This study aimed to determine the prevalence of complementary health approaches (CHAs) specifically for acute complaints in patients assessed in a pediatric emergency department (ED) and factors associated with use (1). A cross-sectional survey was offered to patients between the age of 28 days and 18 years assessed at a tertiary pediatric ED. The results showed that of 475 potential participants, 412 (86.7%) participated, of which 369 (89.5%) completed the survey. Overall, 28.7% reported using any CHA for their child to treat the presenting complaint in the prior 72 hours to the ED visit. Gastrointestinal complaints had the highest use of CHA (46.3% of presentations endorsed use). The most common complementary health products used were vitamins and minerals; the most common complementary health practice used was massage.
- 20 Apr 18
- 16 Apr 18
The purpose of this review is to outline the currently developed non-vitamin K oral anticoagulant (NOAC) molecular antagonists, their potential clinical roles and future directions (1). The incidence and prevalence of atrial fibrillation (AF) is expected to more than double between 2010 and 2030. Accordingly, the use of NOAC agents for thromboembolic stroke prevention is anticipated to increase. The development of effective and safe antidotes is needed to address the unmet need for rapid anticoagulation reversal. The immediate role for these novel antidotes is for reversal of NOAC activity in life threatening bleeding and urgent surgical intervention. In addition, reversal agents may play an important role in simplifying bridging protocols in the peri-procedural period for catheter ablation of AF and elective surgery.
- 16 Apr 18
Circulatory failure, especially with low systemic vascular resistance (SVR), as observed in septic shock, thyrotoxicosis, and anemia, is a particular pattern that should suggest thiamine (vitamin B1) deficiency. The clinical picture of wet beriberi secondary to thiamine deficiency only demonstrates non-specific clinical manifestations. This article presents a rare case of wet beriberi associated with multiple organ failure (MOF) in a prison patient with years of heavy alcohol consumption (1). The patient started treatment with thiamine (100 mg) by intramuscular injection, together with basic supportive care. The outcomes were that the hemodynamic indices improved within 12 hours after thiamine administration. Echocardiographic examinations revealed right ventricular function improvement within a few days, which were normal within a month.
- 15 Apr 18
Vitamin D has been proposed to have anti-inflammatory properties. This study was a meta-analysis to examine the effects on inflammatory markers (1). Multiple databases were searched and randomized controlled trials were identified for analysis. The results showed that 28 studies were included. Vitamin D lowered C-reactive protein, TNF-alpha, and ESR – all inflammatory markers. This meta-analysis provides level 1 evidence that vitamin D supplementation may reduce chronic low-grade inflammation in patients with type 2 diabetes.
- 04 Apr 18
Recommended fish intake differs substantially from observed fish intake. In Denmark, ∼15% of the population consumes the state-recommended fish intake. How much fish individuals eat varies greatly, and this variation cannot be captured by considering the fish intake of the average population. The objective of this study was to propose specific fish intake levels for individuals that meet the recommendations for eicosapentaenoic acid, docosahexaenoic acid, and vitamin D without violating the permitted intake recommendations for methyl mercury, dioxins, and polychlorinated biphenyls (1). Results showed that individual, personal dietary recommendations were successfully modeled. Modeled fish intake levels were compared to observed fish intakes.
- 25 Mar 18
In this study, the authors evaluated the effectiveness and safety of outpatient balneological treatment consisting of hydrotherapy and peloid therapy in elderly patients with osteoarthritis (1). Hydrotherapy was applied as head-out immersion in a tap water pool at 36-38 °C for 20 min and then peloid therapy was applied as a local peloid pack on the painful region or joint at 42-43 °C for 20 min, on each weekday for 2 weeks. Patients were evaluated before and after the treatment and outcome measurements were pain, patient's global assessment, physician's global assessment, Western Ontario and McMaster Universities index, Lequesne hip index, Waddell index, neck pain and disability scale, and health assessment questionnaire. In total, 235 osteoarthritis patients were included in the analysis. The authors found significant improvements in pain and function scores in generalized, knee, lumbar, cervical and hand osteoarthritis.
- 20 Mar 18
Constant exposure to various stressors are leading to an increase in immunocompromising health conditions (1). In this review, the authors discuss the role of herbal immunomodulators. Synthetic chemotherapeutic agents, which are widely available in the commercial market, may be highly efficacious, but most are immunosuppressive and exert many side effects. Numerous herbs used in ethnoveterinary medicine can be successfully employed as adjuvant rehabilitators to negate the deleterious effects of chemotherapeutics. Globally, many studies have been conducted on these herbs and have revealed unique active constituents that activate the innate immune system through the stimulation of macrophages and lymphocytes, and modulation of the cytokine profile, which leads to a state of alertness with a subsequent reduction in the incidence of infection.
- 15 Mar 18
In this study, the authors reported on the long-term (up to 1 year) outcomes of acupuncture as a primary and independent treatment in patients with insomnia. The patient was evaluated with polysomnography. In this study, the diagnosis of chronic insomnia was based on the International Classification of Sleep Disorders insomnia. The patient had no obvious differential diagnosis. Acupuncture treatment was planned for this patient who refused to take medical treatment with chronic insomnia. So the patient received 1 hour of acupuncture treatment for 12 weeks. Polysomnographic evaluation was performed at baseline and 3 months, and 1 year after acupuncture treatment. He was asked to keep a diary of all his insomnia-related symptoms. All outcome measures substantially improved. Moreover, during the observation period, the patient's sleep quality did not worsen. The authors conclude that acupuncture is a viable therapy for chronic insomnia.
- 10 Mar 18
In this study, the authors evaluated which factors predicated a high patient throughput to add more evidence to the body of naturopathic evidence (1). It was a cross-sectional study sampling 1096 practitioners in Germany. Besides, sociodemographic data and practice characteristics topics like job satisfaction and feeling for the job were evaluated. This was supplemented with an evaluation of patient traits which were perceived as challenging. The results showed that the naturopathic practitioners were very satisfied with their job. Naturopathic practitioners described that 40% of their patients are challenging.
- 05 Mar 18
Based on a growing body of evidence implicating low vitamin D status in the development of cardiovascular disease, the authors hypothesized that in Canadian HIV-positive adults, low vitamin D concentration would be associated with increased subclinical vascular disease progression (1). In this study, they analyzed the association. The results showed mean progression was 0.027 mm/year. Only 13.3% of participants were vitamin D deficient (25(OH)D < 50 nmol/L), whereas 61.7% had a 25(OH)D exceeding the sufficiency threshold (75 nmol/L). The authors conclude that baseline vitamin D was associated with carotid intima-media thickness progression in this relatively vitamin D replete, predominately white and male, Canadian HIV-positive population.
(1) Huff H, et al. Vitamin D and progression of carotid intima-media thickness in HIV-positive Canadians. HIV Med. 2018;19(2):143-151.
- 02 Feb 18DHA mediates the protective effect of fish in new episodes of depression In a longitudinal cohort study of young Australian adults, the authors reported that for women higher baseline levels of fish consumption were associated with reduced incidence of new depressive episodes during the 5-year follow-up (1). Fish are high in both n-3 fatty acids and tyrosine. In this study, they tried to determine whether n-3 fatty acids or tyrosine explain the observed association. During 2004-2006, a FFQ (nine fish items) was used to estimate weekly fish consumption among 546 women aged 26-36 years. A fasting blood sample was taken and high-throughput NMR spectroscopy was used to measure 233 metabolites, including serum n-3 fatty acids and tyrosine.02 Feb 18Acupuncture for severe constipation Acupuncture has been shown to help with chronic severe functional constipation (CSFC). Which patients have a better response is unclear and this study examined that (1). The authors performed a secondary analysis of a randomized controlled trial, in which patients received electroacupuncture or sham electroacupuncture. Responders were defined as participants with an increase of at least one complete spontaneous bowel movement in week 20 compared with the baseline period. The results showed that the responder rate was significantly greater in the active group. Both age and comorbidity were negatively associated with clinical response: with every one-year increase in age, the likelihood of clinical response was reduced by 1.2% and patients with comorbidities were approximately 42% less likely to respond to treatment.02 Feb 18High-dose oral multivitamins and minerals after heart attack This study examined a subgroup of the Trial to Assess Chelation Therapy (TACT) (1). It looked at oral multivitamins and minerals after heart attack to see if they improved outcomes and included patients not on statins. There were 460 (27%) of 1,708 TACT participants not taking statins at baseline, 224 (49%) were in the active vitamin group and 236 (51%) were in the placebo group. The intervention was a daily high-dose tablet, 6 per day. The primary end point of TACT was time to the first occurrence of any component of the composite end point: all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for angina. The results showed better outcomes in the vitamin group.02 Feb 18
Pretreatment of myoinositol is a very new method that was evaluated in multiple small studies to manage poor ovarian response in assisted reproduction. This study was to determine the efficacy of myoinositol supplement in infertile women undergoing ovulation induction for intracytoplasmic sperm injection (ICSI) or in vitro fertilization embryo transfer (IVF-ET) (1). A meta-analysis was conducted and 7 trials were included. Inositol was associated with improved clinical pregnancy rates, as well as other positive factors. There were no differences in total oocytes retrieved. The authors conclude that myoinositol supplement increase clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET.02 Feb 18Vitamin B12 after gastric bypass Many guidelines recommend vitamin B12 injections in those with gastric bypass surgery. This study reviewed the efficacy and to see if oral B12 is adequate (1). The authors examined medical databases and obtained 19 articles to review. The results showed that oral vitamin B12 at doses of less than 15 mcg are insufficient to prevent deficiency in bypass patients. Higher supplementation doses showed better results, and in particular, doses of 1000mcg per day lead to an increase in B12 levels and was sufficient for prevention of deficiency.