Helix Research Articles

Efficacy of rhythmical massage in comparison to heart rate variability biofeedback in patients with dysmenorrhea—A randomized, controlled trial

Background20–90% of all women suffer from dysmenorrhea. Standard therapy of primary dysmenorrhea (PD) are NSAIDs and oral contraceptives, effective but not without possible side effects. ObjectiveTo examine the efficacy of rhythmical massage (Anthroposophic Medicine) and heart rate variability biofeedback compared to usual care (control group) on pain intensity in women with primary dysmenorrhea. MethodsThis was a three-arm randomized controlled study. Both interventions (rhythmical massage once a week or HRV biofeedback 15 min daily) were carried out over a period of three months. The third group (control) applied usual care. The primary outcome were between-group differences in mean pain intensity (detected by a Numeric Rating Scale, NRS) during menstruation after three months (post-assessment, t2). Secondary outcomes were the use of analgesics, quality of life (SF-12) and heart rate variability. ResultsThe study involved 60 women, mean age 29.7 years, SD 8.0 (n = 23 rhythmical massage, n = 20 biofeedback, n = 17 control). For the primary outcome there was a significant difference between the groups after three months (p = .005). Bonferroni adjusted post-hoc tests revealed a significant difference between rhythmical massage and control group (mean difference: -1.61; 95 CI: -2.77/-0.44; p = .004; ES: -0.80). No significant differences were found between rhythmical massage and biofeedback (mean difference: -0.71; 95 CI: -1.82/ 0.40; p = .361; ES: -0.34) and between biofeedback and control group (mean difference: -0.90; 95 CI: -2.10/-0.30; p = .211; ES: -0.51). For the secondary outcomes no significant differences were found between the groups at t2. The drop-out rate was higher in the biofeedback group (n = 6) than in the massage (n = 2) or the control group (n = 4). ConclusionPreliminary evidence suggests that rhythmical massage might improve pain intensity after 12 weeks compared to usual care.

Immunogenicity of a novel tetravalent dengue envelope protein domain III-based antigen in mice.

Dengue virus is a mosquito-borne pathogen that causes dengue diseases. All four serotypes of dengue virus are infectious for humans. Therefore, an efficacious dengue vaccine should be tetravalent to provide protection against all types of virus. The goal of this study was to design a new tetravalent recombinant protein from envelope protein of dengue viruses to induce virus-neutralizing antibodies against all four serotypes in mice. A chimeric protein was designed from domain III of envelope protein of all serotypes of dengue virus. Four domain III fragments were linked together by alpha helix making linkers. The final sequence of the designed protein was analyzed in silico and the coding gene sequence was deduced by reverse translation. After cloning and expression of the recombinant protein (ED3-tetravalent protein), identity of the purified protein was confirmed using a pan-dengue specific monoclonal antibody in Western blotting. Then, the immunogenicity of the purified protein was studied in mice using antibody titration. The efficacy of induced antibodies in neutralization of the virus was studies by FRNT method. Furthermore, the induction of cellular immunity was studied by measurement of cytokines using ELISA method and measurement of lymphocyte proliferation using MTT assay. The ED3-tetravalent protein was able to enhance neutralizing immunogenic response against all four dengue serotypes; in similar way to that of tetravalent formulation of four individual domain III-based polypeptides. It is suggested that the ED3-tetravalent fusion protein can induce broadly neutralizing antibody responses against all four serotypes of dengue virus in mice.

Medicinal plants and herbal medicines in Primary Health Care: the perception of the professionals

The Ministry of Health through the National Policy on Integrative and Complementary Practices (PNPIC) encourages the offer of Acupuncture, Homeopathy, Herbal Medicine, Hydrotherapy and Anthroposophical Medicine in the Unified Health System (SUS). This study evaluated the profile for the prescription/suggestion and credibility of herbal medicine usage as complementary therapy among the 157 professionals from the 66 Family Health Strategy (FHS) teams in Blumenau city. Data collection was conducted between the years of 2014 and 2015 through a semi-structured questionnaire applied to a sample comprised of 42 (26.8%) physicians, 40 (25.5%) nurses, 66 (42%) nursing technicians, 5 (3.2%) dentists and 4 (2.5%) oral health technicians. Bivariate associations were assessed using the Chi-Square test or Fisher's exact test for variables. Despite 65.6% of respondents being aware of the existence of the PNPIC, the presence of herbal medicines on the National List of Medicines was unknown by 85.4%. The majority (96.2%) of the professionals believe in the therapeutic effects of medicinal plants but do not prescribe this medicine. However, 98.7% agreed with the initiative to offer this complementary and integrative practice through SUS after training in the area.

Integrative care for children with cancer. Project design for the development of an integrative care programme for use in paediatric oncology

PurposePurpose of this paper is to describe the project design for the development of a context-specific and patient-focused integrative care programme for an intensive care unit for paediatric oncology to ease the strain of the treatments for patients and their families. Integrative care interventions based on anthroposophical medicine such as wraps, compresses and rhythmic body oiling can be used to ease typical side effects such as nausea, pain and agitation. MethodsConduct of a literature research on existing integrative care programmes in medical hospitals and biomedical settings and the identification of appropriate methods to achieve the research aim. ResultsA project design was developed which can be used as a basis for developing, introducing and evaluating an integrative care programme for a paediatric oncological intensive care unit in a German university hospital. A qualitative study design was chosen to develop this programme. This included participant observations and interviews with all stakeholders at the respective oncology ward as well as in existing oncology wards that work with an integrative care programme. The primary emphasis was on the criteria appropriateness for the specific setting, sustainability and financial viability as well as on the development of an appropriate evaluation model. ConclusionsWhen developing an integrative care programme for use in the specific setting of a paediatric oncology ward and selecting the appropriate interventions for inclusion in the programme, particular attention should be paid to the needs of the patients as well as to the practicability for the nursing staff, particularly with regard to resources such as time and personnel. Both the nursing team and nursing management should be actively involved in the project design from the outset. In the evaluation particular importance is attached to feasibility. The challenge for the economic evaluation is to create a robust database for negotiation of financing possibilities.

Optimization of the ultrasonic-microwave assisted enzymatic hydrolysis of freshwater mussel meat

In the present study, the Ultrasonic-Microwave (US-MW) technique was applied for assisting enzymatic hydrolysis of freshwater mussel meat. The operating parameters of enzymatic hydrolysis were investigated and the properties and qualities of the freshwater mussel hydrolysates were also analyzed. The considerable optimum conditions for enzymatic hydrolysis of mussel meat were ratio of liquid to material of 10.36:1, power of 360.52 W, processing time of 6.91 min, enzymolysis time of 4 h. Under these conditions, a degree of hydrolysis (DH) of 48.40% was obtained. The hydrolysates produced under optimum conditions, were characterized in terms of electrophoretic profile, amino acid composition and infrared spectrum analysis. SDS-PAGE profiles of the hydrolysates revealed that several protein bands were cleaved and several light myosin chains (25 kDa and 15 kDa, respectively) and peptides of molecular weight lower than 6.5 kDa were identified. The infrared spectrum absorption peak of amide band A and band III shifted after US-MW pre-treatment, which indicated that the N-H (hydrogen bonding) stretching vibration and triple helix structure of samples were affected. The essential amino acids in hydrolysates with or without US-MW pre-treatment were 36.62 mg/100 g and 33.40 mg/100 g. It was proved that US-MW assisted enzymatic hydrolysis is an effective technology to utilize freshwater mussel meat. Keywords: ultrasonic-microwave (US-MW), freshwater mussel meat, enzymatic hydrolysis, degree of hydrolysis (DH) DOI: 10.25165/j.ijabe.20181105.4104 Citation: Zhou Y J, Yi X L, Wang J Y, Yang Q, Wang S J. Optimization of the ultrasonic-microwave assisted enzymatic hydrolysis of freshwater mussel meat. Int J Agric & Biol Eng, 2018; 11(5): 236–242.

An experimental study on oil-dispersion baths generated by the Jungebad apparatus

BackgroundSince the very early documentation of medical treatments, bathing is an essential part of almost all traditional medical systems. In this context the oil-dispersion bath, developed in the 1930s by Werner Junge has been developed from anthroposophic medicine. We aimed at analyzing the apparatus, which churns water and essential oils into an oil-water dispersion, by means of an experimental study. Material and MethodsUsing three different oils (rheumatic oil, citrus oil and rosemary oil) oil volumetric flow rate and oil droplet size distribution were examined at three different water volumetric flow rates of 5, 10, and 15 l/min at a constant temperature of 40 °C. Additionally, for the rheumatic oil measurements are taken at three different temperatures, 35, 40, and 45 °C at a constant volumetric flow rate of 10 l/min. Finally results were compared with a manual oil dispersion process. ResultsOil volumetric flow rate increases with increasing water volumetric flow rates. Oil flow rate increases with increasing water temperature. Droplet-size distribution shows an optimal fit with a log-normal distribution for a volumetric flow rate of 5 l/min in all oils applied with citrus and rosemary oil showing a larger mean diameter compared to the rheumatic oil. Comparing the oil droplet size distribution for a traditional oil bath, distributions behaved completely different in comparison to our distributions. Moreover it seemed not possible to create an oil-dispersion with repeatable droplet size distributions whereas the Jungebad apparatus created similar oil dispersions with predictable results, independent of the user. DiscussionThis is the first study to explore the mechanisms of creation of the oil-dispersion bath by means of an experimental set up. Based on these experimental results, a more fundamental theoretical approach should be carried out to complement our findings and to gain deeper insights in the hydrodynamic and droplets forming processes in the Jungebad apparatus.

The Subjective Dimension of Integrative Cancer Care: A Qualitative Study Exploring the Perspectives, Themes, and Observations of Experienced Doctors from the Area of Anthroposophic Medicine

Integrative cancer care (ICC) is used by approximately 50% of cancer patients to complement oncologic treatments and to address unmet needs. One ICC practice is anthroposophic medicine, integrating conventional and complementary cancer care. It specifically provides mistletoe therapy (MT), but also intensive counselling, natural remedies, creative and movement therapies, nursing procedures, nutrition, and others. The objective of this study was to explore perceptions, themes, goals, procedures, and observations of experienced AM doctors with regard to the subjective dimensions of ICC. A guideline-based qualitative interview study was conducted with 35 AM doctors working in hospitals and office-based practices in Germany and other countries. Structured qualitative content analysis was applied to examine the data. Triangulation was done with published studies investigating patients' perspectives on AM and MT. The interviewed doctors integrated conventional and holistic cancer concepts. Overarching therapeutic themes were: to enable patients to live with or overcome their disease, to find their own way through their disease, and to possibly reframe their situation. A broad variety of therapeutic goals were pursued, depending on the situation and priorities of the particular patient. Doctors described varying levels of patients' improved strength; increased vitality, thermal comfort, and recovery; relief from suffering, particularly in the areas of fatigue, appetite, sleep, pain, infections, and reactions to toxic anti-cancer therapies. The doctors also described how they perceived changes of patients' emotional level, their coping, autonomy, functional abilities, and finding their own way to deal with the disease. This is consistent with patients' perspectives described in published studies. Themes, goals, and described benefit of ICC from doctors' and patients' perspective may be an important complementation of conventional cancer care, as it meets important needs, distresses and conditions of patients which often stay unmet and unrelieved. Further research should investigate these goals and procedures.

Physiological and emotional effects of pentatonic live music played for preterm neonates and their mothers in the Newborn Intensive Care Unit: A randomized controlled trial

ObjectiveDespite attempts to increase calmness in the Newborn Intensive Care Unit (NICU), preterm neonates still experience stress. The question arises how to further promote the infants’ wellbeing. Therefore, the immediate effects of pentatonic live music on preterm infants and their mothers were examined. Design and methodsIn a two-centre randomized controlled trial with crossover design preterm infants were exposed sequentially to two conditions: live pentatonic harp music (LPHM) used in Anthroposophic Medicine or standard care. The order of the conditions was randomized within each subject. The primary outcome was change of the number of oxygen desaturations < 90%/h, whereas secondary outcomes were: heart rate, respiratory rate, oxygen saturation, heart rate variability (HRV), the perfusion index, pulse-transit-time and maternal anxiety and others not reported on in this article. Results21 preterm infants were randomized (14 girls), mean gestational age at measurement 35 + 0 weeks (SD 1 week). The primary outcome parameter showed no significant changes. Regarding the secondary outcomes the comparison of the pre-post-differences between the conditions showed significant effects for the HRV parameters pNN50 (ΔpNN50 = 1.46%, z = −2.47, p = .001) and SDNN (ΔSDNN=−0.06 ms, z = −2.25, p = .002). The music intervention significantly increased the values of pNN50 (Mdn 1.2% vs. 2.6%, p = 0.04) and marginally those of SDNN (Mdn 31.7 ms vs. 36.4 ms, p = 0.05). No changes were found in the other parameters. ConclusionsWhile the use of music in the NICU had no effect on the number of oxygen desaturations, it increased two HRV parameters indicative of infants’ parasympathetic tone.

NMR assignment of the transmembrane helix of BclxL in phospholipid nanodiscs

NMR assignment of the transmembrane helix of BclxL in phospholipid nanodiscs

Molecular Dynamics Simulations Revealed the Regulation of Ligands to the Interactions between Androgen Receptor and Its Coactivator.

The androgen receptor (AR) plays important roles in gene expression regulation, sexual phenotype maintenance, and prostate cancer (PCa) development. The communications between the AR ligand-binding domain (LBD) and its coactivator are critical to the activation of AR. It is still unclear how the ligand binding would affect the AR-coactivator interactions. In this work, the effects of the ligand binding on the AR-coactivator communications were explored by molecular dynamics (MD) simulations. The results showed that the ligand binding regulates the residue interactions in the function site AF-2. The ligand-to-coactivator allosteric pathway, which involves the coactivator, helix 3 (H3), helix 4 (H4), the loop between H3 and H4 (L3), and helix 12 (H12), and ligands, was characterized. In addition, the interactions of residues on the function site BF-3, especially on the boundary of AF-2 and BF-3, are also affected by the ligands. The MM/GBSA free energy calculations demonstrated that the binding affinity between the coactivator and apo-AR is roughly weaker than those between the coactivator and antagonistic ARs but stronger than those between the coactivator and agonistic ARs. The results indicated that the long-range electrostatic interactions and the conformational entropies are the main factors affecting the binding free energies. In addition, the F876L mutation on AR-LBD affects the ligand-to-coactivator allosteric pathway, which could be the reason for point mutation induced tolerance for the antagonistic drugs such as enzalutamide. Our study would help to develop novel drug candidates against PCa.

Development of a whole plant bioassay to test effects of potentized calcium carbonate in pillule formulation

From a pharmaceutical point of view, we see a need to develop stable preclinical test systems to identify and investigate effects of potentized remedies as used in Anthroposophic Medicine and Homeopathy. We evaluated a plant bioassay regarding its capacity to distinguish homeopathic remedies from placebo, applied as sucrose pillules. Pea seed (Pisum sativum L) was soaked for 24 hours in water with dissolved homeopathic or placebo pillules, or in water only. Shoot length was measured 14 days after planting and treatment groups were compared by analysis of variance (ANOVA). The stability of the system was validated by systematic negative control experiments. The system is suitable to test a common application form - sucrose pillules - of a potentized preparation without influence of the pharmaceutical carrier substance. A screening of 13 potentized preparations revealed Calcium carbonicum to affect pea shoot growth (p < 0.05). Three independent series of main experiments were performed with potentized Calcium carbonicum to assess reproducibility. Meta-analysis of all data revealed significant effects of Calcium carbonicum 12c and 30c on pea shoot growth (p < 0.05), which were however dependent on the date of experiment and/or the experimental series. Potentized Calcium carbonicum, applied as sucrose pillules, influenced pea shoot growth in the assay investigated. However, due to the small effect size and due to the modulation of the effects by still unknown external factors, further optimization of this bioassay is necessary to be used in pharmaceutical quality control or in investigating the biological or pharmaceutical mode of action of potentized preparations.

Hepatocellular carcinoma cell-derived exosomes regulates Treg cells via cyclic adenosine monophosphate response element binding protein/forkhead/winged helix transcription factor P3 pathway

Objective To investigate whether hepatocellular carcinoma cell line HepG2 derived exosomes regulates Treg cells via cyclic adenosine monophosphate response element binding protein/forkhead/winged helix transcription factor P3 (CREB/Foxp3) pathway. Methods Ultracentrifugation was used to isolate exosomes of hepatocellular carcinoma cell line HepG2 and normal hepatocellular cell line L02. Transmission electron microscopy was used to determine the morphology of exosomes and Western blotting was used to detect the protein markers of exosomes and CREB/Foxp3 expression. HepG2-exo and L02-exo were co-cultured with peripheral blood mononuclear cells. The percent of Treg cells were determined by flow cytometry. Results Exosomes was about 30-100 nm with a circular or oval shape vesicular structure. CD81 and CD63 were highly expressed in exosomal proteins, while not expressed in cell proteins derived from HepG2 or L02 cells. Compared to L02-exo [(1.87±0.18)%] and blank control group [(1.43±0.12)%], HepG2-exo strongly increased the percent of Treg cells [(6.87±0.87)%], with P value of 0.005 and 0.004 respectively. Phosphorylation of CREB in HepG2-exo group was 1.74 and 1.63 fold higher than it in L02-exo and blank control group, and both of the P=0.001. Phosphorylation of Foxp3 in HepG2-exo group was 1.93 and 1.78 fold higher than it in L02-exo and blank control group, and both of the P=0.001. Conclusion These results provided evidence that hepatocellular carcinoma cell HepG2 derived exosomes could regulates Treg cells via CREB/Foxp3 pathway. Key words: Exsomes; Treg cell; Cyclic adenosine monophosphate response element binding protein; Forkhead/winged helix transcription factor P3; Hepatocellular carcinoma

On caring and sharing–Addressing psychological, biographical, and spiritual aspects in integrative cancer care: A qualitative interview study on physicians’ perspectives

BackgroundPatients confronted with a cancer diagnosis experience a variety of existential needs encompassing emotional, psychological, and spiritual areas of being. A patient-centered care approach addressing such existential issues is recognized as an essential aspect of health care. The aim of this study is to explore what role psychological, biographical, and spiritual factors play for experienced doctors working in integrative cancer care. MethodThe qualitative study was based on in-depth interviews with 35 purposively sampled doctors, all practicing integrative oncology in the field of anthroposophic medicine in hospitals and/or office-based practices in Germany and other countries. Data were analyzed using structured content analysis. ResultsPsychological, biographical, and spiritual factors are important issues in integrative cancer care. Prevailing themes identified in this study were enabling patients to participate in life, promoting autonomy and coping, stabilizing patients emotionally and cognitively, overcoming the disease, and–primarily if addressed by patients–integrating spiritual issues. Doctors offered conversation, counseling, and time, but also referred to art, music, literature, and nature, so that patients’ ongoing emotional, psychological, and spiritual needs could be explored and addressed. Doctors’ attitudes with regard to existential issues were seen as important, as was maintaining an attitude of openness towards existential issues. ConclusionDoctors in integrative cancer care utilize different methods to explore the needs of patients and employ a variety of treatment methods that address not just patients’ medical issues but their existential concerns as well.

Investigations on the constitutional types under consideration of anthropometric data, autonomic regulation and immunological parameters

ObjectivesOver time different systems were developed for the characterization of individuals according to their physical and psycho-vegetative traits which until today play a role in complementary medicine. This pilot study aimed at investigating if the concepts of polar constitutional types of anthroposophic medicine and according to Kretschmer can be further clarified using empirical method. Methods96 participants, preselected by two polar body mass index (BMI) ranges (17–19.5 kg/m2 and 27–31 kg/m2), were categorized using both classification systems. Anthropometrical measurements were carried out and differences in the autonomic regulation were assessed using a questionnaire. From 12 participants showing a pronounced polar constitutional type, production of reactive oxygen species, proliferation, autophagy, and glucose uptake by lymphocytes, monocytes and granulocytes were measured in vitro. ResultsCorrelations between the BMI and the strength of constitutional classification were found for both classification systems. Additionally, a strong correlation between the two systems themselves could be seen. Analysis of the overall questionnaire score of autonomic regulation did not yield significant correlations. However, using a modified 11 item score, reliability (Cronbach α = 0.656) and a differentiation of polar constitutional types was demonstrated (p < 0.001). Regarding the immune function slightly varying levels of reactive oxygen species, autophagy in granulocytes and differences in the strength of inhibition of lymphocyte proliferation by dexamethasone and cyclosporine A were detected. However, most of these in vitro results did not reach significance. ConclusionThis study represents a first empirical approach toward the classification of anthroposophic constitutional types.

An assessment of the scientific status of anthroposophic medicine, applying criteria from the philosophy of science

ObjectivesThe objective was to evaluate the scientific status of anthroposophic medicine (AM) according to demarcation criteria proposed in contemporary philosophy of science. DesignCriteria for what is science were retrieved from eight publications in the philosophy of science, focusing either on science in medicine or on the demarcation between science and pseudoscience or non-science. Criteria were combined, redundancies were excluded, and the final set of criteria was ordered in a logical sequence. The analysis yielded 11 demarcation criteria (community, domain, problems, goals, axiomatic basis, conceptual basis, quality of concepts, methodology, deontic basis, research products, tradition). ResultsAssessing the scientific status of AM according to the 11 criteria, all criteria were fulfilled by AM. DiscussionAM is grounded on the notion that specific non-atomistic holistic formative forces exist and can be empirically and rationally assessed. From a position claiming that such holistic forces cannot possibly exist or cannot be empirically and rationally assessed, the axiomatic and conceptual basis of AM can be contested. However, such an a priori rejection is problematic in the presence of empirical evidence supporting the validity of holistic concepts, as discussed in the paper. Future research should therefore focus on the tenability of the ontological reductionist position in science and on the further validation of AM non-atomistic holistic concepts, methods and practices. ConclusionIn this analysis, using criteria from philosophy of science, AM fulfilled all 11 criteria for what is science.

Hypericum perforatum to improve post-operative Pain Outcome after monosegmental Spinal microdiscectomy (HYPOS): a study protocol for a randomised, double-blind, placebo-controlled trial

BackgroundSpinal disc herniation is a frequently occurring degenerative disease of the spine. Many patients undergoing surgery suffer from radicular pain, known as memory pain, beginning from the third post-operative day. This results in the prescription of high-dose opioid medications. In homeopathy, Hypericum perforatum is known as a remedy for unbearable, shooting or jabbing pain especially when neural damage is involved. Reduction of pain after application of H. perforatum has been observed in previous studies. This study is aimed to investigate whether homeopathic H. perforatum in a potentisation of C200 leads to the reduction of post-operative pain and a decrease of pain medication compared to placebo.Methods/designThis is a monocentric, double-blind, randomised placebo-controlled trial conducted at the Department of Neurosurgery at the Community Hospital Herdecke, Germany. One hundred study participants are being recruited from inpatients undergoing elective, monosegmental, lumbar microdiscectomy surgery. Patients are randomly allocated to receive homeopathic treatment or placebo in addition to usual pain management after surgery. The primary clinical outcome is pain reduction after 3 days of inpatient care as measured by pain reduction of subjective pain on a 100-mm Visual Analogue Scale (VAS) at the third post-operative day. Statistical analysis will be carried out by means of a covariance model with adjustment for baseline values and patient expectation for all randomised patients.DiscussionThis study is the first trial of classical homeopathy that will evaluate the efficacy of homeopathic H. perforatum after monosegmental spinal microdiscectomy. We intend to clarify the potential of homoeopathic H. perforatum to reduce surgery-associated pain.Trial registrationGerman Clinical Trials Register, ID: DRKS00007913. Registered on 17 October 2014.EudraCT – Nr: 2013–001383-31.Data sets from the German Clinical Trials Register (DRKS, Deutsches Register Klinischer Studien) are updated every 4 weeks automatically to the International Clinical Trials Registry Platform of World Health Organisation: http://apps.who.int/trialsearch/.ResponsibilitiesSponsor:Witten/Herdecke UniversityAlfred-Herrhausen-Straße 5058,448 WittenDeputy of the sponsor:Dr. Wolfgang Eglmeier (Head of Centre for Clinical Trials Witten/Herdecke)Alfred-Herrhausen-Straße 5058,448 WittenE-mail: wolfgang.eglmeier@uni-wh.dePrincipal investigator:Prof. Dr. med. Wolfram ScharbrodtCommunity Hospital HerdeckeDepartment for NeurosurgeryGerhard-Kienle-Weg 458,313 Herdeckew.scharbrodt@gemeinschaftskrankenhaus.deProject coordination:Christa RaakFaculty for Health (Department for Integrative and Anthroposophic Medicine)University Witten/Herdecke gGmbhGerhard-Kienle-Weg 458,313 Herdeckechrista.raak@uni-wh.deProject manager/data analysis/biometry:Prof. Dr. Thomas OstermannFaculty for Health (Department for Psychology and Psychotherapy)University Witten/Herdecke gGmbhAlfred-Herrhausen-Straße 5058,448 Wittenthomas.ostermann@uni-wh.de

Interaction and energy transfer between carbon dots and serum human transferrin

Human serum transferrin has been used as a potential drug carrier to transport anticancer drugs to tumor cells, where transferrin receptors are overexpressed on the surface. Carbon dots are biocomp...

Implementation of an Integrative Oncological Concept in the Daily Care of a German Certified Breast Cancer Center

Background: In recent decades the concept of integrative medicine has attracted growing interest in patients and professionals. At the Gemeinschaftskrankenhaus Havelhöhe (GKH), a hospital specialized in anthroposophical medicine, a breast cancer center (BCC) has been successfully certified for more than 5 years. The objective of the present study was to analyze how integrative strategies were implemented in the daily care of primary breast cancer patients. Methods: Clinical, demographic, and follow-up data as well as information on non-pharmacological interventions were analyzed. In addition, BCC quality measures were compared with data of the National Breast Cancer Benchmarking Report 2016. Results: Between 2011 and 2016, 741 primary breast cancer patients (median age 57.4 years) were treated at the GKH BCC. 91.5% of the patients showed Union for International Cancer Control (UICC) stage 0, I, II, or III and 8.2% were in UICC stage IV. 97% of the patients underwent surgery, 53% radiation, 38% had hormone therapy, and 25% received cytostatic drugs. 96% of the patients received non-pharmacological interventions and 32% received Viscum album L. therapy. Follow-up was performed in up to 93% of the patients 2 years after first diagnosis. Compared to nationwide benchmarking BCCs, the GKH BCC met the requirements in central items. Conclusions: The results of the present study show that integrative therapies offered by the concept of anthroposophical medicine can be implemented in the daily care and treatment of a certified BCC. However, as national guidelines on integrative concepts in oncology are missing, further studies are needed for a systematic evaluation of integrative treatment and care concepts in this field.

Rhythmical massage improves autonomic nervous system function: a single-blind randomised controlled trial

BackgroundRhythmical massage therapy (RMT) is a massage technique used in anthroposophic medicine. ObjectiveThe authors aimed to investigate the physiological action of RMT on the cardiovascular system by analysing heart rate variability (HRV). Design, setting, participants and interventionThis study was a randomised, controlled and single-blinded trial, involving 44 healthy women (mean age: (26.20 ± 4.71) years). The subjects were randomised to one of three arms: RMT with aromatic oil (RA), RMT without aromatic oil (RM) or standardised sham massage (SM). In the study the subjects were exposed to a standardised stress situation followed by one of the study techniques and Holter electrocardiograms (ECGs) were recorded for 24 h. Main outcome measuresHRV parameters were calculated from linear (time and frequency domain) and nonlinear dynamics (symbolic dynamics, Poincare plot analysis) of the 24-h Holter ECG records. ResultsShort- and long-term effects of massage on autonomic regulation differed significantly among the three groups. Immediately after an RMT session, stimulation of HRV was found in the groups RA and RM. The use of an aromatic oil produced greater short-term measurable changes in HRV compared with rhythmic massage alone, but after 24 h the effect was no longer distinguishable from the RM group. The lowest stimulation of HRV parameters was measured in the SM group. ConclusionRMT causes specific and marked stimulation of the autonomic nervous system. Use of a medicinal aromatic oil had only a temporary effect on HRV, indicating that the RM causes the most relevant long-term effect. The effect is relatively specific, as the physiological effects seen in the group of subjects who received only SM were considerably less pronounced. Trial registrationRegistration trial DRKS00004164 on DRKS.

Feeling the sound – short-term effect of a vibroacoustic music intervention on well-being and subjectively assessed warmth distribution in cancer patients—A randomized controlled trial

ObjectivesSo far, the effects of vibroacoustic music therapy in cancer patients are unknown. However, used in anthroposophic medicine, it could be an approach to enhance well-being.The goal of this study was to evaluate the immediate effects of a sound-bed music intervention with respect to the subjective well-being as well as body warmth and pain. Patients and methodsWe treated 48 cancer patients with 10 min of sound-bed intervention in a cross-over design. Primary outcome was the total sum of the Basler Mood Questionnaire (BMQ), secondary outcomes were subscales of the BMQ and questions addressing body warmth and pain. The EORTC-QLQ C30 was used as baseline assessment for quality of life (QOL). ResultsPatients had lower QOL values than the EORTC reference samples (p < .001, d = 0.90). The primary outcome increased after music (p < .001, d = 0.47), no changes were seen in the control condition (p = .73, d = 0.04), the time by condition interaction was significant (p < .05). Secondary outcomes: Increase after music for the BMQ subscales inner balance (p < .001, d = 0.73), vitality (p < .001, d = 0.51) and vigilance (p < .001, d = 0.37) as well as for the additional questions satisfaction (p < .001, d = 0.43), current mood (p < .001, d = 0.43), body warmth (p < .05, d = 0.44) and warmth distribution (p < .01, d = 0.49). No significant changes were seen in pain levels and social extroversion. ConclusionSound-bed intervention improved momentary well-being and caused self-perceived physiological changes associated with relaxation beyond the benefits of simple resting time (control condition). Thus, it might be a promising approach to improve well-being in cancer patients.