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NCCAM Clinical Digest: Yoga for Health

November 5, 2014 Comments off

NCCAM Clinical Digest: Yoga for Health
Source: National Center for Complementary and Alternative Medicine (NCCAM)

This issue of the digest summarizes current scientific evidence about yoga for health conditions, including chronic low-back pain, asthma, and arthritis.

The scientific evidence to date suggests that a carefully adapted set of yoga poses may help reduce pain and improve function in people with chronic low-back pain. Studies also suggest that practicing yoga (as well as other forms of regular exercise) might confer other health benefits such as reducing heart rate and blood pressure, and may also help alleviate anxiety and depression. Other research suggests yoga’s deep breathing is not helpful for asthma, and studies looking at yoga and arthritis have had mixed results.

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New Article Demonstrates Daily Use of Certain Supplements Can Decrease Health Care Expenditures

October 6, 2014 Comments off

New Article Demonstrates Daily Use of Certain Supplements Can Decrease Health Care Expenditures
Source: Council for Responsible Nutrition

Use of specific dietary supplements can have a positive effect on health care costs through avoided hospitalizations related to Coronary Heart Disease (CHD), according to a new article published in the Journal of Dietary Supplements. The article, “From Science to Finance—A Tool for Deriving Economic Implications from the Results of Dietary Supplement Clinical Studies,” published by Christopher Shanahan and Robert de Lorimier, Ph.D., explores a potential cost-benefit analysis tool that, when applied to a high-risk population (U.S. adults over 55 with CHD) who take dietary supplements, specifically omega-3 fatty acid or B vitamin dietary supplements, can result in the reduction of the individuals’ odds of experiencing a costly medical event.

Hospitalizations for all U.S. adults over the age of 55 with CHD cost the United States over $64 billion in 20122, and the amount spent on the treatment of CHD, rather than the prevention, is burdensome on both the societal and individual levels—and only expected to increase, according to the article. “One way to control the burden of CHD costs is to minimize the number of costly inpatient procedures,” the authors said. “Many dietary supplement products are available in the market today that have been shown to have positive effects on heart health through associated clinical studies…Thus, the potential decrease of total health care expenditures in the United States is a strong argument for the daily use of dietary supplements.”

Planning for Marijuana: The Cannabis Conundrum

September 11, 2014 Comments off

Planning for Marijuana: The Cannabis Conundrum
Source: Journal of the American Planning Association

Problem, research strategy, and findings:
Twenty-three states and Washington, DC, have legalized medical marijuana, raising difficult land use questions for planners regarding allowable locations, buffering from sensitive uses, and distribution of facilities. We know little about how local jurisdictions regulate medical marijuana dispensary (MMD) location and operation and how equitably different regulatory models distribute these facilities. We begin with an overview of MMD impacts related to crime, property values, and quality of life. We then review emerging local regulation of MMDs with a particular emphasis on land use controls, and find that most authorities regulate MMD location like they do other locally unwanted land uses (LULUs) such as sex-oriented businesses and liquor stores. Given a history of siting LULUs in less-affluent neighborhoods and communities of color, we conduct a case study of Denver and show that four common regulatory models concentrate land that permits MMDs in socioeconomically disadvantaged tracts and areas with high proportions of persons of color.

Takeaway for practice:
Local planners are often caught unprepared for the land use implications of medical marijuana legalization. This outline of common land use regulatory models and a replicable analytical model help practitioners develop ordinances that square with their own communities’ goals, values, and attributes.

Understanding CAM Natural Health Products: Implications of Use Among Cancer Patients and Survivors

August 19, 2014 Comments off

Understanding CAM Natural Health Products: Implications of Use Among Cancer Patients and Survivors
Source: Journal of the Advanced Practitioner in Oncology

Herbs, vitamins, and other natural health products are being used by cancer patients and survivors with increasing prevalence in the United States. These complementary and alternative medicine (CAM) products, which are also referred to as natural health products in Canada and abroad, are used during cancer treatment and the survivorship period to ease the burden of symptoms such as pain, fatigue, insomnia, anxiety, and depression and hence improve overall quality of life. Data indicate that while patients choose these products for self-treatment, they often do not inform their health-care providers, thereby presenting the potential for negative interactions. This article gives an overview of CAM natural health products, including discussion of herbs, vitamins, and other supplements such as minerals, enzymes, and more. Related research is presented, and implications for advanced practitioners are discussed. Insights into guiding safe and effective use among patients as well as appropriate decision-making strategies are explored.

Acupuncture: What You Need To Know

August 18, 2014 Comments off

Acupuncture: What You Need To Know
Source: National Center for Complementary and Alternative Medicine

What’s the Bottom Line?

How much do we know about acupuncture?
There have been extensive studies conducted on acupuncture, especially for back and neck pain, osteoarthritis/knee pain, and headache. However, researchers are only beginning to understand whether acupuncture can be helpful for various health conditions.

What do we know about the effectiveness of acupuncture?
Research suggests that acupuncture can help manage certain pain conditions, but evidence about its value for other health issues is uncertain.

What do we know about the safety of acupuncture?
Acupuncture is generally considered safe when performed by an experienced, well-trained practitioner using sterile needles. Improperly performed acupuncture can cause serious side effects.

Use of phytoestrogens and effects perceived by postmenopausal women: result of a questionnaire-based survey

July 28, 2014 Comments off

Use of phytoestrogens and effects perceived by postmenopausal women: result of a questionnaire-based survey
Source: BMC Complementary and Alternative Medicine

Background
Use of food supplements-containing phytoestrogens among postmenopausal women is rapidly increasing. Although phytoestrogens are often perceived as safe, evidence for overall positive risk-benefit profile is still inconclusive. The chance to buy them by user’s initiative does not facilitate surveys on their prevalence and pattern of use. The aim of this study was to describe the pattern of use and self-reported positive and negative perceptions of phytoestrogens in post-menopausa.

Methods
A questionnaire was administered to women who were buying food supplements containing phytoestrogens in 22 pharmacies located in the Bologna area (400,000 inhabitants). Questionnaire was structured into 3 sections: (a) socio-demographic information; (b) pattern of use, (c) positive and negative perceptions.

Results
Data on 190 peri- and post-menopausal women (aged 38-77) were collected. Women stated to use phytoestrogens to reduce hot flushes (79%), insomnia (15%), mood disturbances (14%) and prevent osteoporosis (15%). The majority (59%) took phytoestrogens routinely, whereas 28% in 3-month cycles. Among positive perceptions between short- and long-term users, a not negligible difference was reported for relief of hot-flushes (68% in short-term vs. 81% in long-term users; p = 0.04). Negative perceptions were reported more frequently in the long-term group, and this difference was statistically significant for edema (6% in short-term vs. 17% in long-term users; p = 0.04), but not for other effects: e.g., swelling sensation (10% vs. 21%; p = 0.09), somnolence (7% vs. 10% p = 0.62), fatigue (4% vs.11% p = 0.15).

Conclusions
In the Bologna area, the pattern of use of phytoestrogens for menopausal symptoms is heterogeneous, and women overall find these substances to be beneficial, especially for relief of hot-flushes. Other positive perceptions decreased with long-term use. Negative perceptions, especially estrogen-like effects, seem to be infrequent and increase with long-term therapy. Physicians should pay attention to effects perceived by post-menopausal women and routinely monitor the use of phytoestrogens, in order to recognize possible adverse effects and actual benefits.

Use of St. John’s Wort in Potentially Dangerous Combinations

July 22, 2014 Comments off

Use of St. John’s Wort in Potentially Dangerous Combinations
Source: Journal of Alternative and Complementary Medicine

Objectives:
The objective of this study was to assess how often St. John’s wort (SJW) is prescribed with medications that may interact dangerously with it.

Design:
The study design was a retrospective analysis of nationally representative data from the National Ambulatory Medical Care Survey.

Settings:
The study setting was U.S. nonfederal outpatient physician offices.

Subjects:
Those prescribed SJW between 1993 and 2010 were the subjects.

Outcome Measures:
The outcome measures were medications co-prescribed with SJW.

Results: Twenty-eight percent (28%) of SJW visits involved a drug that has potentially dangerous interaction with SJW. These included selective serotonin reuptake inhibitors, benzodiazepines, warfarin, statins, verapamil, digoxin, and oral contraceptives.

Conclusions:
SJW is frequently used in potentially dangerous combinations. Physicians should be aware of these common interactions and warn patients appropriately.

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