This study investigated whether the potential anxiety relief provided by auricular acupressure could improve the efficacy of habit reversal treatment, as evidenced by improved stomatological and other outcomes ⁽¹⁾. In a pragmatic, randomized, crossover, pilot clinical trial, 83 nail biters (8-12 years old) received habit reversal treatment in combination with either auricular acupressure intended to reduce anxiety (Method A) or placebo auricular acupressure (Method B). The alternative protocol was employed after a two-month washout period. The results showed that forty-one children successfully completed both arms of the treatments and attended all appointments. There were significant differences in the efficacy of habit reversal treatment, the anxiety score, the nail status, and the SGI in favor of Method A. The authors conclude that auricular acupressure appears to improve the efficacy of habit reversal treatment, likely by reducing anxiety.

This review discusses immune system dysfunction as a possible target of autism therapy ⁽¹⁾. Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with an unknown etiology and currently few effective therapies. Immune system alterations have being demonstrated in ASD, both in humans and via animal models; immune imbalance thus arises as a possible pathway for drug intervention. In this review, the studies were classified into 2 major groups: (1) clinical research whose authors classify therapies with primary anti-inflammatory and immunomodulatory actions, making use of: sulforaphane, celecoxib, lenalidomide, pentoxifylline, spironolactone, flavonoid luteolin, corticosteroids, oral immunoglobulin, intravenous immunoglobulin, cell therapy, dialyzable lymphocyte extracts, minocycline, and pioglitazone; and (2) other ASD therapies already used or currently under study whose initial characteristics were neither anti-inflammatory nor immunomodulatory initially, but displayed a capacity for immunomodulation throughout the treatment: risperidone, vitamin D, omega-3, Ginkgo biloba, L-carnosine, N-acetylcysteine, and microbiome restoration. These studies used various data acquisition methodologies. Questions arose such the need for randomized and placebo-controlled studies with greater numbers of participants as well as the use of biomarkers to refine the treatment of autistic subjects.

Evidence for blood pressure-lowering effects of vitamin C (VC) supplementation in clinical trials is inconsistent and limited studies have examined the effect of VC supplementation on hypertension (HTN) control. In this study, eligible patients were cluster assigned to receive 300 mg VC per day or nothing for 6 months ⁽¹⁾. During the 6-month follow-up period, a questionnaire survey was obtained and standardized blood pressure measurements were performed on all subjects. Oral administration of VC significantly decreased the diastolic blood pressure and pulse pressure with a significant increase in HTN control. After adjusting for confounding variables, treatment with VC was associated with approximately 0.5 risk reduction of uncontrolled HTN in subjects received anti-hypertensive medications, whereas lower indoor and outdoor and ground temperature were significantly associated with an increased risk of uncontrolled HTN in all patients. The authors suggest that further studies investigating the mechanisms underlying the association between VC and HTN control are warranted.

Recent literature has focused on the association of psoriasis with lower than normal or highly deficient vitamin D blood levels. This study investigated the controversial association between psoriasis and vitamin D levels ⁽¹⁾. From 2012 to 2014, 561 subjects were assessed, of which 170 had psoriasis, 51 had an autoimmune bullous, and 340 were healthy patients. Anagraphical data, 25(OH)D blood levels, and seasons of vitaminD levels assessments were recorded for each group.Vitamin D levels were significantly different among the 3 groups. Psoriatic patients had significantly lower serum levels of 25(OH)D (21.8 ng/mL) than healthy controls (34.3 ng/mL). Patients with bullous diseases showed the lowest vitamin D mean values (18.2 ng/mL). These results confirm the reduced vitamin D levels in psoriatic patients when compared to healthy controls, and provide new evidence regarding the association of vitamin D levels and psoriasis duration.

The goal of this study was to explore the prevalence with which Australian Western herbalists treat menstrual problems and their related treatment, experiences, perceptions, and interreferral practices with other health practitioners ⁽¹⁾. Members of the Practitioner Research and Collaboration Initiative practice-based research network identifying as Western Herbalists (WHs) completed a specifically developed, online questionnaire. Western Herbalists regularly treat menstrual problems, perceiving high, though differential, levels of effectiveness. For menstrual problems, WHs predominantly prescribe individualised formulas including core herbs, such as Vitex agnus-castus, and problem-specific herbs. Estimated clients' weekly cost (median = $25.00) and treatment duration (median = 4-6 months) covering this Western herbal medicine treatment appears relatively low. Only 19% of WHs indicated direct contact by conventional medical practitioners regarding treatment of clients' menstrual problems despite 42% indicating clients' conventional practitioners recommended consultation with WH. The authors conclude that Western herbal medicine may be a substantially prevalent, cost-effective treatment option amongst women with menstrual problems.

Ketogenic diet therapies have proven efficacy for refractory epilepsy. In this study, the authors observed remarkable efficacy of the diet in two patients with hypoxic-ischaemic encephalopathy ⁽¹⁾. They analysed their cases with refractory structural epilepsies of acquired origin to characterize their response to the ketogenic diet. The classical ketogenic diet was implemented with dietary ratios of 3:1 to 4.4:1. Seizure frequency at 1 month, 3 months, 6 months, 1 year, and 2 years was ascertained. A responder was defined as greater than 50% seizure reduction compared to baseline. The results showed that the ketogenic diet was effective in patients with a developmental and epileptic encephalopathy due to an acquired structural aetiology. This cohort may not be routinely considered for the ketogenic diet because of their structural and acquired, rather than genetic, basis. The authors conclude that the ketogenic diet should be considered early in the management of patients with acquired structural encephalopathies as it can improve seizure control with the potential to improve developmental outcome.

Health-related effects of a vegetarian or vegan diet are known to support parameters positively affecting exercise performance in athletes, whereas knowledge about psyche and wellbeing is sparse. Therefore, the aim of the Nutrition and Running High Mileage (NURMI) Study (Step 2) was to compare Quality of Life (QOL) scores among endurance runners following a vegetarian or vegan dietagainst those who adhere to an omnivorous diet ⁽¹⁾. The study was conducted following a cross-sectional design. A total of 281 recreational runners (159 women, 122 men) completed the WHOQOL-BREF questionnaire consisting of the domains physical health, psychological wellbeing, social relationships and environment, which generates scores on a scale from 4 to 20. It was found that 123 subjects followed an omnivorous diet and 158 adhered to a vegetarian/vegan diet. There were 173 runners who met the inclusion criteria ('NURMI-Runners'), among them 103 half-marathoners and 70 marathoners and ultramarathoners, as well as 108 10 km runners as control group. Men had higher scores than women due to high scores in the physical health and psychological well-being dimensions. Adhering to an omnivorous diet affected environment scores for women and social relationships scores for men. Overall QOL scores were high. The results revealed that endurance runners had a high QOL regardless of the race distance or diet choice. The authors conclude that these findings support the notion that adhering to a vegetarian or vegan diet can be an appropriate and equal alternative to an omnivorous diet.

Musculoskeletal symptoms are the most common adverse effects of aromatase inhibitors and often result in therapy discontinuation. Small studies suggest that acupuncture may decrease aromatase inhibitor-related joint symptoms. The goal of this study was to determine the effect of acupuncture in reducing aromatase inhibitor-related joint pain ⁽¹⁾. Patients were randomized 2:1:1 to the true acupuncture (n = 110), sham acupuncture (n = 59), or waitlist control (n = 57) group. True acupuncture and sham acupuncture protocols consisted of 12 acupuncture sessions over 6 weeks (2 sessions per week), followed by 1 session per week for 6 weeks. The waitlist control group did not receive any intervention. All participants were offered 10 acupuncture sessions to be used between weeks 24 and 52. The results showed that among postmenopausal women with early-stage breast cancer and aromatase inhibitor-related arthralgias, true acupuncture compared with sham acupuncture or with waitlist control resulted in a statistically significant reduction in joint pain at 6 weeks, although the authors conclude that the observed improvement was of uncertain clinical importance.

Controversy exists regarding whether the kinesiology tape application direction affects muscle strength. This study examined this idea ⁽¹⁾. Eighteen healthy volunteers (12 men, 6 women) participated. Kinesiology tape was randomly applied to the quadriceps muscles either from origin to insertion or from insertion to origin. A Biodex isokinetic dynamometer was used to measure the peak torque of the quadriceps pre-and post-taping. There was a significant difference in muscle strength after taping, regardless of the kinesiology tape application direction. There were no significant differences in the peak torque of the quadriceps between the 2 kinesiology tape application directions. The authors conclude that the application of kinesiology tape application to the rectus femoris, vastus medialis, and vastus lateralis of the quadriceps increased the muscle torque, regardless of the tape application direction. Therefore, to enhance quadriceps strength, they recommend the application of kinesiology tape to 3 of the muscles of the quadriceps (specifically, the rectus femoris, vastus medialis and vastus lateralis), irrespective of the tape application direction.

The association of dietary patterns representing multiple dietary components and breast cancer risk is not clearly understood. In this study, the author’s objective was to conduct a systematic review of the association between dietary patterns and breast cancer risk ⁽¹⁾. Seventeen case-control and nested case-control studies identified 15 healthy, and 10 unhealthy, dietary patterns determined posteriori, and 7 dietary indices determined a priori. Vegetables were consistently found in breast cancer protective patterns whereas saturated fat and red and processed meats were consistently found in patterns associated with increased breast cancer risk. The authors conclude that these findings suggest that dietary patterns that include vegetables and limit saturated fat and red and processed meats may lower breast cancer risk.

In this study, the authors performed a systematic review aimed to evaluate the current evidence regarding the efficacy and safety of acupuncture on primary dysmenorrhea ⁽¹⁾. This study included randomized controlled trials (RCTs) of women with primary dysmenorrhea; these RCTs compared acupuncture to no treatment, placebo, or medications, and measured menstrual pain intensity and its associated symptoms. The review included 60 RCTs; the meta-analysis included 49 RCTs. Most studies showed a low or unclear risk of bias. They found that compared to no treatment, manual acupuncture and electro-acupuncture was more effective at reducing menstrual pain, and compared to nonsteroidal anti-inflammatory drugs, manual acupuncture, and warm acupuncture were more effective at reducing menstrual pain. Some studies showed that the efficacy of acupuncture was maintained after a short-term follow-up.

Silymarin (SIL) is an active extraction of the silybum marianum, milk thistle, which is an ancient medicinal plant for treatment of various liver diseases for centuries ⁽¹⁾. In this study, the authors assessed the therapeutic effect of SIL in the treatment of nonalcoholic fatty liver disease (NAFLD) through meta-analysis. Eight RCTs involved 587 patients were included in this study. The results showed that SIL reduced the AST and ALT levels more significantly than the control group. Compared with other interventions, there were significant differences decreasing AST and ALT levels when SIL was used alone. The authors conclude that SIL has positive efficacy to reduce transaminases levels in NAFLD patients. SIL can be an encouraging and considerable phytotherapy for NAFLD patients.

In this study, the authors evaluated the efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients ⁽¹⁾. Fifty subjects with elevated serum thyroid stimulating hormone (TSH) levels (4.5-10 μIU/L) aged between 18 and 50 were randomized in either treatment (n = 25) or placebo (n = 25) groups for an 8-week treatment period. Ashwagandha root extract (600 mg daily) or starch as placebo. Efficacy Variables: Serum TSH, serum triiodothyronine (T3), and thyroxine (T4) levels. Ashwagandha treatment effectively normalized the serum thyroid indices during the 8-week treatment period in a significant manner. The authors conclude it may be helpful for this patient population.

In this study, the effectiveness of probiotics for non-alcoholic fatty liver disease (NAFLD) was examined (1). A total of 200 patients with NAFLD were randomly divided into 4 groups: control group (routine treatment group) and combined treatment group A, B and C. Each group had equal patients. The control group received orally polyene phosphatidylcholine capsules; whereas combined group A, B and C were given orally the live "combined Bifidobacterium Lactobacillus and Enterococcus powder" , "two live combined Bacillus subtilis and Enterococcus" , and the both probiotics respectively. The duration of treatment was 1 month. The results showed that in terms of blood lipids and blood glucose, each group improved after treatment with significant differences except for HDL-C. As for liver function, serum ALT and AST decreased after treatment in each group; especially in combined group C which were lower than those of control group. After treatment, all groups showed improvement of fatty liver by ultrasound, but the difference between groups was not statistically significant. The authors conclude that probiotics improve intestinal microecological system in NAFLD patients via inhibiting TNFα and enhancing adiponectin, possibly resulting in regulating blood glucose, lipid metabolism, and protecting liver injury from NAFLD.

Parkinson's disease (PD) is a multifactorial disorder of the nervous system in which there is a progressive loss of dopaminergic neurons. There is a disturbance in the movement in PD and these include resting tremors, rigidity, bradykinesia or akinesia, disturbance, posture and freezing (motor block). The substantia nigra and other parts of the brain are commonly affected. The disorder could be related to oxidative stress and there is an important role of reactive oxygen species (ROS). A number of herbal products contain active components which are known to possess antioxidant action. In this study, the goal was to define the role of different potential herbal extracts on its pathogenesis which may form the basis of treatment (1). We also discuss in detail the active chemical compounds present each herb which are effective in the treatment of PD. These herbs include Baicalei, Erythrina velutin, Resveratrol, Peganum Harmal, Curcuma longa (Zingiberaceae), Carthamus tinctorius L. (Safflower), Pueraria lobate, Juglandis Semen (Walnut), Tianma Gouteng Yin (TGY), Lycium barbarum L fruit, Mucuna pruriens (Velvet bean), Chunghyuldan (CHD), Paeoniae Alba Radix. The authors conclude that these herbs may be beneficial for designing future drugs for effective treatment of PD.