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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 199 records · Page 11Linked to original sources
PubMed2001

Herb-drug interactions: review and assessment of report reliability.

AIMS: The aim of this systematic review was to assess the published clinical evidence on interactions between herbal and conventional drugs. METHODS: Four electronic databases were searched for case reports, case series or clinical trials of such interactions. The data were extracted and validated using a scoring system for interaction probability. RESULTS: One hundred and eight cases of suspected interactions were found. 68.5% were classified as 'unable to be evaluated', 13% as 'well-documented' and 18.5% as 'possible' interactions. Warfarin was the most common drug (18 cases) and St John's wort the most common herb (54 cases) involved. CONCLUSION: Herb-drug interactions undoubtedly do occur and may put individuals at risk. However our present knowledge is incomplete and more research is urgently needed.

Adult↗
PubMed2001

'Neue Deutsche Heilkunde': complementary/alternative medicine in the Third Reich.

The aim of this article is to discuss complementary/alternative medicine (CAM) in the Third Reich. Based on a general movement towards all things natural, a powerful trend towards natural ways of healing had developed in the 19(th)century. By 1930 this had led to a situation where roughly as many lay practitioners of CAM existed in Germany as doctors. To re-unify German medicine under the banner of 'Neue Deutsche Heilkunde', the Nazi officials created the 'Heilpraktiker' - a profession which was meant to become extinct within one generation. The 'flag ship' of the 'Neue Deutsche Heilkunde' was the 'Rudolf Hess Krankenhaus' in Dresden. It represented a full integration of CAM and orthodox medicine. An example of systematic research into CAM is the Nazi government's project to validate homoeopathy. Even though the data are now lost, the results of this research seem to have been negative. Even though there are some striking similarities between today's CAM and yesterday's 'Neue Deutsche Heilkunde' there are important differences. Most importantly, perhaps, today's CAM is concerned with the welfare of the individual, whereas the 'Neue Deutsche Heilkunde' was aimed at ensuring the dominance of the Aryan race.

Complementary Therapies↗
PubMed2001

The case for uncontrolled clinical trials: a starting point for the evidence base for CAM.

Clinical research into the effectiveness of any therapy usually progresses in a series of steps that are aimed at providing evidence that will lead to improved patient care. One important early step is the uncontrolled trial. Uncontrolled trials serve several crucial purposes, including establishing firmly that there is a clinical effect worth investigating, identifying the most suitable patients and the most appropriate treatments, and providing information on how large the effect might be. They can be conducted relatively easily by practitioners in the course of their normal work, and are an excellent first step for anyone interested in clinical research. Such studies are not only satisfying, but develop skills in searching the literature and writing protocols, and promote rigorous thinking and attention to detail. The ultimate purpose of uncontrolled trials is to facilitate subsequent definitive studies that will help define the place of CAM in health care.

Clinical Trials as Topic↗
PubMed2001

Systematic review of adverse events following acupuncture: the Japanese literature.

CONTEXT: Many Japanese cases of adverse events after acupuncture are not listed in medical databases such as Medline. Therefore, they are not easily accessible to researchers outside Japan. OBJECTIVE: To complement existing reviews of adverse events after acupuncture in the West and to provide more detailed discussion and analysis. DATA SOURCES: Literature search using 'Igaku Chuo Zasshi (Japana Centra Revuo Medicina) CD-ROM version' covering the period of 1987-1999. STUDY SELECTION: Case reports of adverse events, which were suspected to be due to acupuncture treatment, were included. Experimental studies, surveys, and news articles were excluded. DATA EXTRACTION: Two independent reviewers extracted data from located articles in a pre-defined structured way, and assessed likelihood of causality in each individual case. DATA SYNTHESIS: 89 articles which reported 124 cases were located. The most frequent adverse events were: pneumothorax (25 cases), spinal cord injury (18 cases), acute hepatitis B (11 cases), and localized argyria (10 cases). There were two fatalities from infections. Forty-eight events were caused by needle breakage including 26 cases of intentionally embedded needle and 16 cases of accidental breakage. There were also 10 cases of injury from self-treatment. CONCLUSION: Although it has already been demonstrated that severe adverse events seem to be uncommon in standard practice, many serious cases of negligence have been found in the present review, suggesting that training system for acupuncturists (including medical doctors) should be improved and that unsupervised self-treatment should be discouraged.

Acupuncture Therapy↗
PubMed2001

Which complementary and alternative therapies benefit which conditions? A survey of the opinions of 223 professional organizations.

UNLABELLED: With the increasing demand and usage of complementary/alternative medicine (CAM) by the general public, it is vital that healthcare professionals can make informed decisions when advising or referring their patients who wish to use CAM. Therefore they might benefit from advice by CAM-providers as to which treatment can be recommended for which condition. AIM: The primary aim of this survey was to determine which complementary therapies are believed by their respective representing professional organizations to be suited for which medical conditions. METHOD: 223 questionnaires were sent out to CAM organizations representing a single CAM therapy. The respondents were asked to list the 15 conditions they felt benefited most from their CAM therapy, the 15 most important contra-indications, the typical costs of initial and any subsequent treatments and the average length of training required to become a fully qualified practitioner. The conditions and contra-indications quoted by responding CAM organizations were recorded and the top five of each were determined. Treatment costs and hours of training were expressed as ranges. RESULTS: Of the 223 questionnaires sent out, 66 were completed and returned. Taking undelivered questionnaires into account, the response rate was 34%. Two or more responses were received from CAM organizations representing twelve therapies: aromatherapy, Bach flower remedies, Bowen technique, chiropractic, homoeopathy, hypnotherapy, magnet therapy, massage, nutrition, reflexology, Reiki and yoga. The top seven common conditions deemed to benefit by all twelve therapies, in order of frequency, were: stress/anxiety, headaches/migraine, back pain, respiratory problems (including asthma), insomnia, cardiovascular problems and musculoskeletal problems. Aromatherapy, Bach flower remedies, hypnotherapy, massage, nutrition, reflexology, Reiki and yoga were all recommended as suitable treatments for stress/anxiety. Aromatherapy, Bowen technique, chiropractic, hypnotherapy, massage, nutrition, reflexology, Reiki and yoga were all recommended for headache/migraine. Bowen technique, chiropractic, magnet therapy, massage, reflexology and yoga were recommended for back pain. None of the therapies cost more than ł60 for an initial consultation and treatment. No obvious correlation between length of training and treatment cost was apparent. CONCLUSION: The recommendations by CAM organizations responding to this survey may provide guidance to health care professionals wishing to advise or refer patients interested in using CAM.

Complementary Therapies↗
PubMed2001

Homeopathic remedies for the treatment of osteoarthritis: a systematic review.

Osteoarthritis is a common rheumatic disease. Limitations of conventional medical management of this condition indicate a real need for safe and effective treatment of osteoarthritic patients. The authors review the clinical evidence for and against the effectiveness of homeopathic medicines in the treatment of patients with osteoarthritis. A systematic review of all randomised controlled clinical trials of homeopathic treatment of patients with this condition is presented. A comprehensive search yielded four trials which are discussed in detail. The authors conclude that the small number of randomised clinical trials conducted to date, although favouring homeopathic treatment, do not allow a firm conclusion as to the effectiveness of homeopathic remedies in the treatment of patients with osteoarthritis. The clinical evidence appears promising, however, and more research into this area seems warranted.

Homeopathy↗
PubMed2001

[Epidemiology of hantaviruses in Baden-Wurttemberg].

Hantavirus, originally named after the Hantaan River in Korea, is the aetiologic agent for the Hemorrhagic Fever with Renal Syndrome (HFRS) in the asian region, in the Americas for the Hantavirus Pulmonary Syndrome (HPS). In Middle Europe hantaviruses are responsible for the "Nephropathia Epidemica" (NE), a mild form of HFRS. Hantaviruses belong to the family of Bunyaviridae. Like other members of this family their genome consists of three segments of single stranded RNA (ss-RNA) leading to various subtypes, strongly associated with different rodent hosts. There are two major groups, the hantaan lineage harbored by murine rodents and the Puumala lineage harbored by arvicolidae ("old world") and sigmodontidae ("new world"). Infected rodents may develop chronic infections for months or even life-long and may shed infectious virus with urine and feces. The primary mode of infection of man occurs by inhaling contaminated aerosols or soil particles. The collection of epidemiologic data in the state of Baden-Württemberg was realized in three different steps: Collection and localisation of clinical cases (n = 62): A concentration of clinical cases in the middle of the state was found. The examination of the seroprevalence of exposed persons: By the examination of 4000 sera from forest workers, a seroprevalence with an average of 2.1% was found. In the districts of Reutlingen and Tübingen seroprevalences up to 9% were found. This leads to the assumption that there are endemic areas. Epidemiologic studies of reservoir hosts: Serologic surveys of rodents (n = 1150) in the described areas yielded to a seroprevalence up to 10-30%. Virus carriers were determined with RT-PCR and nested-PCR testing. The prevalence in the rodent population showed an average of 10%. The isolated subtypes were all identified as members of the Puumala-lineage. The origin of sporadic infections with Hantavirus of the Hantaan-lineage in Baden-Wuerttemberg is still unknown.

Animals↗
PubMed2001

Complementary/alternative therapies for premenstrual syndrome: a systematic review of randomized controlled trials.

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

Complementary Therapies↗
PubMed2001

Herbal medicines for the treatment of osteoarthritis: a systematic review.

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

Databases, Factual↗
PubMed2001

Survey of adverse events following acupuncture (SAFA): a prospective study of 32,000 consultations.

Acupuncture is increasingly used, so it is important to establish whether its benefits outweigh its risks. Numerous case reports of adverse events show that acupuncture is not free of risk, but accurate data from prospective investigations is scarce. A prospective survey was undertaken using intensive event monitoring. Forms were developed for reporting minor events each month and significant events as they occurred. The sample size was calculated to identify any adverse events that occurred more frequently than once in 10,000 consultations. Acupuncturists were recruited from two professional organisations in the UK. Seventy-eight acupuncturists, all doctors or physiotherapists, reported a total of 2178 events occurring in 31,822 consultations, an incidence of 684 per 10,000 consultations. The most common minor adverse events were bleeding, needling pain, and aggravation of symptoms; aggravation was followed by resolution of symptoms in 70% of cases. There were 43 significant minor adverse events reported, a rate of 14 per 10,000, of which 13 (30%) interfered with daily activities. One patient suffered a seizure (probably reflex anoxic) during acupuncture, but no adverse event was classified as serious. Avoidable events included forgotten patients, needles left in patients, cellulitis and moxa burns. In conclusion, the incidence of adverse events following acupuncture performed by doctors and physiotherapists can be classified as minimal; some avoidable events do occur. Acupuncture seems, in skilled hands, one of the safer forms of medical intervention.

Acupuncture Therapy↗