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Edzard Ernst

Publications and source records attributed to Edzard Ernst.

At least 91 records · Page 5Linked to original sources
PubMed2004

[Research into complementary medicine--an account after 10 years].

For ten years now, intensive research into complementary medicine has been undertaken in Exeter, UK. Aimed at providing an interim account of our activities, this paper presents several examples of our results. Although some progress has been made, this field continues to receive too little attention. The future of complementary medicine will depend on whether its modalities can be shown to generate more good than harm for the patient.

Chronic Disease↗
PubMed2004

Complementary and alternative medicine for labor pain: a systematic review.

OBJECTIVES: The purpose of this study was to systematically review the literature for, and critically appraise, randomized controlled trials of any type of complementary and alternative therapies for labor pain. STUDY DESIGN: Six electronic databases were searched from their inception until July 2003. The inclusion criteria were that they were prospective, randomized controlled trials, involved healthy pregnant women at term, and contained outcome measures of labor pain. RESULTS: Our search strategy found 18 trials. Six of these did not meet our inclusion criteria. The remaining 12 trials involved acupuncture (2), biofeedback (1), hypnosis (2), intracutaneous sterile water injections (4), massage (2), and respiratory autogenic training (1). CONCLUSION: There is insufficient evidence for the efficacy of any of the complementary and alternative therapies for labor pain, with the exception of intracutaneous sterile water injections. For all the other treatments described it is impossible to make any definitive conclusions regarding effectiveness in labor pain control.

Acupuncture Therapy↗
PubMed2004

Acupuncture for labor pain management: A systematic review.

Acupuncture is widely used to alleviate symptoms in a variety of painful conditions. In obstetrics and gynecology, acupuncture has also been applied to a range of conditions including labor pain. This systematic review aims to critically evaluate the evidence on analgesic effect of acupuncture during labor. Computerized literature searches of 7 databases were performed for randomized clinical trials (RCTs) of acupuncture involving needle insertion for pain during labor. Three RCTs were identified and their methodologic quality was generally good. Two RCTs compared adjunctive acupuncture with usual care only and reported a reduction of meperidine and/or epidural analgesia. One placebo acupuncture controlled trial showed a statistically significant difference in both subjective and objective outcome measures of pain. No adverse events were reported in any of the trials. It is concluded that the evidence for acupuncture as an adjunct to conventional pain control during labor is promising but, because of the paucity of trial data, not convincing. Further research is warranted to clearly define its place in labor pain management.

Acupuncture Therapy↗
PubMed2004

Complementary and alternative therapies in the treatment of chronic hepatitis C: a systematic review.

BACKGROUND/AIMS: Hepatitis C is an escalating global health problem. The recommended treatment regimen is associated with considerable expense, adverse effects and poor efficacy in some patients. Complementary therapies are widely promoted for and used by patients with hepatitis C. The aim is to systematically assess the efficacy of complementary therapies in treating chronic hepatitis C. METHODS: Systematic searches were conducted in six databases, reference lists of all papers were checked for further relevant publications and information was requested from experts. No language restrictions were imposed. RESULTS: Twenty-seven eligible randomised clinical trials were located involving herbal products and supplements. No randomised clinical trials were identified for any other complementary therapy. In 14 of the trials, patients received interferon-alpha in combination with the complementary therapy. Less than half the trials (11/27) were of good methodological quality. Compared with the control group, significant improvements in virological and/or biochemical response were seen in trials of vitamin E, thymic extract, zinc, traditional Chinese medicine, Glycyrrhiza glabra and oxymatrine. CONCLUSIONS: We identified several promising complementary therapies, although extrapolation of the results is difficult due to methodological limitations. More research is warranted to establish the role of these and other therapies in the treatment of hepatitis C.

Animals↗
PubMed2004

Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy.

Acute respiratory infections represent a significant cause of over-prescription of antibiotics and are one of the major reasons for absence from work. The leaves of Andrographis paniculata (Burm. f.) Wall ex Nees (Acanthaceae) are used as a medicinal herb in the treatment of infectious diseases. Systematic literature searches were conducted in six computerised databases and the reference lists of all papers located were checked for further relevant publications. Information was also requested from manufacturers, the spontaneous reporting schemes of the World Health Organisation and national drug safety bodies. No language restrictions were imposed. Seven double-blind, controlled trials (n = 896) met the inclusion criteria for evaluation of efficacy. All trials scored at least three, out of a maximum of five, for methodological quality on the Jadad scale. Collectively, the data suggest that A. paniculata is superior to placebo in alleviating the subjective symptoms of uncomplicated upper respiratory tract infection. There is also preliminary evidence of a preventative effect. Adverse events reported following administration of A. paniculata were generally mild and infrequent. There were few spontaneous reports of adverse events. A. paniculata may be a safe and efficacious treatment for the relief of symptoms of uncomplicated upper respiratory tract infection; more research is warranted.

Andrographis↗
PubMed2004

Dietary supplements for body-weight reduction: a systematic review.

BACKGROUND: Compliance with conventional weight-management programs is notoriously poor, and a plethora of over-the-counter slimming aids are sold with claims of effectiveness. OBJECTIVE: The objective of the study was to assess the evidence from rigorous clinical trials, systematic reviews, and meta-analyses on the effectiveness of dietary supplements in reducing body weight. DESIGN: The study was a systematic review. Literature searches were conducted on Medline, Embase, Amed, Cinahl, and the Cochrane Library until March 2003. Hand searches of medical journals, the authors' own files, and bibliographies of identified articles were conducted. There were no restrictions regarding the language of publication. The screening of studies, selection, validation, data extraction, and the assessment of methodologic quality were performed independently by the 2 reviewers. To be included, trials were required to be randomized and double-blind. Systematic reviews and meta-analyses of dietary supplements were included if they were based on the results of randomized, double-blind trials. RESULTS: Five systematic reviews and meta-analyses and 25 additional trials were included and reviewed. Data on the following dietary supplements were identified: chitosan, chromium picolinate, Ephedra sinica, Garcinia cambogia, glucomannan, guar gum, hydroxy-methylbutyrate, plantago psyllium, pyruvate, yerba maté, and yohimbe. The reviewed studies provide some encouraging data but no evidence beyond a reasonable doubt that any specific dietary supplement is effective for reducing body weight. The only exceptions are E. sinica- and ephedrine-containing supplements, which have been associated with an increased risk of adverse events. CONCLUSIONS: The evidence for most dietary supplements as aids in reducing body weight is not convincing. None of the reviewed dietary supplements can be recommended for over-the-counter use.

Complementary Therapies↗
PubMed2004

Insufficient evidence to conclude whether or not Transcendental Meditation decreases blood pressure: results of a systematic review of randomized clinical trials.

OBJECTIVE: To carry out an independent, systematic review of randomized clinical trials of Transcendental Meditation (TM) for cumulative effects on blood pressure. METHOD: Searches were made of electronic databases and the collected papers and official web sites of the TM organization. We included only randomized clinical trials, without confounding co-interventions, which measured the cumulative effects of TM on blood pressure. RESULTS: Six trials met the inclusion criteria but one, reported only in abstract form, could not be evaluated. Procedures for establishing baseline blood pressure were adequate in only one trial. Only one of the trials included a follow-on assessment and only one of the evaluable trials tested the effect of TM in hypertensive individuals. Three of the five evaluable trials reported statistically significant differences between intervention groups favouring TM and two found no significant differences between intervention groups. None of the five studies was conducted by independent authors without any affiliation to the TM organization. CONCLUSION: All the randomized clinical trials of TM for the control of blood pressure published to date have important methodological weaknesses and are potentially biased by the affiliation of authors to the TM organization. There is at present insufficient good-quality evidence to conclude whether or not TM has a cumulative positive effect on blood pressure.

Blood Pressure↗
PubMed2004

Impact of federal safety advisories on health food store advice.

In early 2002, the FDA and Health Canada issued federal advisories that people should discontinue taking the herbal antianxiolitic kava kava, until further information regarding safety and potential for liver damage were determined. We conducted a field study 2 months following the advisories in Toronto, Canada to determine whether kava kava continued to be recommended to consumers at retail health food stores. Eight participants asked employees at all stores what was recommended for anxiety and whether the products were safe. Twenty-two of 34 stores recommended kava kava, 9 of which mentioned safety concerns. Physicians should be aware that federal advisories may not affect sales of unsafe products.

Anxiety↗
PubMed2004

Does aromatherapy massage benefit patients with cancer attending a specialist palliative care day centre?

A randomised controlled pilot study was carried out to examine the effects of adjunctive aromatherapy massage on mood, quality of life and physical symptoms in patients with cancer attending a specialist unit. Participants were randomised to conventional day care alone or day care plus weekly aromatherapy massage using a standardised blend of oils for four weeks. At baseline and at weekly intervals, patients rated their mood, quality of life and the intensity and bother of two symptoms most important to them. Forty-six patients were recruited to the study. Due to a large number of withdrawals, only 11 of 23 (48%) patients in the aromatherapy group and 18 of 23 (78%) in the control group completed all four weeks. Mood, physical symptoms and quality of life improved in both groups. There was no statistically significant difference between groups in any of the outcome measures. Despite a lack of measurable benefit, all patients were satisfied with the aromatherapy and wished to continue. Whilst this pilot study has shown that a randomised controlled trial of complementary therapy is feasible, it has also identified several areas that would require further consideration when designing future studies, e.g., the recruitment and retention of appropriate numbers of patients and the outcome measures used.

Aged↗
PubMed2004

Herbal supplement use by persons aged over 50 years in Britain: frequently used herbs, concomitant use of herbs, nutritional supplements and prescription drugs, rate of informing doctors and potential for negative interactions.

BACKGROUND: The use of herbal and nutritional supplements by older British people is increasing and despite the risks of adverse effects and negative herb-drug interactions, doctors are often not informed of their use. The number of herbal and nutritional supplements used most frequently by older people, and which particular herbal extracts are used, are unknown. This study aimed to identify how many herbal and nutritional supplements and which herbal extracts are most frequently used by British people >50 years of age, and to identify which herb-drug interactions represent the greatest risk to this age group. METHOD: A self-completed survey was promoted through websites and a popular magazine aimed at people >50 years of age. RESULTS: Respondents (n = 271) used a mean of 2.26 prescription drugs and 5.91 herbal and nutritional supplements, including 2.66 herbal extracts. The use of herbal medicines by older British people frequently involves the use of several herbs, often involves concomitant use with several nutritional supplements, is poorly reported to doctors and places older people at risk of negative herb-drug interactions. The most frequently used herbs and associated risks of negative interactions with prescription drugs are identified. CONCLUSIONS: Older people should be encouraged to report the use of herbs and nutritional supplements to their doctors, and doctors should be provided with comprehensive and up-to-date information about potential herb-drug interactions.

Aged↗