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PubMed2006

Complementary medicine for depression.

Surveys have demonstrated that complementary medicine use for depression is widespread, although patterns of use vary. A series of systematic reviews provide a summary of the current evidence for acupuncture, aromatherapy and massage, homeopathy, meditation, reflexology, herbal medicine, yoga, and several dietary supplements and relaxation techniques. The quantity and quality of individual studies vary widely, but research interest in complementary therapies is increasing, particularly in herbal and nutritional products. Major questions are still to be answered with respect to the effectiveness and appropriate role of these therapies in the management of depression. Areas for further research and some of the potential challenges to research design are discussed. Finally, several ongoing developments in information provision on this topic are highlighted.

Clinical Trials as Topic↗
PubMed2001

Effects of terpineol on the compound action potential of the rat sciatic nerve.

Terpineol, a volatile terpenoid alcohol of low toxicity, is widely used in the perfumery industry. It is an important chemical constituent of the essential oil of many plants with widespread applications in folk medicine and in aromatherapy. The effects of terpineol on the compound action potential (CAP) of rat sciatic nerve were studied. Terpineol induced a dose-dependent blockade of the CAP. At 100 microM, terpineol had no demonstrable effect. At 300 microM terpineol, peak-to-peak amplitude and conduction velocity of CAP were significantly reduced at the end of 180-min exposure of the nerve to the drug, from 3.28 +/- 0.22 mV and 33.5 +/- 7.05 m/s, respectively, to 1.91 +/- 0.51 mV and 26.2 +/- 4.55 m/s. At 600 microM, terpineol significantly reduced peak-to-peak amplitude and conduction velocity from 2.97 +/- 0.55 mV and 32.8 +/- 3.91 m/s to 0.24 +/- 0.23 mV and 2.72 +/- 2.72 m/s, respectively (N = 5). All these effects developed slowly and were reversible upon 180-min washout.

Action Potentials↗
PubMed2004

Effects of estragole on the compound action potential of the rat sciatic nerve.

Estragole, a relatively nontoxic terpenoid ether, is an important constituent of many essential oils with widespread applications in folk medicine and aromatherapy and known to have potent local anesthetic activity. We investigated the effects of estragole on the compound action potential (CAP) of the rat sciatic nerve. The experiments were carried out on sciatic nerves dissected from Wistar rats. Nerves, mounted in a moist chamber, were stimulated at a frequency of 0.2 Hz, with electric pulses of 50-100-micros duration at 10-20 V, and evoked CAP were monitored on an oscilloscope and recorded on a computer. CAP control parameters were: peak-to-peak amplitude (PPA), 9.9 +/- 0.55 mV (N = 15), conduction velocity, 92.2 +/- 4.36 m/s (N = 15), chronaxy, 45.6 +/- 3.74 micros (N = 5), and rheobase, 3.9 +/- 0.78 V (N = 5). Estragole induced a dose-dependent blockade of the CAP. At 0.6 mM, estragole had no demonstrable effect. At 2.0 and 6.0 mM estragole, PPA was significantly reduced at the end of 180-min exposure of the nerve to the drug to 85.6 +/- 3.96 and 13.04 +/- 1.80% of control, respectively. At 4.0 mM, estragole significantly altered PPA, conduction velocity, chronaxy, and rheobase (P < or = 0.05, ANOVA; N = 5) to 49.3 +/- 6.21 and 77.7 +/- 3.84, 125.9 +/- 10.43 and 116.7 +/- 4.59%, of control, respectively. All of these effects developed slowly and were reversible upon a 300-min wash-out. The data show that estragole dose-dependently blocks nerve excitability.

Action Potentials↗
PubMed2003

Cost of illness of atopic dermatitis in children: a societal perspective.

Childhood atopic dermatitis is a disorder with considerable social and financial costs. Consideration of these costs is increasingly important in view of the growing prevalence of atopic dermatitis, particularly in developed countries over recent decades. The family stress related to the care of children with moderate or severe atopic dermatitis is significantly greater than that of the care of children with type 1 diabetes mellitus. The factors contributing to family stress include sleep deprivation, loss of employment, time taken for care of atopic dermatitis and financial costs. The financial costs for the family and community include medical and hospital direct costs of treatments and indirect costs from loss of employment. There are many interventions utilised in the treatment of childhood atopic dermatitis which involve not only medical practitioners but nurses, pharmacists, dieticians, psychologists and purveyors of so-called alternative therapies such as naturopathy, aromatherapy and bioresonance, all of which contribute to the financial burdens on the parents and the community. It is possible that appropriate interventions directed to reducing trigger factors might produce worthwhile savings, although the cost benefit of these measures has not been demonstrated. In conclusion, atopic dermatitis should not be regarded as a minor skin disorder but as a condition which has the potential to be a major handicap with considerable personal, social and financial consequences both to the family and the community.

Adolescent↗
PubMed2002

The assessment and management of chronic pain in children.

Chronic pain in children and adolescents is frequently misdiagnosed by caregivers. It is not treated until it results in the loss of routine ability and function. Chronic pain is often associated with underlying diseases commonly seen in childhood, including sickle cell disease, malignancy, rheumatologic disorders, inflammatory bowel disease, trauma, and states where there is no identifiable etiology. Chronic pain differs from acute pain in that it serves no useful function. Untreated or under-treated chronic pain will result in the unnecessary suffering of the patient, disruption of family routine, and cohesiveness and restriction of the child's daily activities, thereby increasing long-term disability. Accurate and repeated assessment of chronic pain is required for therapy to be effective. Assessment of chronic pain in children is difficult due to their developing cognitive abilities. The assessment of childhood pain varies with the child's age, type of pain, situation, and prior painful experiences. Assessment tools such as the Varni-Thompson Pediatric Pain Questionnaire and the Visual Analog Scale are helpful for both the patient and physician in helping to identify situations that precipitate pain, to rate the level of pain and determine if therapy has been effective. Documentation of pain assessments and the effectiveness of interventions in the medical record should be included as a routine part of all patient records. Most caregivers have extensive experience in the treatment of acute pain in children but are often not comfortable with the management of complicated and chronic pain states. The therapy for chronic pain in children is multifactorial. It can include agents from multiple classes of pharmacologic agents (nonsteroidal anti-inflammatory drugs, opioids, tricyclic antidepressants, and antineuroleptics) nonconventional therapies (acupuncture and pressure and aromatherapy), as well as herbal and homeopathic remedies.

Acute Disease↗
PubMed2006

Hypersensitivity reactions to complementary and alternative medicine products.

Complementary and alternative medicine (CAM) is becoming increasingly popular, and is often used for treating hypersensitivity diseases. Virtually all alternative remedies can cause hypersensitivity reactions, but the most frequently involved ones are tea tree oil, members of the Compositae family, propolis, oils used in aromatherapy, substances responsible for photosensitization, and metal-containing compounds. The main target organ is skin, with manifestations ranging from contact dermatitis (the most common) to urticaria-angioedema, maculopapular eruptions, photosensitivity reactions, and the Stevens-Johnson syndrome. Other types of reactions are possible, including respiratory and anaphylactic ones. Different pathogenic mechanisms have been suggested for CAM product reactions, including immunologic ones. Basophils and mast cells participate in IgE-mediated reactions through the release of mediators like histamine and tryptase, whereas a T-cell-mediated pathogenic mechanism is involved in most delayed reactions, particularly contact dermatitis and maculopapular eruptions. Skin tests and serum specific IgE assays are carried out to diagnose immediate hypersensitivity reactions, while patch tests and lymphocyte transformation tests are usually performed to evaluate delayed hypersensitivity reactions. Thus clinicians should know about the potential of CAM products for causing adverse reactions. Our study is aimed at highlighting the risk of hypersensitive reactions to CAM remedies on the basis of the numerous cases reported in the literature. Because little is known about adverse reactions to CAM products, further systematic studies and an appropriate regulation by heath authorities are necessary.

Complementary Therapies↗
PubMed2006

A systematic literature review of the effectiveness of non-pharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use.

OBJECTIVES: To determine the effectiveness and cost-effectiveness of non-pharmacological interventions (excluding subjective barriers) in the prevention of wandering in people with dementia, in comparison with usual care, and to evaluate through the review and a qualitative study the acceptability to stakeholders of such interventions and identify ethical issues associated with their use. DATA SOURCES: Major electronic databases were searched up until 31 March 2005. Specialists in the field. REVIEW METHODS: Selected studies were assessed and analysed. The results of two of the efficacy studies that used similar interventions, designs and outcome measures were pooled in a meta-analysis; results for other studies which reported standard deviations were presented in a forest plot. Owing to a lack of cost-effectiveness data, a modelling exercise could not be performed. Four focus groups were carried out with relevant stakeholders (n = 19) including people with dementia and formal and lay carers to explore ethical and acceptability issues in greater depth. Transcripts were coded independently by two reviewers to develop a coding frame. Analysis was via a thematic framework approach. RESULTS: Ten studies met the inclusion criteria (multi-sensory environment, three; music therapy, one; exercise, one; special care units, two; aromatherapy, two; behavioural intervention, one). There was no robust evidence to recommend any non-pharmacological intervention to reduce wandering in dementia. There was some evidence, albeit of poor quality, for the effectiveness of exercise and multi-sensory environment. There were no relevant studies to determine the cost-effectiveness of the interventions. Findings from the narrative review and focus groups on acceptability and ethical issues were comparable. Exercise and distraction therapies were the most acceptable interventions and raised no ethical concerns. All other interventions were considered acceptable except for physical restraints, which were considered unacceptable. Considerable ethical concerns exist with the use of electronic tagging and tracking devices and physical barriers. Existing literature ignores the perspectives of people with dementia. The small number of participants with dementia expressed caution regarding the use of unfamiliar technology. Balancing risk and risk assessment was an important theme for all carers in the management of wandering. CONCLUSIONS: There is no robust evidence so far to recommend the use of any non-pharmacological intervention to reduce or prevent wandering in people with dementia. High-quality studies, preferably randomised controlled trials, are needed to determine the clinical and cost-effectiveness of non-pharmacological interventions that allow safe wandering and are considered practically and ethically acceptable by carers and people with dementia. Large-scale, long-term cohort studies are needed to evaluate the morbidity and mortality associated with wandering in dementia for people both in the community and in residential care. Such data would inform future long-term cost-effectiveness studies.

Confusion↗
PubMed2003

[Anti-Candida albicans activity of essential oils including Lemongrass (Cymbopogon citratus) oil and its component, citral].

The effects of 12 essential oils, popularly used as antifungal treatments in aromatherapy, on growth of Candida albicans were investigated. Mycelial growth of C. albicans, which is known to give the fungus the capacity to invade mucosal tissues, was inhibited in the medium containing 100 micro g/ml of the oils: lemongrass (Cymbopogon citratus), thyme (Thymus vulgaris), patchouli (Pogostemon cablin) and cedarwood (Cedrus atlantica). Not only lemongrass oil but also citral, a major component of lemongrass oil (80%), in the range of 25 and 200 micro g/ml inhibited the mycelial growth but allowed yeast-form growth. More than 200 micro g/ml of citral clearly inhibited both mycelial and yeast-form growth of C. albicans. These results provide experimental evidence suggesting the potential value of lemongrass oil for the treatment of oral or vaginal candidiasis.

Candida albicans↗
PubMed2006

[The effects of inhalation of essential oils on the body weight, food efficiency rate and serum leptin of growing SD rats].

PURPOSES: This experimental study was designed to verify the effect of inhalation of essential oils on body weight, feed intake, food efficiency rate and serum leptin. METHODS: The subjects of this study were 90 growing SD rats (46 males and 44 females). They were allocated into one of four groups, the Fennel group, Patchouli group, Bergamot group and control group. The experimental treatment was the inhalation of aromatherapy essential oils which was applied two times a day for 10 minutes each during 8 weeks. To evaluate the effects, body weight, feed intake, food efficiency rate and serum leptin were measured before and after the treatment. The collected data was analyzed by repeated measures of Kolmogorov-smirnov test and Normal Q-Q plot for normality, Kruskal Wallis test and chi2-test for experimental effects with the SPSS program. RESULTS: The food efficiency rate was significantly lower in the Patchouli group and Fennel group than in the Bergamot group and control group (P=.000). No significant group effects were found for SD rat's body weight, feeding amount and serum leptin. CONCLUSION: In conclusion, these findings indicate that the inhalation of essential oils could be effective in lowering the food efficiency rate rather than the feed intake.

Administration, Inhalation↗
PubMed2001

A primer of complementary and alternative medicine commonly used by cancer patients.

Complementary and alternative medicine (CAM) is frequently used by cancer patients, and many oncologists have limited knowledge of CAM. This article provides a brief, evidence-based introduction to several CAM treatments relevant in the context of cancer. "Alternative" diets, chiropractic, coffee enemas, ozone therapy, and shark cartilage seem to have little to offer cancer patients. The evidence for or against homoeopathy and spiritual healing is at present inconclusive. Acupuncture, aromatherapy, and meditation may be useful for nausea/vomiting, for mild relaxation, and for pain/anxiety, respectively. Herbal treatments offer no reasonable prospect of a cure (mistletoe), but could be useful as palliative treatments (eg, for depression [St John's wort] or anxiety [kava]). Our knowledge regarding the potential benefit and harm of CAM is insufficient.

Complementary Therapies↗
PubMed2002

Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials.

BACKGROUND: Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms. Randomized, controlled trials have evaluated the efficacy and short-term safety of these therapies. PURPOSE: To review randomized, controlled trials of CAM therapies for menopausal symptoms in order to better inform practice and guide future research. DATA SOURCES: Searches of MEDLINE for articles published from January 1966 through March 2002, of the Alternative and Complementary Database (AMED) of the British Library for articles published from January 1985 through December 2000, and of the authors' own extensive files. Search terms were hot flash/flush, menopause, and climacteric, combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine (TCM ), Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch. STUDY SELECTION: 29 randomized, controlled clinical trials of CAM therapies for hot flashes and other menopausal symptoms were identified; of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies. DATA EXTRACTION: Each author extracted information from half of the studies on the number of patients, study design, outcome measures, and results; the other author then checked these results. DATA SYNTHESIS: Soy seems to have modest benefit for hot flashes, but studies are not conclusive. Isoflavone preparations seem to be less effective than soy foods. Black cohosh may be effective for menopausal symptoms, especially hot flashes, but the lack of adequate long-term safety data (mainly on estrogenic stimulation of the breast or endometrium) precludes recommending long-term use. Single clinical trials have found that dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flashes; two trials have shown that red clover has no benefit for treating hot flashes. CONCLUSIONS: Black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms. Clinical trials do not support the use of other herbs or CAM therapies. Long-term safety data on individual isoflavones or isoflavone concentrates are not available.

Acupuncture Therapy↗
PubMedDate not supplied

Complementary therapy in practice.

Dorothy Crowther describes the evolution of the Wirral Holistic Care Services, a company dedicated to helping people cope with cancer. Based on a recognition that such patients want more than the standard NHS fare, initial evaluations suggest that the company is going some way to meeting the extra needs of this group. Available therapies include aromatherapy, kinesiology, reflexology and meditation, incorporating a model of care which endorses putting the patient first.

Adaptation, Psychological↗
PubMedDate not supplied

Stress management in dermatology patients.

The association of skin disorder with emotion has been recognised for some time. Maureen Marshall explores the use of stress management techniques such as relaxation, aromatherapy and therapeutic massage as a means of helping patients with dermatological conditions to cope with the pressures which may exacerbate their skin problems. Nurses, working in tandem with psychologists, have a key role to play in patients' emotional care, but greater commitment in terms of training and funding are required to prepare properly them for this function.

Adaptation, Psychological↗
PubMed1999

[The methods of traditional medicine in the treatment of tuberculosis].

The authors sum up the results of phyto-, aromatherapy and marmot fat complex treatment of 64 patients with pulmonary tuberculosis. In a two-month treatment course in 81.8-95.6% of patients the symptoms of tuberculosis intoxication had disappeared, the body mass increased and the bacteria discharge stopped. It proves that traditional medicine means and methods can be recommended for the rehabilitation periods of tuberculosis patients.

Adaptation, Physiological↗
PubMed2000

The BBC survey of complementary medicine use in the UK.

INTRODUCTION: Recent data about the use of complementary and alternative medicine (CAM) by the general population exist for Australia and the USA, but not for the UK. This study aimed at providing such data. DESIGN: Nationally representative random telephone survey. SETTING AND PARTICIPANTS: 1204 British adults were interviewed. RESULTS: 20% of the sample used CAM in the previous year. Herbalism, aromatherapy, homoeopathy, acupuncture/acupressure, massage and reflexology were the most popular treatment modalities. The main reasons for trying CAM were its perceived effectiveness, a positive inclination towards it, and its relaxing effects. On average, users spent 13.62 +/- 1.61 Pounds on CAM per month, which extrapolates to an annual expenditure of 1.6 billion Pounds for the whole nation. CONCLUSIONS: It is concluded that CAM is prevalent in the UK. Therefore, its scientific validation has become an ethical imperative.

Adult↗
PubMed2000

Complementary therapies and the general practitioner. A survey of Perth GPs.

OBJECTIVE: The purpose of this study was to identify the knowledge, attitudes and referral patterns of general practitioners (GPs) toward 10 specific complementary therapies. METHOD: The study was a descriptive cross-sectional postal survey, conducted between July 1998 and August 1998 inclusive. A random selection of 200 male and 200 female Western Australian GPs residing in Perth and listed in the Australian Medical Association database file of registered GPs. RESULTS: The response rate was 74.8% (n = 282). Over 90% of these GPs reported having been approached by more than 30 patients seeking their advice about complementary therapies in the past nine months. The majority of these patients were women, over the age of 35 years. Ten complementary therapies were listed in the questionnaire: acupuncture, hypnosis, meditation, spinal manipulation, yoga, homeopathy, herbal medicine, naturopathy, massage and aromatherapy. Just under half (132) of the respondents had undertaken studies in at least one of the listed complementary therapies, with over 60% reporting a wish for further training. Overall, 67.8% (191) of all respondents reported they were in favour of GP referrals to complementary therapists. However, 56.1% (158) were against complementary therapies being included in rebates for private health insurance. Overall, 75.0% (211) of GPs surveyed had already formally referred a patient to one or more of the listed therapies, the most frequent of these being acupuncture, massage, meditation, hypnosis and spinal manipulation as a part of their overall medical treatment. CONCLUSION: Perth GPs have a high level of interest in complementary therapies. Government regulation and registration of complementary therapies is seen by GPs as important in order to ensure professional standards of practice. Given the high level of interest, provision of undergraduate and postgraduate education in complementary therapies could be considered. In addition, the development of clinical guidelines would be of benefit.

Adult↗
PubMed2001

Complementary medicine use in children: extent and reasons. A population-based study.

This study used a cross-sectional population survey to determine the prevalence of complementary medicine use in children. Some form of complementary medicine had been used by 17.9% of children at least once, and 6.9% had visited a complementary medicine practitioner. Homoeopathy, aromatherapy, and herbal medicine were most frequently used, most commonly for ear; nose, and throat; dermatology; musculoskeletal; infant; respiratory; and emotional/behavioural health problems. Complementary medicine was used mainly because of word-of-mouth recommendation, dissatisfaction with conventional medicine, and fear of side-effects of conventional treatments. Complementary medicine use is widespread in children; professionals should be aware of this, be alert for possible side-effects/interactions, and encourage adherence to effective conventional treatments where important.

Adolescent↗
PubMed2001

Provider attitudes and use of alternative medicine in a midwestern medical practice in 2001.

OBJECTIVE: To determine the current level of use, referral and desire for service of different complementary and alternative (CAM) therapies among Gundersen Lutheran Medical Center providers. METHODS: A survey was conducted in January of 2001 of all medical and associate staff. RESULTS: The response rate was 79%; 55% reported using 1 or more of 18 therapies for themselves. Over 25% of providers used nutritional supplements, herbal medicines, or hydrotherapy with a patient. Over half of providers had referred a patient for biofeedback or chiropractic care. Over half of providers would like to offer acupuncture, biofeedback, chiropractic care, hydrotherapy, nutritional supplements, or massage to patients in the future. Associate staff, female staff, primary care providers, and those who had personally used CAM therapies were more likely to have used, referred, or wish to offer more therapies in the future. There was little support for aromatherapy, magnetic field therapy, naturopathic medicine, or ethnic healing methods. CONCLUSIONS: Use of and desire for complementary therapies at Gundersen Lutheran was higher than expected by the Integrative Medicine Oversight Committee. Health care organizations should consider having a process in place to manage the increasing demands for complementary and alternative therapies.

Attitude of Health Personnel↗