| |
Click here to login or subscribe
8 matching items were found.
Search again |
| |
|
December, 2012 - VOL. 11, NO. 6 | |
December, 2012 |
| The Path Ahead: What Should We Tell Our Patients About Alcohol? |
| Joseph Pizzorno, ND |
| Over the years I have written several articles about environmental toxins such as mercury and persistent organic pollutants and nutritional deficiencies such as vitamins D and K2 and iodine. The clinical applications are straightforward: decrease exposure to toxins and optimize intake of nutrients. But what about alcohol? Excess alcoholic consumption is clearly a serious clinical problem in North America, with a prevalence of lifetime and 12-month alcohol abuse of 17.8% and 4.7%, and prevalence of lifetime and 12-month alcohol dependence of 12.5% and 3.8%.1 On the other hand, teetotalers do not live as long and have a higher incidence of several diseases as those who consume light to moderate amounts of alcohol, suggesting that some alcohol is beneficial. But what is the right amount? The research is unclear and complicated. |
| read entire article... |
|
| |
|
December, 2012 - VOL. 11, NO. 6 | |
December, 2012 |
| Industry Insights: More Than Two Dozen Studies Demonstrate CAM Cost-effectiveness … plus more |
| John Weeks |
| Systematic Review Finds Cost-effectiveness in Complementary and Integrative Medicine in Over Two Dozen Studies
A critically needed review of all cost-effectiveness studies on complementary and integrative medicine (CIM) found 28 “high-quality studies,” according to lead author Patricia Herman, MS, ND, PhD. The review was global and covered the years 2000 to 2010. Herman, an economist and licensed naturopathic doctor, first engaged the project in 2008 with David Eisenberg, MD, of the Harvard School of Public Health. The report is entitled “Are Complementary Therapies and Integrative Care Cost-effective? A Systematic Review of Economic Evaluations.” 1 In an interview in the Huffington Post, Herman states: “I’m tired of this talk that there is no evidence for cost-effectiveness of complementary and integrative medicine. There is evidence. We need to move on to phase two and look at how transferable these findings are. We can take this evidence and run.”2
Studies that found frank “cost savings” ranged from acupuncture for breech delivery and for low back pain, to manual manipulation for neck pain, natural products for various conditions, and a study of the whole practice of naturopathic medicine for chronic low back pain. Those found to be cost-effective based on analysis of changes in quality adjusted life years included treatment in clinics of Oregon chiropractors, plus others related to massage, tai chi, Alexander technique, and numerous studies of adjunctive acupuncture treatment. |
| read entire article... |
|
| |
|
December, 2012 - VOL. 11, NO. 6 | |
December, 2012 |
| Ensuring the Safety of Compounded Products: Best Clinician Practices and an Existing Solution |
| Paul Savage, MD |
| Without doubt, tragedy has struck hundreds of people due to the contamination of a batch of injectable medication produced by the New England Compounding Center (NECC) of Framingham, Massachusetts. Now fear grips the unaware, the unknowing, and the naïve.
As of October 27, 2012, the Center for Disease Control (CDC) has reported 344 patients diagnosed with fungal meningitis, a potentially life-threatening infection. To date there have been 25 reported deaths from 18 states (Figure 1) and the number has risen as this journal is being prepared for distribution.1
|
| read entire article... |
|
| |
|
December, 2012 - VOL. 11, NO. 6 | |
December, 2012 |
| Outside the “Diagnostic Box”: A Case of Bulimia and Obsessive–Compulsive Disorder |
| Shiva Barton, ND, LAc |
| One of the many challenges of being a primary care physician—and a naturopathic primary care physician—is an inherent directive to consider every patient as a new and unique, highly individualized and complex case.
We do not turn to diagnostic manuals as a first order of business but rather spend a significant amount of time talking with the patient, conducting a physical exam, and requesting any laboratory or others tests we may feel are relevant to the case. The true “art” (or perhaps “discipline”) of diagnosis lies not only in undertaking these steps but also in not allowing our clinical considerations to be constrained by “popular” thought or practice.
A 32-year-old woman came for help with an eating disorder previously diagnosed by other clinicians. She described a daily cycle of vomiting after evening meals with constant underlying anxiety that heightened as evening hours (and thus the evening meal) approached.
The woman was below average weight, with some alopecia. She had consulted with several physicians over her 18-year course with this condition but without apparent success. She did not reveal appreciable physical or psychological trauma or challenges to body image and self-image. These are standard psychological approaches to addressing bulimia and eating disorders, and clinicians often focus on body image, social pressure, or on the act of vomiting. She also didn’t reveal any other features consistent with a psychological origin to her condition.
However, I approach these cases in a different way. My clinical experience and research have shown me that conditions such as hers are an autoimmune disorder affecting the central nervous system. My focus in this case was to determine the biological cause of the woman’s bulimia and determine if it could be eradicated. |
| read entire article... |
|
| |
|
December, 2012 - VOL. 11, NO. 6 | |
December, 2012 |
| A Pilot Study to Evaluate the Physiological Effects of a Spa Retreat That Uses Caloric Restriction and Colonic Hydrotherapy |
| Andrew B Newberg, MD; Joseph C Wilson; Nancy A Wintering, MSW |
| Context: Spa retreats provide comprehensive programs for the purpose of stress reduction, detoxification, weight loss, and improvements in health and wellbeing, and the programs often include caloric restriction and the use of colonic hydrotherapy. Considerable controversy has existed regarding the risks and benefits associated with these therapies. Studies on such programs could help the general public and health care providers to be better informed about their risks and benefits.
Objective: The purpose of this study was to determine initial safety data associated with participating in a spa program that included diet modification, meditation, and colonic hydrotherapy. In addition, the research team hoped to determine the physiological effects of the program.
Design: The study was a pilot in support of development of a more formal efficacy study.
Setting: The We Care Spa in Desert Hot Springs, California was the setting for this study.
Participants: Participants were 15 healthy individuals who were previously planning to participate in a 1-week spa program.
Intervention(s): Over a 1-week period at the spa, the participants (1) received at least four colonics, (2) voluntarily participated in low-risk hatha and Vishnu flow-yoga programs, and (3) followed a juice-fast-cleansing very low calorie diet (VLCD) of approximately 800 calories per day. Stress management was provided through daily structured meditation and yoga programs as well as time for personal meditation to encourage deep breathing, heightened awareness, and a calming effect.
Outcome Measure(s): Participants underwent a standardized physical exam before and immediately upon completion of the spa program. The exams included measures of weight, blood pressure, and laboratory values as well as psychological and spiritual measures. Comparisons of the pre- and post-program values were performed using a paired t test.
Results: A number of significant changes occurred and were associated with undergoing the spa program. Weight decreased from a mean of 162.2 to 155.4 pounds (P = .0001). Diastolic BP decreased from a mean of 73.7 to 68.0 mm Hg (P = .01). Sodium decreased from a mean of 146.4 to 141.0 mEq (P = .006), and chloride decreased from a mean of 108.1 to 100.3 mEq/l (P = .0001). Hemoglobin increased from a mean of 13.6 to 14.4 g/dl (P = .009). Measures of depression (P = .0004), anxiety (P = .001), vigor (P = .0018), and tension (P = .01) were significantly improved. No serious adverse events were reported by any individual.
Conclusions: Overall, the results of this preliminary study demonstrated improvements in several physiological and psychological measures resulting from participation in the spa program in conjunction with a finding of no significant safety concerns. Of note, the decrease in sodium and chloride suggests an influence on electrolytes that should be closely evaluated in individuals who may be at greater risk for electrolyte abnormalities. |
| read entire article... |
|
| |
|
December, 2012 - VOL. 11, NO. 6 | |
December, 2012 |
| Adjunctive Naturopathic Care for Type 2 Diabetes: Patient-reported and Clinical Outcomes After 1 Year |
| Ryan Bradley, ND, MPH; Carlo Calabrese, ND, MPH; Sheryl Catz, PhD; Dan Cherkin, PhD; Lou Grothaus, MA; Luesa Jordan; Erica B Oberg, ND, MPH; Karen J Sherman, PhD, MPH |
| Background: Several small, uncontrolled studies have found improvements in self-care behaviors and reductions in clinical risk in persons with type 2 diabetes who received care from licensed naturopathic physicians. To extend these findings and determine the feasibility and promise of a randomized clinical trial, we conducted a prospective study to measure the effects of adjunctive naturopathic care (ANC) in primary care patients with inadequately controlled type 2 diabetes.
Methods: Forty patients with type 2 diabetes were invited from a large integrated health care system to receive up to eight ANC visits for up to 1 year. Participants were required to have hemoglobin A1c (HbA1c) values between 7.5%-9.5% and at least one additional cardiovascular risk factor (ie, hypertension, hyperlipidemia, or overweight). Standardized instruments were administered by telephone to collect outcome data on self-care, self-efficacy, diabetes problem areas, perceived stress, motivation, and mood. Changes from baseline scores were calculated at 6 and 12 months after entry into the study. Six and 12-month changes in clinical risk factors (ie, HbA1c, lipid and blood pressure) were calculated for the ANC cohort, and compared to changes in a cohort of 329 eligible, nonparticipating patients constructed using electronic medical records data. Between-cohort comparisons were adjusted for age, gender, baseline HbA1c, and diabetes medications. Six months was prespecified as the primary endpoint for outcome assessment.
Results: Participants made 3.9 ANC visits on average during the year, 78% of which occurred within 6 months of entry into the study. At 6 months, significant improvements were found in most patient-reported measures, including glucose testing (P = .001), diet (P = .001), physical activity (P = .02), mood (P = .001), self-efficacy (P = .0001), and motivation to change lifestyle (P = .003). Improvements in glucose testing, mood, self-efficacy, and motivation to change lifestyle persisted at 12 months (all P < .005). For clinical outcomes, mean HbA1c decreased by -0.90 % (P = .02) in the ANC cohort at 6 months, a -0.51 % mean difference compared to usual care (P = .07). Reductions at 12 months were not statistically significant (-0.34% in the ANC cohort, P = .14; -0.37% difference compared to the usual care cohort, P = .12).
Conclusions: Improvements were noted in self-monitoring of glucose, diet, self-efficacy, motivation, and mood following initiation of ANC for patients with inadequately controlled type 2 diabetes. Study participants also experienced reductions in blood glucose that exceeded those for similar patients who did not receive ANC. Randomized clinical trials will be necessary to determine if ANC was responsible for these benefits. |
| read entire article... |
|
| |
|
December, 2012 - VOL. 11, NO. 6 | |
December, 2012 |
| The Evolution of Practice: An Interview With Tris Trethart, MD, CCFP, CCT |
| Karen Burnett |
| Tris Trethart, MD, CCFP, CCT, is a graduate of the University of Manitoba, having completed a family practice residency program and holds a membership with the College of Family Physicians of Canada. He is a past board member of the advisory council of Grant MacEwan University’s Holistic Practitioner Program. He is also a past founding member and secretary/treasurer of the Canadian Complementary Medicine Association and founding member of the Holistic and Complementary Medicine Society of Alberta. Dr Trethart focuses on alternative and complementary medicine including chelation and bio-oxidative therapies, antiaging, regenerative and restorative medicine, and orthomolecular, preventative and nutritional medicine. He has practiced preventative health care in Edmonton, Vancouver, and Toronto, Canada, with more than 30 years of experience.
Dr Trethart is a diplomat candidate of the American College for the Advancement of Medicine with a diploma as a certified chelation therapist. He is enrolled in the Master’s program at South Florida University in antiaging medicine. He is a member of numerous associations including Association for the Advancement of Restorative Medicine, Orthomolecular Medical Association, American Academy of Anti-Aging Medicine and The Institute of Functional Medicine.
Dr Trethart’s foundation of all treatment begins with the establishment of a supportive patient-physician partnership and is committed to the philosophy of continuing patient education, where patients will be given the opportunities to learn about the health implications of their particular lifestyle choices. He is also committed to providing patients with the support needed to take greater responsibility for determining and controlling their own health care treatment. |
| read entire article... |
|
| |
|
December, 2012 - VOL. 11, NO. 6 | |
December, 2012 |
| BackTalk: Brand New Wine |
| Bill Benda, MD |
| One of the worst things about aging is that we tend to become intolerant. One of the best things about aging is that we can get away with it. In fact, curmudgeonly editorializing is currently one of my favorite pastimes.
So this particular BackTalk will expound upon one of my personal pet peeves, conference brochures. You may have noticed these glossy advertisements in your mailbox and on your computer screen heralding the fall contribution to the cornucopia of nutrition and functional medicine and guild gatherings taking place across the country. I have little issue with the conferences themselves, but I do have issue with the advertising touting the wonders that await. (Cue Andy Rooney.) |
| read entire article... |
|
| |
Search again |
|
