Integrative medicine最新文献

The large number of health care professions with overlapping scopes of practice is intimidating to students, confusing to patients, and frustrating to policymakers. As abundant and diverse as the hundreds of health care professions are, they possess sufficient numbers of common characteristics to warrant their placement on a common continuum of health professions that permits methodical comparisons. From 2009-2012, the author developed and delivered experimental courses at 2 community colleges for the purposes of creating and validating a novel method for comparing health care professions. This paper describes the bidirectional health professions continuum that emerged from these courses and its potential value in helping students select a health care career, motivating health care providers to seek interprofessional collaboration, assisting patients with the selection of health care providers, and helping policymakers to better understand the health care professions they regulate.

Context: Autism spectrum disorder (ASD) is currently on the rise, now affecting approximately 1 in 68 children in the United States according to a 2010 surveillance summary from the Centers for Disease Control and Prevention (CDC). This figure is an estimated increase of 78% from the figure in 2002. The CDC suggests that more investigation is needed to understand this astounding increase in autism in such a short period.

Objective: The aim of this pilot study was to determine whether a group of children with ASD exhibited similar variations in a broad array of potential correlates, including medical histories, symptoms, genetics, and multiple nutritional and metabolic biomarkers.

Design: This study was a retrospective, descriptive chart review.

Setting: The study took place at the University of Kansas Medical Center (KUMC).

Participants: Participants were 7 children with ASD who had sought treatment at the Integrative Medicine Clinic at the medical center.

Results: A majority of the children exhibited an elevated copper:zinc ratio and abnormal vitamin D levels. Children also demonstrated abnormal levels of the essential fatty acids: (1) α-linolenic acid (ALA)- C13:3W3, and (2) linoleic acid (LA)-C18:2W6; high levels of docosahexaenoic acid (DHA); and an elevated ω-6:ω-3 ratio. Three of 7 children demonstrated abnormal manganese levels. Children did not demonstrate elevated urine pyruvate or lactate but did have abnormal detoxification markers. Three of 7 patients demonstrated abnormalities in citric acid metabolites, bacterial metabolism, and fatty acid oxidation markers. A majority demonstrated elevated serum immunoglobulin G (IgG) antibodies to casein, egg whites, egg yolks, and peanuts. A majority had absent glutathione S-transferase (GSTM) at the 1p13.3 location, and 3 of 7 children were heterozygous for the glutathione S-transferase I105V (GSTP1). A majority also exhibited genetic polymorphism of the mitochondrial gene superoxide dismutase A16V (SOD2).

Conclusions: The findings from this small group of children with ASD points to the existence of nutritional, metabolic, and genetic correlates of ASD. These factors appear to be important potential abnormalities that warrant a case control study to evaluate their reliability and validity as markers of ASD.

Context: Studies employing methods for measurement of zinc sulfate taste acuity have had diverse results, and although the studies have had limitations in design and implementation, they have suggested salient findings beyond the assessment of taste acuity. These findings have included, but were not limited to, relationships between zinc sulfate taste acuity and weight, levels of serum zinc, diastolic hypertension, levels of salivary carbonic anhydrase 6, and frequency of illness. However, current protocols for zinc sulfate taste assessment are problematic and warrant improvement.

Objective: The current study intended to compare the ranking scale for the original Bryce-Smith and Simpson zinc taste test (BS-ZTT) with a novel, taste-intensity visual analog scale (TI-VAS) to explore the potential for improved zinc sulfate taste-acuity measurement.

Design: Participants were administered a 0.1% solution of zinc sulfate and assessed using the 2 scales.

Setting: The study took place at West Liberty University, in West Liberty, WV, USA.

Participants: Participants were 500 West Liberty University students who volunteered to participate in the study.

Results: A strong, statistically significant, positive correlation existed between the BS-ZTT and the TI-VAS scores (r s = 0.79; P < .0001; n = 491).

Conclusions: The study found that the BS-ZTT offered a limited number of ordinal variable ranks and depended on an examiner's evaluation. Conversely, the TI-VAS had an expanded range of variables and was independent of the examiner. The TI-VAS can be used as a taste-acuity test for zinc sulfate and as a benchmark for future analyses of zinc sulfate taste acuity and zinc taste tests.

This article presents an integrative approach to the problem of pediatric obesity, which is a multifaceted medical condition that is epidemic in the United States and elsewhere in the world. In this article, definitions of pediatric obesity are provided, and its prevalence, etiological factors, medical complications, and comorbidities are reviewed. Psychological and spiritual factors associated with pediatric obesity are discussed, together with their importance to integrative treatment. This review suggests that the use of psychological interventions, such as cognitive behavioral therapy (CBT) and animal-assisted therapy (AAT), can be considered in conjunction with medical and educational interventions to treat pediatric obesity successfully.

Loss of function in mitochondria, the key organelle responsible for cellular energy production, can result in the excess fatigue and other symptoms that are common complaints in almost every chronic disease. At the molecular level, a reduction in mitochondrial function occurs as a result of the following changes: (1) a loss of maintenance of the electrical and chemical transmembrane potential of the inner mitochondrial membrane, (2) alterations in the function of the electron transport chain, or (3) a reduction in the transport of critical metabolites into mitochondria. In turn, these changes result in a reduced efficiency of oxidative phosphorylation and a reduction in production of adenosine-5'-triphosphate (ATP). Several components of this system require routine replacement, and this need can be facilitated with natural supplements. Clinical trials have shown the utility of using oral replacement supplements, such as l-carnitine, alpha-lipoic acid (α-lipoic acid [1,2-dithiolane-3-pentanoic acid]), coenzyme Q10 (CoQ10 [ubiquinone]), reduced nicotinamide adenine dinucleotide (NADH), membrane phospholipids, and other supplements. Combinations of these supplements can reduce significantly the fatigue and other symptoms associated with chronic disease and can naturally restore mitochondrial function, even in long-term patients with intractable fatigue.

Chronic back pain is one of the most common conditions treated in the United States. Informed consent is the communication of treatment alternatives, benefits, and risks and must be provided to patients in most instances. The alternatives provided during this discussion should include all options supported by research evidence and the patient's preferences. This article proposes a model for chronic back pain that includes the communication of complementary therapies as part of a patient-centered, integrative approach to informed consent. The content of informed consent is determined by common law (court cases), legislation, regulations, and evidence-based research. The practitioner's and patient's knowledge and the patient's values should be used to filter this information. Finally, shared decision making should be used to arrive at the patient's final decision regarding informed consent for treatment.