Alternative therapies in health and medicine最新文献

Introduction: Schizophrenia is a chronic mental disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions. Clozapine, a second-generation antipsychotic, is commonly prescribed for treatment-resistant schizophrenia. However, its use is frequently associated with side effects, notably hypersalivation. This case report discusses the clinical consequences of clozapine-induced hypersalivation, emphasizing the importance of individualized nursing care planning.

Methods: The descriptive case report presents the clinical course of a 47-year-old male patient diagnosed with schizophrenia. The patient exhibited symptoms such as anger, suspiciousness, anxiety, and auditory and visual hallucinations, as well as hypersalivation, which was attributed to clozapine therapy.

Results: Three nursing diagnoses were identified: (1) impaired swallowing due to pharmacological side effects, (2) risk of aspiration associated with swallowing difficulties, and (3) ineffective coping mechanisms related to anxiety stemming from fear of choking. Relevant nursing interventions were implemented in line with these diagnoses.

Conclusion: This case highlights the critical role of psychiatric nurses in recognizing and managing drug-related side effects. It underscores the necessity for a biopsychosocial approach in psychiatric nursing and points to the need for enhanced training regarding the adverse effects of psychotropic medications.

Keywords: schizophrenia, clozapine, hypersalivation, psychiatric nursing care, side effects, case report.

Objective: This 28-day pilot study aimed to evaluate the effects of plant-based melatonin (phytomelatonin) derived from Somato® tomato fruit extract (Nutraland USA) on key physiological and psychological domains associated with sleep quality, autonomic function, and health-related quality of life (HRQoL).

Methods: Thirty-five healthy men and women (mean age: 42 years) were enrolled in a decentralized, open-label, real-world evidence study. Participants consumed 2 mg of phytomelatonin daily from Somato® oral strips for 28 days. Objective biometric data were collected using Oura Ring wearable devices. Validated participant-reported outcomes (e.g., Pittsburgh Sleep Quality Index (PSQI) and Short Form 36 Health Survey (SF-36)) helped to explore perceived tolerability, early efficacy signals, and mechanistic trends in a healthy adult population.

Results: Twenty-two participants completed the study and were included in the final analysis. Compared to baseline, supplementation with Somato® tomato fruit extract significantly improved percentage change of sleep latency (-33%, PSQI, P = .005; -11.55%, Oura ring, P = .016), time awake (Oura ring, -10.08%, P = .002), sleep efficiency (Oura ring, -1.21%, P = .011), and global PSQI score (-14.22%, P = .025). A significant improvement was also noted in emotional well-being (8.22%, P = .02) based on the SF-36 health-related quality of life questionnaire. Other SF-36 variables also showed improvements that did not reach statistical significance, including general health (3.22%), energy & fatigue (15.12%), limitations due to emotional problems (15.22%), pain (5.83%), social functioning (6.11%), and physical function (2.81%).

Conclusion: Supplementation with 2 mg/day of phytomelatonin from Somato® tomato fruit extract improved both physiological and psychological measures associated with sleep quality, autonomic function, and health-related quality of life. These findings support the feasibility of phytomelatonin as a plant-based sleep aid and warrant further investigation in a larger, randomized controlled trial.

Keywords: tomato, melatonin, phytomelatonin, sleep latency, sleep efficiency, Pittsburgh Sleep Quality Index, Short Form 36 Health Survey, Oura ring, emotional well-being, energy, fatigue, pain, social functioning, physical function.

Background: Large language models have demonstrated remarkable promise in medical data analysis, but serious concerns about reliability and error propagation persist. This study reports a novel approach of using iterative consultation between two independent AI systems to analyze complex clinical neuroimaging data.

Methods: A 63-year-old woman with a family history of Alzheimer's disease and Parkinsonism underwent brain MRI volumetry showing apparent 10-13% increases in gray matter volume following intensive multimodal interventions (Functional Medicine and HYLANE™ treatment). Despite clinical improvement, objective cognitive testing declined during the same period. Two AI systems (Claude and Perplexity) independently analyzed neuroimaging reports, cognitive testing, and clinical data over 5-7 iterative cycles, systematically challenging each other's interpretations.

Results: Initial analyses diverged substantially (45-60 percentage-point difference in probability estimates). Through autonomous error detection and cross-validation, systems converged to a consensus (<10 percentage-point difference). Critical autonomous discoveries included: (1) 3.5% increase in total intracranial volume (physiologically impossible, indicating measurement artifact), (2) 11-month temporal gap between cognitive testing and MRI, and (3) literature review revealing hyperbaric oxygen therapy produces maximum 1-2% volumetric changes. Final consensus: modest real improvements (2-4%) embedded within measurement artifact (3-5%).

Conclusions: Dual-AI iterative consultation achieved autonomous error detection, literature integration, and convergent validity without requiring human identification of critical flaws. This approach may enhance reliability in complex clinical decision-making while maintaining appropriate physician oversight.

Keywords: artificial intelligence, clinical decision support, neuroimaging, automated volumetry, large language models, convergent validity, error detection.

Background: Kundalini Yoga (KY) integrates breathwork, meditation, dynamic movement, and chanting, and has gained recognition as a therapeutic intervention. Despite promising results from individual randomized controlled trials (RCTs), to our knowledge, no systematic review has exclusively synthesized RCT evidence on KY across health domains.

Objective: To critically assess the clinical effectiveness and safety of KY interventions across diverse cognitive, psychological, emotional, sleep-related, and physical health outcomes.

Methods: PRISMA-guided systematic review of RCTs evaluating KY was conducted from January 2015 to December 2024. Databases included MEDLINE (PubMed), Scopus, CENTRAL (Cochrane Library), Embase, PsycINFO, and CINAHL. Risk of bias was independently assessed using the Joanna Briggs Institute Critical Appraisal Checklist.

Setting: Studies were conducted worldwide, across multiple sites.

Participants: Approximately 1370 participants ranging from healthy adults to those diagnosed with conditions such as Mild Cognitive Impairment (MCI), Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), insomnia, chronic pain, and post-treatment Lyme disease syndrome. No serious adverse events were reported.

Intervention: KY protocols (pranayama, asana/kriya, meditation, chanting) delivered in person, online, or hybrid formats; duration 6 weeks-12 months (most 8-12 weeks) with practice from once weekly to daily.

Outcome measures: Pre-specified validated measures assessed cognitive function, psychological symptoms (e.g., anxiety, depression), sleep quality, emotional regulation, and physical health outcomes (e.g., hippocampal metrics, absenteeism, blood pressure).

Results: This systematic review included 15 studies, among which 13 demonstrated a low risk of bias. The findings suggest that KY significantly improves memory, executive functioning, and hippocampal structure, reduces symptoms of anxiety, PTSD, OCD, and depression, enhances sleep quality and emotional regulation, and modestly improves fatigue, blood pressure, and functional outcomes.

Conclusion: KY appears safe and shows benefits for a wide range of cognitive, psychological, and physical health conditions. However, larger, standardized RCTs with active comparators, biomarkers, and longer follow-up are needed.

Keywords: Kundalini Yoga, randomized controlled trials, cognitive function, mental health, sleep, PTSD, hypertension, complementary therapy, mind-body intervention.

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No Abstract Available.

Context: The Lancet report of the CHAIN trial evaluating FYTF-919, a traditional Chinese medicine (TCM) for moderate to severe acute intracerebral hemorrhage, concluded "no effect" on functional recovery, survival, and health-related quality of life compared to placebo.

Objective: The current study intended to re-examine its methodology and conclusions about the efficacy of FYTF-919.

Design: Reanalysis of data from the Lancet report.

Intervention: Adopting the PICO framework and the CONSORT Extension, a critical appraisal of the trial's report and supplementary materials was conducted. Definition of TCM-specific patterns, sample size calculation, use of multiple concomitant therapies, timing of primary outcome assessment, and interpretation of results have been examined.

Results: There was a risk of performance bias in the trial as it did not report TCM-specific patterns, despite FYTF-919 being formulated for qi deficiency, potentially including patients unsuitable for this intervention. The sample size calculation was flawed and inconsistently applied, altering the mean difference and potentially underestimating FYTF-919's effect. Both the FYTF-919 and placebo groups had 19 concomitant therapies applied as needed, making it difficult to isolate FYTF-919's benefits. The study mistakenly hypothesized that there was no difference between the two groups due to the use of the 19 concomitant therapies, referred to as "routine treatment". The main report ignored multiple significant differences in subgroups and at earlier timepoints. These potentially positive findings were not highlighted, raising concerns of a substantial risk of selective reporting bias.

Conclusions: The trial's conclusion of "no effect" is questionable due to methodological flaws, trial design, and reporting errors. Proper assessment of complex interventions, clearer adherence to TCM-specific guidelines, rigorous sample size calculation, and balanced consideration of early recovery data and subgroups are essential. The current analysis of the appraisal found that the effect of the FYTF-919 was superior to that of the placebo.

Keywords: Intracerebral hemorrhage, Traditional Chinese Medicine, FYTF-919, multiple interventions, CHAIN trial, selective report bias, critical appraisal, Zhongfeng Xingnao.

Background: Obesity is a health condition characterized by excessive fat accumulation in the body, which adversely affects life expectancy and leads to various health issues. Conventional medical interventions involve pharmacological treatments and invasive procedures, which have risks and side effects. Recent studies have investigated the efficacy of moxibustion with other therapies for obesity management.

Objectives: This study aimed to investigate the metabolic effects of moxibustion on obesity using a gas chromatography-mass spectrometry (GC-MS)-based metabolomic approach.

Methods: Forty-eight male Sprague-Dawley rats were randomly divided into six groups: Normal (standard diet), Control (obesity-induced without treatment), CV12 (obesity-induced with moxibustion at CV12 acupoint), and ST36 (obesity-induced with moxibustion at ST36 acupoint). The remaining two standard diet groups were presented as reference data in the supplementary materials. Following eight weeks of high-fat diet induction, moxibustion treatment was applied three times per week for an additional eight weeks, totaling 24 sessions in the CV12 and ST36 groups. Fecal metabolomic profiling was performed using GC-MS, and pathway enrichment analysis was conducted to identify metabolic alterations.

Results: Moxibustion at CV12 resulted in significant improvements in body weight and fat accumulation, whereas ST36 primarily contributed to metabolic modulation, reflecting distinct physiological impacts of each acupoint. Metabolomic analysis revealed distinct metabolic alterations, with the CV12 and ST36 groups exhibiting increased levels of ribose and xylitol, whereas the Control group showed elevated levels of 3-hydroxybutyrate and hypoxanthine. Pathway enrichment analysis reveals acupoint-specific metabolic modulations, with CV12 primarily influencing lipid and carbohydrate metabolism (via pentose phosphate and butanoate pathways), while ST36 affected amino acid metabolism (via arginine, proline, and histidine pathways).

Conclusion: These findings suggest that moxibustion exerts acupoint-dependent metabolic effects, with CV12 acupoint targeting lipid metabolism and ST36 acupoints modulating amino acid pathways. The results highlight the potential of moxibustion as a non-invasive intervention for obesity management, warranting further clinical validation.

Keywords: gas chromatography-mass spectrometry, metabolomics, moxibustion, obesity, metabolic pathway.

Background: This case study examines the effects of diindolylmethane (DIM) on lowering Prostate-specific antigen (PSA) levels and improving hormonal balance in a 78-year-old male patient. It further considers whether the timing of hormonal changes in relation to DIM use suggests a possible causal link. The patient presented with steadily rising PSA levels and declining testosterone, raising concerns about potential prostate pathology. Given his reluctance to undergo a prostate biopsy-due to concerns about its invasiveness and potential complications-a functional medicine approach was adopted to address the hormonal imbalances contributing to his condition. The intervention included discontinuing cholesterol-lowering supplements and introducing 100 mg per day of DIM-Evail™ for three months to modulate estrogen metabolism. Over the three months, the patient's PSA dropped from 4.6 to 2.4 ng/mL, while the total and free testosterone notably increased from 436 ng/dL to 615 ng/dL. This case highlights the potential of targeted nutraceutical interventions in modulating hormone metabolism and supporting prostate health, though, as a single case, the findings warrant further validation through larger clinical studies.

Keywords: Diindolylmethane (DIM), Prostate-specific antigen reduction, aromatase inhibition therapy, estrogen metabolism modulation, testosterone restoration, prostate cancer risk biomarkers, nutraceutical intervention for elevated prostate-specific antigen.

Abstract: This case report evaluates the effectiveness of botanical oral health products in managing bacterial overgrowth and enhancing gingival and periodontal health in a 34-year-old female patient with mild-to-moderate gingivitis. The patient presented with bleeding on probing and positive pathogenic bacterial culture testing. The treatment regimen included a botanical toothpaste and oral rinse (Dentalcidin® and Dentalcidin® LS), oral probiotic, and dysbiosis protocol (Bioclear® Microbiome Detox Program). Post-treatment assessments revealed significant reductions in bleeding on probing and a marked decline in bacterial colony counts, indicating improved microbial balance. The bleeding index was reduced from 21% to 4% after six months, and from 4% to 1% during the subsequent three months using a botanical toothpaste and oral rinse. Periodontal pathogens that were present pre-treatment at high-risk levels were reduced to low-risk levels. These findings suggest that botanical oral health products can reduce bacterial overgrowth and improve periodontal parameters, offering a viable alternative to conventional therapies.

Keywords: case report, oral microbiome, biofilm, oral dysbiosis, Tannerella forsythia, Fusobacterium nucleatum, herbal (botanical) medicine.