Galens Watch Member's Report Issue 6, 2009

GALEN'S REPORT Member's Edition Issue 6, 2009

Welcome,

Often a study will fit into two categories easily. However, that would make for a repetitive and long report. A few studies in this issue would have fit into the categories of Women's Health and Botanical Therapy. In this case they were placed in the category of Women's Health as the fit was stronger. Therefore it is a good idea to at least scan through all the categories.

Galen's Watch is a synopsis of CAM relevant articles from over 80 complementary, alternative and mainstream peer reviewed medical journals and consumer news sources.

Galen's Watch proudly supports the continuing effort to promote naturopathic medicine.

Sabra Way MNIMH
Editor in Chief and Founder, Galen's Watch

In This Issue

Key Study Citations - Acupuncture

Acupuncture Improves Recovery of Male Basketball Athletes.

To assess the effect of acupuncture on elite athlete recovery, this study enrolled 30 elite basketball players and randomly assigned them to 3 groups. Group one received acupuncture at the Neiguan (PC6) and Zusanli (ST36) acupoints, beginning 15 minutes prior to exercise and continuing until exhaustion of the subject, group 2 received sham acupuncture at points 1 cm away from the same points, and group 3 received no acupuncture treatment. Heart rate, oxygen consumption and blood lactic acid were measured during the rest period and at 3 recovery points (5/30/60 minutes post-exercise). The acupuncture group had significantly lower heart rate, oxygen consumption and blood lactic acid than the sham or control groups at 30 minutes post exercise. Lactic acid was significantly lower at 60 minutes post-exercise than the other 2 groups

Am J Chin Med. 2009;37(3):471-81.
Effects of acupuncture stimulation on recovery ability of male elite basketball athletes.

Seven-star Needle Stimulation Improves Language and Social Interaction of Autistic Children

This trial randomized 32 children with Autistic Spectrum Disorder (ASD) to either Seven-star needle stimulation treatment or a control group. The treatment group underwent 30 sessions of stimulation over 6 weeks, each session lasting 5-10 minutes. The stimulation was performed on the 2 sides on the child's back along the spine (about half an inch on each side) from the lumbar to the thoracic region, along the midline on the front side of the body, and also on the dorsal and the posterior parts of the head. Each stimulation site was tapped 3 times, with a distance of about 2 cm between each tap. Evaluation was based on parental report of neurophysiological changes and by quantitative EEG. Of the 32 participants, half did not complete the EEG portion. 16 participants completed the EEG (9 control, 7 treatment). The treatment group showed significant improvement in language and social interaction, but not in stereotyped behavior or motor function, compared to control. The researchers speculate that the small effects seen in the study are due to the short treatment length. They cite two cases from the treatment group that continued: a 6-year-old child who was not able to write the alphabet could do so after 3 months treatment, and after 6 months the child could write complete sentences; another child was not able to speak with 2-word sentences and after 1 year of treatment could speak 8 word sentences.

Am J Chin Med. 2009;37(3):495-504.
Seven-star needle stimulation improves language and social interaction of children with autistic spectrum disorders.

Acupuncture Improves Balance in Stroke Patients

This single-blinded, controlled, randomized study of 30 patients investigated the effect of acupuncture with and without the obtaining of qi on first-time stroke patients with either left or right hemisphere infarction and the ability to walk 6 meters. The experimental group received acupuncture accompanied by manual twisting of needles and obtaining qi (sensations of soreness, numbness, swelling and heaviness, while the acupuncturist experienced a sensation of needle resistance), and the control group did not receive the manual twisting of needles to obtain qi. Acupuncture stimulation was applied to Baihui (GV 20) acupoint as well as to 4 spirit acupoints (1.5 cun anterior, posterior, left and right laterals from Baihui acupoint, respectively) for 20 minutes. The experimental group had a greater decrease in the displacement area from the centre of gravity and reduction in the displacement area. After acupuncture stimulation, the time to reach a standing position from a seated one and the time to walk 6 meters decreased in both experimental and control groups. Hip and knee extensor muscle strength in the paralyzed and non-paralyzed sides was increased in the experimental but not the control group. The researchers suggest that acupuncture stimulation may induce an immediate effect that improves balance in stoke patients.

Am J Chin Med. 2009;37(3):483-94.
Acupuncture stimulation improves balance function in stroke patients: a single-blinded controlled, randomized study.

Key Study Citations - Botanical Therapy

Stinging Nettle Cream for Osteoarthritis.

This study assessed the effectiveness of nettle cream for osteoarthritis. 32 patients with radiologically confirmed osteoarthritis applied nettle (Urtica dioca) cream twice daily for 2 weeks. The cream was prepared by compounding 13.33% stinging nettle extract in an oil-in-water emulsion. Nettle extract was provided by Liquid Phytocaps nettle leaf, Gaia Herbs, North Carolina. The Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) short form was used at baseline and 2 weeks. Patients were monitored for adverse reactions. There was a mean reduction of 4.17 in WOMAC from a mean baseline score of 17.22. Two patients experienced transient tingling and mild discomfort. Many patients requested a continuance of the treatment. The researchers said no firm conclusion could be drawn, but the potential for efficacy is supported. Fresh nettles with intact hairs have been used as a counter-irritant in arthritis. The nettle extract in this study did not have intact hairs but still contained multiple potential modulators of inflammatory or pain pathways. The stinging hairs of nettle are known to contain histamine, acetylcholine and serotonin.

Altern Ther Health Med. 2009 Jul-Aug;15(4):60-1.
Stinging nettle cream for osteoarthritis.

Artichoke Extract for Chronic Hepatitis C

17 patients with chronic hepatitis C and persistently elevated aminotransferase levels were treated for 12 weeks with 3200 mg standardized artichoke leaf extract (ALE). Outcome measures were alanine aminotransferase (ALT) normalization, the course of ALT, aspartate aminotransferase and gamma glutamyltransferase levels, quantitative HCV RNA, subjective symptoms frequently associated with chronic hepatitis C (fatigue, upper abdomen discomfort, joint problems), and safety. There was no significant change in aminotransferase or viral load at baseline. Fatigue and joint problems improved at 4 weeks, but there was no significant difference at 12 weeks. Tolerability was good, but ALE was not an effective agent in improving aminotransferase levels.

Phytomedicine. 2009 Sep;16(9):801-4. Epub 2009 May 8.
Artichoke leaf extract for chronic hepatitis C - a pilot study.

Key Study Citations - Women's Health

Senna Treatment Safe in Pregnant Women

This study compared cases of congenital abnormalities and their matched controls in pregnant women with constipation who used senna. The range of senna doses was 10-30mg with most women using 20 mg daily. The mothers that used senna treatment were older with a larger proportion of primiparae. There was no higher risk for 23 different congenital abnormalities after senna treatment during 2nd and/or 3rd gestational month in 260 women compared to 500 controls. The researchers concluded that senna treatment was not associated with the higher risk congenital abnormalities in the offspring of pregnant women with constipation. Congenital abnormalities were seen in 2.2% of mothers using senna treatment and 2.5% of control group mothers.

Reprod Toxicol. 2009 Jul;28(1):100-4. Epub 2009 Feb 24.
Senna treatment in pregnant women and congenital abnormalities in their offspring: a population-based case-control study.

Safety of St. John's Wort in Pregnancy

A group of pregnant women were prospectively collected who were taking St. John's Wort (SJW, (n=54), using pharmacologic therapy for depression, or healthy with no known teratogen exposure (n=108 women in pharmacological and healthy group combined). The major malformation rate was similar across all 3 groups with 5%, 4% and 0%, respectively. This was not different then the 3-5% risk expected in the genial population. Live birth and prematurity rates were not different among the 3 groups. The researcher recommended larger scale studies but felt this study provided some evidence of fetal safety in women using SJW. Another prospective observational trial gathered data on 33 breastfeeding women using SJW (Group1) and matched them to 101 disease-matched (Group 2) and 33 age- and parity-matched non-disease controls (Group 3). 1 infant in each of Groups 2 and 3 was reported to be colicky. There were 2 cases of "colic", 2 of "drowsiness," and 1 of "lethargy" in Group 1. Three women in Group 1 consulted their doctor and no specific medical treatment was required. There was no difference between the groups of decreased milk product and no difference found in infant weight for the first year.

Reprod Toxicol. 2009 Jul;28(1):96-9. Epub 2009 Feb 24.
Evaluating the safety of St. John's Wort in human pregnancy

J Clin Psychiatry. 2003 Aug; 64(8):966-8. (Pdf)
The safety of St. John's Wort (Hypericum perforatum) during breastfeeding.

Vitamin D Stores and Success Following in Vitro Fertilization

84 women infertile women undergoing IVF were tested for 25OH-D levels in their follicular fluid (FF) and serum. Serum and FF levels were highly correlated with clinical pregnancy outcomes. Lower FF 25OH-D levels were noted in Black versus non-Black patients. Patients achieving clinical pregnancy (CP) had significantly higher FF 25OH-D levels. Adjusting for age, body mass index, ethnicity, and number of embryos transferred, each ng/mL increase in FF 25OH-D increased the likelihood for achieving CP by 6%. Serum and FF levels of 25OH-D were highly correlated with CP, defined as evidence of intrauterine gestation sac on ultrasound following IVF. Researchers concluded that women with higher vitamin D level in their serum and FF are significantly more likely to achieve clinical pregnancy following IVF-embryo transfer.

Fertil Steril. 2009 Jul 7. [Epub ahead of print]
Replete vitamin D stores predict reproductive success following in vitro fertilization.

Key Study Citattions - Supplement Therapy

Chromium Picolinate does not Improve Key Features of Metabolic Syndrome

This double-blind, placebo-controlled, randomized trial enlisted 63 patients diagnosed with metabolic syndrome. Participants were randomized to either receive chromium picolinate (CrPic) 1000 mcg/day or placebo for 16 weeks. The primary outcome measure was change in insulin sensitivity index, and secondary outcomes included changes in glucose metabolism, oxidative stress, fasting serum lipids, and high sensitivity C-reactive protein. At the end of the study, there was no significant change in glucose metabolism between groups. Acute insulin response to glucose was increased in the CrPic group. No significant effect was seen in glucose metabolism, body weight, serum lipids, or measures of inflammation and oxidative stress.

Metab Syndr Relat Disord. 2009 Summer;7(2):143-50.
Chromium picolinate does not improve key features of metabolic syndrome in obese nondiabetic adults.

Probiotics Reduce Number of Missed School Days in Children

This double-blind, placebo-controlled study randomly assigned 326 children (3-5 years of age) to receive placebo, Lactobacillus acidophilus NCFM, or L acidophilus NCFM in combination with Bifidobacterium animalis subsp lactis Bi-07 twice a day for 6 months. With single and combination probiotics, but not placebo, reduced fever incidence, coughing incidence and rhinorrhea incidence were observed. Overall, fever, coughing, and rhinorrhea duration was decreased significantly, relative to placebo, by 32% (single strain) and 48% (combination). Antibiotic use and absentee days were also reduced. Results were better for the combination probiotics group than the single strain probiotics group. The researchers concluded that daily dietary probiotic supplementation for 6 months was a safe, effective way to reduce fever, rhinorrhea, and cough incidence, duration and antibiotic prescription incidence, as well as the number of missed school days attributable to illness, for children 3 to 5 years of age. In a 2008 study, it was found that that a regular, long-term intake of various synbiotics may improve health by reducing the incidence and severity of respiratory diseases during the cold season. That 3-stage prospective, randomized, double blind, placebo-controlled study was carried out over a 3-year period with several synbiotic preparations containing 3-5 strains of Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium lactis, lactoferrin and prebiotics such as either FOS (short-chain fructooligosaccharides) or GOS (galactooligosaccharides).

Pediatrics. 2009 Aug;124(2):e172-9. Epub 2009 Jul 27.
Probiotic effects on cold and influenza-like symptom incidence and duration in children.

J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 2:S224-33.
A new chance of preventing winter diseases by the administration of synbiotic formulations.

Treating Vitiligo with Narrowband Ultraviolet B and Oral Antioxidants.

To determine the efficacy of oral antioxidants with narrowband ultraviolet B phototherapy (NB-UVB). 24 patients with stable vitiligo were randomly assigned to be treated with NB-UVB �oral vitamin E (20 patients completed the study). Outcome was measured by extent of repigmentation in existing lesions. Plasma malondialdehyde and reduced glutathione were measured before and after treatment. Marked to excellent repigmentation was noted in 72% of the vitamin E group and 56% of the NB-UVB-only group. Mild erythema was experienced in 70% of the vitamin E group and 85% in the non-vitamin E group. The vitamins E group had a significant reduction in plasma malondiadehyde.

J Clin Pharmacol. 2009 Jul;49(7):852-5.
Response of vitiligo to narrowband ultraviolet B and oral antioxidants.

Antioxidants Combined with Resistance Training Improves Bone Density in Elderly Women

To determine the effect of antioxidants and resistance training on bone mineral density (BMD) in postmenopausal women, 34 healthy elderly women were randomized to 1 of 4 groups: placebo, antioxidants, exercise with placebo, or exercise with antioxidants for 6 months. Antioxidant supplements were 600 mg vitamin E and 1000 mg vitamin C daily, and resistance training was 3 times a week. Femoral neck and lumbar spine BMD were measured before and after the trial. BMD for the lumbar spine remained stable in all groups except the placebo group. No changes were seen in the femoral neck BMD. The researchers concluded that antioxidant vitamins offer protection against bone loss similar to resistance training, but combing them does not produce additional benefits.

Osteoporos Int. 2009 Jul;20(7):1253-8. Epub 2008 Nov 20.
Effect of antioxidants combined to resistance training on BMD in elderly women: a pilot study.

L-arginine Supplementation Improves Endothelial Function, Insulin Sensitivity and Inflammation in Cardiopathic Patients

To assess the long-term effects of L-arginine, 32 patients with cardiovascular disease and nondiabetic response (defined by oral glucose load to define their glucose tolerance) were enrolled in this double-blind randomized trial to receive 6.4 g a day of L-arginine or placebo for 6 months. Compared with placebo, the L-arginine group had decreased asymmetric dimethylarginine levels, indices of endothelial dysfunction, and increased cyclic guanosine monophosphate, L-arginine to asymmetric dimethylarginine ratio, and reactive hyperemia. L-arginine also increased insulin sensitivity index and adiponectin, and decreased interleukin-6 and monocyte chemoattractant protein-1 levels. The researchers concluded that L-arginine seems to have anti-inflammatory and metabolic advantages in cardiovascular patients

Metabolism. 2009 Jul 8. [Epub ahead of print]
Oral L-arginine supplementation improves endothelial function and ameliorates insulin sensitivity and inflammation in cardiopathic nondiabetic patients after an aortocoronary bypass.

Omega-3 fatty acids Improve Lipemia in Nephrotic Range Proteinuria Patients

17 patients with nephritic-range proteinuria were matched against controls to assess the effect of omega-3 fatty acids on lipids and lipoproteins. Group 1 was given 4 g daily of omega-3 fatty acids (Omacor*) or placebo for 8 weeks. Baseline postprandial chylomicron was greater in Group 1 compared with Group 2 controls, median 18.5 mmol/lh vs 9.3 mmol/lh. Following treatment, Group 1 chylomicron fell, but there was no significant reduction in Group 2 controls. After 8 weeks treatment, chylomicron was no longer significantly different between Group 1 and Group 2 . There was an excess of postprandial chylomicron density fraction in patients with nephritic-range proteinuria, which these researchers found was reduced by treatment with omega-3 fatty acids. The researchers suggest this would be an ideal therapy in combination with statins for this high-risk group of patients.
*Each 1 gram Omacor capsule contains 90% omega-3-acid ethyl esters. These are predominantly ethyl esters of eicosapentaenoic acid (EPA) 460 mg and docosahexaenoic acid (DHA) 380 mg.

Atherosclerosis. 2009 Jul;205(1):296-301. Epub 2008 Dec 6.
Omega-3 fatty acids improve postprandial lipemia in patients with nephrotic range proteinuria.

Key Study Citations- Therapy

Effect of Slow- and Fast-Breathing Exercises on Patients with Essential Hypertension.

This randomized, prospective, controlled clinical study divided subjects into 3 groups. The subjects were 60 males and females aged 20-60 years with stage 1 essential hypertension. Subjects were divided into a control group and 1 of 2 interventions of slow or fast breathing exercises. Slow breathing was alternate nostril breathing with a goal of 5-6 breaths per minute for 15 minutes. Fast breathing "breath of fire" was breathing quickly and deeply, with an inhalation and exhalation time of 1 second each for 1 minute, after which they were given 3 minutes of rest. The procedure was repeated 4 to 5 times over a period of 15 minutes. Subjects practiced their breathing for 3 months. The control group was instructed to not change their diet or exercise routine for 3 months. BP decreased in both breathing groups and there was a significant change in hand grip and cold press or test only in the slow breathing group. All patients in the control group were on antihypertensive medication and 60 % of the subjects in the intervention groups. Improvement was seen in the breathing groups but not the control group demonstrating the benefit of the breathing exercises.

J Altern Complement Med. 2009 Jun 17. [Epub ahead of print]
Effect of Slow- and Fast-Breathing Exercises on Autonomic Functions in Patients with Essential Hypertension.

Reiki for Pain and Anxiety in the Elderly with Dementia

To assess the effects of Reiki on pain and anxiety in elderly people diagnosed with dementia, 6 participants aged 68-91 years from an adult day service received a 20 minute Reiki therapy twice a week for 4 weeks. Blood pressure and heart rate were recorded before and after each session. The Wong-Baker Smiley Face Scale was used to asses the general level of well being and pain. Behavioral changes were documented by an activities therapist, a recreational therapist and the participant's family. Five of the 6 participants experienced less anxiety after the Reiki sessions and cumulatively for the next 3 weeks. Three of the participants had pain, 2 experienced a reduction in pain, the other participant had no change on average, but less pain on some days. Five of the 6 participants had a reduction in heart rate of 2.72-9.31%. Overwhelmingly, the participants emerged from the treatment feeling better, more talkative, less depressed, more relaxed and with less pain. The Mini Mental State Exam score did not seem to demonstrate any beneficial difference in the participants.

Altern Ther Health Med. 2009 Jul-Aug;15(4):56-7.
Effects of Reiki on pain and anxiety in the elderly diagnosed with dementia: a series of case reports.

Key Study Citations- Lifestyle

The Effect of Physical Activity in Patients with Nonalcoholic Fatty Liver Disease.

This study assessed the impact of change in physical activity and its effect on participants with fatty liver disease. 141 participants with non-alcoholic fatty liver disease were enrolled in either low or moderate intensity lifestyle intervention or a control group. Individual counseling was used to increase physical activity. Improvements in liver enzyme profiles were seen in participants increasing or maintaining their reported physical activity to ≥150 minutes/week. The greatest benefits in liver enzymes and other metabolic indices were seen in participants that increased their fitness levels. This effect was independent of weight loss. Physical activity of greater than 2 hours a week led to greater weight loss but did not provide additional benefit to liver enzymes.

Hepatology. 2009 Jul;50(1):68-76.
Independent effects of physical activity in patients with nonalcoholic fatty liver disease.

Yoga Reduces Binge Eating

To examine the effects of yoga on binge eating disorder, 90 women aged 25-63 with a BMI >25 were randomized to either a yoga group or a waiting list for 12 weeks. Results were gathered on 50 participants, 25 from each group. The yoga group was set up with formal weekly sessions and a home-based practice. In the yoga group there was statistically significant self-reported reductions in binge eating and increases in physical activity. There was small but significant reduction in BMI and waist measurement in the yoga group. The waiting list control group did not improve significantly on any measure.

Complement Ther Med. 2009 Aug;17(4):196-202. Epub 2009 Jun 13.
Yoga as a treatment for binge eating disorder: a preliminary study.

Tango Dancing for Improves Some Aspects of Parkinson Disease

14 participants with idiopathic Parkinson's disease were scheduled to 1.5 hours of Argentine tango dance lessons within a 2-week period. Their gate, balance and mobility were assessed before and after the dance lessons. Participants significantly improved on the Berg Balance Scale, the Unified Parkinson Disease Rating Scale Motor Subscale III and the percent of time spent in stance during forward walking. There were non-significant improvements in Timed Up and Go and 6 minute walk.

Complement Ther Med. 2009 Aug;17(4):203-7. Epub 2009 Jan 7.
Short duration, intensive tango dancing for Parkinson disease: an uncontrolled pilot study.

Key Study Citations- Diet

Sodium Reduction Should be Part of Resistant Hypertension Treatment

To examine the effects of dietary salt restriction and resistant hypertension, 12 subjects with resistant hypertension were randomized in this crossover evaluation of low (50 mmol/day) and high sodium (250 mmol/day) diets separated by a 2-week wash-out period. Subjects were on an average of 3-4 antihypertensive medications with a mean BP of 145.8 � 10.8/83.9 � 11.2 mm Hg. A low sodium diet decreased systolic and diastolic blood pressure by 22 and 9 mm Hg, respectively. The researchers suggest that a reduction in dietary sodium should be part of the overall treatment of resistant hypertension. In 2004, a Cochrane Review of the effects of low versus high sodium intakes on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglycerides suggested that low sodium was useful in reducing blood pressure in the short term and that the benefit was greater in Black and Asian patients than in Caucasians.

Hypertension. 2009 Sep;54(3):444-6.

Effects of dietary sodium reduction on blood pressure in subjects with resistant hypertension: results from a randomized trial.

Cochrane Database Syst Rev. 2004;(1):CD004022.
Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride.

Reviews

Rethinking Blood Pressure Targets for Hypertension.

New guidelines are recommending that blood pressure (BP) guidelines be lowered from the current targets of ≤140-160/ 90-100 mmHg. This review assessed whether lowered BP targets of (≤135/85 mmHg) reduce mortality or morbidity compared to the standard targets. Seven trials were included with 22,089 subjects comparing different diastolic BP targets. They found that attempting to achieve lower targets instead of standard targets did not change total mortality, myocardial infarction, stroke, congestive heart failure, major cardiovascular events, or end stage renal disease. They found that lower BP targets did not reduce mortality or morbidity. Guidelines are recommending even lower targets for diabetes mellitus and chronic renal disease, and the researchers are currently conducting systematic reviews in those patient groups.

Cochrane Database Syst Rev. 2009 Jul 8;(3):CD004349.
Treatment blood pressure targets for hypertension.

Antioxidant Vitamins and Asthma Outcome Measures

This review included 40 studies. Vitamin A intake was significantly lower in people with asthma than without asthma and especially in those with severe asthma as compared to milk asthma. Lower intakes and serum levels of vitamin C were associated with increased odds of asthma. Vitamins E was not significantly related to asthma, but much lower levels were found in severe as opposed to mild asthma. The reviewers concluded that relatively low dietary intakes of vitamins A and C are associated with statistically significantly increased odds of asthma and wheeze.

Thorax. 2009 Jul;64(7):610-9. Epub 2009 Apr 30.
Association between antioxidant vitamins and asthma outcome measures: systematic review and meta-analysis.

The Effectiveness of Willow Bark for Musculoskeletal Pain

This review reported on trials of willow bark for musculoskeletal pain. All studies investigated ethanolic willow extracts with up to 240 mg salicin for up to 6 weeks. Three studies showed a dose-dependent analgesic effect in patients with low back pain. Two studies showed conflicting results in patients with osteoarthritis. One study showed no significant effect, howeverthe researchers noted that this trial was grossly underpowered. In conclusion, the researchers found willow ethanolic extract was moderately effective for low back pain and they postulated that higher doses may be needed. A study conducted in 2000 of willow bark for low back pain found that the higher dose of 240 mg of salicin relieved back pain better than a lower dose of 120 mg.

Phytother Res. 2009 Jul;23(7):897-900.
A systematic review on the effectiveness of willow bark for musculoskeletal pain.

Am J Med. 2000 Jul;109(1):9-14.
Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study.

Kava and St. John's Wort: Use in Mood and Anxiety Disorders

This comprehensive review of Kava and St. John's Wort (SJW) assessed the evidence of efficacy, mode of action, pharmacokinetics, safety and use in major depressive disorder, bipolar disorder, seasonal affective disorder (SAD), generalized anxiety disorder, social phobia (SP), panic disorder (PD), obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). The researchers found current evidence that supports the use of SJW in treating mild-to-moderate depression and weak evidence for its use in SAD. They also found evidence for the use of Kava in the treatment of generalized anxiety. There were no published human trials of Kava in the treatment of affective disorders, or in OCD, PTSD, PD, or SP. In addressing the safety issues associated with Kava, the researchers suggest possible removal of over-the-counter public use and the short-term intermittent use of aqueous root preparations standardized for <250 mg kavalactones, avoiding concomitant alcohol use, or use in cases of known hepatic insufficiency or disease. The researchers recommend SJW as a first-line treatment in mild-to-moderate depression. SJW extracts can be hyperforin-enriched or free. They recommend hyperforin-rich SJW extracts for people not currently taking medication as the higher hyperforin may improve efficacy. In cases of co-medicating, a low or free hyperforin formula should be used to minimize potential drug interactions.

J Altern Complement Med. 2009 Jul 20. [Epub ahead of print]
Kava and St. John's Wort: current evidence for use in mood and anxiety disorders.

The Effect of Long-chain Polyunsaturated Fatty Acids on Pregnancy

This systematic review investigated randomized controlled trials and the effect of n-3 long-chain polyunsaturated fatty acid (LCPUFA) supplementation on pregnancy outcomes inlow- and high-risk pregnancies. N-3 LCPUFA supplementation significantly enhanced duration of pregnancy in low-risk pregnancies, but not in high-risk pregnancies. The relative risk of giving birth before the 34th week of gestation was reduced by n-3 LCPUFA in both groups. A review in 2007 concluded that supplementation with n-3 LCPUFA in high-risk pregnancies reduced the risk of early preterm delivery compared with placebo.

Br J Nutr. 2007 Aug;98(2):253-9. Epub 2007 Apr 10.
Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials.

Adv Exp Med Biol. 2009;646:65-9.
Effects of supplementing LCPUFA to the diet of pregnant women: data from RCT.

Garlic for the Common Cold

This review, after applying the selection criteria, only included one study: Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Adv Ther. 2001 Jul-Aug;18(4):189-93. The reviewers found that there was insufficient evidence because there was only one study. The study that was reviewed relied on self-reportation but was of reasonable quality. The study itself found that a once-a-day capsule of an allicin-containing garlic supplement over 12 weeks between November and February significantly reduced virally-challenged days and shortened symptoms. It should be noted that this study was conducted by the Garlic Centre in the UK.

Cochrane Database Syst Rev. 2009 Jul 8;(3):CD006206.
Garlic for the common cold.

Qigong for Type 2 Diabetes

This review of qigong and diabetes care included 9 clinical trials: 3 randomized clinical trials (RCT), 1 controlled clinical trial (CCT) and 5 uncontrolled observational studies (UOS). The RCTs comparing qigong to usual care found favourable effects of qigong on glycosylated hemoglobin (HbA1c), 2h plasma glucose (2hPG), insulin sensitivity, and blood viscosity. The CCT compared qigong to no treatment and did not show any effect of qigong on fasting plasma glucose (FPG), 2hPG, HbA1c and insulin sensitivity. All UOSs showed beneficial effects of qigong on FPG and 2hPG. The reviewers found that collectively this evidence is insufficient to suggest that qigong is an effective treatment for type 2 diabetes

Complement Ther Med. 2009 Aug;17(4):236-42. Epub 2009 Jun 12.
Qigong for type 2 diabetes care: a systematic review.

Acupuncture for Bell's Palsy

This review of acupuncture for Bell's palsy included 6 studies and 537 participants. Five studies used acupuncture and 1 used acupuncture and drugs. The researchers found the quality of the included trials was inadequate to allow any conclusion about the efficacy of acupuncture. In all of the studies. the outcome measures were not currently recognized and did not provide objective data. The trials varied in nature of the acupuncture intervention and duration. Also, because the trials reported outcome as grades such as " cure", "markedly effective", "effective", and "ineffective", they could not be combined for meta-analysis.

J Altern Complement Med. 2009 Jul;15(7):759-64.
Acupuncture for Bell's palsy.

Additional Studies

Saffron for Erectile Dysfunction

20 male patients with erectile dysfunction were given 200 mg of saffron each morning for 10 days. After 10 days, there was a statistically significant improvement in tip rigidity and tip tumescence as well as base rigidity and tumescence. International index of erectile function questionnaire total scores were significantly higher in patients after saffron treatment.

Phytomedicine. 2009 Aug;16(8):690-3. Epub 2009 May 9.
Evaluation of Crocus sativus L. (saffron) on male erectile dysfunction: a pilot study.

Chronic Fatigue Syndrome after Infectious Mononucleosis in Adolescents.

This prospective cohort study found that infectious mononucleosis (IM) may be a risk factor for chronic fatigue syndrome (CFS) in female adolescents and in those having greater fatigue severity. 301 adolescents were screened for non-recovery 6 months after IM. Medical evaluation and follow-up screening was done at 12 and 24 months after IM. The adolescents were blind-reviewed and diagnoses of CFS were made at 6, 12 and 24 months. At 6, 12 and 24 months after IM, 13%, 7% and 4%of the adolescents met the criteria for CFS, respectively. All 13 adolescents with CFS at 24 months were female and on average reported greater fatigue severity at 12 months. Steroid therapy dosing in the acute phase of IM did not increase the risk of developing CFS. The rates of CFS in adolescents following IM were about 20 times higher than those found in the general adolescent population.

Pediatrics. 2009 Jul;124(1):189-93.
Chronic fatigue syndrome after infectious mononucleosis in adolescents.

Spearmint Tea has Anti-androgen Effects in Polycystic Ovarian Syndrome

42 women with hirsutism were randomized to drink spearmint tea twice a day for 1 month or a placebo tea and the effect on androgen levels was measured. At 0, 15 and 30 days, serum androgen and gonadotrophins were checked. The degree of hirsutism was assessed clinically and by self assessment. Over the 30-day period, free and total testosterone levels were significantly reduced, LH and FSH increased, and subjective assessments of hirsutism were reduced in the spearmint group. However, objective measurements of hirsutism saw no significant reduction between the 2 groups. It was demonstrated that spearmint tea had an antiandrogen effect, but it did not translate to clinical practice with a reduction in hirsutism. The researchers pointed out that the trial was not long enough to show a reduction in hirsutism.

Phytother Res. 2009 Jul 7. [Epub ahead of print]
Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome: a randomized controlled trial.

Sleep-disordered Breathing and Behaviors in Children with Asthma.

194 children aged 4-10 years with asthma were assessed for sleep disordered breathing (SDB) and its possible effects on behavior. Overall, 33% of the children experienced SDB. Children with SDB had significantly higher (worse) behavior scores compared with children who did not have SDB. SDB was also associated with the subdomains of externalizing, internalizing, anxious/depressed, headstrong, and hyperactive behaviors. The researchers concluded that poor sleep was independently associated with behavior problems in children with asthma.

Free Author Manuscript
Pediatrics. 2009 Jul;124(1):218-25.
Sleep-disordered breathing and behaviors of inner-city children with asthma.

Proton-pump Inhibitor Therapy Induces Acid-related Symptoms in Healthy Volunteers after Withdrawal of Therapy.

To examine the effects of proton pump inhibitors (PPI) on rebound acid hypersecretion (RAHS). 120 healthy participants were randomized and blinded to 12 weeks of placebo or 8 weeks of esomeprazole 40 mg/d followed by 4 weeks of placebo. The Gastrointestinal Symptom Rating Score was filled out weekly. There was no difference between groups at baseline. 44% of the PPI group had significantly higher scores in weeks 9-12 versus the placebo group. In the PPI group reporting of dyspepsia, heartburn and acid regurgitation were 22%, 22% and 21% at weeks 10, 11 and 12 versus 7%, 5% and 2% for the placebo group. The researchers concluded that PPI therapy induces acid-related symptoms in healthy volunteers after withdrawal.

Gastroenterology. 2009 Jul;137(1):80-7, 87.e1. Epub 2009 Apr 10.
Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy.

Electric toothbrush is a Reliable Test for Differentiating Temporomandibular Disorder Pain

To test the reliability and validity of using an electric toothbrush as a screening tool in temporomandibular disorders (TMD) with myofascial pain and arthralgia, 14 female subjects with TMD were compared to 13 pain-free female subjects. The electric toothbrush was applied with 1 pound of pressure for 30 seconds in 4 locations: over the lateral pole of the temporomandibular joint, masseter, temporalis, and mid-ventral surface of the forearm. The electric toothbrush had excellent test-retest reliability. Validity of the scores was demonstrated with modest sensitivity and good specificity for differentiating TMD pain patients from controls. The researchers commented that "the application of a vibrotactile stimulus using an electric toothbrush is a reliable and valid approach to measuring central pain sensitization in the orofacial region of subjects with TMD pain for screening purposes. This implies that the application of such a stimulus may be able to distinguish people who have increased central sensitization associated with the presentation of trigeminally-mediated TMD pain from those who do not have such pain."

Full free text
BMC Musculoskelet Disord. 2009 Jul 30;10(1):94. [Epub ahead of print]
Electric toothbrush application is a reliable and valid test for differentiating temporomandibular disorders pain patients from controls.

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