Integrative Medicine in Plastic Surgery: A Systematic Review of Our Literature.

BACKGROUND: Surveys have reported that as high as 80% of plastic surgery patients utilize integrative medicine approaches including natural products (NPs) and mind-body practices (MBPs). Little is known regarding the evidence of benefit of these integrative therapies specifically in a plastic surgery patient population. METHODS: We conducted a systematic review of studies in MEDLINE, PubMed, and EMBASE (inception through December 2016) evaluating integrative medicine among plastic surgery patients. Search terms included 76 separate NP and MBP interventions as listed in the 2013 American Board of Integrative Health Medicine Curriculum. Two independent reviewers extracted data from each study, including study type, population, intervention, outcomes, conclusions (beneficial, harmful, or neutral), year of publication, and journal type. Level of evidence was assessed according to the American Society of Plastic Surgeons Rating Levels of Evidence and Grading Recommendations. RESULTS: Of 29 studies analyzed, 13 studies (45%) evaluated NPs and 16 (55%) studied MBPs. Level II reproducible evidence supports use of arnica to decrease postoperative edema after rhinoplasty, onion extract to improve scar pigmentation, hypnosis to alleviate perioperative anxiety, and acupuncture to improve perioperative nausea. Level V evidence reports on the risk of bleeding in gingko and kelp use and the risk of infection in acupuncture use. After year 2000, 92% of NP studies versus 44% of MBP studies were published (P = 0.008). CONCLUSIONS: High-level evidence studies demonstrate promising results for the use of both NPs and MBPs in the care of plastic surgery patients. Further study in this field is warranted.

A perspective on complementary/alternative medicine use among survivors of hematopoietic stem cell transplant: Benefits and uncertainties.

The widespread use of complementary and alternative medicine (CAM) in cancer survivors is well known despite a paucity of scientific evidence to support its use. The number of survivors of hematopoietic stem cell transplant (HCT) is growing rapidly and HCT clinicians are aware that many of their patients use CAM therapies consistently. However, due to a paucity of data regarding the benefits and harms of CAM therapies in these survivors, clinicians are reluctant to provide specific recommendations for or against particular CAM therapies. A systematic literature review was conducted with a search using PubMed, the Cochrane Database of Systematic Reviews, and Ovid online for each CAM therapy as defined by the National Center of Complementary and Alternative Medicine. The search generated 462 references, of which 26 articles were deemed to be relevant for the review. Due to extensive heterogeneity in data and limited randomized trials, a meta-analysis could not be performed but a comprehensive systematic review was conducted with specified outcomes for each CAM therapy. In randomized controlled trials, certain mind and body interventions such as relaxation were observed to be effective in alleviating psychological symptoms in patients undergoing HCT, whereas the majority of the other CAM treatments were found to have mixed results. CAM use is an understudied area in HCT survivorship and clinicians should convey the benefits and uncertainties concerning the role of CAM therapies to their patients.

Lay etiology concepts of cancer patients do not correlate with their usage of complementary and/or alternative medicine.

BACKGROUND: The usage of complementary and alternative medicine (CAM) is widespread among cancer patients. While reasons for and aims of using CAM have been evaluated in many studies, less is known about whether patients' concepts of how and why cancer develops has an influence on the choice of the CAM method. METHODS: We pooled the data from all studies of our working group containing questions on lay etiological concepts and CAM usage and reanalyzed them with respect to the associations between these parameters. RESULTS: The pooled dataset from 12 studies included 4792 patients. A third (1645 patients) reported using CAM. Most often used were supplements (55.9%), relaxation techniques (43.6%), and homeopathy (37.9%). Regarding perceived causes, patients most often marked stress (35.4%) followed by genes (31.9%). While all lay etiological beliefs were highly significantly associated with usage of CAM in general, there was no association between single lay etiological concepts and types of CAM used. Yet, in a network analysis, we found two associations: one comprising trauma, mistletoe, genes, and nutritional supplements, the other yoga, vitamin C, nutritional supplements, and TCM herbs. In the correlation heatmap, one cluster comprises etiological concepts of personality, immune system and trauma, and two clusters of CAM methods emerged: one comprising praying, yoga, meditation, and relaxation procedures, the other nutritional supplements, selenium, vitamins A and C. CONCLUSION: While physicians are trained to derive treatment strategies from etiological concepts, lay people choosing CAM do not follow these rules, which may point to other needs of patients addressed by CAM.

Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review.

BACKGROUND: Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM). The use of CAM is also substantial among patients with diseases/illnesses of unknown aetiology. Chronic fatigue syndrome (CFS), also termed myalgic encephalomyelitis (ME), is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population. METHODS: Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs) of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded. RESULTS: A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium. CONCLUSIONS: The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted.

Moving towards a contemporary chiropractic professional identity.

Since the inception of the chiropractic profession, debate has continued on differing practice objectives and philosophical approaches to patient care. While the political and academic leaders of the profession continue to dominate the discourse, little is known on the perspectives of the everyday practising chiropractor on their professional identity. In this paper, professional identity within the profession of chiropractic was evaluated using a systematised search strategy of the literature from the year 2000 through to May 2019. Initially 562 articles were sourced, of which 24 met the criteria for review. The review confirmed three previously stated professional identity subgroups; two polarised approaches and a centrist or mixed view. The musculoskeletal biomedical approach is in contrast to the vertebral subluxation vitalistic practice approach. Whilst these three main chiropractic identity subtypes exist, within the literature the terminology used to describe them differs. Research aimed at categorising the chiropractic profession identity into exclusive subtypes found that at least 20% of chiropractors have an exclusive vertebral subluxation focus. However, deeper exploration of the literature shows that vertebral subluxation is an important practice consideration for up to 70% of chiropractors. Patient care with a musculoskeletal spine focus is dominant in clinical practice. This review found that practising chiropractors consider themselves to be primary care or primary contact practitioners with a broad scope of practice across a number of patient groups not limited to musculoskeletal management. Across the research, there is a marked difference in the categories of practice objectives evaluated, and future research could examine the relatedness of these. Additionally, future research could explore the professional identity construct over time and within different practice contexts to help facilitate the progression of the profession.

Alternative approaches to epilepsy treatment.

Complementary and alternative medicine (CAM) is a diverse group of health care practices and products that fall outside the realm of traditional Western medical theory and practice and that are used to complement or replace conventional medical therapies. The use of CAM has increased over the past two decades, and surveys have shown that up to 44% of patients with epilepsy are using some form of CAM treatment. This article reviews the CAM modalities of meditation, yoga, relaxation techniques, biofeedback, nutritional and herbal supplements, dietary measures, chiropractic care, acupuncture, Reiki, and homeopathy and what is known about their potential efficacy in patients with epilepsy.

An overview of CAM: components and clinical uses.

Complementary and alternative medicine (CAM), more recently known as integrative health or integrative medicine, is a diverse field comprising numerous treatments and practitioners of various levels of training. This review defines several of the main CAM modalities and reviews some of the research relevant to their clinical application. The goal is to provide healthcare providers with a basic understanding of CAM to start the incorporation of proven treatments into their clinical practice as well as guide them to working with CAM providers; ultimately, such knowledge is a fundamental part of a collaborative approach to optimal patient health and wellness.

Perspectiva holística en salud: la contribución de la Homeopatía / Holistic Perspective in Health: The Contribution of Homeopathy

En el panorama de la salud, el cuerpo humano, en su estado natural, se revela como una intrincada unidad que opera en armonía para mantener el equilibrio dinámico. Sin embargo, esta homeostasis puede verse afectada, dando lugar a la dualidad y a trastornos que comprometen la estabilidad vital. Este artículo propone una reflexión sobre la perspectiva homeopática, destacando su enfoque único en comparación con la medicina convencional. Diferenciándose al tratar al individuo como un todo integrado, la Homeopatía reconoce la transitoriedad de la dualidad representada por las enfermedades y enfatiza la importancia de la armonía entre el cuerpo y la mente en la búsqueda de la homeostasis. Inspirada en las ideas de Hahnemann, la Homeopatía se destaca por su visión holística, rechazando el dualismo estricto y proponiendo intervenciones que van más allá de la supresión de los síntomas. Anclada en la ley de los similares, busca sustancias que reproduzcan los síntomas del paciente en un estado saludable, buscando una cura profunda y la restauración de la unidad dinámica del organismo. A pesar de los desafíos, como la resistencia y la falta de métodos de investigación universalmente aceptados, la Homeopatía persiste a nivel mundial, sugiriendo un valor único. Este artículo promueve una reflexión sobre el enfoque homeopático, enfatizando su contribución a la comprensión de la salud y su papel en el panorama terapéutico.

n the landscape of health, the human body, in its natural state, reveals itself as an intricate unity, operating harmoniously to maintain dynamic balance. However, this homeostasis can be disrupted, leading to duality and disturbances that compromise vital stability. This article reflects on the homeopathic perspective, highlighting its unique approach compared to conventional medicine. Distinguishing itself by treating the individual as an integrated whole, homeopathy recognizes the transience of duality represented by diseases and emphasizes the importance of harmony between body and mind in the pursuit of homeostasis.Inspired by Hahnemann's ideas, homeopathy stands out for its holistic view, rejecting strict dualism and proposing interventions that go beyond symptom suppression. Anchored in the Law of Similars, it seeks substances that would reproduce the patient's symptoms in a healthy state, aiming for a profound cure and the restoration of the dynamic unity of the organism. Despite challenges, such as resistance and a lack of universally accepted research methods, homeopathy persists globally, suggesting unique value. This article encourages reflection on the homeopathic approach, emphasizing

Esoteric healing traditions: a conceptual overview.

This paper presents, for the first time, a comprehensive scholarly examination of the history and principles of major traditions of esoteric healing. After a brief conceptual overview of esoteric religion and healing, summaries are provided of eight major esoteric traditions, including descriptions of beliefs and practices related to health, healing, and medicine. These include what are termed the kabbalistic tradition, the mystery school tradition, the gnostic tradition, the brotherhoods tradition, the Eastern mystical tradition, the Western mystical tradition, the shamanic tradition, and the new age tradition. Next, commonalities across these traditions are summarized with respect to beliefs and practices related to anatomy and physiology; nosology and etiology; pathophysiology; and therapeutic modalities. Finally, the implications of this survey of esoteric healing are discussed for clinicians, biomedical researchers, and medical educators.

O cuidado em saúde promovido pelas religiões afro-brasileiras / Health care promoted by afro-brazilian religions / El cuidado en salud promovido por las religiones afrobrasileñas

No decorrer da história, sempre foram infindáveis os casos em que os sujeitos recorriam a centros espíritas ou terreiros de religiões de matrizes africanas em decorrência de problemas como doenças, desempregos ou amores mal resolvidos, com o objetivo de saná-los. Por conta disso, este artigo visa apresentar os resultados da pesquisa relacionados ao objetivo de mapear os processos de cuidado em saúde ofertados em três terreiros de umbanda de uma cidade do litoral piauiense. Para isso, utilizamos o referencial da Análise Institucional "no papel". Os participantes foram três líderes de terreiros e os respectivos praticantes/consulentes dos seus estabelecimentos religiosos. Identificamos perspectivas de cuidado que se contrapunham às racionalidades biomédicas, positivistas e cartesianas, e faziam referência ao uso de plantas medicinais, ao recebimento de rezas e passes e à consulta oracular. A partir desses resultados, podemos perceber ser cada vez mais necessário, portanto, que os povos de terreiros protagonizem a construção, implementação e avaliação das políticas públicas que lhe sejam específicas.(AU)

In history, there have always been endless cases of people turning to spiritual centers or terreiros of religions of African matrices due to problems such as illnesses, unemployment, or unresolved love affairs. Therefore, this article aims to present the research results related to the objective of mapping the health care processes offered in three Umbanda terreiros of a city on the Piauí Coast. For this, we use the Institutional Analysis reference "on Paper." The participants were three leaders of terreiros and the respective practitioners/consultants of their religious establishments. We identified perspectives of care that contrasted with biomedical, positivist, and Cartesian rationalities and referred to the use of medicinal plants, the prescript of prayers and passes, and oracular consultation. From these results, we can see that it is increasingly necessary, therefore, that the peoples of the terreiros lead the construction, implementation, and evaluation of public policies that are specific to them.(AU)

A lo largo de la historia, siempre hubo casos en los cuales las personas buscan en los centros espíritas o terreros de religiones africanas la cura para sus problemas, como enfermedades, desempleo o amoríos mal resueltos. Por este motivo, este artículo pretende presentar los resultados de la investigación con el objetivo de mapear los procesos de cuidado en salud ofrecidos en tres terreros de umbanda de una ciudad del litoral de Piauí (Brasil). Para ello, se utiliza el referencial del Análisis Institucional "en el Papel". Los participantes fueron tres líderes de terreros y los respectivos practicantes / consultivos de los establecimientos religiosos que los mismos conducían. Se identificaron perspectivas de cuidado que se contraponían a las racionalidades biomédicas, positivistas y cartesianas, y hacían referencia al uso de plantas medicinales, al recibimiento de rezos y pases y a la consulta oracular. Los resultados permiten concluir que es cada vez más necesario que los pueblos de terreros sean agentes protagónicos de la construcción, implementación y evaluación de las políticas públicas destinadas específicamente para ellos.(AU)

Um capítulo esquecido na história da psicologia? sexualidades desviantes, psicopatologia e normalidade / A forgotten chapter in the history of psychology? deviant sexualities, psychopathology, and normality / ¿Un capítulo olvidado en la historia de la psicología? sexualidades desviadas, psicopatología y normalidad

Este artigo tem como objetivo produzir uma análise histórica sobre as intersecções entre Psicologia e sexualidade desviantes da norma no Brasil, de fins do século XIX a meados da década de 1980. Esta temporalidade foi escolhida por abarcar o surgimento das pesquisas científicas sobre sexualidade e desvios sexuais, a consolidação dos estudos psicológicos sobre a temática e o processo mais recente de despatologização da homossexualidade. Em termos teóricos e metodológicos, foram adotados os pressupostos da História Social da Psicologia e da historiografia das homossexualidades no Brasil. Desse modo, buscou-se compreender como as ideias, concepções e práticas psicológicas foram mudando ao longo do tempo, em conexão com as transformações socioculturais e políticas que ocorreram durante o século XX. Para isto, foram utilizadas fontes primárias e secundárias de pesquisa com vistas à produção de interpretações sobre as conexões entre as ideias, os atores e os eventos narrados. Argumenta-se, ao longo do artigo, que as ideias e práticas psicológicas estão intrinsecamente conectadas aos contextos socioculturais e políticos de seu tempo, sendo os movimentos dinâmicos e os conflitos presentes nesses contextos fatores determinantes para a sua constituição.(AU)

This article aims to produce a historical analysis of the intersections between Psychology and sexualities that deviate from the norm in Brazil, from the late 19th century to the mid-1980s. This period was chosen because it encompasses the emergence of scientific research on sexuality and sexual deviations, the consolidation of psychological studies on the subject and the most recent process of de-pathologization of homosexuality. Theoretically and methodologically, the assumptions of the Social History of Psychology and the historiography of homosexualities in Brazil were adopted. Therefore, we sought to understand how psychological ideas, conceptions and practices have changed over time, in connection with the sociocultural and political transformations that occurred throughout the 20th century. For this, primary and secondary sources of research were used to produce interpretations about the connections between the ideas, the actors and the narrated events. It is argued, throughout the article, that the psychological ideas and practices are intrinsically connected to the sociocultural and political contexts of their time, being the dynamic movements and conflicts present in these contexts determining factors for their constitution.(AU)

Este artículo tiene como objetivo realizar un análisis histórico de las intersecciones entre la Psicología y las sexualidades desviadas de la norma en Brasil desde finales del siglo XIX hasta mediados de la década de 1980. Esta temporalidad fue elegida por abarcar el surgimiento de las investigaciones científicas sobre sexualidad y desvíos sexuales, la consolidación de los estudios psicológicos sobre el tema y el más reciente proceso de despatologización de la homosexualidad. En el marco teórico y metodológico, se adoptaron los presupuestos de la Historia Social de la Psicología y de la historiografía de las homosexualidades en Brasil. De esta manera, se pretende comprender cómo las ideas, concepciones y prácticas psicológicas han cambiado a lo largo del tiempo, en conexión con las transformaciones socioculturales y políticas ocurridas durante el siglo XX. Para ello, se utilizaron las fuentes de investigación primarias y secundarias con miras a generar interpretaciones sobre las conexiones entre las ideas, los actores y los eventos narrados. Se argumenta, a lo largo de este artículo, que las ideas y las prácticas psicológicas están intrínsecamente conectadas a los contextos socioculturales y políticos de su tiempo, y los movimientos dinámicos y los conflictos presentes en estos contextos fueron los factores determinantes para su constitución.(AU)

Restoring Balance for People with Cancer Through Integrative Oncology.

Integrative Oncology incorporates conventional and western cancer treatment approaches with the best of ancient and traditional medicine including nutrition, supplements, Qigong, herbal medicine, mind-body practices, and more. This article offers a guiding conceptual paradigm from an integrative perspective based on the principles of balance and imbalance. An integrative approach is used to help improve quality of life, enhance lifestyle choices and mitigate symptoms and side effects from conventional treatments. By supporting the patient's mind, body and spirit throughout the cancer treatment journey, the primary care physician is in a key position to work with their patient's oncologist to provide supportive care and recommendations during cancer treatment.

Status of credentialing alternative providers within a subset of U.S. academic health centers.

BACKGROUND: Complementary and alternative medicine (CAM) clinical services are increasingly provided within conventional health care settings. OBJECTIVE: To determine how a subset of U.S. academic health centers is credentialing CAM providers. DESIGN: An electronic survey was created focusing on the credentialing method utilized for six specific types of CAM clinical practitioners within academic medical settings. METHODS: This survey was electronically distributed to 33 academic health centers in the United States during the summer 2004. RESULTS: Ninety-five percent (95%) of academic centers surveyed provide some CAM clinical care. Acupuncture and massage are most common, with naturopathy and homeopathy least common. State licensure requirements for CAM providers appear to not be well-understood. Most commonly, CAM professionals do not receive full medical staff credentials. LIMITATIONS: Results cannot be extrapolated to remaining academic health centers within the United States. Mind-body practitioners were not included in the survey. CONCLUSIONS: Credentialing and privileges are most commonly granted via indirect methods. Variability in state licensure compounds the challenge of credentialing CAM practitioners. Suggestions for beginning discussions on guiding principles for integrating CAM practitioners within conventional settings are proposed.

Complementary and alternative pain therapy in the emergency department.

One primary reason patients go to emergency departments is for pain relief. Understanding the physiologic dynamics of pain, pharmacologic methods for treatment of pain, as well CAM therapies used in treatment of pain is important to all providers in emergency care. Asking patients about self-care and treatments used outside of the emergency department is an important part of the patient history. Complementary and alternative therapies are very popular for painful conditions despite the lack of strong research supporting some of their use. Even though evidenced-based studies that are double blinded and show a high degree of interrater observer reliability do not exist, patients will likely continue to seek out CAM therapies as a means of self-treatment and a way to maintain additional life control. Regardless of absolute validity of a therapy for some patients, it is the bottom line: "it seems to help my pain." Pain management distills down to a very simple endpoint, patient relief, and comfort. Sham or science, if the patient feels better, feels comforted, feels less stressed, and more functional in life and their practices pose no health risk, then supporting their CAM therapy creates a true wholistic partnership in their health care.CAM should be relatively inexpensive and extremely safe. Such is not always the case, as some patients have discovered with the use of botanicals. It becomes an imperative that all providers be aware of CAM therapies and informed about potential interactions and side effects when helping patients manage pain and explore adding CAM strategies for pain relief. The use of regulated breathing, meditation, guided imagery, or a massage for a pain sufferer are simple but potentially beneficial inexpensive aids to care that can be easily employed in the emergency department. Some CAM therapies covered here, while not easily practiced in the emergency department, exist as possibilities for exploration of patients after they leave, and may offer an improved sense of well-being and empowerment in the face of suffering and despair. The foundations of good nutrition, exercise, stress reduction, and reengagement in life can contribute much to restoring the quality of life to a pain patient. Adding nondrug therapies of physical therapy, cognitive-behavioral therapy, TENS, hypnosis, biofeedback, psychoanalysis, and others can complete the conventional picture. Adding in simple mind/body therapies, touch therapies, acupuncture, or others may be appropriate in select cases, and depending on the circumstances, may effect and enhance a conventional pain management program. Armed with an understanding of pain dynamics and treatments, practitioners can better meet patient needs, avoid serious side effects, and improve care when addressing pain management in the emergency department.

The experiences of persons living with HIV who participate in mind-body and energy therapies: a systematic review protocol of qualitative evidence.

REVIEW QUESTION/OBJECTIVE: The purpose of this systematic review is to explore the experiences and perceptions of persons living with HIV who participate in mind-body and energy therapies. The review will focus on the use of mind-body medicine and energy therapies that include meditation, prayer, mental healing, Tai Chi, yoga, art therapy, music therapy, dance therapy, Qigong, reiki, therapeutic touch, healing touch and electromagnetic therapy. These mind-body and energy therapies are selected categories because they do not involve options that might be contraindicated to an individual's current treatment regime. More specifically, the review questions are: BACKGROUND: Complementary and alternative medicine (CAM) is a popular adjunct to conventional medicine across global populations. Complementary generally refers to a non-mainstream approach together with conventional medicine whereas alternative refers to a non-mainstream approach in place of conventional medicine. Most people use non-mainstream approaches along with conventional treatments. The World Health Organization [WHO] defines CAM as distinct health-care practices that have not been assimilated into a country's mainstream health care system.The USA's National Center for Complementary and Integrative Health (NCCIH), formerly National Center for Complementary and Alternative Medicine (NCCAM), organizes CAM into five medical system categories: whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, and energy therapies. Whole medical systems include homeopathy, naturopathy, traditional Chinese medicine and Ayurveda. Mind-body medicine includes meditation, prayer, mental healing, Tai Chi, yoga, art therapy, music therapy and dance therapy. Biologically based practices include dietary supplements, herbal supplements and a few scientifically unproven therapies. Manipulative and body-based practices include massage and spinal manipulation such as chiropractic and osteopathic. Energy therapies include Qigong, reiki, therapeutic touch, healing touch and electromagnetic therapy.The NCCAM, the Alternative Medicine's Strategic Plan for 2011-2015 and the Healthy People 2020 envision a society in which all people have the opportunity to live long, healthy lives. In most countries, life expectancy has increased, but unfortunately, the incidence of chronic illnesses such as cardiovascular disease, cancer, hypertension, diabetes and depression continues to increase. Research findings indicate that the use of CAM is often greater among people living with a chronic or life threatening illness compared with the general population,Until the development of highly active antiretroviral medications (ARVs) in 1996, a diagnosis of human immunodeficiency virus (HIV) was considered to be a death sentence. The human immunodeficiency virus attacks the immune system and weakens a person's ability to combat infections and some types of cancer. Currently, there is no cure for HIV but because of lifesaving medications, the mortality rate has declined significantly. The disease is now considered a chronic illness and highly manageable. Effective treatment has resulted in approximately 35 million people worldwide still living with HIV at the end of 2012.Because HIV is no longer a death sentence but a chronic illness, there is a need to evaluate the experiences and perceptions of people using CAM, considering the prevalence of CAM use within this population. In the United States and Canada, the rate of CAM use among HIV positive persons is approximately 50% to 70%, whereas in Africa, rates of CAM use range from 36% to 68%. Popular forms of CAM among persons living with HIV include herbal or nutritional supplements, mind and body practices, and spiritual or religious healing. Worldwide, only a small percentage of persons who have access to ARVs refuse to take them and utilize CAM exclusively to treat their HIV infection.People living with HIV often report using CAM because they believe that these therapies will improve their overall health and well-being and provides them an opportunity to take some responsibility in managing their personal health, which includes medication side effects. However, the effect of CAM on an individual's physical health often cannot be measured physiologically, but may be felt or experienced.Understanding CAM use is essential so that health professionals will have the most accurate information about which integrative therapies may or may not be helpful for people living with HIV. As recommended by the Institute of Medicine report entitled, 'Integrative Medicine and Patient Centered Care', health professionals have a moral commitment to find innovative ways of obtaining evidence and expanding knowledge about diverse interpretations of health and healing. Research aimed at exploring patients' experiences and perceptions of mind-body and energy therapies is imperative so asto offer comprehensive care and promote shared decision making regarding complementary therapeutic options.

Psychosomatic illness in the analytical approach: an integrative literature review / Adoecimento psicossomático na abordagem analítica: uma revisão integrativa da literatura / Enfermedad psicosomática en el enfoque analítico: una revisión integradora de la literatura

It is known that studies about the dynamic mind-body aim at a better comprehension of the human being. According to the medical-scientific logic, some approaches dichotomize that interaction, relegating the term to cases of illnesses with no evident etiology. The psychosomatic approach proposes a holistic perspective on the individual, beyond the cure of physical symptoms. An integrative review on the comprehended psychosomatic was realized, in the paradigm of analytical psychology (AP). The search resulted in 44 articles that compounded theoretic-clinical discussion and/or empirical research about the object of study. Publications included philosophical and epistemological matters in psychosomatic, analysis of specific clinical cases, and possibilities of psychotherapeutic intervention. AP classic and developmental approaches are emphasized, and the main concepts found to comprehend the illness were psychic energy, teleology, synchronicity, and ego-self development. It was observed a higher concentration of articles with theoretical analysis illustrated with clinical vignettes and presentation of psychotherapeutic intervention proposals aiming to comprise the demands of the singular process in the dynamic between health and disease.

Estudos sobre a dinâmica mente-corpo visam à melhor compreensão sobre o ser humano. Há vertentes que dicotomizam tal interação, relegando o termo aos quadros de adoecimentos sem etiologia evidente conforme a lógica médico-científica. A abordagem psicossomática propõe perspectiva holística sobre o indivíduo, para além da cura do sintoma físico. Foi realizada uma revisão integrativa da psicossomática compreendida no paradigma da Psicologia Analítica (PA). A busca resultou em 44 artigos que compunham discussão teórico-clínica e/ou pesquisa empírica sobre o objeto de estudo. As publicações abrangiam questões filosóficas e epistemológicas em psicossomática, análise sobre casos clínicos específicos e possibilidades de intervenção psicoterapêutica. Ressaltam-se as vertentes clássica e desenvolvimentista da PA, e os principais conceitos encontrados para compreender o adoecimento foram energia psíquica, teleologia, sincronicidade e desenvolvimento do ego-Self. Observou-se maior concentração de artigos com análise teórica ilustrados com vinhetas clínicas e apresentação de propostas de intervenção psicoterapêutica visando compreender a demanda do processo singular na dinâmica entre saúde e doença.

Los estudios sobre la dinámica mente-cuerpo visan mejor comprensión sobre el ser humano. Hay vertientes que dicotomizan tal interacción, relegando el término a los casos de enfermedades sin etiología evidente conforme a la lógica médico-científica. El abordaje psicosomático propone perspectiva holística, además de la cura del síntoma físico. Se realizó una revisión integrativa de la psicosomática en el paradigma de la Psicología Analítica (PA). La búsqueda resultó en 44 artículos que componían discusión teórico-clínica y/o investigación empírica. Las publicaciones abarcaban cuestiones filosóficas y epistemológicas en psicosomática, análisis sobre casos clínicos específicos y posibilidades de intervención psicoterapéutica. Se resaltan las vertientes clásica y desarrollista de la PA, y los principales conceptos encontrados para comprender la enfermedad fueron energía psíquica, teleología, sincronicidad y ego-Self desarrollo. Se observó una mayor concentración de artículos con análisis teórico ilustrados con viñetas clínicas y presentación de propuestas de intervención psicoterapéutica destinadas a comprender las demandas del proceso singular en la dinámica entre salud y enfermedad.

[Alternative and complementary medicine in the basic health system network in Brazil: a qualitative approach]. / Medicina complementar e alternativa na rede básica de serviços de saúde: uma aproximação qualitativa.

This article focuses on the social representations of health professionals about the introduction of complementary and alternative medical practices in the public health service network in Campinas city (SP, Brazil). Based in an essentially qualitative methodological perspective, the article analyses the general conditions, the problems and the obstacles related to the implementation of such practices. The success of this inclusion was found in four main reasons: the clientele disposition which gives support and demands this kind of service; the health vision of the sanitarian doctors, which is open to such project; the wide support given by the non-medical health professions, which intend to add value and amplify their practice and, finally, the own perspective of the alternative and complementary medicines, which agree with the Unified Health System (SUS) proposals. Despite the success in the implementation of such practices in the health basic system, two negative aspects were detected: the insufficient planning and the simplified vision which converts such rationalities in mere techniques, which follow the same mechanistic principles of the allophatic medicine and the same reified understanding of disease.

Effectiveness of CAM therapy: understanding the evidence.

By definition, complementary and alternative medicine (CAM) attempts to diagnose and treat illnesses in unconventional ways. CAM has been classified as: (1) alternative medical systems (eg, traditional Chinese medicine [including acupuncture], naturopathic medicine, ayurvedic medicine, and homeopathy); (2) biologic-based therapies (eg, herbal, special dietary, and individual biologic treatments); (3) energy therapies (eg, Reiki, therapeutic touch, magnet therapy, Qi Gong, and intercessory prayer); (4) manipulative and body-based systems (eg, chiropractic, osteopathy, and massage); and (5) mind-body interventions (eg, meditation, biofeedback, hypnotherapy, and the relaxation response). This review focuses on how to assess the effectiveness of CAM therapies for chronic musculoskeletal pains, emphasizing the role of specific and nonspecific analgesic mechanisms, including placebo.