Hepatitis C; a retrospective study, literature review, and naturopathic protocol.
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The standard medical treatment of hepatitis C infection is only associated with sustained efficacy in a minority of patients. Therefore, the search for other treatments is of utmost importance. Several natural products and their derivatives have demonstrated benefit in the treatment of hepatitis C and other chronic liver conditions. Other herbal and nutritional supplements have mechanisms of action that make them likely to be of benefit. This article presents comprehensive protocol, including diet, lifestyle, and therapeutic interventions. The authors performed a retrospective review of 41 consecutive hepatitis C patients. Of the 14 patients with baseline and follow-up data who had not undergone interferon therapy, seven had a greater than 25-percent reduction in serum alanine aminotransferase (ALT) levels after at least one month on the protocol. For all patients reviewed, the average reduction in ALT was 35 U/L (p=0.026). These data appear to suggest that a conservative approach using diet and lifestyle modification, along with safe and indicated interventions, can be effective in the treatment of hepatitis C. Controlled trials with serial liver biopsy and viral load data are necessary to confirm these preliminary findings. (+info)
Sociodemographic and health behaviour factors among dietary supplement and natural remedy users.
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OBJECTIVE: To investigate which subgroups of the Swedish adult population use dietary supplements and natural remedies, taking into account sociodemographic and health behaviour factors. DESIGN: A cross-sectional survey conducted in 1996/1997 by Statistics Sweden was used for the analyses. In face-to-face interviews participants reported consumption of dietary supplements and natural remedies during the previous 2 weeks. SETTING: Sweden SUBJECTS: A nationally representative sample of 11 422 adults (5596 men, 5826 women) aged 16-84 y. The response rate was 78%. RESULTS: Overall, 33% of Swedish women and 22% of Swedish men reported use of dietary supplements; prevalence of natural remedy users was 14 and 7%, respectively. The best predictors for use of dietary supplements and natural remedies were age, sex and subjective health. Women and older individuals were more likely to be dietary supplement and/or natural remedy users. Obese men and women were less likely to use dietary supplements than underweight ones. Among men subjective health was significantly related to use of these preparations. Men who reported excellent health ate less than men reporting poor health. This association was weaker among women. Exercise was another important factor. Both men and women (except female dietary supplement users) who reported moderate or heavy exercise were significantly more frequent users of these preparations than those who reported practically no exercise. CONCLUSION: Use of dietary supplements and natural remedies is associated with several sociodemographic and health behaviour factors. SPONSORSHIP: Karolinska Institutet Research Fund. (+info)
Teaching Evidence-Based Complementary and Alternative Medicine (EBCAM); changing behaviours in the face of reticence: a cross-over trial.
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BACKGROUND: The effectiveness of teaching critical appraisal to students of Complementary and Alternative Medicine (CAM) has not been studied. In this study we attempt to determine if a workshop for final year students at a naturopathic college improved their ability to utilize critical appraisal concepts. METHODS: We assigned 83 Naturopathic Interns to two groups: Group A (n = 47) or Group B (n = 36). We conducted a baseline assessment of all subjects' critical appraisal skills. Group A was assigned to receive a 3(1/2) hour workshop on Evidence Based Medicine (EBM) and Group B received a workshop on bioethics (control intervention). The groups critical appraisal skills were re-evaluated at this time. We then crossed over the intervention so that Group B received the EBM workshop while Group A received the bioethics workshop. Assessment of critical appraisal skills of the two groups was again performed. RESULTS: The students mean scores were similar in Group A (14.8) and Group B (15.0) after Group A had received the intervention and Group B had received the control (p = 0.75). Group scores were not significantly improved at the end of the trial compared to at the beginning of the study (Group A: 15.1 to 16.1) (Group B 15.6 to 15.9). Student's confidence in reading research papers also did not improve throughout the course of the study. CONCLUSION: The final year is a difficult but important time to teach critical appraisal and evidence skills. Single, short intervention programs will likely yield negligible results. A multi-factorial approach may be better suited to implementing EBCAM than single short interventions. (+info)
Characteristics of visits to licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians.
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BACKGROUND: Despite growing popularity of complementary and alternative medical (CAM) therapies, little is known about the patients seen by CAM practitioners. Our objective was to describe the patients and problems seen by CAM practitioners. METHODS: We collected data on 20 consecutive visits to randomly sampled licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians practicing in Arizona, Connecticut, Massachusetts, and Washington. Data were collected on patient demographics, smoking status, referral source, reasons for visit, concurrent medical care, payment source, and visit duration. Comparative data for conventional physicians were drawn from the National Ambulatory Medical Care Survey. RESULTS: In each profession, at least 99 practitioners collected data on more than 1,800 visits. More than 80% of visits to CAM providers were by young and middle-aged adults, and roughly two thirds were by women. Children comprised 10% of visits to naturopathic physicians but only 1% to 4% of all visits to other CAM providers. At least two thirds of visits resulted from self-referrals, and only 4% to 12% of visits were from conventional physician referrals. Chiropractors and massage therapists primarily saw musculoskeletal problems, while acupuncturists and naturopathic physicians saw a broader range of conditions. Visits to acupuncturists and massage therapists lasted about 60 minutes compared with 40 minutes for naturopathic physicians and less than 20 minutes for chiropractors. Most visits to chiropractors and naturopathic physicians, but less than one third of visits to acupuncturists and massage therapists, were covered by insurance. CONCLUSIONS: This information will help inform discussions of the roles CAM practitioners will play in the health care system of the future. (+info)
Bioactive natural compounds for the treatment of gastrointestinal disorders.
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Many healthy subjects and patients are taking natural bioactive products for the prevention and treatment of multiple conditions, including gastrointestinal disorders. Based on current evidence, the scientific validity of the use of many of these commercial compounds by the general public is severely limited, with quality control and regulatory issues continuing to be a concern. Nevertheless, there is sufficient preliminary data to warrant further research of these products in order to identify novel compounds for potential clinical use in addition to performing formal randomized controlled clinical trials of the commercial preparations. (+info)
Severe Serratia liquefaciens sepsis following vitamin C infusion treatment by a naturopathic practitioner.
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A 66-year-old female patient developed severe Serratia liquefaciens sepsis following vitamin C infusion treatment by a naturopathic practitioner. The clinical course of the infection was characterized by several complications, and the direct costs of the hospital stay amounted to about 40000 Euro. Genotypically identical S. liquefaciens was isolated from the residue of the infusate given to the patient, as well as from the washbasin overflow and from two other infusion bottles. A careful inspection of the dispensing facilities and review of procedures used to prepare the infusate revealed several indications of poor hygiene. However, the source of contamination could not be fully clarified. This case report raises questions about the local facilities and personal qualifications required for naturopathic practitioners to conduct invasive procedures and demonstrates that lapses in hygiene can lead to severe morbidity and high cost. (+info)
Visiting family physicians and naturopathic practitioners. Comparing patient-practitioner interactions.
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OBJECTIVE: To explore similarities and differences in patient visits with family physicians (FPs) and naturopathic practitioners (NPs). DESIGN: Exploratory study combining quantitative and qualitative methods. SETTING: Southern Ontario. PARTICIPANTS: A purposeful sample of 10 practitioners (five FPs and five NPs matched for age, sex, and number of years in practice): each agreed to recruit three consecutive patients with new complaints to participate in the study. MAIN OUTCOME MEASURES: Patient and visit characteristics; qualitative (content analysis of audiotaped interactions) and quantitative (ie, patient-centred care scores) information was gathered and analyzed. RESULTS: Qualitative analysis revealed that information gathering and treatment planning were very similar whether patients were visiting FPs or NPs. Most important differences were length of interaction (mean 54 minutes for NPs and 16.5 minutes for FPs) and patients' reasons for visits. Naturopathic practitioners were more likely to recommend medications (usually natural health products) than FPs. Quantitative data suggested that patients perceived no differences in patient-centred care from FPs and NPs. CONCLUSION: Overall, there were more similarities than differences in visits to the two types of practitioners. (+info)
Naturopathy: a critical appraisal.
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"Naturopathic medicine" is a recent manifestation of the field of naturopathy, a 19th-century health movement espousing "the healing power of nature." "Naturopathic physicians" now claim to be primary care physicians proficient in the practice of both "conventional" and "natural" medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care. An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical, and potentially dangerous practices. Despite this, naturopaths have achieved legal and political recognition, including licensure in 13 states and appointments to the US Medicare Coverage Advisory Committee. This dichotomy can be explained in part by erroneous representations of naturopathy offered by academic medical centers and popular medical Web sites. (+info)