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

Published by Mary Ann Liebert
Online ISSN: 1557-7708
Publications
Article
Early phase research in complementary and alternative medicine (CAM) is especially important because of the large influence it has on the subsequent expenditure of money and effort in particular areas of CAM therapies. The culture of biomedical research has, however, blurred the distinction between early and late-phase research, and this has distorted the very distinct aims of these two activities. The purpose of this paper is to reaffirm the critical role of early phase CAM research and to encourage CAM researchers to value and conduct early phase studies for their proper purposes.
 
Article
To determine the potential toxicity and safety of the Chinese herbal medicine NPI-028 in rats following subchronic (3-month) exposure via daily oral consumption. Subchronic toxicity was evaluated in four groups of rats (n = 10 per group) receiving NPI-028 orally at a dose of either 0.0 (normal diet control), 0.5, 1.0, or 2.0 g/kg, ingested as part of their daily diet for 3 months. NPI-028 was incorporated into powdered rat chow diet as a specific percent of the total diet provided each day. The primary active isoflavone content of NPI-028 (puerarin) used in the rat diet was also determined. Subchronic toxicity was assessed over a 3-month period by biweekly measurement of water and food intake, weight gain, and visual inspection for maintenance of grooming and normal behavior. At the end of the study period rats were euthanized and blood was obtained for hematologic and chemical analysis. Organs were removed for histopathologic examination. Rats in all three NPI-028 dose groups were similar to the control group in weight gain, food intake, and water intake over the study period. Hematology, blood chemistries, and organ histology in rats at all three NPI-028 doses did not significantly differ from control rats. Minor exceptions were elevated urea nitrogen values at all NPI-028 doses, and increased triglyceride and thyroid-stimulating hormone values in the lowest NPI-028 dose-treated group. Puerarin (used as a dietary isoflavone marker) content of NPI-028 was 26 mg/g dry weight. NPI-028 ingested orally at doses up to 2.0 g/kg per day in the rat diet for up to 3 months resulted in normal growth with no changes in hematologic or hepatic parameters, and only minor alterations in renal and blood chemistry parameters. There was no evidence of abnormal histology. These data suggest the long-term daily oral consumption of NPI-028 as a part of the daily diet for 3 months, at the doses studied, is safe in rats. Thus, NPI-028 may potentially be safe for clinical use as an antidipsotropic agent.
 
Article
This study was proposed to evaluate the reliability by 2005 Sasangin Diagnosis Questionnaire for Mongolian (05' SDQ-M). Questions from the 05'SDQ were translated into Mongolian, and the 05'SDQ-M was constructed. The questionnaire was administered to 193 Mongolians and they were asked to complete the questionnaire again 2 weeks after the first administration. To evaluate the internal consistency, Cronbach's alpha coefficient was calculated. A reliability analysis for each individual question was conducted using the test-retest method to verify the independence and agreement between the questions. To verify independence, a chi(2) test with crosstabs analysis and p-values was used. The agreement verification was conducted by using the Cohen kappa coefficient. In addition, the constitutional variable was defined as the constitutional attribute of each question, and Pearson's correlation coefficient was confirmed after testing the scale. After testing the internal consistency of the scale, the consistency was shown to range from 0.59 to 0.67, suggesting that the questions on the questionnaire were reliable. The test-retest method showed that Pearson's correlation coefficients for the results of the two tests ranged from 0.65 to 0.80. The x(2) test results indicated that one independent item demanded close attention. Among the other 123 questions, the agreement test revealed that 80 questions (64.5%) showed common agreement.
 
Box plots of birth seasons for 25(OH)D in children with autism.  
Distribution of birth months for children with au- tism.  
Correlation between 25(OH)D and calcium in children with autism (r ¼ 0.309, p < 0.01).  
Box plots of birth seasons for 1,25(OH) 2 D in children with autism.  
Article
The aim of this study was to investigate the potential role of vitamin D in autism through serum level assessment. This was a case-controlled cross-sectional study. The study was conducted at the Out-patient Clinic for "Children with Special Needs" at the Medical Services Unit of the National Research Centre in Cairo, Egypt. Seventy (70) children with autism diagnosed according to the DSM-IV criteria of the American Psychiatric Association were recruited for this study. The mean age +/- standard deviation (SD) of the patients was 5.3 +/- 2.8 years. Controls included 42 age-matched randomly selected healthy children of the same socioeconomic status (mean age +/- SD, 6.1 +/- 1.8 years). Circulating levels of both forms of vitamin D (25(OH)D and 1,25(OH)(2)D) and serum calcium were measured for all subjects. Associations between vitamin D status, birth season, and clinical characteristics of autism were examined. Children with autism had significantly lower 25(OH)D (p < 0.00001) and 1,25(OH)(2)D (p < 0.005) as well as lower calcium (p < 0.0001) serum values than the controls. A significant positive correlation was obtained between 25(OH)D and calcium (correlation coefficient r = 0.309, p < 0.01) within the children with autism. No significant difference was found on comparison of birth month and season of birth between children with autism and healthy controls. Furthermore, associations linking parental consanguinity or convulsions with vitamin D could not be established. Serum values of 25(OH)D in the children with autism of this study could classify them as being "vitamin D inadequate," which lends support to the hypothesis that autism is a vitamin D deficiency disorder.
 
Relationship between consultations with CAM practitioners for pregnancy-related health conditions and use of pain management techniques during labour and birth 
Article
Objectives: This study examines involvement with a range of complementary and alternative medicine (CAM) during pregnancy on the use of pharmacologic (PPMT) and nonpharmacologic (NPMT) pain management techniques for labor and birth. Design: Longitudinal analysis of survey data. Participants: A substudy (n=2445) of the "young" cohort of the nationally representative Australian Longitudinal Study on Women's Health was conducted. Outcome measures: Use of PPMT and NPMT during labor and birth. Results: The survey was completed by 1835 women (response rate, 79.2%). Most respondents used either intrapartum PPMT (81.9%) or NPMT (74.4%). Many (60.7%) used some form of CAM during pregnancy and also used PPMT during birth. More than two thirds of women (66.7%) who used NPMT used CAM during pregnancy. There was a general trend of increased likelihood of NPMT use by women who applied CAM during pregnancy. There was an inverse effect on use of epidural analgesia for women who consumed herbal teas during pregnancy (odds ratio, 0.60). Conclusions: Because of the study design, this paper does not confirm a causative relationship between the use of CAM during pregnancy and intrapartum pain management choices. It does, however, indicate that the use of CAM during pregnancy may not significantly affect the uptake of intrapartum PPMT, despite possible attempts to reduce PPMT by using NPMT. It also highlights the possibility of potential interactions between CAM and PPMT, given the high prevalence of concomitant use.
 
Article
Aqueous, methanolic, and dichloromethane extracts from 27 Lebanese plants were investigated for their in vitro immunomodulatory and antileishmanial activities as compared to their toxicity against human cells. Extracts from yellow chamomile (Anthemis tinctoria), white larkspur (Consolida rigida), Syrian broom (Cytisus syriacus), coast spurge (Euphorbia paralias), shield fibigia (Fibigia clypeata), Auchers golden-drop (Onosma aucheriana), shell-flower sage (Salvia multicaulis), snowy woundwort (Stachys nivea), Palestine woundwort (Stachys palaestina), and polium-leaved speedwell (Veronica polifolia) exhibited interesting antileishmanial activities on the intracellular amastigote form of the parasite, while several extracts from A. tinctoria, F. clypeata, and O. aucheriana were shown to induce nitrous oxide (NO) production by human macrophages. Further experiments should be performed in order to purify and characterize the chemical compounds responsible for these activities.
 
Article
Although numerous trials have demonstrated the clinical effects of acupuncture, the mechanism of its therapeutic effect still remains uncertain. Recent neuroimaging studies using functional magnetic resonance imaging, single-photon emission computed tomography (SPECT), and positron emission tomography (PET) have revealed that acupuncture therapy may alter brain activity. This study was performed to evaluate changes in regional cerebral blood flow and glucose metabolism following electroacupuncture (EA) in normal volunteers. Twenty (20) normal volunteers were enrolled for brain SPECT and 13 normal volunteers were enrolled for (18)F-fluorodeoxyglucose PET. A few days after the baseline measurements, EA was performed at two acupoints (LI 4 and LI 11) for 15 minutes and a second brain image was acquired for each subject. We used statistical parametric mapping 2 to analyze the changes in brain perfusion and glucose metabolism. Significant increases in perfusion were observed in the left middle frontal gyrus, the superior parietal gyrus, the right superior frontal gyrus, and the middle parietal gyrus. Following EA, glucose metabolism significantly increased in the left superior medial frontal gyrus, the middle frontal gyrus, and the right superior medial frontal gyrus (paired t-test, uncorrected p < 0.005). There were specific increases in both regional cerebral blood flow and glucose metabolism following EA in both frontal regions. This common brain response in localized regions was induced from stimulation of specific acupoints (LI 4 and LI 11).
 
Article
This study was performed to investigate the effect of immune-related acupuncture points on serum tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hsCRP) levels. Ninety (90) healthy volunteers (aged 20-30 years) were randomly assigned into five equal groups. Acupuncture needles were placed into single acupoints bilaterally in each group. The points were Da Zhui (Du-14), Qu Chi (Li-11), Zu San Li (St-36), San Yin Jiao (Sp-6) and a sham point, which is not an acupoint. Manual acupuncture treatment was performed in 6 sessions of 30 minutes each, 3 times per week for 2 weeks. Serum samples were obtained before and after the acupuncture treatments and the serum TNF-α and hsCRP levels were measured. The TNF-α values (mean ± standard deviation) in the Du-14, Li-11, St-36, Sp-6, and sham acupuncture groups at baseline were 37.63 ± 10.58, 37.36 ± 10.24, 33.83 ± 7.36, 35.73 ± 6.75, and 32.05 ± 5.66 pg/mL, respectively. After treatment, the mean TNF-α values were 35.89 ± 11.61, 34.80 ± 6.98, 35.89 ± 9.22, 33.30 ± 5.45, and 33.78 ± 5.98 pg/mL, respectively. In the serum TNF-α levels, no significant change was seen in any of the groups (p > 0.05). The mean hsCRP values in the Du-14, Li-11, St-36, Sp-6, and sham acupuncture groups at baseline were 0.90 ± 0.77, 1.07 ± 1.35, 0.77 ± 0.54, 0.75 ± 0.54, and 0.94 ± 0.68 mg/L, respectively. After treatment, they were 1.09 ± 1.17, 0.84 ± 0.43, 0.74 ± 0.49, 0.80 ± 0.53, and 0.62 ± 0.44 mg/L, respectively. In the statistical analysis, it was found that hsCRP levels were significantly reduced in the sham acupuncture group (p < 0.01). There was not any significant difference between acupuncture and sham groups in terms of serum TNF-α and hsCRP values (p > 0.05). Acupoints, which are considered to have effects on the immune system, may not mediate the immune system via TNF-α, a known inflammatory cytokine, directly in healthy young individuals. However, the changes related to hsCRP values in the sham group need future confirmation studies.
 
Article
Japanese style, superficial acupuncture (SA) has been clinically evaluated for its therapeutic benefit, yet the neurophysiologic responses associated with SA remain unclear. This study was performed to measure changes in regional cerebral blood flow (rCBF) following SA at LI-4 and LI-11 in healthy volunteers using single photon emission computed tomography (SPECT). Changes in SPECT activity following Japanese style SA were compared to previous reports of SPECT changes following electroacupuncture (EA) at the same acupoints. Ten (10) healthy volunteers were enrolled for this study. A few days after the baseline brain SPECT, SA was performed at LI-4 and LI-11 for 15 minutes and a second brain perfusion image was acquired for each subject. We used SPM2 to analyze the changes in rCBF after SA through a paired t test. In addition, the differences of rCBF changes between SA and EA were compared using a two-sample t test. Cerebral blood perfusion significantly increased after SA in the left superior frontal gyrus, left middle cingulum, left insular, right medial orbital frontal gyrus, and right middle cingulum (paired t test, uncorrected p < 0.005), while no regions showed a significant decrease. The results comparing poststimulation images between SA and EA demonstrated that the perfusion in the right lingual, both thalamus, left middle temporal gyrus, left insula, and both cerebellum were significantly increased in SA compared with EA (false discovery rate [FDR] corrected p < 0.05). There were specific increase patterns of rCBF following SA at LI-4 and LI-11, which were similar to those following EA. However, there were significant differences in the decrease pattern of rCBF between SA and EA, which might be due to the difference of the strength of acupuncture stimulation between the two methods. These results may contribute to developing a better strategy to a select stimulation method in acupuncture therapy.
 
Article
The objectives of this study were to chart the patterns and determine the factors associated with acupuncture consultations among a large cohort of mid-aged women in Australia over a 6-year period. A longitudinal analysis of questionnaires completed in 2001, 2004, and 2007 as part of the Australian Longitudinal Study on Women's Health. Statistical analyses included Generalized Estimating Equations. Mid-aged women (n=11,200) were randomly selected from the Australian Medicare database, with oversampling of women from rural and remote areas. The outcome measure was consultation with an acupuncturist in the 12 months prior to each survey. The percentage of women who consulted an acupuncturist in the years 2001, 2004, and 2007 were 4.2%, 4.3%, and 5.9%, respectively. Only 0.5% of women consulted with an acupuncturist at all survey periods, 2.0% at two survey periods, and 7.4% at only one survey period. Acupuncture consultations significantly increased if the women had back problems (odds ratio [OR]=1.5), arthritis (OR=1.3), had higher levels of education (OR=1.9), were high users of general practitioners/family practitioners (OR=2.6), and high users of biomedical specialists (OR=1.4). Use of acupuncturists among mid-age women appears to be strongly influenced by poor physical health. The percentage of women in the community who use acupuncture remained relatively consistent over the study period. Women do not tend to consistently use acupuncture over time, but instead appear to use acupuncture as a one-off treatment or at selected time points.
 
Article
We aim to identify the genetic loci responsible for Sasang constitution type, which is important for effective personalized treatments in traditional Korean medicine. Forty (40) individuals in a Korean family were recruited for linkage analysis and 310 unrelated individuals for association analysis to confirm the linkage result. Outcome measures: Genome-wide linkage analysis was performed for the Korean family using the Affymetrix 500K arrays. MERLIN software was used for multipoint nonparametric linkage (NPL) analysis. The significant candidate regions in linkage analysis were also investigated with association analysis of independent 310 individuals. Linkage analysis showed four significant peaks, 3q27.3, 8p11.21, 8q11.22-23, and 11q22.1-3, whose NPL Z scores are greater than 5.0. Among the significant loci, the 8q11.22-23 and 11q22.1-3 regions were supported by independent association analysis at the level of p < 0.05. The 8q11.22-23 and 11q22.1-3 regions were suggested as the candidate region for significant linkage to Sasang constitution.
 
Flow diagram of study procedures. TENS, transcutaneous electrical nervous stimulation. 
Changes in Lung Function and Heart Rate Variability Before and After Interventions 
The Lung meridian is outlined and acupoints along the meridian are marked. 
Article
Objectives: To investigate the change of skin impedance of acupoints along the Lung meridian in response to transcutaneous electrical nervous stimulation over an acupoint (Acu-TENS) over BL13 (Feishu). Design: This was a double-blinded, randomized, controlled crossover study. Settings/location: The study was conducted in a laboratory. Subjects: Eighteen (18) healthy individuals comprised the study subjects. Interventions: The intervention was a session of 45-minute Acu-TENS (application of TENS on BL13, Feishu) or placebo-TENS (similar to Acu-TENS but without electrical output). Outcome measures: Skin impedance at 10 acupoints on the Lung meridian was recorded before and after the 45-minute intervention period. Heart rate variability during the intervention was analyzed from continuous heart rate monitoring. Results: Skin impedance at all acupoints along the lung meridian decreased significantly after Acu-TENS, when compared to placebo-TENS (p<0.05). A significant reduction in sympathetic activity was also observed after Acu-TENS (p=0.012). Conclusions: Acu-TENS appears to modify skin impedance of acupoints along a related meridian and possibly modulates sympathovagal balance.
 
Article
In order to facilitate the conduct and dissemination of high-quality systematic reviews in CAM further, three key issues were discussed at the Melbourne Cochrane Colloquium: (a) How to improve the overall methodological quality of CAM reviews in general, (b) how to improve the quality of Traditional Chinese Medicine reviews and trials; and (c) how to make the CAM reviews more accessible to the lay public throughout the world. A summary of each of these is presented.
 
Article
This paper reports on the results of a literature survey involving 166 different species of plants used in the Ayurvedic pharmacopoeia, based on a sampling of the literature available to us. We found a wide range of clinical and other in vivo studies for many of the plant-based therapies utilized in the Ayurvedic system. Of the 166 plants investigated, 72 (43%) had at least one or more human studies and 103 (62%) had one or more animal studies. These results appear to contradict the generally held notion that herbal remedies used in non-Western systems of botanical medicine have not been evaluated in human or in vivo trials. Some of these studies are not always as large or methodologically rigorous as clinical studies reported in major medical journals. Indeed, a critical assessment of the research according to the standards of evidence-based medicine would eliminate many of these studies for lack of rigor according to criteria of randomization, sample size, adequacy of controls, etc. However, the studies do suggest which species might be appropriate for larger and better-controlled trials in the future. Accordingly, a synopsis of the plants, their therapeutic applications, and their clinical or experimental evaluations is presented.
 
Article
The "Neurobiological Correlates of Acupuncture" Conference was convened November 17-18, 2005 in Bethesda, Maryland. The conference was sponsored by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), U.S. Department of Health and Human Services (DHHS). Its goals were to encourage exchange of ideas regarding the direction of neuroimaging in acupuncture research as well as to discuss some of the challenges in this field. The use of neuroimaging, a relatively recent advance in the study of acupuncture, holds the promise of localizing and characterizing brain activity associated with acupuncture interventions in real time and in a minimally invasive way. Among the main challenges to research into the biological mechanisms of acupuncture are the multiple treatment variables and the difficulties of selecting appropriate experimental controls. Despite these challenges, numerous findings from acupuncture neuroimaging experiments were presented and discussed at the conference on topics related to possible signaling networks, sham acupuncture controls, acupoint specificity, acupuncture analgesia, acupuncture-associated brain response, and the potential for using neuroimaging in conjunction with translational and clinical acupuncture research. Future directions in acupuncture neuroimaging research, as recommended by conference participants, should focus on (1) continuing exploration of acupuncture signaling networks; (2) establishing standards and recommendations for performing and reporting acupuncture neuroimaging results; (3) enabling data sharing in the acupuncture neuroimaging community; (4) gaining a better understanding of placebo and control groups in acupuncture neuroimaging experiments; and (5) developing biomarkers that relate to physiologically and/or clinically relevant acupuncture responses to neuroimaging results.
 
Crude Drug Composition of TJ-15 
Patient flow chart. 
Crude Drug Composition of TJ-17 
Change of SCORAD Score 
Change of EASI Score 
Article
Hwang-Yeon-Hae-Dok-San (TJ-15) and Ou-Ryung-San (TJ-17) are two common herbal formulas that have been used to treat atopic dermatitis (AD), especially the Dampness-Heat pattern of AD. The aim of this study was to determine the safety and efficacy of TJ-15 plus TJ-17 for patients with the Dampness-Heat pattern of AD based on pattern identification. This study was a parallel, randomized, active-controlled, double-blind trial. A total of 24 patients were enrolled. Either a combination of TJ-15 plus TJ-17, or TJ-15 alone was orally administered 3 times daily for 4 weeks. Of the patients enrolled, 19 patients completed the 4-week treatment course (TJ-15 plus TJ-17: n=8, TJ-15: n=11). Efficacy was assessed using the scoring atopic dermatitis (SCORAD) index; area of eczema and severity index (EASI); as well as the symptoms related to the Dampness-Heat by pattern identification. Efficacy measures were evaluated at the baseline and at 4 weeks. Safety was assessed throughout the study using ongoing laboratory tests. Both the SCORAD and EASI showed more improvement in the TJ-15 plus TJ-17 group than in the TJ-15 group; however, the differences were not statistically significant. The symptoms related to the Dampness-Heat pattern were reduced in both groups, and the changes were similar. There were no reported adverse events during this study, or abnormalities observed on aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, and creatinine testing. The results of this study suggest that both the TJ-15 plus TJ-17 and the TJ-15 provided safe and effective treatment for patients with the Dampness-Heat pattern type of AD.
 
Article
Background: Recent evidence shows that acupuncture is effective for chronic pain. However we do not know whether there are characteristics of acupuncture or acupuncturists that are associated with better or worse outcomes.
 
Article
It has been reported that postherpetic neuralgia (PHN) in patients over 60 years of age is aggravated under cold stimulation and is often difficult to treat. Keishikajutsubuto (TJ-18) and Bushi-matsu (TJ-3022) are traditional Japanese herbal medicines and have long been used to treat neuralgia and arthralgia, which are aggravated following cold stimulation. This study was designed to evaluate the effectiveness of combined TJ-18 and TJ-3022 therapy in cases of PHN aggravated by self-reported cold stimulation. Fifteen (15) PHN patients aged 60 years and over were examined. Patients were aware of the persistent pain despite other treatments; pain was generally aggravated following exposure to cold stimulation. First, TJ-18 (7.5 g/day) was administered to patients, and then TJ-3022 (1.0 g/day) was also administered and progressively increased by 0.5-1.0 g increments every 2-4 weeks, until stable improvement was achieved, which was rated using the visual analogue scale (VAS). Analgesic effects were evaluated using the VAS during each patient visit. Background variables, responses to treatment (time course of VAS rating, VAS improvement rate), the amount of additional TJ-3022 administered, and adverse reactions were analyzed. Twelve (12) of the 15 patients completed the entire trial. Patient ages were 61-85 years, the male-to-female ratio was 4:8, and length of time after onset of herpes zoster was 2-92 months. In 3 patients, oral TJ-18 treatment was not possible due to hot flash or gastric discomfort. The VAS improvement rate for patients being orally administered both TJ-18 and TJ-3022 was 76.5±27.7% (mean±standard deviation). The additional TJ-3022 dose was 1.0-5.0 g/day. Twelve (12) patients have been treated without serious adverse reactions. TJ-18 and TJ-3022 combination treatment is a promising means of treating intractable PHN, which has a self-reported tendency to aggravate pain under cold stimulation.
 
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Article
The objective of this study was to describe the profile of a cohort of patients who presented to a Neuro-Emotional Technique (NET) clinic. This study investigated the change in the Distress and Risk Assessment Method (DRAM) outcome measure score after a 3-month course of NET was administered to participants. This was an uncontrolled cohort study in private practice. One hundred and eighty-eight (188) consecutive new patients presented to a NET clinic. The intervention was a 3-month course of NET, which incorporates elements of muscle testing, general semantics, Traditional Chinese Medicine, acupuncture, and chiropractic principles to manage patients' conditions. Scoring on the DRAM questionnaire was the outcome measure. Of the participants, 55.9% had musculoskeletal complaints, 34.6% had nonmusculoskeletal complaints, and 9.6% reported no presenting complaint. Strongly significant differences in the mean DRAM scores and the mean individual component scores were found between pre- and post-treatment. There was strong evidence to suggest that the Modified Somatic Perceptions Questionnaire and the Modified Zung Depression Index scores were correlated (p < 0.001), and that the allocation of subjects in any pretest category to categories on the basis of post-test scores changed from category to category. NET is different from traditionally described chiropractic practice, and appears, based on this one clinic, to have far more nonmusculoskeletal presentations. This profile, if consistent with other practices, has strong implications for scope of practice for this form of chiropractic practitioners. Many participant presentations were "at risk" of, or were clinically depressed, according to the DRAM. The DRAM status of the patient cohort significantly and clinically improved with the NET treatment. As this study was nonrandomized and uncontrolled, the results should be viewed with caution. We recommend that larger-scale randomized controlled trials be commenced to investigate the preliminary findings of this report.
 
Article
Objectives: The objective of this study was to make non-Chinese readers better informed about the current safety situation of acupuncture in China. Methods: Four (4) major Chinese comprehensive databases were searched: Chinese Journal Full-text Database (1949-2010), China Biomedical Literature Database (1978-2010), Chinese Technology Journal Database (1989-2010), and Wanfang (1998-2010). Case reports of adverse events related to acupuncture therapy were included. Literature reviews, case-control study, translations, duplicate literatures in various databases, and duplicate published articles with duplicate data were excluded. Results: One hundred and sixty-seven (167) articles were included with 1038 cases, among which 35 patients died. The most frequent adverse events were syncope (468 cases), pneumothorax (307 cases), and subarachnoid hemorrhage (64 cases). Conclusions: Acupuncture-related adverse events were mainly caused by mental tension of the patient, improper operation by the doctor, and incompleteness of sterilization. Most of them can be avoided by standardizing teaching and clinical practices. Making the corresponding safety standards can greatly lower the risk of adverse events and protect patient safety to the greatest extent.
 
Use of Terms: Patient Versus Consumer 
Focus of Article: Disease Versus Wellness 
Article
The objectives of this study were to examine and describe the portrayal of complementary and alternative medicine (CAM) in mass print media magazines. The sample included all 37 articles found in magazines with circulation rates of greater than 1 million published in the United States and Canada from 1980 to 2005. The analysis was quantitative and qualitative and included investigation of both manifest and latent magazine story messages. Manifest analysis noted that CAM was largely represented as a treatment for a patient with a medically diagnosed illness or specific symptoms. Discussions used biomedical terms such as patient rather than consumer and disease rather than wellness. LATENT analysis revealed three themes: (1) CAMs were described as good but not good enough; (2) individualism and consumerism were venerated; and (3) questions of costs were raised in the context of confusion and ambivalence.
 
Article
This study presents the adverse effects of acupuncture as recorded in the Medline database for the years 1981-1994. A total of 125 papers were localized by the keywords acupuncture adverse effects. Articles without case reports were excluded, and 78 reports forms the basis for the present paper. A total of 193 patients were reported with adverse effects of acupuncture in 14 years. Pneumothorax is the most common mechanical organ injury, while hepatitis dominates among infections. Acupuncture treatment is claimed to be responsible in the death of three patients. One patient died from bilateral pneumothorax, another got endocarditis, and died of complications. The third patient died of severe asthma while under acupuncture treatment. Most adverse effects of acupuncture seem to rely on insufficient basic medical knowledge, low hygienic standard, and inadequate acupuncture education. The study confirms the adverse effects of acupuncture under certain circumstances. Serious adverse effects, however, are few, and acupuncture can generally be considered as a safe treatment.
 
EFFECTS OF SEVENTY-TWO-HOUR TREATMENT OF HL-60 CELLS WITH VARIOUS CONCENTRATIONS OF ETHANOL OR AQUEOUS EXTRACTS OF I'M-YUNITY™ a 
EFFECTS OF ETHANOL AND AQUEOUS EXTRACTS OF I'M-YUNITY™ a ON RELATIVE CHANGES OF IL-1/IL-8 AND IL-6/IL-8 I'm-Yunity™ a 
Article
The goal of this in vitro study was to test the cytostatic and cytotoxic activities of extracts derived from the polysaccharopeptide (PSP), I'm-Yunity (Integrated Chinese Medicine Holdings Ltd., Kowloon, Hong Kong) prepared from strain Cov-1 of the mushroom Coriolus versicolor. Different volumes of 70% ethanol and water extracts of I'm-Yunity were incubated with cultures of human promyelocytic leukemic HL-60 cells, and compared to nontreated control cells. At various times after treatment, cells were harvested and analyzed with respect to: (1). proliferation and cell cycle phase distribution, (2). induction of apoptosis, and (3). changes in expression of the immunomodulating cytokines interleukin (IL)-1 beta, IL-6, and IL-8. To test whether extracts also affected normal cells, similar experiments were also performed using isolated peripheral blood lymphocytes from healthy volunteers, with and without stimulation by the mitogen phytohemagglutinin (PHA). The ability of extracts to affect the secretion of IL-1 beta, IL-6, and IL-8 were assessed by enzyme-linked immunosorbent assay. HL-60 cells incubated with various amounts (1, 3, 5, 7.5, and 10 micro l/mL) of the extracts for 1-3 days showed dose-dependent, time-dependent growth suppression and decrease in cell viability. Flow cytometric analysis revealed partial cell arrest in the G(1) phase at less than 5 micro L/mL and induction of apoptosis at 10 micro L/mL or more of ethanol and water extracts, with the latter exhibiting more pronounced inhibition than the former. Experiments performed with lymphocytes demonstrated that extracts of I'm-Yunity alone were without effect; moreover, they also did not affect the lymphocyte response to PHA. Water extract of I'm-Yunity also significantly increased IL-1 beta and IL-6 while substantially lowering IL-8. I'm-Yunity acts selectively in HL-60 leukemic cells, resulting in cell cycle restriction through the G(1)/S checkpoint and the induction of apoptosis.
 
Article
This study was conducted to examine whether the potentized homeopathic remedy Carcinosin 200, fed alone and in combination with Chelidonium 200, has differential protective effects against p-dimethylaminoazobenzene (p-DAB)-induced hepatocarcinogenesis in mice. Liver tumors were induced in mice through chronic feeding of p-DAB (initiator) and phenobarbital (PB, promoter). The mice were divided into two subgroups: (1) one was fed potentized Alcohol 200 and served as controls; and (2) the other was fed Carcinosin 200 alone or in combination with Chelidonium 200 and divided into several sets. The relative efficacy of the two potentized remedies, alone or in combination, in combating hepatocarcinogenesis was assessed through several cytogenetical endpoints such as chromosome aberrations, induction of micronuclei, sperm head anomaly, and mitotic index at several intervals of fixation (days 7, 15, 30, 60, 90, and 120). Several toxicity biomarkers such as acid and alkaline phosphatases, glutamate oxaloacetate transaminase, glutamate pyruvate transaminase, and lipid peroxidation activity were also assayed in three organs of treated and control mice. In addition, recovery by the homeopathic drugs, if any, of tissue damage inflicted because of chronic feeding of p-DAB and PB was also assessed by optical, scanning, and transmission electron microscopies of liver done at days 60 and 120. Both Carcinosin 200 and Chelidonium 200 when administered alone show considerable ameliorative effect against p-DAB-induced hepatocarcinogenesis in mice; but the conjoint feeding of these two drugs appears to have had a slightly greater protective effect. These homeopathic remedies have the potential to be used as complementary and alternative medicine in liver cancer therapy, particularly as supporting palliative measures.
 
Article
The field of radiology can play a crucial role in the movement beyond allopathic and complementary medicine to a true combination approach. Radiologists are proponents of minimal invasiveness and are familiar with the overreliance on diagnostic imaging tests. Their experience can be used to design appropriate applications for technology and to plan research methods to explore the questions raised by a combination medicine paradigm.
 
Article
Background: The Consolidated Standards of Reporting Trials (CONSORT) guidelines were developed in 1996 by researchers and journal editors to improve the quality of reporting of biomedical research by providing a standardized format for researchers to present information on randomized controlled clinical trials (RCTs). This improved data reporting allows readers to independently assess the quality and conclusions of these studies, and has been widely incorporated in contemporary research reports. In 2001, a supplemental set of criteria that specifically address the reporting of design and implementation issues for RCTs involving the use of acupuncture was introduced, termed the STRICTA (Standards for Reporting Interventions in Controlled Trials of Acupuncture) recommendations.The CONSORT guidelines are stated to be part of a broader effort to improve the quality of research, as they can be used by researchers to optimize the design of future trials. Similarly, the STRICTA recommendations outline research reporting standards that are and should be considered when designing controlled clinical trials that involve the use of acupuncture. The CONSORT and STRICTA recommendations thus not only serve to improve research reporting, but also serve to provide guidance for optimizing the designs of future clinical trials. Objectives: This paper presents a review of the STRICTA recommendations for reporting the results of controlled trials utilizing acupuncture, discusses their potential limitations, and offers suggestions for additions/enhancements to those standards based on research issued subsequent to the issuance of the STRICTA recommendations in 2001.
 
Article
This report provides a summary of the background and inputs of various groups who attended the Global Forum on Safety of Herbal and Traditional Medicine conference held in the Gold Coast, Australia, on July 7, 2001. Keynote presentations covered the status of regulation of complementary medicine in Australia and comparative examples from Africa and Bangladesh. There was substantial input about work to date on databases, reflecting the need to have a focus on safety outcomes as a point of direction for the forum. Safety evaluation, which incorporates quality procedures, was identified as another point of focus. Clear evidence for the nonutilization of plants known to contain certain compounds producing deleterious effects was exemplified via data and information on the dangers of ingesting pyrrolizidine alkaloids.
 
Age-standardized prevalence with 95% confidence interval (CI) of use of 16 complementary and alternative medicine therapies a in the past 12 months among adults aged 18 years or older with chronic disease-related functional limitations in 2002 and 2007. 
Article
Objectives: This study examined changes in the use of complementary and alternative medicine (CAM) therapies by U.S. adults aged 18 years or older with chronic disease-related functional limitations between 2002 and 2007. Design: The study was a cross-sectional survey. Setting/location: The study was conducted in the United States. Subjects: The study comprised adults aged 18 years or older with chronic disease-related functional limitations. Methods: Data were obtained from the 2002 and 2007 U.S. National Health Interview Survey to compare the use of 22 CAM therapies (n=9313 and n=7014, respectively). Estimates were age adjusted to the year 2000 U.S. standard population. Results: The unadjusted and age-standardized prevalence of overall CAM use (22 therapies comparable between both survey years) was higher in 2007 than in 2002 (30.6% versus 26.9%, p<0.001 and 34.4% versus 30.6%, p<0.001, respectively). Adults with functional limitations that included changing and maintaining body position experienced a significant increase in CAM use between 2002 and 2007 (31.1%-35.0%, p<0.01). The use of deep breathing exercises was the most prevalent CAM therapy in both 2002 and 2007 and increased significantly during this period (from 17.9% to 19.9%, p<0.05). The use of meditation, massage, and yoga also increased significantly from 2002 and 2007 (11.0%-13.5%, p<0.01; 7.0%-10.9%, p<0.0001; and 5.1% to 6.6%, p<0.05, respectively), while the use of the Atkins diet decreased (2.2%- 1.4%, p<0.01). Conclusions: Among U.S. adults with chronic disease-related functional limitations, the overall increase in CAM use from 2002 to 2007 was significant, particularly among those with changing and maintaining body position limitations.
 
Top-cited authors
Alberto Chiesa
  • University of Bologna
Alessandro Serretti
  • University of Bologna
Sue A Thomas
  • University of Maryland, Baltimore
Alyson Ross
  • National Institutes of Health
Barry Oken
  • Oregon Health and Science University