Traditional Medical Therapy Research Articles

Pharmacological Agents Targeting Myocardial Metabolism for the Management of Chronic Stable Angina : an Update.

Despite continuous advances in myocardial revascularization procedures and intracoronary devices, patients with ischemic heart disease (IHD) still experience worse prognosis and poor quality of life (QoL). Indeed, chronic stable angina (CSA) is a common disease with a large burden on healthcare costs. Traditionally, CSA is interpreted as episodes of reversible myocardial ischemia related to the presence of stable coronary artery plaque causing myocardial demand/supply mismatch when myocardial oxygen consumption increases. Accordingly, revascularization procedures are performed with the aim to remove the flow limiting stenosis, whereas traditional medical therapy (hemodynamic agents) aims at reducing myocardial oxygen demands. However, although effective, none of these treatment strategies or their combination is either able to confer symptomatic relief in all patients, nor to reduce mortality. Failure to significantly improve QoL and prognosis may be attributed at least in part to this "restrictive" understanding of IHD. Despite for many years myocardial metabolic derangement has been overlooked, recently it has gained increased attention with the development of new pharmacological agents (metabolic modulators) able to influence myocardial substrate selection and utilization thus improving cardiac efficiency. Shifting cardiac metabolism from free fatty acids (FA) towards glucose is a promising approach for the treatment of patients with stable angina, independently of the underling disease (macrovascular and/or microvascular disease). In this sense cardiac metabolic modulators open the way to a "revolutionary" understanding of ischemic heart disease and its common clinical manifestations, where myocardial ischemia is no longer considered as the mere oxygen and metabolites demand/supply unbalance, but as an energetic disorder. Keeping in mind such an alternative approach to the disease, development of new pharmacological agents directed toward multiple metabolic targets is mandatory.

Do health beliefs explain traditional medical therapies utilisation? Evidence from Ghana

AbstractAlthough the direct impact of health beliefs on unconventional medical therapies consumption are well documented, the previous empirical findings of the relationship have been much inconsistent and theoretically subtle in Ghana. Using social cognitive thesis, this paper examines how relative effects of personal health beliefs influence the use of traditional medicine in the Ashanti Region of Ghana. Drawing on a qualitative approach involving rural and urban peculiarities and 36 in-depth interviews, this research study adopts a posteriori inductive reduction model to derive broad- and sub-themes. Results suggest that health-seeking behaviour in Ghana is a socially negotiated process in which cultural beliefs play a major role in moulding the use of unconventional therapies. Perceived displeasure and pure medicalisation of western medicine push individuals into traditional medicine use. Cultural norms and health beliefs in the form of personal philosophies, desire to be part of the healing process, ...

Pharmacist-based health coaching: A new model of pharmacist-patient care.

This paper describes a provider-patient communication process, which although not new to health care in general, is new to the pharmacy profession. Health coaching is a technique that empowers patients to make lasting health behavior changes that improve overall well-being. It provides patients with health care implementation options that better suit their lifestyle and abilities. Health coaching programs have the potential to foster better health outcomes, especially with patients who are chronically ill or represent an at risk population for medication non-adherence (e.g. elderly, patients on psychotropic medications). Other health professions (e.g. nursing and medicine) have had success with the implementation of health coaching models. For example, nurse coaching is recognized by the American Nurse Association and recent statistics show 3.1 million nurses in the U.S.A are also trained in nurse coaching. The pharmacy profession has yet to tap the patient-related benefits of health coaching. This commentary will discuss (i) The theoretical foundations of health coaching (ii) Distinctions between health coaching, motivational interviewing and traditional medication therapy counseling (iii) Training necessary for health coaching; and (iv) How pharmacists can use health coaching in practice.

Unconventional medical practices among Ghanaian students: A university-based survey

Research on unconventional medical practices among students has proliferated lately in the global space, hitherto, little is known explicitly in Ghana. This paper teases out insights for recent utilisation patterns of traditional medical therapies at Kwame Nkrumah University of Science and Technology (KNUST), Ghana. A sample of 754, randomly selected undergraduates were involved in a retrospective cross-sectional survey. Data were analysed using multivariate logistic regression and Pearson's χ2 test with p < 0.05 as significant. Overall prevalence of traditional therapies consumption was 89.1% in the last 12 months. Herbal-based products (67%), prayer healing (15%) and body-mind therapies (11%) were principally used and, accessed through purchases from pharmacy shops (29%) and encounter with faith healers (26%). Although students' knowledge on traditional therapies was acquired through family members (50%) and media (23%), literary materials remained significant information routes for Science related students compared to the Non-science related counterparts (p < 0.001). Pursuing Non-science-related programme [odds ratio (OR) 6.154 (95% confidence interval (CI) 3.745–10.111; p < 0.001)] and having Christian faith [OR 2.450 (95% CI 1.359–4.415; p = 0.003)] were strongly associated with students' traditional therapies use. Although students exhibited positive attitude towards unconventional therapies, there is an urgent need to validate the quality of traditional therapies through randomised clinical trials and regulatory practices to ensure quality control. Health forces should intensify efforts towards intercultural health care system in Ghana.

¿Estamos cerrando muchos forámenes ovales permeables en Colombia? Foramen ovale permeable, aneurisma del septum interauricular y riesgo de ataque cerebrovascular criptogénico recurrente. Revisión sistemática de la literatura

IntroductionPatent foramen ovale and atrial septal aneurysm are frequent findings in the average population. Over the last years multiple studies have suggested there is an association between both entities and cerebrovascular accidents of cryptogenic origin as a consequence of paradoxical embolism, specially among population under age 55, which has stimulated the development of devices for percutaneous closure of these defects with the goal of reducing recurring cerebral ischemic events, without a clear demonstration of their efficacy. MotivationTo perform a systematic review of literature to assess the risk of recurrence and benefits of this surgery. Results1,208 articles were collected for this evaluation, with a total of 11 papers included in the analysis following selection, assessment and application of selection criteria. 3 of them were clinical trial and 8 were systematic reviews or meta-analysis. ConclusionsIn adult patients with cryptogenic cerebrovascular ischemic or transient ischemic attacks with patent foramen ovale documented via transthoracic echocardiogram no decrease has been found in the risk of recurrence of cerebrovascular attacks, transient ischemic accidents or neurological events in comparison with traditional medical therapy.

The study of traditional Chinese medical elongated-needle therapy promoting neurological recovery mechanism after spinal cord injury in rats

Ethnopharmacological relevanceAcupuncture is a key part of traditional Chinese medicine, shown to induce favorable neuroplasticity for injuries in the central and peripheral nervous systems. Recent studies report elongated needle therapy (ENT) with BL54 and ST28 may restore acute spinal cord injury (ASCI). However, the precise mechanism for this has not been elucidated. Aim of the studyIn our current study, we investigated the effects of ENT on inflammation and neuronal apoptosis induced by ASCI, and whether PI3K/Akt and MAPK/ERK signaling pathways are involved in the ENT restoration effect. Materials and methodsRat models of moderate SCI were established in accordance with the modified Allen's method and were treated with ENT continuously for 7 days. Spontaneous activities were evaluated by the Basso Beattie and Bresnahan locomotor scale. Levels of inflammatory cytokines, such as tumor necrosis factor alpha, interleukin-6, IL-1β, and nuclear factor kappa-β, were determined by enzyme-linked immunosorbent assay. Cell apoptosis was examined by the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. The proportions of cells with positive Bcl-2 and Bax expression were determined by immunohistochemical assays, whilst the expression profiles of p-AKT and p-ERK in spinal cord tissues were evaluated by western blotting. Furthermore, the expression profiles of Cytochrome-C (Cyt-C) and caspase-3 in vivo were analyzed by reverse transcription polymerase chain reaction. The potential inhibitory effects downstream of the Akt and ERK signaling pathways were examined by administration of specific inhibitors LY294002 and PD98059 in vivo. ResultsAs indicated by this study, inflammation as well as PI3K/Akt- and MAPK/ERK signaling pathway-mediated neuronal apoptosis were involved in the course of SCI in rats. The neuro-protective effect of ENT was associated with reduced Bax protein-positive neurons and increased Bcl-2 protein-positive neurons. ENT enhanced recovery of rat activities. Activation of p-Akt and p-ERK in the PI3K/Akt and MAPK/ERK signaling pathways, inhibited expression of the critical component Cyt-C. Cyt-C is required for the mitochondrial apoptosis pathway and cascade of caspase-3, which is involved in activation of neuronal apoptosis through down-regulation of Bax protein and up-regulation of Bcl-2, as determined by TUNEL. The administration of PI3K/Akt and MAPK/ERK signaling pathway specific inhibitors, LY294002 and PD98059, suppressed expression of both p-Akt and p-ERK. ConclusionENT with BL54 and ST28 points can promote the recovery of ASCI. And the neuro-protective effect of ENT during the restoration of SCI may be associated with the suppression of both inflammation and activation of PI3K/Akt and MAPK/ERK signaling pathways, resulting from down-regulation of Bax protein, up-regulation of Bcl-2, and inhibition of the mitochondrial apoptosis pathway.

MP67-01 PRELIMINARY EVIDENCE SUGGESTS PERIURETERAL BOTULINUM TOXIN TYPE A INJECTION IMPROVES URETERAL STONE PASSAGE IN THE PORCINE MODEL

INTRODUCTION AND OBJECTIVES: We evaluated the use of periureteral injection of botulinum toxin type A (Botox , BTX-A) to facilitate passage of ureteral stones in a porcine model. We believe that reducing detrusor muscle tone around the intramural ureter may facilitate passage of ureteral stones through the ureterovesical junction. METHODS: With complete Institutional Animal Care and Use Committee approval, artificial stones (BegoStone plus) were placed by retrograde ureteroscopy into the proximal ureter using fluoroscopic guidance using an in vivo porcine model. Six animals underwent periureteral BTX-A injection 30 U / mL to 3 locations around the ureteral orifice and 6 animals were in the control group undergoing periureteral injection of normal saline. RESULTS: There was a significant decrease in time to stone passage in the BTX-A group compared to the control group, 2.6 1.3 vs. 6.8 2.9 days respectively (p1⁄4 0.018). None of the animals had evidence of vesicoureteral reflux post-procedure (N1⁄40/12). CONCLUSIONS: Preliminary results suggest periureteral injection of BTX-A facilitates ureteral stone passage in this model. BTX-A may provide a simple, office-based endoscopic treatment option for ureteral stones. Further studies would be necessary to evaluate its efficacy in humans as compared to traditional medical expulsive therapy.

Preliminary Evidence Suggests Periureteral Botulinum Toxin Type A Injection Improves Ureteral Stone Passage in the Porcine Model.

We evaluated the use of periureteral injection of botulinum toxin type A (Botox(®), BTX-A) to facilitate passage of ureteral stones in a porcine model. We believe that reducing detrusor muscle tone around the intramural ureter may facilitate passage of ureteral stones through the ureterovesical junction. With complete Institutional Animal Care and Use Committee approval, artificial stones (BegoStone plus) were placed by retrograde ureteroscopy into the proximal ureter using fluoroscopic guidance using an in-vivo porcine model. Six animals underwent periureteral BTX-A injection 30 U/mL to three locations around the ureteral orifice, and six animals were in the control group undergoing periureteral injection of physiologic saline. There was a significant decrease in time to stone passage in the BTX-A group compared with the control group, 2.6 ± 1.3 vs 6.8 ± 2.9 days, respectively (p = 0.018). None of the animals had evidence of vesicoureteral reflux postprocedure (N = 0/12). Preliminary results suggest that periureteral injection of BTX-A facilitates ureteral stone passage in this model. BTX-A may provide a simple, office-based endoscopic treatment option for ureteral stones. Further studies would be necessary to evaluate its efficacy in humans compared with traditional medical expulsive therapy.

Treatment of hidradenitis suppurativa with biologic medications

Given the absence of significant improvement in the treatment of hidradenitis suppurativa (HS) with traditional medical and surgical therapies, biologics have piqued the interest of research investigators. The efficacy of biologics in the treatment of inflammatory conditions like psoriasis and rheumatoid arthritis is well-documented. More recently, success with biologics has been demonstrated in atopic dermatitis, another dermatological condition associated with inflammatory states. Researchers have begun to probe the utility of biologic agents in less prevalent conditions that feature inflammation as a key characteristic, namely, hidradenitis suppurativa. Five agents in particular adalimumab, anakinra, etanercept, infliximab, and ustekinumab, have been explored in the setting of HS. Results to date put forward adalimumab and infliximab as biologic treatments that can safely be initiated with some expectant efficacy. Other biologic agents require more rigorous examination before they are worthy of addition to the treatment armamentarium.

Effects of Catgut -Embedding Therapy in Patients with Carpal Tunnel Syndrome: a Retrospective Pilot Study

Objectives: We evaluated the effect of the traditional Korean medical therapy of catgut-embedding therapy in patients with carpal tunnel syndrome (CTS). Methods: Thirteen patients(20 hands) with CTS underwent catgut-embedding therapy once per week for a total of 1-4 sessions. We measured the time to tingling in the fingers on performing Phalen’s test. We also had patients use a visual analog scale (VAS) to indicate the severity of tingling. We also asked about the awakening time at night due to pain and tingling. We controlled the treatment as being limited to four sessions. Even if a patient had not been treated for four sessions, we ended the patient’s treatment if symptoms resolved. Results: Patients who received catgut-embedding therapy showed significant improvements in the clinical symptoms of CTS. After treatment, in a total of 19 hands, the status of fourteen was changed from positive to negative in Phalen’s test and the average of tingling occurrence time in that test was delayed. Among the 20 hands, the VAS in eight hands changed to zero and the average of VAS score decreased. Furthermore, in nine patients, four could sleep well without the use of a splint. Conclusions: Patients undergoing this traditional Korean medical therapy showed alleviation of finger tingling after even a single treatment. We thus concluded that this traditional Korean catgut-embedding therapy, may be effective for treating CTS. However, to confirm the effects of catgut-embedding therapy on CTS, further tests are required, including under the defined, strict conditions of a randomized controlled trial.

Traditional Chinese medical comprehensive therapy for cancer-related fatigue.

Cancer-related fatigue (CRF) is a common and one of the most severe symptom in the period of onset, diagnosis, treatment and rehabilitation process of cancer. But there are no confirmed measures to relieve this problem at present. Traditional Chinese medical comprehensive therapy has its advantages in dealing with this condition. Based on the research status of CRF, the following problems have been analyzed and solved: the term of CRF has been defined and recommended, and the definition has been made clear; the disease mechanism is proposed, i.e. healthy qi has been impaired in the long-term disease duration, in the process of surgery, chemotherapy, radiotherapy and biology disturbing; it is clear that the clinical manifestations are related to six Chinese medicine patterns: decreased functioning of the Pi (Spleen) and Wei (Stomach), deficiency of the Pi with dampness retention, deficiency of the Xin (Heart) and Pi, disharmony between the Gan (Liver) and Pi, deficiency of the Pi and Shen (Kidney), and deficiency of the Fei (Lung) and Shen. Based on its severity, the mild patients are advised to have non-drug psychological intervention and sleep treatment in cooperation with appropriate exercise; diet therapy are recommended to moderate patients together with sleep treatment and acupuncture, severe patients are recommended to have herbal treatment based on pattern differentiation together with physiological sleep therapy.

Supratrochlear and Supraorbital Nerve Stimulation for Chronic Headache: a Review.

Chronic daily headache accounts for a significant socioeconomic burden due to decreased productivity, work absenteeism, multiple office and ER visits, and hospital admissions for pain control. Associated comorbidities add to this cost. Current traditional medical therapies may fail to provide adequate relief leading to the search for and use of other therapeutic modalities such as innovative medical devices. It is in this setting of the urgent demand for better pain control and to assimilate chronic headache sufferers back into society that a variety of neuromodulatory approaches have been emerging. This review aims to familiarize the reader with current literature regarding supraorbital and supratrochlear nerve stimulation for chronic headache, point out the advantages of this approach, address unanswered questions about this subject, and highlight future directions.

Present situation and prospects about application of microelectrode array in study on acupuncture efficacy

As a component of traditional Chinese medical therapies, the therapeutic effects of acupuncture for some nervous system diseases have been proven by a large number of clinical and experimental studies. But, the electrophysiological techniques of the commonly used EEG and evoked potentials are still not sufficient to reveal the functional mechanism of acupuncture therapy. The recording technique of microelectrode array (MEA), a kind of electrophysiological technique originated from the overseas biological electrical signal monitoring technique, can be used to record multiple electrical signals of the nervous cells in vivo or in vitro, and maintain the accuracy and stability of the recorded information at the same time, which greatly enriches the means of electrophysiological study. This technique has been already applied in the basic study and clinical treatment abroad, but it is very seldom used in the study of acupuncture field. In order to guide the application of MEA in the research field of acupuncture science, a general survey about the application of MEA technique in vivo was done, and the present situation and prospects of the application of the technique in acupuncture science was briefly analyzed.

Effectiveness of Synthetic Medicine versus FI Matrix Natural Therapy for Auto‐immune Diseases and Cancer

Autoimmune disorders with a dysfunctional immune system may be severely disabling. To determine the clinical efficacy and safety of F1 matrix natural therapy compared to traditional allopathic therapy using NSAIDs, COX‐2 inhibitors, and other agents for autoimmune disorders including rheumatoid arthritis and osteoarthritis[n=20], gout [n=10], and for certain adenocarcinomas [n=10] we randomly applied the GP Einstein F1 matrix therapy to patients with autoimmune conditions compared with conventional therapy. Previous studies with the GP Einstein matrix described below demonstrated that Integrated Immuno‐ Stimulation Mathematical Function and Matrixes of Sigma (3Σ) Quantum Energy Therapy Model is highly effective in infections, auto‐immune diseases and shrinking tumors.Einstein Mathematical Model of Effective Therapy is presented as follows: ∂ΣIQBET &gt; ∂ΣIQBPDE (1) ∂t1 ∂t2, Where the left side of the equation represents the effectiveness of the Einstein Integrated Immuno‐Stimulation Mathematical Functions and Matrixes of Natural Therapy over time, and the right side of the equation represents traditional synthetic pharmacologic Medical Therapy including potential toxicity and side effects. Results demonstrated marked reduction in pain index and improvement in quality of life in all arthritic, gouty, and fibromyalgia patients who received the Natural Matrix therapy and reduction in tumor mass in adenocarcinoma patients. These results suggest that application of the Einstein Natural F1 matrix therapy is a safe and effective treatment regimen for a broad range of autoimmune and other pathophysiologic states.

Rhinotopic Therapy for Refractory Rhinosinusitis: Clinical Effectiveness and Impact on the Epithelial Membrane and Mucosal Biofilms

Objective: To evaluate the clinical effectiveness of rhinotopic therapy, and its impact on the mucosal membrane and mucosal biofilms of patients with refractory chronic rhinosinusitis (CRS). Study design: Prospective pilot clinical study. Setting: Tertiary rhinology referral center. Subjects and methods: Twenty-three patients with refractory CRS were treated with the rhinotopic protocol, a multimodality therapy consisting of topical sinus application of antibiotics and corticosteroids through gel and nebulization, endoscopic sinus debridement and saline irrigation. Clinical outcome was assessed using Lund-Kennedy (LK) symptom and endoscopic appearance scores. Mucosal epithelial barrier changes were evaluated through H & E stain. The impact on biofilms was assessed through colony forming units (CFUs) counts. Results: Following treatment, there was a significant improvement in the patients’ LK symptom and endoscopic appearance scores, in the mucosal epithelial barrier and in the biofilms CFUs count. The clinical improvement was sustained at least 6 months following completion of therapy. Conclusion: Refractory CRS is a difficult to treat entity that does not respond to traditional medical therapy, including repeated oral antibiotics, commercial nasal steroids, nasal saline rinses and sinus debridement. This work shows that rhinotopic therapy is effective in improving clinical symptoms, healing mucosal damage and disrupting biofilm load in refractory CRS patients. Further work is needed to investigate if single aspects or a collective implementation of the different components of this therapy are responsible for improvement.

Prevalence and pattern of traditional medical therapy utilisation in Kumasi metropolis and Sekyere south district, Ghana

Ethnopharmacological relevanceWhilst over three-quarters of the world׳s population continues to use traditional medicine (TRM) with an increasing trend globally, limited data exist in the Ashanti Region regarding TRM utilisation. This study espoused a retrospective cross-sectional quantitative approach to examine the prevalence and pattern of TRM use among the general population in the Kumasi Metropolis and Sekyere South District, Ghana. Materials and methodsA sample of 324, drawn through systematic random sampling was used. The main instrument for data collection was formal face-to-face interviewer-administered questionnaire. Data were analysed using Chi-square and Fisher’s exact tests from the PASW (V.17.0) with p≤0.05 as significant. ResultsThe survey found that TRM use alongside conventional medicines was pervasive with prevalence of 86.1%. Biologically-based therapies (88.5%) and distant prayer interventions (58.4%) were commonly used modalities through the influence of families (50.3%), friends (19.4%) and the mass media (18.0%). Whilst self-administration and purchases from pharmacy shops remained important sources of TRM, TMPs׳ consultation was less credible (p<0.005). The disclosure rate of TRM use to health care professionals remained low (12.2%; p<0.001). ConclusionConcomitant TRM use with conventional therapies without disclosure may interfere with the potency of treatment regimen and result in drug interactions. Inclusion of alternative medicines on the National Health Insurance Scheme’s drug plan will fortify monitoring and professional administration of TRM. Information as regards TRM use needs to be incorporated into clinical and medical practice, hence the need to prioritise patient-physician communication.

Can therapy dogs improve pain and satisfaction after total joint arthroplasty? A randomized controlled trial.

The use of animals to augment traditional medical therapies was reported as early as the 9th century but to our knowledge has not been studied in an orthopaedic patient population. The purpose of this study was to evaluate the role of animal-assisted therapy using therapy dogs in the postoperative recovery of patients after THA and TKA. We asked: (1) Do therapy dogs have an effect on patients' perception of pain after total joint arthroplasty as measured by the VAS? (3) Do therapy dogs have an effect on patients' satisfaction with their hospital stay after total joint arthroplasty as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)? A randomized controlled trial of 72 patients undergoing primary unilateral THA or TKA was conducted. Patients were randomized to a 15-minute visitation with a therapy dog before physical therapy or standard postoperative physical therapy regimens. Both groups had similar demographic characteristics. Reduction in pain was assessed using the VAS after each physical therapy session, beginning on postoperative Day 1 and continuing for three consecutive sessions. To ascertain patient satisfaction, the proportion of patients selecting top-category ratings in each subsection of the HCAHPS was compared. Patients in the treatment group had lower VAS scores after each physical therapy session with a final VAS score difference of 2.4 units (animal-assisted therapy VAS, 1.7; SD, 0.97 [95% CI, 1.4-2.0] versus control VAS, 4.1; SD, 0.97 [95% CI, 3.8-4.4], p<0.001) after the third physical therapy session. Patients in the treatment group had a higher proportion of top-box HCAHPS scores in the following fields: nursing communication (33 of 36, 92% [95% CI, 78%-98%] versus 69%, 25 of 36 [95% CI, 52%-84%], p=0.035; risk ratio, 1.3 [95% CI of risk ratio, 1.0-1.7]; risk difference, 23% [95% CI of risk difference, 5%-40%]), pain management (34 of 36, 94% [95% CI, 81%-99%], versus 26 of 36, 72% [95% CI, 55%-86%], p=0.024; risk ratio, 1.3 [95% CI of risk ratio, 1.1-1.6]; risk difference, 18% [95% CI of risk difference, 5%-39%]). The overall hospital rating also was greater in the treatment group (0-10 scale) (9.6; SD, 0.7 [95% CI, 9.3-9.8] versus 8.6, SD, 0.9 [95% CI, 8.3-8.9], p<0.001). The use of therapy dogs has a positive effect on patients' pain level and satisfaction with hospital stay after total joint replacement. Surgeons are encouraged to inquire about the status of volunteer-based animal-assisted therapy programs in their hospital as this may provide a means to improve the immediate postoperative recovery for a select group of patients having total joint arthroplasty. Level II, randomized controlled study. See Instructions for Authors for a complete description of levels of evidence.

Inflammation and cardiovascular disease: from pathogenesis to therapeutic target.

Atherosclerosis represents the most common pathological substrate of coronary heart disease (CHD), and the characterization of the disease as a chronic low-grade inflammatory condition is now largely accepted. A number of mediators of inflammation have been widely studied, both as surrogate biomarkers and as causal agents, in the pathophysiological network of atherogenesis and plaque vulnerability. The epidemiological observation that biomarkers of inflammation are associated with clinical cardiovascular risk supports the theory that targeted anti-inflammatory treatment appears to be a promising strategy in reducing residual cardiovascular risk on the background of traditional medical therapy. A large number of randomized controlled trials have shown that drugs commonly used in cardiovascular disease (CVD), such as statins, may be effective in the primary and secondary prevention of cardiovascular events through an anti-inflammatory effect. Moreover, several anti-inflammatory drugs are being tested for their potential to reduce residual cardiovascular risk on the background of validated medical therapy for atherosclerotic disease. In this paper, we review relevant evidence with regard to the relationship between inflammation and CVD, from pathogenesis to therapeutic strategies.

Application of Traditional Medical Ideas to Geriatric Syndrome

Background. Japan is a superaging society, with the percentage of persons aged &gt;65 years increasing year after year. Traditional medicine (TM) for elderly has been practiced worldwide for thousands of years. Treatment methods for aspiration pneumonia, gait disorder, glaucoma, and bowel symptoms have been developed. The ideas of acupuncture, moxibustion, and herbal medicine have been implemented in modern medical settings, and medical devices using heat transfer engineering and nanotechnology have been developed. An ultrasound scanner can be used for the evaluation of effects and indications for these therapeutic measures. Objectives. To review published literature and our studies that evaluated medical treatments for the elderly on the basis of ideas of TM. Search Methods. We searched Pubmed, Scopus, and reference lists of relevant clinical trials. Authors’ Conclusions. Many studies were found. But there are insufficient data on the effects of traditional medical therapies and further research is needed. TM therapies vary widely and studies of these therapies that ascertain practical application are essential for the utilization of ideas of TM in modern medicine. Moreover, to verify practical application, a quantitative evaluation index is necessary. Nonetheless, modalities using ideas of TM may be promising treatments for some diseases in the elderly.

Sling Exercise for Chronic Low Back Pain: A Systematic Review and Meta-Analysis

BackgroundTrials on sling exercise (SE), commonly performed to manage chronic low back pain (LBP), yield conflicting results. This study aimed to review the effects of SE on chronic LBP.MethodsThe randomized controlled trials comparing SE with other treatments or no treatment, published up to August 2013, were identified by electronic searches. Primary outcomes were pain, function, and return to work. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated, using a random-effects model.ResultsRisk of bias was rated as high in 9 included trials, where some important quality components such as blinding were absent and sample sizes were generally small. We found no clinically relevant differences in pain or function between SE and other forms of exercise, traditional Chinese medical therapy, or in addition to acupuncture. Based on two trials, SE was more effective than thermomagnetic therapy at reducing pain (short-term: WMD –13.90, 95% CI –22.19 to –5.62; long-term: WMD –26.20, 95% CI –31.32 to –21.08) and improving function (short-term: WMD –10.54, 95% CI –14.32 to –6.75; long-term: WMD –25.75, 95% CI –30.79 to –20.71). In one trial we found statistically significant differences between SE and physical agents combined with drug therapy (meloxicam combined with eperisone hydrochloride) but of borderline clinical relevance for pain (short-term: WMD –15.00, 95% CI –19.64 to −10.36) and function (short-term: WMD −10.00; 95% CI −13.70 to −6.30). There was substantial heterogeneity among the two trials comparing SE and thermomagnetic therapy; both these trials and the trial comparing SE with physical agents combined with drug therapy had serious methodological limitations.InterpretationBased on limited evidence from 2 trials, SE was more effective for LBP than thermomagnetic therapy. Clinically relevant differences in effects between SE and other forms of exercise, physical agents combined with drug therapy, traditional Chinese medical therapy, or in addition to acupuncture could not be found. More high-quality randomized trials on the topic are warranted.