Use of complementary and alternative medicine in children with type 1 diabetes mellitus - prevalence, patterns of use, and costs.

BACKGROUND: Complementary and alternative medicine (CAM) is increasingly used in adults and children. Studies on CAM in diabetes have mainly focused on the adult population and its use among children with type 1 diabetes has not been well characterized. OBJECTIVES: This study determines prevalence, parental reasons and motivations, perceived effectiveness, costs, and communication of CAM use. Moreover, caregiver-related variables associated with the use of CAM were investigated. METHODS: A self-completed anonymous questionnaire was administered to parents of children with type 1 diabetes in four pediatric diabetes centers in Germany (Leipzig, Berlin, Stuttgart, and Bonn). RESULTS: Two hundred and twenty eight (65.9%) of 346 families completed the survey. Mean age of the diabetic patients was 11.9 +/- 3.8 yr. Forty two (18.4%) received one or more types of CAM, with the most common types being homeopathy (14.5%), vitamins and minerals (13.7%), modified diet (12.9%), aloe vera (7.3%), and cinnamon (5.6%). Users had a significantly higher family income and parental tertiary education (p < 0.05) and stated a significantly stronger interest in self-care (p < 0.01). Parents' motivations for using CAM were the hope for an improved well-being (92.1%), to try everything (77.8%), and assumption of fewer side effects (55.2%). Costs for the entire treatment varied between less than euro100 and up to euro5000, with mostly no reimbursement. CONCLUSIONS: Use of CAM in children with type 1 diabetes is less common than that documented for adults. Parents using CAM do not question the need for insulin. When using CAM, improved well-being and quality of life are important considerations where CAM can have a role.

Onset and pattern of substance use in intravenous drug users of an opiate maintenance program.

OBJECTIVES: To assess the initiation of substance use of participants in an opiate maintenance program by a cross-sectional survey. METHOD: Participants (n=184) filled out a questionnaire assessing age at initial substance use and age at onset of regular drug use. RESULTS: Of 15 substances investigated, alcohol, nicotine, analgesics and marijuana were initiated and consumed regularly before the age of 18 years. Barbiturates, benzodiazepines, cocaine, and opiates were begun later. The time gap between initial and regular use varied depending on the substance. Regular use exceeded 50% for alcohol, benzodiazepines, cocaine, heroin, marijuana and nicotine. CONCLUSIONS: Specific knowledge about the age of onset and sequence of substances used by drug addicts may help to prevent substance use more age specifically.

Age at diagnosis in bladder cancer: does opium addiction play a role?

BACKGROUND: Bladder cancer is a major health problem, especially among men. Opium addiction can be an important risk factor. One important question is whether it can affect the age of onset of bladder cancer .We performed this study to evaluate this question. MATERIALS AND METHODS: In a cross-section study, records of patients diagnosed with bladder carcinoma in Shahid Labbafinejad Medical Center, within 1999-2008 were included. Data were extracted from records regarding age at onset, gender, smoking status, and opioid addiction and analyzed with SPSS 13. RESULTS: Within 10 years, 920 cases were diagnosed with bladder cancer of which 97 percent were transitional cell carcinoma. In 698 cases, opium addiction status was recorded in 21.3% (n=149). Age at diagnosis was 59.7±11.51 (median: 60) among opioid addicts which was significantly lower than non- addicts (63.1±13.65, Median: 65) (P<0.001). CONCLUSIONS: Opium addiction can decrease the age of onset of bladder cancer.