Traditional
Chinese medicine and naturopathic medicine may offer effective treatments for
temporomandibular joint (TMJ) disorders.
The
study compared whole system traditional Chinese medicine and naturopathic
medicine to state-of-the-art specialty care in 160 women 25-55 years of age attending
a Kaiser Permanente Northwest TMD specialty clinic.
Music
therapy may improve depression, anxiety and relationships in psychiatric
patients, a new study reports.
Music
is an ancient tool of healing that was recognized in the writings of the Greek
philosophers Pythagoras, Aristotle and Plato. The modern discipline of music
therapy began early in the 20th Century with community musicians visiting
veterans' hospitals around the country to play for those traumatized by war.
The positive response prompted many hospitals to hire musicians to play for
their patients.
Studies
suggest that music may be used to influence physical, emotional, cognitive and
social well-being and improve quality of life for healthy people, as well as
those who are disabled or ill. It may involve either listening to or performing
music, with or without the presence of a music therapist.
Music
therapists are professionally trained to design specialized applications of
music according to an individual's needs using improvisation, receptive
listening, song writing, lyric discussion, imagery, performance or learning
through music. They work in psychiatric hospitals, prisons, rehabilitative
facilities, medical hospitals, outpatient clinics, day treatment centers,
agencies serving developmentally disabled persons, community mental health
centers, drug and alcohol programs, senior centers, nursing homes, hospice
programs, correctional facilities, halfway houses, schools and private
practices.
Infants,
children, adolescents, adults, the elderly and even animals can all potentially
benefit from music therapy. Research supports all forms of music as having
therapeutic effects, although music from one's own culture may be most
effective. Types of music differ in the types of neurological stimulation they
evoke. For example, classical music has been found to soothe and comfort the
listener, while rock music may be unsettling and cause distress.
Researchers
from the Graduate School of Art Therapy, Daejeon University, Daejeon, South
Korea, tested whether group music therapy is effective for improving
depression, anxiety and relationships in 26 patients allocated to either a
music intervention group or a routine care group.
The
music intervention group received 60 minutes of music intervention for 15
sessions (one or two times weekly).
The
study found that after 15 sessions, the music intervention group showed
significant improvements in depression, anxiety and relationships compared with
the control group.
The
authors concluded that despite the positive results, objective and replicable
measures are required from a randomized controlled trial with a larger sample
size and an active comparable control.
There
is evidence that music that reflects the listener's personal preference is more
likely to have desired effects. It is possible that music through headphones
during medical procedures could interfere with the patient's cooperation with
the procedures. Further research is needed in this area.
Two
new studies examined how ethnicity may influence dietary habits, which may in
turn affect health. Obesity rates are higher and more dramatic in African
American and Hispanic populations compared to Caucasians and researchers
attribute this to socioeconomic and ethnic disparities.
A
study by the RAND Corporation in Pittsburgh, PA, examined the associations
between fruit and vegetable intake and neighborhood socioeconomic status. The
researchers analyzed whether socioeconomic status explains ethnic differences
in food intake, and explored the extent to which socioeconomic status has
differential effects by ethnicity of U.S. adults.
The
researchers found that socioeconomic status was positively associated with
fruit and vegetable intake: a higher socioeconomic status was associated with the
consumption of nearly two additional servings of fruit and vegetables per week.
The
authors concluded that socioeconomic status explained some of the African
American-Caucasian disparity in fruit and vegetable intake and was
differentially associated with fruit and vegetable intake among Caucasians, African
Americans and Mexican Americans.
In
a related study by the Center for Human Nutrition, Johns Hopkins Bloomberg
School of Public Health, Baltimore, MD, researchers observed that dairy
consumption and associated nutrients may be protective against some of the
components of the metabolic syndrome. The metabolic syndrome is a group of risk
factors of a metabolic origin that increase the risk of diabetes, coronary
heart disease, stroke and peripheral vascular disease; it is also called
syndrome X.
The
study examined the association between the consumption of a variety of dairy
products and their related nutrients with obesity, central obesity and metabolic
syndrome and it attempted to explain some of the ethnic differences in
metabolic outcomes through dairy consumption using national data.
Indicators
of obesity, central obesity and metabolic syndrome among U.S. adults were
constructed from the National Health and Nutrition Examination Survey 1999-2004
data, including direct anthropometric assessments, blood pressure and laboratory
tests. Sample sizes ranged from 4,519 for metabolic syndrome to 14,618 for
obesity.
The
study found a significant inverse association between metabolic syndrome and the
intake of whole milk, yogurt, calcium and magnesium. Using structural equation
models, ethnic differences in some metabolic syndrome outcomes, such as body
mass index and systolic blood pressure, were partly explained by variations in
dairy-related nutrients.
The
authors concluded that dairy products may have differential associations with
metabolic disorders, including obesity. Ethnic differences in dairy consumption
may explain in part the ethnic disparities in metabolic disorders in the U.S.
population.
For
more information on nutrition and health, please visit Natural Standard’s
Health & Wellness and Nutrition databases.
A
new study surveyed chiropractic practitioners in the United States to determine
whether or not they identified themselves in the complementary and alternative
medicine (CAM) category.
Researchers
from Cleveland Chiropractic College-Kansas City, Kansas City, MO, explained
that chiropractic care in the United States exhibits characteristics of both
mainstream healthcare and CAM.
The
study investigated the opinions of a sample of chiropractic faculty and
practitioners on the appropriate classification of their profession, in terms
of CAM versus mainstream.
The
faculty sample consisted of all faculty members holding Doctor of Chiropractic
(D.C.) degrees at four chiropractic colleges: two in the Midwest and two in
southern California. The practitioner sample consisted of all 108 participants,
located in 32 states in the United States, in a chiropractic practice-based
research network.
In
the study, 191 D.C. faculty were invited to participate, and 71 (37 percent) completed
the survey. Of the 108 practicing D.C.s invited to participate, 61 (57 percent)
completed the survey.
The
researchers found that of the total sample of 132, 69 percent did not agree
that chiropractic should be categorized as CAM. Rather, 27 percent thought that
chiropractors should be classified as integrative medicine, and 20 percent of
practitioners and six percent of faculty considered chiropractic mainstream
medicine.
The
authors concluded that the majority of the chiropractors in this sample rejected
being characterized as CAM practitioners, showing some preference for the term
integrative medicine.
For
more information about chiropractic care, please visit Natural Standard’s
Health & Wellness database.
A
new review noted the growing use of traditional Chinese medicine in the
treatment of infertility.
Researchers
explained that recent studies demonstrated that traditional Chinese medicine
could regulate the gonadotropin-releasing hormone to induce ovulation and
improve the uterus blood flow and menstrual changes of the endometrium. In
addition, it also has an impact on patients with infertility resulting from
polycystic ovarian syndrome, anxiety, stress and immunological disorders.
Although
study design with adequate sample size and appropriate control for the use of
traditional Chinese medicine is not sufficient, the effective studies have
already indicated the necessity to explore the possible mechanisms, including
effective dose, side effects and toxicity of traditional Chinese medicine, in
the treatment of infertility.
The
authors concluded that the growing popularity of traditional Chinese medicine
used alone or in combination with Western medicine highlights the need to
examine the pros and cons of both Western and traditional Chinese medicine
approaches.
They suggested integrating the principle and knowledge from well-characterized approaches and quality control of both traditional Chinese medicine and Western medical approaches.
For more information about traditional Chinese medicine,
please visit Natural Standard’s Health & Wellness database.
Various
types of psychotherapy, such as cognitive and behavioral therapy and guided
imagery, may help treat patients with fibromyalgia. Fibromyalgia is
characterized by chronic, widespread pain in the muscles and soft tissues
surrounding the joints, and it is accompanied by fatigue.
Researchers
from the University of Heidelberg in Germany developed a guideline for the
treatment and diagnostic procedures in fibromyalgia syndrome in cooperation
with 10 German medical and psychological associations and two patient self-help
groups.
A
systematic literature search was performed in the Cochrane Collaboration
Reviews (1993-12/2006), Medline (1980-12/2006), PsychInfo (1966-12/2006) and
Scopus (1980-12/2006). Levels of evidence were assigned according to the
classification system of the Oxford Centre for Evidence-Based Medicine.
Grading
of the strengths of recommendations was done according to the German program
for disease management guidelines. Standardized procedures to reach a consensus
on recommendations were used.
The
study found that cognitive and operant behavioral therapy is strongly
recommended and guided imagery/hypnotherapy and written emotional disclosure
are recommended.
The authors concluded that psychotherapeutic programs tailored to fibromyalgia subgroups should be developed and tested.
For
more information about fibromyalgia, please visit Natural Standard’s Medical
Conditions database.
A
new study supports the growing evidence that healthy marriages equal healthier
men and women.
Researchers
from Mayo Clinic, in Rochester, MN, investigated whether marital status and
self-assessed mental health are independent risk factors for poor self-rated
overall health among female primary care patients.
The
cross-sectional survey of family medicine patients treated in a clinic in rural
Minnesota included 723 women. Self-ratings of mental health, demographics and
symptoms were used to predict self-rated overall health.
The
study found that women who were single, divorced or otherwise not married or
widowed had lower odds of good self-rated overall health compared with married
women. Women who were 65 years of age and over, women who rated themselves as
depressed and women who reported more physical symptoms also were less likely
to have good health compared with younger women, women who did not feel
depressed and women with fewer physical symptoms, respectively.
Education
was not independently related to health in this sample. Worry was related to
health in the univariate analysis but not after controlling for self-assessed
depression.
The
study authors concluded that in order to improve overall health among rural
women seen in primary care settings, special attention may need to be directed
at women who are single, are older, report more physical symptoms and feel
depressed. They suggested that programs include self-help materials, support
groups and counseling services addressing social isolation, employment and
financial hardship.
This
study comes during a time of marriage crisis in America; almost half of all
marriages continue to end in divorce. However, couples who stay married report
happier and healthier lives.
In
an article for Discovery Health, David Popenoe, a professor of sociology at
Rutgers University and co-director of the National Marriage Project, dispelled
common myths about marriage. Popenoe asserted that recent research suggests
that men and women benefit about equally from marriage, although in different
ways. Both men and women live longer, happier, healthier and wealthier lives
when they are married. Husbands typically gain greater health benefits, while
wives gain greater financial advantages.
Other
research found that couples with children have a slightly lower rate of divorce
than childless couples. Popenoe found that the most common reasons couples give
for their long-term marital success are commitment and companionship. He warned
that many studies have found that those who live together before marriage have
less satisfying marriages and a considerably higher chance of eventually
breaking up. And, according to a large-scale national study, married people
have both more and better sex than do their unmarried counterparts; they report
enjoying it more, both physically and emotionally.
Another
recent study of 17 developed nations found that married persons have a
significantly higher level of happiness than persons who are not married after
controlling for gender, age, education, children, church attendance, financial
satisfaction and self-reported health. The authors asserted that "the
strength of the association between being married and being happy is remarkably
consistent across nations." Marriage boosted financial satisfaction and
health; cohabitation, by contrast, did not increase financial satisfaction or
perceived health and the boost to happiness from having a live-in lover was
only about a quarter of that of being married, stated the researchers.
And
finally, the U.S. Department of Health and Human Services: Administration for
Children and Families found benefits for children, men, women and communities.
Children
and youth who are raised by parents in healthy marriages, compared to unhealthy
marriages, are: more likely to attend college, more likely to succeed
academically, physically healthier, emotionally healthier, less likely to
attempt or commit suicide, less likely to have behavioral problems in school,
less likely to be a victim of physical or sexual abuse, less likely to abuse
drugs or alcohol, less likely to commit delinquent behaviors, more likely to
have a better relationship with their mothers and fathers, less likely to
divorce when they get married, less likely to become pregnant as a teenager or
impregnate someone, less likely to be sexually active as teenagers, less likely
to contract STDs and less likely to be raised in poverty.
Women
who are in healthy marriages are: more likely to have a more satisfying
relationship, emotionally healthier, physically healthier, wealthier, less
likely to be victims of domestic violence, sexual assault or other violent
crimes, less likely to attempt or commit suicide, less likely to abuse drugs or
alcohol, less likely to contract STDs, less likely to remain or end up in
poverty and more likely to have better relationships with their children.
Men
who are in healthy marriages, compared to unhealthy marriages, are: more likely
to live longer, physically healthier, wealthier, more likely to have increased
stability of employment, more likely to have higher wages, emotionally
healthier, less likely to abuse drugs or alcohol, more likely to have better
relationships with their children, more likely to have a satisfying sexual
relationship, less likely to commit violent crimes, less likely to contract
STDs and are less likely to attempt or commit suicide.
And
lastly, communities with a higher percentage of couples in healthy marriages
report the following: higher rates of physically healthy citizens, higher rates
of emotionally healthy citizens, higher rates of educated citizens, lower
domestic violence rates, lower crime statistics, lower teen age pregnancy
rates, lower rates of juvenile delinquency, higher rates of home ownership,
lower rates of migration, higher property values and decreased need for social
services.
For
more information, please visit Natural
Standard's Medical Conditions database, specifically the Marital
Distress Monograph.
Mindfulness-based
stress reduction may be more effective than cognitive-behavioral stress
reduction, a new study reports.
Mindfulness
is an approach in which attention is focused on a physical sensation (such as
breath). When thoughts intrude, the individual returns to the focus. Attention
is placed on the present moment, rather than on the future or past. This
technique may involve a "body scan," in which one focuses on the body
from head to feet, concentrating on areas of pain or illness. This is usually
performed while lying down. Regular practice is suggested to enhance
self-awareness.
Researchers
from New Mexico investigated the effects of mindfulness-based stress reduction
and cognitive-behavioral stress reduction in 50 subjects. Participants
self-selected into mindfulness-based stress reduction (36 participants) or
cognitive-behavioral stress reduction (14 participants) courses taught at
different times. There were no initial differences between the
mindfulness-based stress reduction and cognitive-behavioral stress reduction
subjects among demographics, including age, gender, education and income.
Mindfulness-based
stress reduction was an eight-week course using meditation, gentle yoga and
body-scanning exercises to increase mindfulness. Cognitive-behavioral stress
reduction was an eight-week course using cognitive and behavioral techniques to
change thinking and reduce distress.
The
researchers analyzed perceived stress, depression, psychological well-being,
neuroticism, binge eating, energy, pain and mindfulness before and after each
course. Weekly meetings for both courses were held in a large room on a
university medical center campus.
The
study found that mindfulness-based stress reduction subjects improved in all
eight outcomes, with all of the differences being significant. Similarly,
cognitive-behavioral stress reduction subjects improved in six of eight
outcomes, with significant improvements on well-being, perceived stress and
depression.
According
to the researchers, mindfulness-based stress reduction subjects had better
outcomes across all variables, when compared with the cognitive-behavioral
stress reduction subjects; particularly, mindfulness-based stress reduction
subjects had better outcomes with regard to mindfulness, energy, pain and a
trend for binge eating.
The
study authors concluded that while mindfulness-based stress reduction and
cognitive-behavioral stress reduction may both be effective in reducing
perceived stress and depression, mindfulness-based stress reduction may be more
effective in increasing mindfulness and energy and reducing pain. The authors
recommended that future studies examine the differential effects of cognitive
behavioral and mindfulness-based interventions and attempt to explain the
reasons for the differences.
For
more information on these therapies, please visit Natural Standard's Foods, Herbs & Supplements and Health &
Wellness databases.
An
after-school sports program may be an effective weight control intervention for
overweight children, a new study reports.
According
to the American Heart Association, about 20 percent of children are overweight.
Researchers
from Stanford University, School of Medicine, Stanford, CA, explained that
current clinical child obesity treatment programs require substantial
resources, are able to serve limited numbers of children, are not available in
all communities and have generally demonstrated only modest efficacy.
They
hypothesized that an organized after-school team sports program may address
neighborhood safety concerns that may keep children indoors. Additionally, the
researchers suggested that playing sports, being part of a team, receiving
mentoring, modeling and friendship from young adult coaches and having
opportunities to demonstrate skills in front of friends and family may be fun
and highly motivating for children.
The
study evaluated the feasibility, acceptability and efficacy of an after-school
team sports program for reducing weight gain in overweight children from
low-income families.
In
the study, 21 children in grades 4 and 5 with a body mass index at or above the
85th percentile were enrolled in an after-school soccer program or "active
placebo" control intervention consisting of an after-school health
education program (9 to the soccer intervention and 12 to the health education
intervention).
The
main outcome measures were: implementation, acceptability, body mass index,
physical activity measured using accelerometers, reported television and other
screen time, self-esteem, depressive symptoms and weight concerns.
The
study found that compared with children receiving health education, children in
the soccer group had significant decreases in body mass index scores at three
and six months and significant increases in total daily, moderate and vigorous
physical activity at three months.
The
study authors concluded that an after-school team soccer program for overweight
children can be a feasible, acceptable and efficacious intervention for weight
control.
Integrative
therapies that have been studied in the treatment of obesity with strong or
good scientific evidence include ephedra, 5-HTP, the Atkins diet, DHEA and
psychotherapy. It is important to note that most of these therapies have been
studied in adults, not children, and individuals should consult with a
qualified healthcare professional before beginning any weight loss plan.
Ephedra
contains the chemical ephedrine, which appears to cause weight loss when used
in combination with caffeine, based on the available scientific evidence.
However, even though this herb has been shown to help reduce weight, it is
unsafe for humans for this indication. Serious reactions, including heart
attack, stroke, seizure and death, have occurred with using ephedra. The U.S.
Food and Drug Administration (FDA) has banned sales of ephedra dietary supplements
in all states except for Utah.
5-HTP
is the precursor for serotonin, the brain chemical associated with sleep, mood,
movement, feeding and nervousness. 5-HTP may alter serotonin levels in the
brain, which may then reduce eating behaviors and promote weight loss in obese
individuals.
The
Atkins Diet® is an eating style that radically departs from the U.S. Food and
Drug Administration's (FDA) food pyramid. The Atkins Diet® advocates an
increased consumption of fats as the primary source of energy while
simultaneously restricting the intake of carbohydrates. This limitation is
based on the premise that eating carbohydrates results in the excessive
secretion of insulin, potentially resulting in increased fat stores. A
carbohydrate-restricted diet has been shown to result in weight loss in obese
and non-obese individuals. However, patients should consult with a qualified
healthcare professional before beginning any new diet.
DHEA
(dehydroepiandrosterone) is a hormone that is produced by the adrenal glands.
Most human studies investigating the effects of DHEA on weight or fat loss
support its use for this purpose.
Psychotherapy
is an interactive process between a person and a qualified mental health
professional. The patient explores thoughts, feelings and behaviors to help
with problem solving. Several studies indicate that people who are overweight
or obese may benefit from behavioral and cognitive-behavioral psychotherapy in
combination with diet and exercise to lose weight. Use cautiously with serious
mental illnesses or some medical conditions because some forms of psychotherapy
may stir up strong emotional feelings and expressions.
Integrative
therapies with fair negative evidence in the treatment of obesity include
acupressure or shiatsu and beta-glucan.
During
acupressure, finger pressure is applied to specific acupoints on the body.
Preliminary evidence suggests that acupressure may not be effective for weight
loss.
Beta-glucan
is a fiber that comes from the cell walls of algae, bacteria, fungi, yeast and
plants. Short-term use of fermentable fiber or nonfermentable fiber supplements
does not appear to promote weight loss. More study is needed to confirm these
findings.
Whole
body vibration appears to be as effective as conventional physical therapy for
treating gait and improving balance in patients with Parkinson's disease.
Parkinson's
disease is a movement disorder that is chronic and progressive; symptoms
continue and worsen over time. It affects nerve cells in a part of the brain
that controls muscle movement.
Parkinson's
disease occurs when a group of cells in an area of the brain called the
substantia nigra begin to malfunction and die. The cells in the substantia
nigra produce a chemical called dopamine. Dopamine is a neurotransmitter, or
chemical messenger, which sends information to the parts of the brain that
control movement and coordination.
When
an individual has Parkinson's disease, his/her dopamine-producing cells begin
to die and the amount of dopamine produced in the brain decreases. Messages
from the brain telling the body how and when to move are therefore delivered
more slowly, leaving a person incapable of initiating and controlling movements
in a normal way.
The
four primary symptoms of Parkinson's disease are tremor, or trembling in hands,
arms, legs, jaw and face; rigidity, or stiffness of the limbs and trunk;
bradykinesia, or slowness of movement; and postural instability, or impaired
balance and coordination (parkinsonian gait). As these symptoms become more
severe, patients may have difficulty walking, talking or completing other
simple tasks.
Parkinson's
disease usually affects people over the age of 50. There are 1-1.5 million
people in the United States living with Parkison's. The disorder occurs in all
races but is somewhat more prevalent among Caucasians. Men are affected slightly
more often than women.
Researchers
from Germany compared the effects of whole body vibration and conventional
physiotherapy on levodopa-resistant disturbances of balance and gait in
idiopathic Parkinson's disease.
In
the study, 27 patients with Parkinson's disease and dopa-resistant imbalance on
stable dopamine replacement medication were randomized (intent-to-treat
population) to receive whole body vibration (13 patients) or conventional
physical therapy (14 patients).
The
subjects received 30 sessions (two 15-min sessions a day, 5 days a week) of
either whole body vibration on an oscillating platform or conventional balance
training including exercises on a tilt board.
Twenty-one
patients (per protocol population) completed follow-up (14 men, 7 women; 10
from the whole body vibration group and 11 controls).
The
primary measure was the Tinetti Balance Scale score. Secondary clinical ratings
included stand-walk-sit test, walking velocity, Unified Parkinson's Disease
Rating Scale (section III motor examination) score, performance in the pull
test and dynamic posturography.
The
study found that the Tinetti score improved from 9.3 to 12.8 points in the
whole body vibration group and from 8.3 to 11.7 in the controls. All secondary
measures, except posturography, likewise improved at follow-up compared with
baseline in both groups.
Quantitative
dynamic posturography only improved in patients with whole body vibration and
there was no significant change in controls.
The
study authors concluded that equilibrium and gait improved in patients with
Parkinson's disease receiving both conventional whole body vibration and
conventional physical therapy in the setting of a comprehensive rehabilitation
program. There was no conclusive evidence for the superior efficacy of whole
body vibration compared with conventional balance training.
Integrative
therapies with good scientific evidence in the treatment of Parkinson's disease
include 5-HTP and music therapy.
5-HTP
has been observed to have benefits in some people who have difficulty standing
or walking because of cerebral ataxia (failure of part of the brain to regulate
body posture and limb movements). Some research shows that 5-HTP may allow
individuals with unsteady movements to stand alone without assistance, walk
without aid or have improved coordination. Other research shows no benefit.
Further research is needed before a conclusion can be drawn.
Music
therapy has been reported to improve symptoms in people with Parkinson's
disease. Modest improvement in symptoms including motor coordination, speech
intelligibility and vocal intensity, bradykinesia (slow movement), emotional
functions, activities of daily living and quality of life were seen.
Kava
is an integrative therapy with fair negative evidence in the treatment of
Parkinson's disease. It has been shown to increase 'off' periods in Parkinson
patients taking levodopa and can cause a semicomatose state when given with
alprazolam. Therefore, it is not recommended.
Cognitive
behavioral therapy may be an effective treatment option for adolescents with
chronic fatigue syndrome, a new study suggests.
Cognitive
behavioral therapy is a psychotherapy based on modifying cognitions,
assumptions, beliefs and behaviors with the aim of influencing disturbed
emotions.
The
particular therapeutic techniques vary, but commonly include: keeping a diary
of significant events and associated feelings, thoughts and behaviors;
questioning and testing cognitions, assumptions, evaluations and beliefs that
might be unhelpful and unrealistic; gradually facing activities that may have
been avoided; and trying out new ways of behaving and reacting. Relaxation and
distraction techniques are also commonly used.
Chronic
fatigue syndrome is a disorder that causes extreme fatigue. The condition does
not improve with bed rest. The flu-like symptoms associated with the disorder
may last for years.
Researchers
at the U.S. Centers for Disease Control and Prevention (CDC) identified the
disease in 1988. However, the cause remains unknown, and there is currently no
method to measure the severity of the condition. Also, since little is known
about the disease, there are few treatment options available.
According
to the CDC, about one million Americans have chronic fatigue syndrome. This
disease affects more Americans than multiple sclerosis, lupus, lung cancer or ovarian
cancer.
Researchers
from Radboud University, Nijmegen, The Netherlands, assessed the long-term
outcome of adolescents with chronic fatigue syndrome who received cognitive
behavioral therapy.
A
previous randomized, controlled trial of 66 adolescent patients with chronic
fatigue syndrome showed that cognitive
behavioral therapy was effective in reducing fatigue and improving physical
functioning.
Fifty
subjects also participated in a follow-up study and received cognitive
behavioral therapy for chronic fatigue syndrome (32 formed the cognitive
behavioral therapy group in the original trial, and 18 patients received
cognitive behavioral therapy after the waiting period). The remaining 16
patients had refused cognitive behavioral therapy after the waiting period.
The
main outcome measures were fatigue severity (Checklist Individual Strength),
physical functioning (Short-Form General Health Survey) and school attendance.
Data were complete for 61 patients at follow-up (cognitive behavioral therapy
group: 47 patients; no-treatment group: 14 patients). The mean follow-up time
was 2.1 years.
The
study found that there was no significant change in fatigue severity between
post-treatment and follow-up in the cognitive behavioral therapy group.
However, there was a significant (10 percent) further increase in physical
functioning and school attendance.
The
adolescents in the cognitive behavioral therapy group were significantly less
fatigued and less functionally impaired, and had higher school attendance at
follow-up than those in the no-treatment group. Fatigue severity of the mother
was a significant predictor of the treatment outcome.
The
study authors concluded that the positive effects of cognitive behavioral
therapy in adolescents with chronic fatigue syndrome are sustained after treatment.
Additionally, higher fatigue severity of the mother may impact treatment
outcome in adolescent patients.
Integrative
therapies with unclear evidence in the prevention or treatment of chronic
fatigue syndrome include DHEA, evening primrose oil, folate and liver extract.
The
scientific evidence remains unclear regarding the effects of dehydroepiandrosterone
(DHEA) supplementation in patients with
chronic fatigue syndrome. Better research is necessary before a clear
conclusion can be drawn.
Not
enough information is available to advise the use of evening primrose oil for
symptoms of chronic fatigue syndrome or fatigue following a viral infection.
Some
patients with CFS also have decreased folic acid levels. Daily injections of a
combination of folic acid, bovine liver extract and vitamin B12 for three weeks
were not beneficial for CFS in one study. Folate appears to be well tolerated
in recommended doses.
And
finally, an injectable solution of bovine liver extract containing folic acid
and cyanocobalamin has been studied as a potential treatment of chronic fatigue
syndrome. Preliminary study indicates that patients with chronic fatigue
syndrome reacted positively to intramuscular bovine liver extract. Additional study
is needed to make a firm recommendation.
Daily
sessions of repetitive transcranial (through the head) magnetic stimulation may
help treat ringing in the ears or tinnitus.
Repetitive
transcranial magnetic stimulation was developed by scientists in the 1980s as a
tool for neurodiagnosis, nerve fiber study and the development of a functional
brain map.
In
the late 1980s, scientists started to use repetitive transcranial magnetic
stimulation for the treatment of depression. Over time, the use of repetitive
transcranial magnetic stimulation has expanded and is currently not only used
for the treatment of depression, but also to treat Parkinson's disease,
auditory hallucination schizophrenia, migraines, eating disorders, obsessive
compulsive disorder and other mood disorders.
Repetitive
transcranial magnetic stimulation is a more specific form of magnet therapy.
Magnet therapy is the use of magnets to provide health benefits. Repetitive
transcranial magnetic stimulation uses a coil rather than a magnet to produce
an electrical current and is specifically used on the scalp. Repetitive
transcranial magnetic stimulation is a procedure in which electrical activity
in the brain is influenced by a pulsed magnetic field generated by brief
current pulses through figure-eight coils of wire. These wires are encased in
plastic and held close to the scalp. The location of the device allows for
stimulation of specific areas of the cortex (the surface of the brain).
Repetitive
transcranial magnetic stimulation is non-invasive and requires no anesthesia.
Few patients report any serious side effects. Mild side effects include
headache and the perception of unwanted noise. These problems are typically
treated with acetaminophen (Tylenol®) and ear plugs, respectively.
Researchers
from Assiut University Hospital, Assiut, Egypt, compared the effects of
different frequencies of repetitive transcranial magnetic stimulation and sham
stimulation given daily over the left temporoparietal cortex for two weeks on
66 patients with chronic tinnitus randomly divided into four treatment groups.
Patients
were assessed using the Tinnitus Handicap Inventory, self-ratings of symptoms
and audiometric measures of residual inhibition before, immediately after two
weeks' treatment and monthly thereafter for four consecutive months.
There
were no significant differences in measures between the four groups of patients
at the beginning of the study.
The
study found that real repetitive transcranial magnetic stimulation produced
greater improvement than sham. However, there was no significant difference
between the responses to different frequencies of repetitive transcranial
magnetic stimulation. The response to repetitive transcranial magnetic
stimulation depended on the duration of tinnitus; patients who had tinnitus for
the longest period of time were the least likely to respond to treatment.
The
study authors concluded that daily sessions of repetitive transcranial magnetic
stimulation over the temporoparietal cortex may be a useful potential treatment
for tinnitus.
Other
integrative therapies studied for the treatment of tinnitus with unclear or
conflicting evidence include ginkgo, hypnotherapy, hypnosis, physical therapy,
relaxation therapy and zinc.
For
more information on repetitive transcranial magnetic stimulation, please visit
Natural Standard's Health & Wellness database.
A
new study reviewed the effects of EDTA, or ethylene diamine tetraacetic acid,
used in the anticancer drug dexrazoxane.
Dexrazoxane
hydrochloride (Zinecard®, Pharmacia) is a medication used to protect the heart
against the cardiotoxic side effects of anthracycline chemotherapy. As a
derivative of EDTA, dexrazoxane chelates iron, but the precise mechanism by
which it protects the heart is not known.
EDTA
is a chelating (claw-like) molecule used to remove heavy metals and calcium
from the human body. It is one way of treating heavy metal toxicity and
atherosclerotic deposits in arteries.
EDTA
chelation became well known during the 1950s, when it was proposed as a method
to cleanse the blood and blood vessel walls of toxins and minerals. The
technique involves infusing EDTA into the blood. The therapy is sometimes given
by mouth, and occasionally, other chemicals may be used.
Initially,
chelation was used to treat heavy metal poisoning. It was felt by some
observers that other benefits occurred in patients receiving this therapy. In
current times, chelation practitioners may recommend this treatment for
diabetes, for clogged arteries in the heart or legs (peripheral vascular
disease) and for numerous other conditions.
Twenty
or more sessions may be recommended and can cost several thousand dollars. It
has been proposed that treatment with chelation may break down cholesterol
plaques in the arteries. Other mechanisms, such as removal of calcium from
these plaques and antioxidant properties, have also been suggested. However,
there is little scientific evidence to support these theories.
Serious
side effects have been associated with chelation therapy, such as dangerously
low calcium blood levels, damage to bone marrow that decreases the ability to
make new blood cells, kidney damage (with elevated creatinine levels), very low
blood pressure, fast heart rate, increased risk of bleeding or blood clots
(including interference with the effects of the blood thinning drug warfarin
[Coumadin®]), bacterial blood infections, seizures, allergic or immune system
reactions, heart rhythm abnormalities and unstable blood sugars. Other side
effects may include fever, nausea, vomiting, gastrointestinal upset, excessive
thirst, sweating (diaphoresis), headache, decreased thyroid function, fatigue,
low white blood cell count (leukopenia) or low blood platelet count
(thrombocytopenia). Severe reactions have occurred in which people have stopped
breathing. Although deaths have been reported in people receiving chelation, is
not clear that chelation therapy was the direct cause.
Researchers
from the University of Manitoba in Canada explained that the use of the
anthracycline anticancer drugs doxorubicin, daunorubicin, epirubicin and
idarubicin sometimes results in accidental extravasation injury and can be a
serious complication of their use.
They
concluded that dexrazoxane has been shown in two clinical studies and in
several case reports to be highly efficacious in preventing
anthracycline-induced extravasation injury. Dexrazoxane likely acts by removing
iron from the iron-anthracycline complex, thus preventing formation of damaging
reactive oxygen species.
Behavioral
fitness programs proved no more effective than informational pamphlets, a new
study reports.
Researchers
from the University of Cambridge, UK, explained that declining physical
activity is associated with a rising burden of global disease. Efforts to
reverse this trend have not been successful.
The
study assessed the efficacy of a facilitated behavioral intervention to
increase the physical activity of sedentary individuals at familial risk of
diabetes. Researchers recruited 365 sedentary adults who had a parental history
of type 2 diabetes from either diabetes or family history registers at 20
general practice clinics in the UK.
Participants
were randomly assigned to one of two intervention groups or to a comparison
group. All participants were sent a brief advice leaflet. One intervention
group was offered a one-year behavior-change program to be delivered by trained
facilitators in participants' homes, and the other the same program by
telephone. The program was designed to alter behavioral determinants, as
defined by the theory of planned behavior, and to teach behavioral-change
strategies.
The
principal outcome at one year was daytime physical activity, which was
objectively measured as a ratio to resting energy expenditure. Analysis was by
intention to treat.
Out
of 365 patients, researchers analyzed primary endpoints for 321 (88 percent)
for whom they had data after one-year of follow-up. At one year, the
physical-activity ratio of participants who received the intervention, by
either delivery route, did not differ from the ratio in those who were given a
brief advice leaflet. The physical-activity ratio did not differ between
participants who were delivered the intervention face-to-face or by telephone.
The
study authors concluded that a facilitated theory-based behavioral intervention
was no more effective than an advice leaflet for promotion of physical activity
in an at-risk group. The authors suggested that healthcare providers remain
cautious about commissioning behavioral programs into individual preventive
healthcare services.
For
more information on exercise, please visit Natural Standard's Health & Wellness database.
Integrating
physical activity into the average workday may improve health of employees, a
new study reports.
Researchers
from UCLA Jonsson Comprehensive Cancer Center in Los Angeles, CA, explained
that proactive worksite strategies that change the physical or sociocultural
environment(s) to incorporate obligatory physical activity may be necessary to
engage sedentary people.
This
study analyzed the implementation and evaluation of an intervention, Pausa para
tu Salud (Pause for Your Health), that integrated a brief period of group
exercise into the workday.
The
study tested the effects of integrating daily 10-minute exercise breaks during
paid work time during January 2003 through January 2004. A total of 335 Mexican
Ministry of Health office workers provided baseline data as a part of routine
annual clinical screening examinations.
Baseline
mean body mass index and waist circumferences were recorded at 27.8
kilograms/meter squared and 87.6 centimeters for women and 26.6 kilograms/meter
squared and 89.7 centimeters for men. Complete data were available for 271 (80.9
percent) employees at one-year follow-up.
The
study found that the body mass index decreased by 0.32 kilograms/meter squared
and waist circumference by 1.6 centimeters overall. The body mass index
decrease, however, was significant only for men. Multivariate analyses revealed
a significant decrease in diastolic blood pressure among women.
The
study authors concluded that physical activity integrated into a work schedule
may result in significant improvements in employee health. The authors
suggested that substantive health and organizational benefits may result from
integrating brief periods of physical activity into the workday if these
findings are replicated in randomized controlled trials in other worksites.
For more information on fitness, please visit Natural Standard's Health & Wellness database.
Two
new studies offer insight on methods for losing weight as well as the common
stumbling blocks of overweight and obese individuals.
In
one study, researchers asked the question, "Exercise makes you feel good,
but does feeling good make you exercise?"
Researchers
from Bowling Green State University in Bowling Green, OH, explained that while
exercise-induced mood enhancement has been well documented, the relationship
between mood and exercise participation is less understood.
The
researchers hypothesized that mood states influence evaluative judgments that
could plausibly influence a decision to exercise
The
study investigated the influence of morning mood on exercise, exercise
intensity/duration on mood enhancement and daily change in mood on exercise
days compared with non-exercise days in obese behavioral weight loss program
participants. Thirty-six individuals recorded morning, evening and pre-and post-exercise
mood, as well as the type, duration and intensity of exercise.
The
study found that morning mood was associated with an increased likelihood of
exercising, mood ratings were higher following exercise of greater intensity
and duration and daily mood enhancement was associated with greater exercise
initiation and greater exercise intensity.
The
study authors suggested that measuring mood before and after exercise may yield
important clinical information that can be used to promote physical activity in
obese adults.
A
related study examined the dietary practices, dining out behavior and physical
activity correlates of weight loss maintenance.
Researchers
from the Centers for Disease Control and Prevention (CDC) explained that loss
of excess weight can improve blood lipids, insulin sensitivity and blood
pressure.
Using
the 2004 Styles survey, a mailed survey of U.S. adults aged 18 years or older,
the study examined behaviors associated with weight loss maintenance among
people who reported trying to lose weight. Data on the number of daily fruit
and vegetable servings, minutes per week of physical activity, dining out
behavior and confidence in one's ability to engage in behavioral strategies
were assessed.
The
study found that more men (35.5 percent) than women (27.7 percent) were
classified as successful weight loss maintainers. Compared with adults who
reported eating at a fast-food restaurant two or more times per week, adults
who reported not eating at fast-food restaurants were more successful at weight
loss maintenance. Additionally, the study reported that compared with adults
who consumed fewer than five fruit and vegetable servings per day and were
sedentary, adults who consumed fewer than five fruit and vegetable servings per
day and accrued 420 minutes or more per week of physical activity or consumed
five or more fruit and vegetable servings and accrued 150 minutes or more per
week of activity were more successful at weight loss maintenance.
The
study authors concluded that the behavioral strategy of reducing consumption of
fast foods could assist people in maintaining weight loss. Furthermore, the
combined approach of consuming five or more fruit and vegetable servings per
day and attaining 150 minutes or more per week of physical activity was a
common strategy among adults successful at weight loss maintenance.
Assessment
of weight involves evaluating body mass index, waist circumference and the
patient's risk factors.
Many
factors, including an individual's age, gender and height, are considered to
determine if he/she is overweight. People increase in weight until they are
fully grown. On average, females tend to gain about 16 pounds of body weight
from age 25-54. In contrast, males tend to gain about 10 pounds of body weight
from age 25-45. By around age 55, both men and women start to decline in
weight. Females naturally have more body fat and less muscles mass than men. It
is also normal for taller individuals to weigh more than shorter individuals.
Obesity
is typically considered a long-term condition that often persists for many
years. Researchers believe that many factors, including poor diet, overeating,
pregnancy, medications, medical conditions, genetics, gender and age, may
contribute to a person becoming obese.
Obesity
can have serious long-term effects on health. Individuals who are overweight
have an increased risk of developing many life-threatening illnesses, including
heart disease, high blood pressure, stroke, obesity, diabetes, osteoporosis and
cancer. According to the American Heart Association, obesity was associated
with nearly 112,000 deaths in 2005.
In
the United States, obesity is considered an epidemic. More than half of all
Americans are considered overweight, and about 20 percent of children are
overweight.
For
more information on integrative weight loss approaches, please visit Natural
Standard's Comparative Effectiveness database.
An
integrated breathing and relaxation technique may help ease the symptoms
associated with asthma, a new study reports.
Asthma
is a chronic, inflammatory lung disease. The air passages within the lungs are
constantly swollen, restricting the amount of air allowed to pass through the
trachea. Asthmatics have recurrent breathing problems and a tendency to cough
and wheeze.
According
to the American Lung association, about 20 million Americans have asthma, which
causes about 5,000 deaths each year. Asthma is incurable, but many medications
and changes in behavior may help manage the condition.
Researchers
from London, England, explained that an integrated breathing and relaxation
technique known as the Papworth method has been implemented by physiotherapists
since the 1960s for patients with asthma and dysfunctional breathing.
The
study analyzed the effectiveness of the Papworth method in 85 patients (36 men)
who were randomized to the control group (46 patients) or to the intervention
group receiving five sessions of treatment by the Papworth method (39
patients). Both groups received usual medical care. Assessments were undertaken
at baseline, post-treatment (six months after baseline) and at 12 months.
The
study found that symptoms were slightly relieved in the intervention group;
however, the groups did not differ significantly following the treatment on
objective measures of respiratory function except for relaxed breathing rate.
The
study authors concluded that the Papworth method appears to relieve respiratory
symptoms, dysfunctional breathing and adverse mood compared with usual care.
The authors suggested that further controlled trials are warranted to confirm
this finding, assess the effect in other patient groups and determine whether
there is some effect on objective measures of respiratory function.
Integrative
therapies with good scientific evidence in the treatment of asthma include
boswellia, choline, coleus, psychotherapy, Pycnogenol® and yoga.
For
more information on asthma, please visit Natural Standard's Medical Conditions
or Allergy & Immunology database. For more information on the therapies
mentioned in this article, please visit Natural Standard's Foods, Herbs &
Supplements database.
Faith
in God and belonging to a religion may reduce stress and anxiety in family
caregivers, a new study suggests.
Researchers
from Stanford University examined the impact of prayer, faith and religion on
the well-being of individuals who serve as caregivers to a family member.
It
has been suggested that patients who pray for themselves or are aware that
others are praying for them may develop stronger coping skills and decreased
anxiety, thereby potentially improving health outcomes. Other theories include
beneficial effects of prayer or "positive thinking" on the immune
system, central nervous system (brain) or hormonal system. The meditative,
relaxing effects of prayer have been suggested to have beneficial effects such
as lowering blood pressure. There are no plausible scientific explanations for
the possible effects of intercessory prayers said without the knowledge of
patients.
The
study, conducted over a 14-month period, used participant observation and
in-depth interviews to evaluate the health of African American adults providing
in-home care for a family member with chronic confusion.
The
majority of caregivers were adult daughters. Nearly half attributed chronic
confusion to a difficult life and emotional stress or "worry;" a
third believed it to be a natural component of "old age." The study
reported that caregivers tended to view their work as an expression of love and
devotion that was accompanied by emotional stress and personal sacrifice. While
just under half of the caregivers had no other family members willing or
available to assist with the physical care of the elder, the majority were able
to turn to family members for emotional support.
The study found that caregivers identified strong religious beliefs as the primary force that sustain