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CAM and integrative medicine.

Lemanne D, Maizes, V.

Advising women undergoing treatment for breast cancer: A narrative review. Journal of Alternative and Complementary Medicine, 24(9): 902-909. DOI: 10.1089/acm.2018.0150

A majority of women undergoing conventional treatment for breast cancer also undertake complementary and integrative approaches. Practitioners knowledgeable about the evidence base behind common integrative approaches can help patients attain improved quality of life, and at times, improved survival. Evidence-based recommendations include the following: a plant-based diet for general health after diagnosis, and carbohydrate restriction for patients with estrogen receptor-positive postmenopausal breast cancer may be prudent. Other dietary recommendations include a 13-h daily overnight fast. Carefully selected patients may choose to fast the day before and the day of chemotherapy to decrease side effects. Specific food recommendations include avoidance or limitation of alcohol, and liberal culinary use of cruciferous vegetables, coffee, green tea, soy, and flaxseed. Promising supplements include diindolylmethane and melatonin. Omega 3 fatty acids may help with bone density in patients on aromatase inhibitors, but may increase chemotherapy resistance. Findings regarding the usefulness of multivitamins, vitamin D, vitamin C, and vitamin E are weak and/or mixed different exercise modalities may have different effects and thus play different roles in breast cancer therapy. Aerobic and resistance training combined during breast cancer chemotherapy may confer a survival benefit, while yoga may improve outcome in lymphedema patients. Current evidence suggests that meditation, yoga, breathing, music therapy, guided imagery, and hypnosis may improve mood and quality of life during breast cancer treatment. Acupuncture is useful for treating side effects of breast cancer therapies, including hot flushes, aromatase inhibitor-induced joint pain, chemotherapy-induced peripheral neuropathy, and vulvodynia. Vaginal moisturizers and vaginal rings supplying low-dose estrogen can be useful in the treatment of symptoms of estrogen-deprivation states caused by breast cancer treatments; such symptoms include vaginal dryness, dyspareunia, and sexual dysfunction. Carbon dioxide laser technology can rejuvenate atrophied vaginal mucosa and relieve dyspareunia, allowing avoidance of estrogen therapy. Tertiary sexual health centers are available for referral.

Mbizo J, Okafor A, Sutton MA, Leyva B, Stone LM, Olaku O.

Complementary and alternative medicine use among persons with multiple chronic conditions: Results from the 2012 National Health Interview Survey. BMC Complementary and Alternative Medicine, 2018, 18:281. https://doi.org/10.1186/s12906-018-2342-2

Background: Although a quarter of Americans are estimated to have multiple chronic conditions, information on the impact of chronic disease dyads and triads on use of complementary and alternative medicine (CAM) is scarce. The purpose of this study is to: 1) estimate the prevalence and odds of CAM use among participants with hypercholesterolemia, hypertension, diabetes, and obesity; and 2) examine the effects of chronic condition dyads and triads on the use of CAM modalities, specifically manipulative and body-based methods, biological treatments, mind-body interventions, energy therapies, and alternative medical systems.

Methods: Data were obtained from the 2012 National Health Interview Survey and the Adult Alternative Medicine supplement. Statistical analyses were restricted to persons with self-reported hypercholesterolemia, hypertension, diabetes, or obesity (n = 15,463).

Results: Approximately 37.2% of the participants had just one of the four chronic conditions, while 62.4% self-reported multiple comorbidities. CAM use among participants was as follows (p <0.001): hypercholesterolemia (31.5%), hypertension (28.3%), diabetes (25.0%), and obesity (10.8%). All combinations of disease dyads and triads were consistently and significantly associated with the use of mind-body interventions (2-4%, p<0.001). Two sets of three dyads were associated with use of manipulative methods (23-27%, p<0.05) and energy therapies (0.2-0.3%, p<0.05). Use of biological treatments (0.04%, p<0.05) and alternative systems (3%, p<0.05) were each significant for one dyad. One triad was significant for use of manipulative methods (27%, p< 0.001).

Conclusions: These findings point to future directions for research and have practical implications for family practitioners treating multimorbid patients.

Hekmatpou D, Mehrabi F, Rahzani K, Aminiyan A.

The effect of Aloe Vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: a randomized triple-blind clinical trial. BMC Complementary and Alternative Medicine, 2018,18:264. https://doi.org/10.1186/sl 2906-018-2326-2

Background: One of the most common orthopedic problems is the incidence of pressure ulcer followed by immobility. This study aimed to investigate the effect of Aloe Vera gel on the prevention of pressure ulcer in patients hospitalized in the orthopedic ward.

Method: This study is a randomized, triple-blind clinical trial which was done on 80 purposefully selected patients in orthopedic ward in Arak town, Iran, 2016. Patients were randomly assigned into two intervention and control groups based on blocking sampling method. In each group the routine daily cares to prevent bed sores were performed by nurses. In the intervention group in addition to routine nursing care to prevent bed sores, twice a day (hours of 9 and 21) pure Aloe Vera gel on the areas of hip, sacrum and heel were rubbed, but in the control group placebo (gel of water and starch) were used. Then sacral, hip and heel of both groups on days 3, 7 and 10 for of signs of pressure ulcers was evaluated.

Results: The mean age of patients in the control group was (42.34 [+ or -] 12.19) and in the intervention group Was (41.71 [+ or -] 11.50) years, respectively. In the intervention group 1 patient afflicted with sore of hip and two people with sacral pressure ulcer. In the control group 3 patients affiliated with sore of hip, 8 people with sacral pressure ulcer, and 1 person had pressure sore of heel. Analysis of the data showed that both groups had statistically significant differences in the incidence of pressure ulcers (P = 0.047). This means that Aloe Vera gel could prevent the occurrence of pressure ulcers in the intervention group.

Conclusion: Due to the effect of Aloe Vera gel to prevent a rise in temperature, non-blanchable redness, swelling and pain of the skin of regions under study in hospitalized patients in the orthopedic ward, applying of it toward the prevention of pressure ulcers in patients at risk of pressure ulcer development is recommended.
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Title Annotation:RECENT RESEARCH; complementary and alternative medicine
Publication:Journal of the Australian Traditional-Medicine Society
Article Type:Author abstract
Date:Jun 22, 2018
Words:1019
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