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A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (1 September 2019) | Viewed by 78177

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Special Issue Editor

Dr. Jon Wardle

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Guest Editor

University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Sydney, Australia
Interests: complementary medicine; integrative medicine; primary health care; public health; health policy; health law

Special Issue Information

Dear Colleagues,

Complementary medicine, which includes a range of self-directed and practitioner-directed health practices (e.g., meditation and yoga, chiropractics, naturopathy) and products (e.g., herbal medicine, homeopathy, nutritional supplements), forms an increasingly significant component of the contemporary health sector in many countries. Combining complementary and conventional medical approaches to health care (also called integrative medicine) is also increasingly common. Complementary medicine is somewhat unique among recognized health specializations in that its definition is based solely on exclusion, rather than on a set of unified professional traits. It is a field of tremendous heterogeneity, encompassing evidence-based yet hitherto non-adopted treatments performed by licensed and qualified practitioners, to fringe, unorthodox and non-scientific therapies that are performed by unqualified and sometimes unscrupulous practitioners. Complementary and integrative medicine is also unique in that it is one of the truly patient-driven phenomena of health care, with significant and growing utilization often occurring despite barriers to its incorporation in more readily accessible generic health systems. This can be the result of cultural factors (such as the high use of traditional medicines in communities where those traditions are indigenous) as well as social factors (such as the push and pull factors associated with patient desire for more holistic and patient-focused care). In addition to questions of evidence and efficacy, the high utilization and presence of traditional and complementary medicine also has direct relevance for diverse research fields such as public health (e.g., does higher complementary medicine use place the public at risk of harm), policy (e.g., can—or should—complementary medicines be incorporated into regulatory regimes), and sociology (e.g., what drives people to use complementary medicine even when conventional medicine is freely accessible). In light of the growing utilization and presence of complementary and integrative medicine globally there is a need for multi-disciplinary, critical and rigorous examination of complementary and integrative medicine. This Special Issue aims to examine complementary and integrative medicine from a variety of different disciplinary experiences. By inviting submissions from multiple research fields, this Special Issue will cast a critical eye on the field of complementary and integrative medicine.

Dr. Jon Wardle
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

complementary medicine
traditional medicine
integrative medicine
public health
patient-centered care
health behaviors

Published Papers (14 papers)

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Research

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11 pages, 2467 KiB

Open AccessArticle

Pleurotus highking Mushroom Induces Apoptosis by Altering the Balance of Proapoptotic and Antiapoptotic Genes in Breast Cancer Cells and Inhibits Tumor Sphere Formation

by Md. Anwarul Haque and Md. Anwar Ul Islam

Medicina 2019, 55(11), 716; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55110716 - 28 Oct 2019

Cited by 18 | Viewed by 4039

Abstract

Background and objectives: Mushrooms that have medicinal properties are part of many traditional diets. The aim of the present study was to use the human breast cancer cell line MCF-7 to investigate the anticancer activity of Pleurotus highking mushroom purified extract fraction-III (PEF-III) and to elucidate the possible mechanism of that activity. Materials and Methods: The effects of PEF-III on cell proliferation and viability were evaluated by a colony formation assay and an MTT assay, respectively. Cell morphological changes, annexin-V phycoerythrin and propidium iodide (PI) staining, DNA fragmentation, and caspase 3/7 activity assays were performed to determine the induction of apoptosis by PEF-III. The genes responsible for regulation of apoptosis were analyzed by means of Western blot analysis. In vitro tumor sphere formation assay was performed using a 3D sphere culture system. Results: PEF-III significantly reduced the proliferation and viability of MCF-7 cells. Cell shrinkage and rounding, and annexin-V phycoerythrin and PI staining followed by flow cytometry indicated that the cell death was due to apoptosis. Additionally, a laddering DNA pattern and increased levels of caspase-3/7 enzyme also corroborated the notion of apoptosis-mediated cell death. This incidence was further confirmed by upregulation of proapoptotic genes (p53 and its target gene, Bax) and downregulation of the expression of an antiapoptotic gene (Bcl-2). PEF-III also reduced the size and number of the tumor spheres in 3D culture conditions. Conclusions: The anticancer activity of PEF-III is due to induction of apoptosis by a shift in the balance of proapoptotic and antiapoptotic genes. Therefore, the findings of the present study may open a path to exploring potential drug candidates from the P. highking mushroom for combating breast cancer. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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7 pages, 313 KiB

Open AccessArticle

Reinforced Olive Pâté as a Source of Antioxidants with Positive Effects on Young Smokers

by Pierpaolo Cavallo, Francesco Vinale, Immacolata Sepe, Gennaro Galasso, Francesca Luisa Fedele, Andrea Sicari, Loredana Zito and Matteo Lorito

Medicina 2019, 55(10), 680; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55100680 - 09 Oct 2019

Cited by 1 | Viewed by 1784

Abstract

Background and objectives: Olive pâté (OP) is an olive-derived product with potentially beneficial effects on human health due to the presence of natural antioxidants. The present dietary supplementation study aimed to evaluate the effects on blood antioxidant levels of an olive pâté reinforced with natural antioxidants (ROP) recovered from olive mill waste. Materials and methods: Ninety-eight healthy volunteers (M = 54, 55%, age 18–25) were divided into two groups: A (n = 49), practicing three or more days of physical activity a week, and B (n = 49), practicing less than two. Each group was split into two subgroups, receiving dietary supplementation with OP or ROP. The status of smoker was also recorded, and a biological antioxidant potential (BAP) test was performed on each subject. Results: The BAP values increased with both OP (n = 30) and ROP (n = 68) but ROP supplementation showed higher increments (736.9 μmol/L) than OP (339.6). The increment was significantly higher for smokers (n = 15), 1122.9 vs. non-smokers (n = 53), 635.7, with values in percent of baseline, respectively, 34.6% and 16.2% (P < 0.01). Conclusions: The ROP nutritional supplementation appears useful to increase antioxidant activity, with better effect in smokers; further studies should confirm the finding and investigate its biological bases. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

11 pages, 307 KiB

Open AccessArticle

Health Behavior Change and Complementary Medicine Use: National Health Interview Survey 2012

by Felicity L Bishop, Romy Lauche, Holger Cramer, Jonquil W Pinto, Brenda Leung, Helen Hall, Matthew Leach, Vincent CH Chung, Tobias Sundberg, Yan Zhang, Amie Steel, Lesley Ward, David Sibbritt and Jon Adams

Medicina 2019, 55(10), 632; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55100632 - 24 Sep 2019

Cited by 15 | Viewed by 3774

Abstract

Background and objectives: Complementary and alternative medicine (CAM) use has been associated with preventive health behaviors. However, the role of CAM use in patients’ health behaviors remains unclear. This study aimed to determine the extent to which patients report that CAM use motivates them to make changes to their health behaviors. Materials and Methods: This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. Results: Overall, 45.4% of CAM users reported being motivated by CAM to make positive health behavior changes, including exercising more regularly (34.9%), eating healthier (31.4%), eating more organic foods (17.2%), reducing/stopping smoking (16.6% of smokers), or reducing/stopping drinking alcohol (8.7% of drinkers). Individual CAM therapies motivated positive health behavior changes in 22% (massage) to 81% (special diets) of users. People were more likely to report being motivated to change health behaviors if they were: aged 18–64 compared to those aged over 65 years; of female gender; not in a relationship; of Hispanic or Black ethnicity, compared to White; reporting at least college education, compared to people with less than high school education; without health insurance. Conclusions: A sizeable proportion of respondents were motivated by their CAM use to undertake health behavior changes. CAM practices and practitioners could help improve patients’ health behavior and have potentially significant implications for public health and preventive medicine initiatives; this warrants further research attention. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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13 pages, 582 KiB

Open AccessArticle

Utilisation of and Attitude towards Traditional and Complementary Medicine among Ebola Survivors in Sierra Leone

by Peter Bai James, Jon Wardle, Amie Steel and Jon Adams

Medicina 2019, 55(7), 387; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55070387 - 18 Jul 2019

Cited by 3 | Viewed by 4561

Abstract

Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors’ attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57–9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92–13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10–30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74–9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors’ attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner–survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for treatment, but also to fill gaps in conventional health care services. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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14 pages, 302 KiB

Open AccessArticle

“I’ve Only Just Heard About It”: Complementary and Alternative Medicine Knowledge and Educational Needs of Clinical Psychologists in Indonesia

by Andrian Liem

Medicina 2019, 55(7), 333; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55070333 - 03 Jul 2019

Cited by 5 | Viewed by 3161

Abstract

Background and objectives: The inadequate knowledge of complementary and alternative medicine (CAM) among health professionals may put their clients at risk because clients would then find information about CAM from unreliable sources. Clinical psychologists (CPs), as health professionals, also have the opportunity to provide psychoeducation on the latest scientific CAM research for their clients. The current study aimed to explore knowledge and educational needs regarding CAM among CPs in Indonesia because previous studies on exploring CAM knowledge and educational needs regarding CAM were primarily conducted in Western countries. Materials and Methods: Data were collected through semi-structured face-to-face interviews with 43 CPs in public health centers (PHCs) in Indonesia. Most interviews were conducted at the PHCs where the participants worked and lasted for 55 minutes on average. The interview recordings were transcribed and were analyzed using deductive thematic analysis. Results: Five main themes emerged within participants’ responses regarding CAM knowledge and educational needs. First (CAM understanding), participants’ responses ranged from those with little or no prior knowledge of CAM treatments and uses, to those with much greater familiarity. Second (source of knowledge), participants’ access ranged widely in terms of references, from popular to scientific literature. Third (why is it important?), participants identified CAM as an essential part of Indonesian culture and considered it therefore crucial to have this cultural knowledge. Fourth (the challenges and what is needed?), the challenges for improving participants’ knowledge came from personal and institutional levels. Fifth (what and how to learn?), participants advised that only CAM treatments that fit in brief psychotherapy sessions should be introduced in professional training. Conclusions: This qualitative study discovered that CAM was neither well-known nor understood widely. Participants advised that professional associations and health institutions should work together in enhancing knowledge of CAM and incorporating CAM education into psychology education. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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18 pages, 2186 KiB

Open AccessArticle

In Vitro Antioxidant and Bactericidal Efficacy of 15 Common Spices: Novel Therapeutics for Urinary Tract Infections?

by Suresh Mickymaray and Mohammed Saleh Al Aboody

Medicina 2019, 55(6), 289; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55060289 - 19 Jun 2019

Cited by 27 | Viewed by 4074

Abstract

Background and Objectives: Bacterial urinary tract infection (UTI) is the most common ailment affecting all age groups in males and females. The commercial antibiotics usage augments antibiotics resistance and creates higher recurrence rates of such communal infections. Hence, this study is aimed at investigating the antibacterial and antioxidant potentials of 15 common spices against 11 UTI-causing bacterial pathogens. Materials and Methods: The antioxidant potential of the methanolic extracts was analyzed as contents of total phenols and flavonoids; radical scavenging, total reducing power, the ferric reducing power assay. Urinary pathogens were subjected to spice extracts to investigate antibacterial assays. Results: Preliminary phytochemical study of spices was performed to find those containing alkaloids, flavonoids, phenolic compounds, and steroids that can be recognized for their noteworthy bactericidal effects. The outcome of the antioxidative potential from the four methods demonstrated the sequence of potent antioxidant activity: Acorus calamus > Alpinia galanga > Armoracia rusticana > Capparis spinosa > Aframomum melegueta. The total polyphenols and flavonoids in the studied species positively correlated with their antioxidant properties. The four most effective spices (A. calamus, A. galanga, A. rusticana, and C. spinosa) had a zone of inhibition of at least 22 mm. A. calamus, A. melegueta, and C. spinosa had the lowest minimum inhibitory concentration (MIC) value against Enterobacter aerogenes, Staphylococcus aureus and Proteus mirabilis. All 15 spices had the lowest minimum bactericidal concentration (MBC) value against most of the pathogenic bacteria. Conclusion: The four highly potent and unique spices noted for the in vitro control of UTI-causing pathogens could be pursued further in the development of complementary and alternative medicine against UTI-causing pathogens. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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14 pages, 2520 KiB

Open AccessArticle

GC-MS Chemical Characterization and In Vitro Evaluation of Antioxidant and Toxic Effects Using Drosophila melanogaster Model of the Essential Oil of Lantana montevidensis (Spreng) Briq.

by Maria Rayane Correia de Oliveira, Luiz Marivando Barros, Antônia Eliene Duarte, Maria Gabriely de Lima Silva, Bruno Anderson Fernandes da Silva, Anita Oliveira Brito Pereira Bezerra, Cícera Datiane Morais Oliveira Tintino, Victor Afonso Pereira de Oliveira, Aline Augusti Boligon, Jean Paul Kamdem, Henrique Douglas Melo Coutinho and Irwin Rose Alencar de Menezes

Medicina 2019, 55(5), 194; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55050194 - 23 May 2019

Cited by 12 | Viewed by 3361

Abstract

Background and objectives: Natural products such as essential oils with antioxidant potential can reduce the level of oxidative stress and prevent the oxidation of biomolecules. In the present study, we investigated the antioxidant potential of Lantana montevidensis leaf essential oil (EOLM) in chemical and biological models using Drosophila melanogaster. Materials and methods: in addition, the chemical components of the oil were identified and quantified by gas chromatography coupled to mass spectrometry (GC-MS), and the percentage compositions were obtained from electronic integration measurements using flame ionization detection (FID). Results: our results demonstrated that EOLM is rich in terpenes with Germacrene-D (31.27%) and β-caryophyllene (28.15%) as the major components. EOLM (0.12–0.48 g/mL) was ineffective in scavenging DPPH radical, and chelating Fe(II), but showed reducing activity at 0.24 g/mL and 0.48 g/mL. In in vivo studies, exposure of D. melanogaster to EOLM (0.12–0.48 g/mL) for 5 h resulted in 10% mortality; no change in oxidative stress parameters such as total thiol, non-protein thiol, and malondialdehyde contents, in comparison to control (p > 0.05). Conclusions: taken together, our results indicate EOLM may not be toxic at the concentrations tested, and thus may not be suitable for the development of new botanical insecticides, such as fumigants or spray-type control agents against Drosophila melanogaster. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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14 pages, 1118 KiB

Open AccessArticle

Use of Complementary and Alternative Medicine by Patients with Irritable Bowel Syndrome According to the Roma IV Criteria: A Single-Center Italian Survey

by Tiziana Larussa, Marianna Rossi, Evelina Suraci, Raffaella Marasco, Maria Imeneo, Ludovico Abenavoli and Francesco Luzza

Medicina 2019, 55(2), 46; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55020046 - 13 Feb 2019

Cited by 16 | Viewed by 3880

Abstract

Aim: This study was conducted to evaluate the impact of complementary and alternative medicine (CAM) in patients with irritable bowel syndrome (IBS) as assessed by the Rome IV criteria. Methods: Consecutive patients referring for IBS were re-evaluated according to the Rome IV criteria. Demographic features and characteristics potentially associated with the use of CAM were collected. A validated, self-administered, survey questionnaire dealing with CAM and patients’ level of knowledge, motivation, perception, and information seeking-behavior toward the use of CAM was analyzed. Multivariate logistic regression analysis was performed in order to identify predictors of CAM use among participants. Results: Among 156 patients claiming IBS, 137 (88%) met the Rome IV criteria, and 62 of them (45%) were CAM users. Biologically based therapy was the most chosen CAM (78%). Significant risk factors (adjusted odds ratio, 95% confidence interval) for the use of CAM were female gender (7.22, 2.31–22.51), a higher BMI (1.16, 1.02–1.33), and a good knowledge of CAM (4.46, 1.73–11.45), while having children was a protective factor (0.25, 0.07–0.95). Only 19% of patients used CAM due to medical advice and over half (51%) thought it was a “more natural” approach. Although a minority of patients (16%) had full satisfaction from CAM, 81% of users would repeat the CAM experience for their IBS symptoms. Conclusions: The widespread use of CAM in IBS, the patients’ belief in its safety, and their willingness to re-use it suggest that knowledge of health-care providers and patient education should be improved. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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Review

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17 pages, 1922 KiB

Open AccessReview

Conventional and Complementary Medicine Health Care Practitioners’ Perspectives on Interprofessional Communication: A Qualitative Rapid Review

by Janet Nguyen, Lorraine Smith, Jennifer Hunter and Joanna E. Harnett

Medicina 2019, 55(10), 650; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55100650 - 27 Sep 2019

Cited by 28 | Viewed by 7334

Abstract

Background and Objectives: People have multi-faceted health care needs and consult a diverse range of health care practitioners (HCP) from both the conventional and complementary medicine healthcare sectors. The effective communication between HCP and with patients are obvious requisites to coordinating multidisciplinary care and shared decision making. Further, miscommunication is a leading cause of patient harm and is associated with reduced patient satisfaction, health literacy, treatment compliance and quality of life. In conventional healthcare settings, the differences in professional hierarchy, training, communication styles and culture are recognised communication barriers. Less is known about interprofessional communication (IPC) that includes traditional and complementary medicine (TCM) HCP. This review aims to summarise the experiences and perceptions of conventional and complementary HCP and identify factors that influence IPC. Methods: A qualitative rapid literature review was conducted. Six databases were searched to identify original research and systematic reviews published since 2009 and in English. Excluded were articles reporting original research outside of Australia that did not include TCM-HCP, already cited in a systematic review, or of low quality with a score of less than three on a critical appraisal skills programme (CASP) checklist. A thematic analysis of included studies was used to identify and explore important and recurring themes. Results: From the conducted searches, 18 articles were included, 11 of which reported data on complementary HCP and seven were literature reviews. Four key themes were identified that impact IPC: medical dominance, clarity of HCP roles, a shared vision, and education and training. Conclusion: IPC within and between conventional and complementary HCP is impacted by interrelated factors. A diverse range of initiatives that facilitate interprofessional learning and collaboration are required to facilitate IPC and help overcome medical dominance and interprofessional cultural divides. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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16 pages, 1789 KiB

Open AccessReview

Drimia indica: A Plant Used in Traditional Medicine and Its Potential for Clinical Uses

by Sonali Aswal, Ankit Kumar, Ruchi Badoni Semwal, Ashutosh Chauhan, Abhimanyu Kumar, Jörg Lehmann and Deepak Kumar Semwal

Medicina 2019, 55(6), 255; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55060255 - 07 Jun 2019

Cited by 13 | Viewed by 5768

Abstract

Drimia indica (Roxb.) Jessop (Asparagaceae) is a reputed Ayurvedic medicine for a number of therapeutic benefits, including for cardiac diseases, indigestion, asthma, dropsy, rheumatism, leprosy, and skin ailments. The present work aimed to critically and extensively review its traditional uses, phytochemistry, pharmacology, toxicology, and taxonomy together with the mechanisms of action of selected extracts of D. indica. A systematic literature survey from scientific databases such as PubMed, Scopus, and Web of Science as well as from some textbooks and classical texts was conducted. The plant, mainly its bulb, contains various bioactive constituents, such as alkylresorcinols, bufadienolides, phytosterols, and flavonoids. Various scientific studies have proven that the plant has anthelmintic, anticancer, antidiabetic, antimicrobial, antioxidant, and wound healing activities. The present work concludes that D. indica has the potential to treat various diseases, mainly microbial infections. This review also suggests that bufadienolides, flavonoids, and steroids might be responsible for its bioactive potential. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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10 pages, 947 KiB

Open AccessReview

A Systematic Review of the Role of Prebiotics and Probiotics in Autism Spectrum Disorders

by Qin Xiang Ng, Wayren Loke, Nandini Venkatanarayanan, Donovan Yutong Lim, Alex Yu Sen Soh and Wee Song Yeo

Medicina 2019, 55(5), 129; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55050129 - 10 May 2019

Cited by 82 | Viewed by 11346

Abstract

Background: Autism spectrum disorder (ASD) is a complex developmental condition typically characterized by deficits in social and communicative behaviors as well as repetitive patterns of behaviors. Despite its prevalence (affecting 0.1% to 1.8% of the global population), the pathogenesis of ASD remains incompletely understood. Patients with ASD are reported to have more frequent gastrointestinal (GI) complaints. There is some anecdotal evidence that probiotics are able to alleviate GI symptoms as well as improve behavioral issues in children with ASD. However, systematic reviews of the effect of prebiotics/probiotics on ASD and its associated symptoms are lacking. Methods: Using the keywords (prebiotics OR probiotics OR microbiota OR gut) AND (autism OR social OR ASD), a systematic literature search was conducted on PubMed, EMBASE, Medline, Clinicaltrials.gov and Google Scholar databases. The inclusion criteria were original clinical trials, published in English between the period 1st January 1988 and 1st February 2019. Results: A total of eight clinical trials were systematically reviewed. Two clinical trials examined the use of prebiotic and/or diet exclusion while six involved the use of probiotic supplementation in children with ASD. Most of these were prospective, open-label studies. Prebiotics only improved certain GI symptoms; however, when combined with an exclusion diet (gluten and casein free) showed a significant reduction in anti-sociability scores. As for probiotics, there is limited evidence to support the role of probiotics in alleviating the GI or behavioral symptoms in children with ASD. The two available double-blind, randomized, placebo-controlled trials found no significant difference in GI symptoms and behavior. Conclusion: Despite promising preclinical findings, prebiotics and probiotics have demonstrated an overall limited efficacy in the management of GI or behavioral symptoms in children with ASD. In addition, there was no standardized probiotics regimen, with multiple different strains and concentrations of probiotics, and variable duration of treatments. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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12 pages, 1069 KiB

Open AccessReview

The Beneficial Effects of Traditional Chinese Exercises for Adults with Low Back Pain: A Meta-Analysis of Randomized Controlled Trials

by Yanjie Zhang, Paul D. Loprinzi, Lin Yang, Jing Liu, Shijie Liu and Liye Zou

Medicina 2019, 55(5), 118; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55050118 - 29 Apr 2019

Cited by 40 | Viewed by 6484

Abstract

Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, Cinahl, Web of Science, Cochrane library, China National Knowledge Infrastructure, and Wanfang). The searched period was from inception to 1 March 2019. Randomized controlled trials (RCTs) assessing the effect of TCE on pain intensity and back disability in LBP patients were included. Pooled effect sizes were calculated using the random-effects models and 95% confidence interval (95% CI). Results: Data from eleven RCTs (886 individuals with LBP) meeting the inclusion criteria were extracted for meta-analysis. Compared with the control intervention, TCE induced significant improvements in the visual analogue scale (VAS) (Hedge’s g = −0.64, 95% CI −0.90 to −0.37, p < 0.001), Roland–Morris Disability Questionnaire (RMDQ) (Hedge’s g = −0.41, 95% CI −0.79 to −0.03, p = 0.03), Oswestry Disability Index (ODI) (Hedge’s g = −0.96, 95% CI −1.42 to −0.50, p < 0.001), and cognitive function (Hedge’s g = −0.62, 95% CI −0.85 to −0.39, p < 0.001). In a meta-regression analysis, age (β = 0.01, p = 0.02) and total exercise time (β = −0.0002, p = 0.01) were associated with changes in the VAS scores, respectively. Moderator analyses demonstrated that Tai Chi practice (Hedge’s g = −0.87, 95% CI −1.38 to −0.36, p < 0.001) and Qigong (Hedge’s g = −0.54, 95% CI −0.86 to −0.23, p < 0.001) reduced VAS scores. Interventions with a frequency of 1–2 times/week (Hedge’s g = −0.53, 95% CI −0.98 to −0.07, p = 0.02) and 3–4 times/week (Hedge’s g = −0.78, 95% CI −1.15 to −0.42, p < 0.001) were associated with reduced VAS scores, but this significant reduction on this outcome was not observed in the weekly training frequency of ≥5 times (Hedge’s g = −0.54, 95% CI −1.16 to 0.08, p = 0.09). Conclusions: TCE may have beneficial effects for reducing pain intensity for individuals with LBP, regardless of their pain status. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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Other

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11 pages, 1880 KiB

Open AccessCase Report

Antrodia Cinnamomea Prolongs Survival in a Patient with Small Cell Lung Cancer

by Huei Long, Chi-Tan Hu and Ching-Feng Weng

Medicina 2019, 55(10), 640; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55100640 - 26 Sep 2019

Cited by 12 | Viewed by 5092

Abstract

Introduction: Antrodia cinnamomea (AC) is an extremely rare medicinal fungus native to forested regions of Taiwan. It possesses numerous biological activities, especially anti-tumor effects shown in various in vitro cancer cells and in vivo animal models. However, there are few clinical reports about AC as a treatment for cancer patients. This report attempts to demonstrate the therapeutic effect of dish-cultured AC (DAC) on a small cell lung cancer (SCLC) patient taken orally for an extended duration. Patient concerns: An 88-year-old male with a history of diabetes mellitus and hypertension visited the outpatient department with the symptoms of dyspnea and a cough for two weeks. After a diagnosis of SCLC, the patient declined both chemotherapy and radiotherapy because of the side effects and only accepted supportive care without additional therapy. Diagnosis: Limited-stage SCLC (T4N2M1a, stage IV) after the chest radiograph, computed tomography-guided biopsy, and pathological diagnosis. Interventions: The patient was prescribed DAC with an increasing dosage, from 5 g/d up to 10 g/d DAC, for six months, without radiation or chemotherapy treatment. Outcomes: DAC caused the tumor to shrink substantially. Surprisingly, the patient survived for 32 months without relapse after six months of DAC treatment. Laboratory examinations indicated that the patient’s health had improved significantly, reverting to near normal levels. Notably, he had a good quality of life with a high Barthel index score. Unfortunately, this patient died of septic shock caused by acute cholangitis. Conclusion: DAC may exert an anti-cancer effect, which can lead to tumor regression. This is supposed to be achieved by the combined DAC’s immunomodulatory, anti-angiogenic, anti-metastatic, anti-proliferative, and pro-apoptotic effects mediated through multiple signaling pathways. We propose that DAC can be used as a complementary medicine to prolong the life expectancy and improve the life quality of SCLC patients. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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Open AccessCommentary

Naturopathy as a Model of Prevention-Oriented, Patient-Centered Primary Care: A Disruptive Innovation in Health Care

by Ryan Bradley, Joanna Harnett, Kieran Cooley, Erica McIntyre, Joshua Goldenberg and Jon Adams

Medicina 2019, 55(9), 603; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina55090603 - 18 Sep 2019

Cited by 8 | Viewed by 11679

Abstract

Background and Objective: The concept of a “disruptive innovation,” recently extended to health care, refers to an emerging technology that represents a new market force combined with a new value system, that eventually displaces some, or all, of the current leading “stakeholders, products and strategic alliances.” Naturopathy is a distinct system of traditional and complementary medicine recognized by the World Health Organization (WHO), emerging as a model of primary care. The objective here is to describe Naturopathy in the context of the criteria for a disruptive innovation. Methods: An evidence synthesis was conducted to evaluate Naturopathy as a potentially disruptive technology according to the defining criteria established by leading economists and health technology experts: (1) The innovation must cure disease; (2) must transform the way medicine is practiced; or (3) have an impact that could be disruptive or sustaining, depending on how it is integrated into the current healthcare marketplace. Results: The fact that Naturopathy de-emphasizes prescription drug and surgical interventions in favor of nonpharmacological health promotion and self-care could disrupt the present economic model that fuels health care costs. The patient-centered orientation of Naturopathy, combined with an emphasis on preventive behaviors and popular complementary and integrative health services like natural products, mind and body therapies, and other therapies not widely represented in current primary care models increase the likelihood for disruption. Conclusions: Because of its patient-centered approach and emphasis on prevention, naturopathy may disrupt or remain a durable presence in healthcare delivery depending on policymaker decisions. Full article

(This article belongs to the Special Issue Complementary and Integrative Medicine)

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