicians and had lumbar magnetic resonance imaging and x-rays performed. All were read as normal. Examination revealed tenderness of the testicles bilaterally with no masses or other abnormality of the testicles or scrotum. Orthopedic and neurological testing was unremarkable. Tenderness rated 8 out of 10 was noted at the L4 spinous process. Intervention: The patient was treated with Cox Technic (flexion-distraction) of the lumbar spine, receiving a total of 19 treatments over an 8-week time period. Results: After 4 weeks, the patient's low-back pain was decreased and his leg pain was gone. The testicular pain was improved after the first treatment and gone after 3 weeks of care. The patient was followed up by telephone at 3 and 6 months after discharge to find out if the testicle pain had returned, which it had not. Conclusions: This case was one of chronic idiopathic testicular pain. The patient was treated with the Cox Technic, and his low-back pain improved with complete remission of his leg and testicular pain. The testicular pain had not returned 6 months following his discharge from care.

• How Do Plants in Hospital Waiting Rooms Reduce Patient Stress?

  Authors: Ann Linda Baldwin

  Journal of alternative and complementary medicine (New York, N.Y.).

• Stress-Reducing Effects of Real and Artificial Nature in a Hospital Waiting Room.

  Authors: Camiel J Beukeboom, Dion Langeveld, Karin Tanja-Dijkstra

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: This field study investigated the potential stress-reducing effects of exposure to real or artificial nature on patients in a hospital waiting room. Additionally, it wasAbstract Objectives: This field study investigated the potential stress-reducing effects of exposure to real or artificial nature on patients in a hospital waiting room. Additionally, it was investigated whether perceived attractiveness of the room could explain these effects. Design: In this between-patients experimental design, patients were exposed to one of the following: real plants, posters of plants, or no nature (control). These conditions were alternately applied to two waiting rooms. Location: The location of this study was two waiting rooms at the Radiology Department of a Dutch hospital. Subjects: The subjects comprised 457 patients (60% female and 40% male) who were mostly scheduled for echocardiogram, dual-energy x-ray absorptiometry, magnetic resonance imaging, computed tomography scans, or nuclear research. Results: Patients exposed to real plants, as well as patients exposed to posters of plants, report lower levels of experienced stress compared to the control condition. Further analyses show that these small but significant effects of exposure to nature are partially mediated by the perceived attractiveness of the waiting room. Conclusions: Natural elements in hospital environments have the potential to reduce patients' feelings of stress. By increasing the attractiveness of the waiting room by adding either real plants or posters of plants, hospitals can create a pleasant atmosphere that positively influences patients' well-being.

• Ginkgo biloba Extract: A Novel Addition to Antipsoriasis Ammunition?

  Authors: Nader Pazyar, Reza Yaghoobi

  Journal of alternative and complementary medicine (New York, N.Y.).

• Natural Polypill Xuezhikang: Its Clinical Benefit and Potential Multicomponent Synergistic Mechanisms of Action in Cardiovascular Disease and Other Chronic Conditions.

  Authors: Yan Feng, Hao Xu, Keji Chen

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Polypill has been a hot issue since it was first advanced in 2003. This new concept immediately spurred a worldwide discussion. Xuezhikang is a partially purified extract of fermented redAbstract Polypill has been a hot issue since it was first advanced in 2003. This new concept immediately spurred a worldwide discussion. Xuezhikang is a partially purified extract of fermented red yeast rice (Monascus purpureus). It is composed of 13 kinds of natural statins, unsaturated fatty acids, ergosterol, amino acids, flavonoids, alkaloid, trace element, and other substances, and thus could be regarded as a natural lipid-lowering polypill. Interestingly, Xuezhikang in the China Coronary Secondary Prevention Study trial lowered lipid levels less as compared with provastatin in the Cholesterol and Recurrent Events trial, but seemed to gain more benefit in reducing the cardiovascular events and the risk of death from cancer. In recent years, Xuezhikang has been further demonstrated to have additional health benefits and thus raised great interest. This article reviews the clinical benefits of Xuezhikang and the potential multicomponent synergetic mechanism. The authors hold that polypill is anticipated to be a more effective and feasible way to treat complicated diseases.

• Clinical Effects of Scalp Electrical Acupuncture in Stroke: A Sham-Controlled Randomized Clinical Trial.

  Authors: Wu Tu Hsing, Marta Imamura, Kayleen Weaver, Felipe Fregni, Raymundo S Azevedo Neto

  Journal of alternative and complementary medicine (New York, N.Y.).

  Abstract Objectives: The majority of individuals who survive a stroke are disabled because of persisting neurological impairments. The objective of this study was to evaluate the efficacy ofAbstract Objectives: The majority of individuals who survive a stroke are disabled because of persisting neurological impairments. The objective of this study was to evaluate the efficacy of subcutaneous electrical stimulation of the scalp in spontaneous functional recovery of patients with chronic ischemic stroke, by evaluating clinical, neurological, and functional findings. Subjects and methods: Sixty-two (62) subjects who were at least 18 months postdiagnosis of ischemic stroke were randomized to receive 10 sessions of placebo or active low-frequency electrical stimulation (2/100 Hz) using subcutaneous acupuncture needles over the scalp. Functional and neurological evaluations were indexed by the Barthel, Rankin, and National Institutes of Health Stroke Scale (NIHSS). Results: Results show that there was a significant difference in functional improvement between the sham and active group as indexed by NIHSS scale. The active group had a larger functional improvement after 10 sessions of scalp electrical acupuncture. The other two functional scales (Rankin and Barthel) failed to show significant differences between the two treatment groups. Conclusions: These results support further testing of scalp electrical acupuncture for the treatment of stroke as well further mechanistic studies to understand mechanisms associated with the observed improvement. Further studies need to consider longer follow-up assessments to investigate potential functional changes associated with electrical acupuncture.

• Practitioners' Prognoses: Potential Clinical and/or Research Tool?

  Authors: Tracy Stuardi

  Journal of alternative and complementary medicine (New York, N.Y.).

• Hallowed by History, But Not by Facts: "Evidence-Based" Assessments of Homeopathy.

  Authors: Christopher Johnson

  Journal of alternative and complementary medicine (New York, N.Y.).

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