Seminars in Integrative Medicine最新文献

Vanilla has been coveted over the ages for culinary and medicinal reasons alike. Vanilla’s high status in the culinary world comes from a long history of flavoring sweet, sensual desserts such as ice cream, sugar cookies, puff pastries, and butter creams. While vanilla’s history is steeped in culinary traditions, its lesser know uses as an aphrodisiac and a medical botanical stretch back to its discovery in Mesoamerica by ancient cultures who cultivated and honored the sweet orchid. European nations also historically valued vanilla for its flavor, its lore as a love potion, and its medicinal uses. While traditional medical uses of vanilla have faded away, its culinary traditions have changed little. Present day advances in basic science research have shed light on the medical benefits of vanillin, vanilla’s active constituent.

A pilot study was conducted to determine whether a cumulative 1-h daily exposure to a portable biaxial pulsed magnetic field stimulator over the carpal tunnel region for a 2-week period could reduce neuropathic pain scores and influence sleep interruption and possibly be an alternative conservative therapy option. Patients with advanced carpal tunnel syndrome (CTS) have often failed conservative therapy and are left with refractory numbness, tingling, and burning pain with disability. Previously, we demonstrated that constant application of static permanent magnets to the wrists for a 1-month period reduced neuropathic pain (NP) and improved motor distal latency of the median nerve compared with placebo. Since pulsed time-varying magnetic fields are capable of inducing changes within biological tissues and influencing signal transduction and reducing musculoskeletal pain, we postulated that nociceptive sensory fibers within the carpal tunnel could be influenced at a neuronal level. Thirty-five symptomatic hands (23 subjects) with medical and/or surgically refractory symptoms were enrolled in this nonplacebo trial. Baseline daily NP and sleep interruption scores (VAS 0-10) were tabulated. A distal median nerve latency was performed at baseline and at end of trial. A portable device (Palm Mag) was given to each patient to take home and apply daily for 1 h. This device generates a minimum to maximum sweep of 8-23 Hz at the target area. There is a maximum sweep of 1400 rotations/s. Daily VAS scores were maintained and statistical analyses (two-tailed t-test) were performed. Twenty-nine hands (19 subjects) completed this 2-week study with 6 dropouts (4 subjects). There was a significant reduction in NP scores, especially in the moderate–severe cohort, VAS 5.0-10, (P < 0.05). Sleep interruption scores were also reduced (P < 0.01). There were no changes in neurological examination or electrophysiological testing serially. There were no safety issues. Despite absence of placebo controls, these novel preliminary pilot data demonstrating short-term antinociceptive benefit suggest the feasibility of future trials using randomized, placebo-controlled design. If biologically positive, it would suggest that time-varying magnetic fields targeting the carpal tunnel region will be a future conservative therapeutic option.

Advancements in scientific techniques have enabled researchers to critically examine and scrutinize nonconventional therapies to either validate or reject them for routine clinical practice. The substantiation of the homeopathic system has been controversial since there is no standard drug dilution strength that can be subjected to clinical tests. Homeopaths usually claim to achieve curative effects by using homeopathic substances ranging in concentration from mother tinctures in crude forms to infinitesimal dilutions with a probability of almost zero active ingredients in them. The issue becomes further confused when different criteria are applied to drug dilution preparations that are inconsistent with any established scientific metric such as Avogadro’s number. This fact was well known to its founder, Dr. Hahnemann, who tried to establish drug standardization around the 30th dilution during his last years of life. He even developed a semi-nonlinear method, known as LM potencies, which was revealed in his postmortem publication of Organon of Medicine, 6th edition, in 1921. Dr. Hering, founder of American Homeopathy, devised the decimal dilution method, which, like the earlier dilution methods, lacked any fundamental metric such as Avogadro’s number. A literature search revealed that the drug dilution and standardization issues were never settled in homeopathy. The issues of miracle cures with different dilutions become questionable when such claims are examined in the absence of any placebo or control studies. In short, homeopathy has failed to establish validity of its dilutions’ effects in general research settings. The common denominator to all such failures can be attributed to the absence of standardization of drug dilutions based on scientific metrics. Different drugs are composed of different numbers of atoms/molecules to start with. A single linear no-threshold method cannot standardize the heterogeneous drugs to a desired unique scale. A nonlinear method is needed to standardize homeopathic drugs to a single scale such as the 30th to either validate or reject them on scientific grounds. This issue becomes more important in the light of new emerging nanotechnology. Homeopathic drug standardization based on scientific metrics is needed for research and reproducibility for routine clinical practice.

First line comprehensive care is fundamental to integrative medicine, an emerging specialty within American healthcare. Primary focus is on functional and predictive tests to identify remediable causes of suffering and ill health. Integrative health professionals are learning a more functional language—it is both a language of causes and of deeper insights into more fundamental molecular and submolecular mechanisms of both our good health and our ill health. Anthropogenic xenobiotics, especially the bioaccumulating and bioconcentrating toxic minerals (TMs) and persistent organic pollutants (POPs) are the focus of this article as they are, in their more toxic forms, largely anthropogenic, human-sourced intoxicants. Bioconcentration operates in the following way: Ocean krill and algae convert less toxic, inorganic mercury to biotoxic organic mercury. Alga are ingested by small fish. Larger fish eat small fish, and humans, in turn, eat larger fish. The longer the lifespan, the more mercury accumulates in those people who have lost (phenotypic expression) or have innately impaired (genotypic expression) abilities to detoxify and eliminate these anthropogenic xenobiotic toxicants. Since accumulation of POPs takes place primarily in the fat while TM accumulates more prominently in muscle and bone cells and extracellular matrix, it follows that such toxins might contribute to the novel and more severe treatment-resistant musculoskeletal conditions observed in practice. Scientific evidence is also “bioaccumulating” for a clinical imperative to mitigate exposure where possible and to optimize innate host defenses, generally through strategic mental and functional, nutritional, and environmental adaptations. This article outlines the current standards of care for integrative medicine physicians incorporating the 2005 American Board of Clinical Metal Toxicology (ABCMT) training guidelines for practitioners. The practice of first line comprehensive care is emerging as outcome and cost effective compared with today’s conventions in most chronic diseases as well as in the implementation of proactive, cost-effective, and outcome-effective health promotion approaches. If not now, when will we implement widely what we know that cost effectively and outcome effectively promotes sustainable good health and general well being?