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Yazdanian M, Rostamzadeh P, Alam M, Abbasi K, Tahmasebi E, Tebyaniyan H, Ranjbar R, Seifalian A, Moghaddam MM, Kahnamoei MB. Evaluation of antimicrobial and cytotoxic effects of Echinacea and Arctium extracts and Zataria essential oil. AMB Express 2022; 12:75. [PMID: 35705727 PMCID: PMC9200929 DOI: 10.1186/s13568-022-01417-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 06/08/2022] [Indexed: 12/19/2022] Open
Abstract
Dental caries and oral infections have become a widespread issue in the modern world. This study aimed to investigate the antibacterial, antifungal, and cytotoxicity characteristics of the extracts of Echinacea purpura, Arctium lappa, and the essential oil of Zataria multiflora as a potential herbal mouthwash. The essential oil of Z. multiflora leaves and the extracts of E. purpurea and A. lappa roots were prepared. The characterization was carried out by GC-MS and also, total phenol and flavonoid were assed for all three samples. The antimicrobial and anti-biofilm effects were evaluated against Streptococcus mutans, Streptococcus mitis, Streptococcus salivarius, Lactobacillus acidophilus, Escherichia coli, Staphylococcus aureus, and Candida albicans. The cytotoxic effect of the samples was evaluated on HEK 293 and HDFa cells by MTT test. Thymol and carvacrol contents in EO of Z. multiflora were measured at 31% and 42.2%, respectively. A. lappa had the lowest total phenolic and flavonoid value among the samples. On the other hand, the total phenolic content of Z. multiflora and the total flavonoid content of E. purpurea were the highest. The MIC values of Zataria, Arctium, and Echinacea against S. mutans were 0.011% v/v, 187.5 mg/ml, and 93.75 mg/ml, while MBC were 0.011% v/v, 375 mg/ml, and 187.5 mg/ml, respectively. The formulation showed bactericidal activity against S. mutans in the concentration of 5.86 mg/ml for Echinacea and Burdock extracts and 0.08 µl/ml for EO of Zataria. The formulation significantly affected microbial biofilm formation and induced biofilm degradation. The cell viability percentages were higher than 50% during 24 and 48 h. The formulation had a significant antimicrobial effect on cariogenic bacteria and C. albicans, with the lowest cytotoxic effects. Therefore, this formulation can be an appropriate candidate for mouthwash.
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Affiliation(s)
- Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.,School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Pouya Rostamzadeh
- Scientific Research Center (DSSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran. .,School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Hamid Tebyaniyan
- Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Reza Ranjbar
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.,School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alexander Seifalian
- Nanotechnology and Regenerative Medicine, Commercialization Centre (NanoRegMed Ltd), The London Bioscience Innovation Centre, London, UK
| | | | - Majid Balaei Kahnamoei
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Porter KE, Brennan-Ing M, Burr JA, Dugan E, Karpiak SE. HIV Stigma and Older Men's Psychological Well-Being: Do Coping Resources Differ for Gay/Bisexual and Straight Men? J Gerontol B Psychol Sci Soc Sci 2020; 74:685-693. [PMID: 28977625 DOI: 10.1093/geronb/gbx101] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 07/05/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study investigated whether sexual orientation moderated the mediation effects of coping resources (i.e., spirituality and complementary and integrative health [CIH] use) in the relationship between HIV stigma and psychological well-being (PWB) among older men with HIV (MWH). METHOD Data from the Research of Older Adults with HIV (ROAH) study was used (N = 640, Age 50+). Structural equation modeling (SEM) was employed to examine a coping resource mediation model. We used a multiple-group procedure to test moderation effects by sexual orientation. RESULTS HIV stigma was negatively associated with spirituality and PWB. HIV stigma accounted for a significant amount of variance in PWB, with significant indirect effects via spirituality, indicating a partial mediation. Chi-square difference tests supported the hypothesis that this mediation effect was moderated by sexual orientation. CIH use was not statistically significant. DISCUSSION HIV stigma's negative relationship with PWB was salient in both groups. Spirituality's buffer between HIV stigma and PWB was stronger in older gay/bisexual MWH compared to their heterosexual counterparts. With respect to HIV stigma, older gay/bisexual MWH exhibited a "crisis competence" in coping with stigma, perhaps through overcoming past homophobia related to their sexual minority status (i.e., homophobia).
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Affiliation(s)
| | - Mark Brennan-Ing
- Center on HIV & Aging, ACRIA, New York.,New York University Rory Meyers College of Nursing
| | - Jeffrey A Burr
- Department of Gerontology, University of Massachusetts, Boston
| | - Elizabeth Dugan
- Department of Gerontology, University of Massachusetts, Boston
| | - Stephen E Karpiak
- Center on HIV & Aging, ACRIA, New York.,New York University Rory Meyers College of Nursing
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Abrams AL, Falkenberg T, Rautenbach C, Moshabela M, Shezi B, van Ellewee S, Street R. Legislative landscape for traditional health practitioners in Southern African development community countries: a scoping review. BMJ Open 2020; 10:e029958. [PMID: 31915157 PMCID: PMC6955546 DOI: 10.1136/bmjopen-2019-029958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Globally, contemporary legislation surrounding traditional health practitioners (THPs) is limited. This is also true for the member states of the Southern African Development Community (SADC). The main aim of this study is to map and review THP-related legislation among SADC countries. In order to limit the scope of the review, the emphasis is on defining THPs in terms of legal documents. METHODS This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews methods. Two independent reviewers reviewed applicable legal definitions of THPs by searching the Southern African Legal Information Institute (SAFLII) database in April 2018 for legislation and bills. To identify additional legislation applicable in countries not listed on SAFLII and/or further relevant SADC legislation, the search engines, Google and PubMed, were used in August 2018 and results were reviewed by two independent reviewers. Full texts of available policy and legal documents were screened to identify policies and legislation relating to the regulation of THPs. Legislation was deemed relevant if it was a draft of or promulgated legislation relating to THPs. RESULTS Four of 14 Southern African countries have legislation relating to THPs. Three countries, namely South Africa, Namibia and Zimbabwe, have acknowledged the roles and importance of THPs in healthcare delivery by creating a council to register and formalise practices, although they have not operationalised nor registered and defined THPs. In contrast, Tanzania has established a definition couched in terms that acknowledge the context-specific and situational knowledge of THPs, while also outlining methods and the importance of local recognition. Tanzanian legislation; thus, provides a definition of THP that specifically operationalises THPs, whereas legislation in South Africa, Namibia and Zimbabwe allocates the power to a council to decide or recognise who a THP is; this council can prescribe procedures to be followed for the registration of a THP. CONCLUSIONS This review highlights the differences and similarities between the various policies and legislation pertaining to THPs in SADC countries. Legislation regarding THPs is available in four of the 14 SADC countries. While South Africa, Tanzania, Namibia and Zimbabwe have legislation that provides guidance as to THP recognition, registration and practices, THPs continue to be loosely defined in most of these countries. Not having an exact definition for THPs may hamper the promotion and inclusion of THPs in national health systems, but it may also be something that is unavoidable given the tensions between lived practices and rigid legalistic frameworks.
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Affiliation(s)
- Amber Louise Abrams
- Environment and Health, South African Medical Research Council, Durban, South Africa
- Future Water institute, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Torkel Falkenberg
- Department of Neurobiology, Caring Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Mosa Moshabela
- School of Nursing and Public Health, University of KwaZulu-Natal College of Health Sciences, Durban, South Africa
| | - Busisiwe Shezi
- Environment and Health, South African Medical Research Council, Durban, South Africa
| | - Suné van Ellewee
- Faculty of Law, North-West University, Potchefstroom, South Africa
| | - Renee Street
- Environment and Health, South African Medical Research Council, Durban, South Africa
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Nguyen D. Mapping knowledge domains of non-biomedical modalities: A large-scale co-word analysis of literature 1987-2017. Soc Sci Med 2019; 233:1-12. [PMID: 31176056 DOI: 10.1016/j.socscimed.2019.05.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/21/2019] [Accepted: 05/25/2019] [Indexed: 11/28/2022]
Abstract
This paper presents a systematic mapping of the disparate literature on non-biomedical therapeutic modalities using co-word analysis. Non-biomedical modalities are defined in this paper as therapeutic modalities that exist in separation, but not isolation from, biomedicine. Bibliometric visualisation based on co-word analysis, a method sensitive to the configuration of socio-cognitive networks of knowledge, is employed to create a semantic topography of thirty years' literature from across different disciplines. The proliferation of terminologies to describe non-biomedical modalities from different disciplines raises important issues about the structure of scholarly knowledge about this area, particularly with regards to domains of meaning and conceptual spaces that lay dormant within this discourse. Drawing from a bibliographic dataset of 17,163 peer-reviewed publications written in English between 1987 and 2017 (retrieved on September 31, 2018), this paper presents a rigorous map with which to navigate the highly complex and interdisciplinary literature on non-biomedical knowledge and practices. Arguing that knowledge production about non-biomedical modalities in scholarly literature resembles that of problematic networks of interest, this paper substantiates the separation from biomedicine that contradistinguishes non-biomedical modalities. It does so by analysing the semantic trajectories of the most widely used terminologies in this domain, namely traditional medicine, alternative medicine, herbal medicine, and unclassified drug. Although all equally problematic, these contested terminologies are unlikely to replace one another in any form of paradigmatic shift in the foreseeable future. Their persisting conceptual usefulness is anchored in their own respective clusters of meaning, and researchers wishing to engage in the production of knowledge in this domain should be mindful of the pitfalls associated with their terminology use. Non-biomedical modalities as a term might be better equipped to capture the diversity as well as the historical continuities and discontinuities of therapeutic traditions and practices at the margin of mainstream scientific medicine.
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Affiliation(s)
- Dang Nguyen
- School of Historical and Philosophical Studies, University of Melbourne, Parkville, VIC, 3010, Australia.
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Bolan S, Kunhikrishnan A, Seshadri B, Choppala G, Naidu R, Bolan NS, Ok YS, Zhang M, Li CG, Li F, Noller B, Kirkham MB. Sources, distribution, bioavailability, toxicity, and risk assessment of heavy metal(loid)s in complementary medicines. ENVIRONMENT INTERNATIONAL 2017; 108:103-118. [PMID: 28843139 DOI: 10.1016/j.envint.2017.08.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 08/05/2017] [Accepted: 08/09/2017] [Indexed: 05/27/2023]
Abstract
The last few decades have seen the rise of alternative medical approaches including the use of herbal supplements, natural products, and traditional medicines, which are collectively known as 'Complementary medicines'. However, there are increasing concerns on the safety and health benefits of these medicines. One of the main hazards with the use of complementary medicines is the presence of heavy metal(loid)s such as arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg). This review deals with the characteristics of complementary medicines in terms of heavy metal(loid)s sources, distribution, bioavailability, toxicity, and human risk assessment. The heavy metal(loid)s in these medicines are derived from uptake by medicinal plants, cross-contamination during processing, and therapeutic input of metal(loid)s. This paper discusses the distribution of heavy metal(loid)s in these medicines, in terms of their nature, concentration, and speciation. The importance of determining bioavailability towards human health risk assessment was emphasized by the need to estimate daily intake of heavy metal(loid)s in complementary medicines. The review ends with selected case studies of heavy metal(loid) toxicity from complementary medicines with specific reference to As, Cd, Pb, and Hg. The future research opportunities mentioned in the conclusion of review will help researchers to explore new avenues, methodologies, and approaches to the issue of heavy metal(loid)s in complementary medicines, thereby generating new regulations and proposing fresh approach towards safe use of these medicines.
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Affiliation(s)
- Shiv Bolan
- Global Centre for Environmental Remediation, ATC Building, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Anitha Kunhikrishnan
- Department of Agro-Food Safety, National Institute of Agricultural Science, Wanju, Jeollabuk-do 55365, Republic of Korea
| | - Balaji Seshadri
- Global Centre for Environmental Remediation, ATC Building, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Girish Choppala
- Southern Cross GeoScience, Southern Cross University, Lismore, New South Wales 2480, Australia
| | - Ravi Naidu
- Global Centre for Environmental Remediation, ATC Building, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Nanthi S Bolan
- Global Centre for Environmental Remediation, ATC Building, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Yong Sik Ok
- O-Jeong Eco-Resilience Institute (OJERI) & Division of Environmental Science and Ecological Engineering, Korea University, Seoul, Republic of Korea
| | - Ming Zhang
- Department of Environmental Engineering, China Jiliang University, Hangzhou, China
| | - Chun-Guang Li
- National Institute of Complementary Medicine, Western Sydney University, Penrith, NSW 2751, Australia
| | - Feng Li
- National Institute of Complementary Medicine, Western Sydney University, Penrith, NSW 2751, Australia
| | - Barry Noller
- Sustainable Minerals Institute, University of Queensland, Brisbane, Australia
| | - Mary Beth Kirkham
- Department of Agronomy, Throckmorton Plant Sciences Center, Kansas State University, Manhattan, KS, USA
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Porter KE, Brennan-Ing M, Burr JA, Dugan E, Karpiak SE. Stigma and Psychological Well-being Among Older Adults With HIV: The Impact of Spirituality and Integrative Health Approaches. THE GERONTOLOGIST 2017; 57:219-228. [PMID: 26329318 DOI: 10.1093/geront/gnv128] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/16/2015] [Indexed: 11/12/2022] Open
Abstract
Purpose of the Study The National Institutes of Health calls for research that explores what it means to age optimally with HIV/AIDS as half of the U.S. people with HIV are aged 50 or older. This study applied the stress process model to examine the association between HIV stigma and psychological well-being and mediating resources (i.e., spirituality and complementary and integrative health [CIH]) approaches) in older adults with HIV. Design and Methods Using data from the Research on Older Adults with HIV (ROAH) study, structural equation modeling was used to estimate these relationships within a latent variable model. Namely, a direct negative association between HIV stigma and psychological well-being was hypothesized that would be mediated by spirituality and/or CIH use. Results The analyses showed that the model fits the data well [χ2 (137, N = 914) = 561.44, p = .000; comparative fit index = .964; root mean square error of approximation = .058, 95% confidence interval = .053 to .063]. All observed variables significantly loaded on their latent factor, and all paths were significant. Results indicated that spirituality and CIH use significantly mediated the negative association between HIV stigma and psychological well-being. Implications Findings highlight the importance of spiritual and CIH interventions for older adults with HIV/AIDS. Practice recommendations are provided at the micro- and mesolevel.
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Affiliation(s)
- Kristen E Porter
- ACRIA, Center on HIV and Aging, New York.,Department of Gerontology, University of Massachusetts, Boston
| | - Mark Brennan-Ing
- ACRIA, Center on HIV and Aging, New York.,New York University College of Nursing
| | - Jeffrey A Burr
- Department of Gerontology, University of Massachusetts, Boston
| | - Elizabeth Dugan
- Department of Gerontology, University of Massachusetts, Boston
| | - Stephen E Karpiak
- ACRIA, Center on HIV and Aging, New York.,New York University College of Nursing
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Gureje O, Nortje G, Makanjuola V, Oladeji B, Seedat S, Jenkins R. The role of global traditional and complementary systems of medicine in treating mental health problems. Lancet Psychiatry 2015; 2:168-177. [PMID: 26052502 PMCID: PMC4456435 DOI: 10.1016/s2215-0366(15)00013-9] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/26/2014] [Indexed: 11/26/2022]
Abstract
Traditional and complementary systems of medicine (TCM) encompass a broad range of practices which are commonly embedded within contextual cultural milieu, reflecting community beliefs, experiences, religion and spirituality. Evidence from across the world, especially from low- and middle-income countries (LMIC), suggests that TCM is commonly used by a large number of persons with mental illness. Even though some overlap exists between the diagnostic approaches of TCM and conventional biomedicine (CB), there are major differences, largely reflecting differences in the understanding of the nature and etiology of mental disorders. However, treatment modalities employed by providers of TCM may sometimes fail to meet common understandings of human rights and humane care. Still, there are possibilities for collaboration between TCM and CB in the care of persons with mental illness. Research is required to clearly delineate the boundaries of such collaboration and to test its effectiveness in bringing about improved patient outcomes.
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Affiliation(s)
- Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Gareth Nortje
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rachel Jenkins
- Health Service and Population Research Department, Institute of Psychiatry, King's College, London
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ElMazoudy RH, Attia AA. Efficacy ofGinkgo bilobaon Vaginal Estrous and Ovarian Histological Alterations for Evaluating Anti-Implantation and Abortifacient Potentials in Albino Female Mice. ACTA ACUST UNITED AC 2012; 95:444-59. [DOI: 10.1002/bdrb.21032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 11/02/2012] [Indexed: 01/13/2023]
Affiliation(s)
- Reda H. ElMazoudy
- Zoology Department; Faculty of Science; Alexandria University; Alexandria; Egypt
| | - Azza A. Attia
- Zoology Department; Faculty of Science; Alexandria University; Alexandria; Egypt
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Footracer KG, Monaghan M, Wisniewski NP, Mandel E. Attitudes and practices of massage therapists as related to conventional medicine. Int J Ther Massage Bodywork 2012; 5:18-24. [PMID: 22553480 PMCID: PMC3312644 DOI: 10.3822/ijtmb.v5i1.149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Research into opinions about complementary and alternative medicine (CAM) has focused on conventional medical practitioners with little exploration of CAM practitioners’ views. Purpose To survey attitudes and practices of massage therapists toward conventional medicine. Research Design An anonymous online survey consisting of Likert-type scales, fill-in answers, and multiple-choice questions was used. Participants Members of the Associated Bodywork & Massage Professionals (ABMP), the largest massage therapy association in the US with over 77,000 members. Main Outcome Measures Participants were asked about their years of practice and training, choice of health care practitioners, sources for information about CAM and Western/allopathic medicine, client referral patterns, optimal treatment approaches for various medical conditions, and overall impressions of CAM and Western/ allopathic medicine. Results Analysis of n = 3,148 responses indicated that while 66.9% of respondents had a neutral or worse impression of Western/allopathic medicine, 64.3% use a conventional medicine practitioner as their primary health care provider, 61.9% have referred clients to a conventional medicine practitioner in the past six months, and 90.5% seek out information on Western/allopathic medicine. The mode response of the best treatment approach to various medical problems was a mix of Western/allopathic medicine and CAM. Conclusions This study suggests that despite the ambivalence of many massage therapists towards conventional medicine, many use it, encourage clients to do so, and see involvement of both as crucial to health.
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Affiliation(s)
- Katherine G Footracer
- Family Practice and Urgent Care Departments, Lakeside Community Healthcare, West Covina, CA
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Herman PM, Poindexter BL, Witt CM, Eisenberg DM. Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations. BMJ Open 2012; 2:bmjopen-2012-001046. [PMID: 22945962 PMCID: PMC3437424 DOI: 10.1136/bmjopen-2012-001046] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts. DATA SOURCES PubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included. STUDY APPRAISAL METHODS: All recent (and likely most cost-relevant) full economic evaluations published 2001-2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported. RESULTS A total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001-2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability ('generalisability'). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460). CONCLUSIONS This comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies.
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Affiliation(s)
- Patricia M Herman
- Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona, USA
| | - Beth L Poindexter
- Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology and Health Economics, Charite’ University Medical Center, Berlin, Germany
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - David M Eisenberg
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Harvard School of Public Health, Boston, Massachusetts, USA
- Samueli Institute, Alexandria, Virginia, USA
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Perfecting the Plate: Adding Cardioprotective Compounds to the Diet. J Am Coll Surg 2012; 214:97-114. [DOI: 10.1016/j.jamcollsurg.2011.09.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 09/15/2011] [Accepted: 09/21/2011] [Indexed: 11/22/2022]
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Boddy K, Younger P. What a difference an interface makes: just how reliable are your search results? ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.2042-7166.2009.tb01854.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wider B, Boddy K. Conducting systematic reviews of complementary and alternative medicine: common pitfalls. Eval Health Prof 2009; 32:417-30. [PMID: 19942632 DOI: 10.1177/0163278709346818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systematic reviews (SRs) are considered the best tools for summarizing the evidence for or against the effectiveness of health care interventions. The principles and methods of SRs apply equally to both, mainstream and complementary/alternative medicine (CAM). Certain challenges are, however, more commonly encountered in CAM or even specific to it; this article is aimed at raising awareness of these among systematic reviewers. When searching for literature, specific issues relating to specialist databases, indexing, access, foreign language studies, and certain forms of publication bias need to be considered. Researchers also need to be aware of the difficulties of comparing CAM studies and address the variability between studies. CAM modalities are highly diversified and great variations exist in the standardization of herbal products and other dietary supplements. Individualization of treatment as well as different classifications of disease and different diagnostic methods need to be addressed. Expectation bias is high in CAM, and finding appropriate controls and blinding are often challenging. It is important that these issues are taken into account early on in the planning stages of an SR so that proper consideration can be given to the search strategies, inclusion/exclusion criteria and methods of analysis with the overall aim of reducing bias.
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Affiliation(s)
- Barbara Wider
- Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, United Kingdom.
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Cassidy CM. Some terminology needs for writers, researchers, practitioners, and editors as we move toward integrating medicines. J Altern Complement Med 2008; 14:613-5. [PMID: 18620478 DOI: 10.1089/acm.2007.0125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mahadevan S, Park Y. Multifaceted therapeutic benefits of Ginkgo biloba L.: chemistry, efficacy, safety, and uses. J Food Sci 2008; 73:R14-9. [PMID: 18211362 DOI: 10.1111/j.1750-3841.2007.00597.x] [Citation(s) in RCA: 215] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The new age of nutraceuticals is now embracing the centuries old herbal extract of Ginkgo biloba (Mantissa Plantarum Altera, 1771, Ginkgoceae). The standardized preparation of the Ginkgo leaf extract (EGb 761) contained 2 main bioactive constituents, flavonoid glycosides (24%) and terpene lactones (6%), along with less than 5 ppm of the allergenic component, ginkgolic acid. The Ginkgo leaf extract has been reported to have neuroprotective, anticancer, cardioprotective, stress alleviating, and memory enhancing effects and possible effects on tinnitus, geriatric complaints, and psychiatric disorders. The therapeutic mechanisms of action of the Ginkgo leaf extract are suggested to be through its antioxidant, antiplatelet, antihypoxic, antiedemic, hemorrheologic, and microcirculatory actions, where the flavonoid and the terpenoid constituents may act in a complementary manner. Toxicity studies show that the Ginkgo leaf extract is relatively safe for consumption, although a few side effects have been reported, that is, intracerebral hemorrhage, gastrointestinal disturbances, headaches, dizziness, and allergic skin reactions. The use of Ginkgo leaf extract may be promising for treatment of certain conditions, although its long-term use still needs to be evaluated.
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Affiliation(s)
- S Mahadevan
- Department of Food Science, University of Massachusetts, 100 Holdsworth Way, Amherst, MA 01003, USA
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