Use of integrative and complementary health practices by Brazilian population: results from the 2019 National Health Survey.

BACKGROUND: In 2006, Brazil implemented the National Policy on Integrative and Complementary Practices of the SUS. and in 2015, the Brazilian Ministry of Health issued a reinforcement to this policy to increase access to integrative and complementary health practices (ICHP). In this study, we described the prevalence of ICHP in Brazilian adults according to their sociodemographic characteristics, self-perceived health, and chronic diseases. METHODS: This is a nationally representative cross-sectional survey including 64,194 participants from the 2019 Brazilian National Health Survey. Types of ICHP were categorized according to their purposes: health promotion (Tai chi/Lian gong/Qi gong, yoga, meditation, and integrative community therapy) or therapeutic practices (acupuncture, auricular acupressure, herbal treatment and phytotherapy, and homeopathy). Participants were classified as non-practitioners and practitioners, who in turn were grouped according to use of ICHP in the last 12 months: only used health promotion practices (HPP); only used therapeutic practices (TP); used both (HPTP). Multinomial logistic regressions were performed to estimate the associations of ICHP with sociodemographic characteristics, self-perceived health status, and chronic diseases. RESULTS: Brazilian adults showed an ICHP use prevalence of 6.13% [95%CI = 5.75-6.54]. Compared to non-practitioners, women and middle-aged adults were more likely to use any ICHP. Afro-Brazilians were less likely to use both HPP and HPTP, whereas Indigenous people were more likely to use both HPP and TP. We found a positive gradient of association among participants with higher income and educational attainment and access to any ICHP. People from rural areas and those with negative self-perceived health were more likely to use TP. Participants with arthritis/rheumatism, chronic back problems, and depression were more likely to use any ICHP. CONCLUSIONS: We found that 6% of Brazilian adults reported using ICHP in the previous 12 months. Women, middle-aged individuals, chronic patients, people with depression, and wealthier Brazilians are more likely to use any type of ICHP. Of note, rather than suggesting to expand the offer of these practices in the Brazilian public health system, this study diagnosed Brazilians' behavior of seeking for complementary healthcare.

Homeopathic Treatment in Patients with COVID-19: Analysis of Clinical Evolution and Comparison between Cases in 2020 and 2021.

BACKGROUND: The manifestations of coronavirus disease 2019 (COVID-19) can result in several prognoses and lead patients to look for appropriate complementary or alternative treatment options according to their personal situation and available health care. Patients with mild symptoms or those who have not yet reached the maximum severity of their condition are those who seek outpatient care, where homeopathic treatment might be considered, given the well documented history of this medical system in several epidemics in the past. OBJECTIVE: The aim of this study was to compare the homeopathic treatment used for symptomatic cases of COVID-19 in March and April 2020 with cases treated in March and April 2021. METHOD: This is a retrospective observational study based on the analysis of the medical records of symptomatic COVID-19 patients treated on an outpatient basis with homeopathy at the Hahnemanniano George Galvão Institute in São Paulo, Brazil. We analyzed 54 cases, divided into two samples (27 cases in each year), similar in relation to age, gender and origin of the patients. RESULTS: The development was distinct in the 2 years, with improvement of symptoms after 3 days of the first homeopathic prescription in 2020 whilst in 2021 the improvement occurred from the sixth day onward. The most frequently prescribed homeopathic medicine also differed in the two samples (Antimonium tartaricum in 2020; Arsenicum album in 2021), which indicates the different disease characteristics at these two moments of the epidemic. CONCLUSION: In 2020, the symptomatology of the cases was mainly acute and the main medicine was Antimonium tartaricum. By comparison, in 2021 a greater interference from individuals' previous chronic miasmatic disease may explain the change in the main medicines used that year, with Arsenicum album being the most prescribed in the cases studied.

Comparative Evaluation of Homeopathic Therapy in the Treatment of Chronic Periodontitis.

CONTEXT AND OBJECTIVE: Periodontitis and type 2 diabetes (T2D) are chronic diseases generally treated with conventional therapies alone. The aim of this study was to compare the effects of homeopathy as an adjunct to conventional periodontal therapy in individuals with periodontitis and T2D. DESIGN: 85 individuals, age between 35 and 70 years, of both genders, participated in this randomized study; 70 patients were from the Institute of Endocrinology and Diabetes of Rio de Janeiro, Brazil. They were divided into 2 groups: G1, individuals with periodontitis without systemic conditions; and G-2, individuals with periodontitis and T2D. Both groups received homeopathic treatment and were evaluated in clinical and laboratory examinations. The medication used was chosen based on the similarity principle: Berberis 6CH, Mercurius Solubilis/Belladona /Hepar Sulfur and a Pyrogenium 200CH biotherapic. Medications were prescribed in diluted low ultra-diluted concentration doses for all signs and symptoms, while biotherapics were used for chronic stimulation. SETTING: The study was performed in Brazil by university research professors of homeopathy and periodontics. RESULTS: Both groups showed significant clinical and laboratory improvements during the study from baseline to 1 year with reductions in total cholesterol (total-C), triglycerides, glucose, glycated hemoglobin (A1cHb), uric acid and C-reactive protein (CRP). Statistical and descriptive analyses were performed. For most parameters, G1 performed better than G2 (P < .05). CONCLUSION: Homeopathy as an adjunct to periodontal treatment improves local and systemic clinics and can provide better health conditions for patients with or without T2D.

Impact of the National Policy on Integrative and Complementary Practices on Brazilian Public Homeopathy Services.

BACKGROUND: Homeopathy has been experiencing a period of expansion in Brazil due to its practical relevance in the face of new global and national health demands, culminating in the launch in 2006 of the National Policy for Integrative and Complementary Practices (NPICP) by the Ministry of Health of Brazil, which standardized and regularized the position of homeopathy within the Brazilian Unified Health System (SUS). AIMS: To understand the impact of the guidelines proposed by the NPICP on homeopathy services in the SUS, specifically in the south-east region of Brazil, according to the perceptions of their managers. METHODS: This is a descriptive, exploratory research study with a qualitative approach, conducted in homeopathy services in the south-east region of Brazil, through semi-structured interviews and with data processed using content analysis. RESULTS: The data show the importance of the NPICP in regulating and offering homeopathy in the services studied. However, the NPICP's objective of promoting and fully developing integrative and complementary practices has not been achieved because it has failed to translate strategies into actions. CONCLUSION: Though important to the development of homeopathy services in any given location, policies stated in the NPICP were revealed to have limited impact on the implementation and development of new services. Without further legislation, training programs and appropriate budget allocation, new services will be unable to thrive and their users unable to benefit from a more comprehensive approach to healthcare.

Homeopathy for COVID-19 Prevention: Report of an Intervention at a Brazilian Service Sector Company.

BACKGROUND: COVID-19 quickly became a serious public health problem worldwide, with serious economic and social repercussions. Homeopaths around the world have been studying to find a genus epidemicus (GE) medicine that might help in the prevention and treatment of this disease. OBJECTIVE: To compare the incidence of COVID-19 between employees who received or did not receive a homeopathic GE medicine for disease prevention. METHODS: Retrospective cohort analysis. The study population comprised all employees of a service sector company in São Paulo, Brazil, and followed up by the corporate Occupational Health department. Intervention consisted of administering Arsenicum album 30cH in a one-weekly dose. Primary outcome was incidence of COVID-19 during 3-months' follow-up (April to July, 2020). RESULTS: We analyzed 1,642 of 1,703 employees without previous diagnosis of COVID-19 at onset of the study period: 53.34% of employees were referred to telework at home and did not receive intervention (Group 1, G1); 24.66% remained working on-premises in the state of São Paulo and received the intervention (Group 2, G2); 21.98% remained working on company premises in other states and did not receive intervention (Group 3, G3). Incidence rate of COVID-19 was respectively 13.35%, 0.74%, and 67.87% (p < 0.001). The odds ratio of being infected in (1) G3 versus G1 was 13.70 (95% confidence interval [CI], 10.21 to 18.39), (2) G3 versus G2 was 283.02 (95% CI, 88.98 to 900.18), and (3) G1 versus G2 was 20.66 (95% CI, 6.53 to 65.39). LIMITATIONS: The present is a retrospective analysis of a real-world experience. We could not ensure direct observed treatment, and neither could we control adherence to general prevention measures outside company premises. CONCLUSION: The incidence of COVID-19 was significantly lower amongst on-premises employees who received the GE medication in comparison to workers who did not receive the intervention (those either at other company premises or teleworking at home).

Prevalence and Likelihood Ratio of Six Objective Signs among Good Responders to Natrum muriaticum: Multi-centre Observational Assessment.

BACKGROUND: The reliability of homeopathic prescriptions may increase through resource to objective signs and guiding symptoms with significant positive likelihood ratio (LR). We estimated LR for six objective signs attributed to the homeopathic medicine Natrum muriaticum (Nat-m). METHODS: In this multi-centre observational assessment, we investigated the prevalence of six signs in the general patient population and among good responders to Nat-m in daily homeopathic practice. Next, we calculated LR for these six signs. RESULTS: Data from 36 good responders to Nat-m and 836 general population patients were compared. We found statistically significant positive LR (95% confidence interval) for signs such as lip cracks (1.94; 1.15 to 3.24), recurrent herpes (2.29; 1.20 to 4.37), hairline eruptions (2.07; 1.03 to 4.18), and dry hands (2.13; 1.23 to 3.69). CONCLUSIONS: Objective signs with significant positive LR might increase the reliability of homeopathic prescriptions. Further studies are warranted to confirm the validity of this approach.

Silicea terra and Zincum metallicum Modulate the Activity of Macrophages Challenged with BCG In Vitro.

BACKGROUND: The homeopathic medicines Silicea terra (Sil) and Zincum metallicum (Zinc) modulate macrophage activity and were assessed in an experimental study in-vitro for their effects on macrophage-BCG (Bacillus Calmette-Guérin) interaction. METHODS: RAW 264.7 macrophages were infected with BCG, treated with different potencies of Sil and Zinc (6cH, 30cH and 200cH) or vehicle, and assessed 24 and 48 h later for bacilli internalization, hydrogen peroxide (H2O2) and cytokine production, and lysosomal activity. RESULTS: Treatment with vehicle was associated with non-specific inhibition of H2O2 production to the levels exhibited by uninfected macrophages. Sil 200cH induced significant reduction of H2O2 production (p < 0.001) compared with the vehicle and all other treatments, as well as higher lysosomal activity (p ≤ 0.001) and increased IL-10 production (p ≤ 0.05). Such effects were considered specific for this remedy and potency. The number of internalized bacilli was inversely proportional to Zinc potencies, with statistically significant interaction between dilution and treatment (p = 0.003). Such linear-like behavior was not observed for Sil dilutions: peak internalization occurred with the 30cH dilution, accompanied by cellular degeneration, and IL-6 and IL-10 increased (p ≤ 0.05) only in the cells treated with Sil 6cH. CONCLUSION: Sil and Zinc presented different patterns of potency-dependent effect on macrophage activity. Bacterial digestion and a balanced IL-6/IL-10 production were related to Sil 6cH, though reduced oxidative stress with increased lysosomal activity was related to Sil 200cH. Degenerative effects were exclusively related to Sil 30cH, and potency-dependent phagocytosis was related only to Zinc.

Impact of Homeopathic Treatment on the Quality of Life of Women with Chronic Diseases: A Randomized Controlled Pragmatic Trial.

BACKGROUND: Despite the increasing demand for complementary and integrative medicine, only a few studies have evaluated the effect of these types of treatments on the quality of life (QoL) of patients with chronic diseases. The objective of this study was to evaluate the QoL of women treated with homeopathy within the Public Health System of Belo Horizonte, Brazil. METHODS: This is a prospective randomized controlled pragmatic trial. The patients were divided into two independent groups, one group underwent homeopathic treatment in the first 6-month period and the other did not receive any homeopathic treatment. In both randomized groups, patients maintained their conventional medical treatment when necessary. The World Health Organization Quality of Life abbreviated questionnaire (WHOQOL-BREF) was used for QoL analysis prior to treatment and 6 months later. RESULTS: Randomization afforded similar baseline results in three domains of QoL analysis for both groups. After 6 months' treatment, there was a statistically significant difference between groups in the physical domain of WHOQOL-BREF: the average score improved to 63.6 ± (SD) 15.8 in the homeopathy group, compared with 53.1 ± (SD) 16.7 in the control group. CONCLUSIONS: Homeopathic treatment showed a positive impact at 6 months on the QoL of women with chronic diseases. Further studies should be performed to determine the long-term effects of homeopathic treatment on QoL and its determinant factors.

Antimonium Tartaricum as a Possible Homeopathic Prophylactic Remedy in the COVID-19 Epidemic.

The current COVID-19 (coronavirus disease 2019) epidemic has proved challenging due to its high impact on physical and mental health. According to Hahnemann, the founder of homeopathy, in an epidemic the most severe symptoms of the clinical condition presented by the population in question should be the basis for selecting the medication that is as similar as possible to them, and which should be administered to individuals who have been exposed to the disease but have not yet developed it. This medicine is called the genus epidemicus. This study aims to demonstrate the reasoning used to propose the homeopathic medicine Antimonium tartaricum (Ant-t) as a genus epidemicus in the COVID-19 epidemic. It was decided to develop the reasoning based on the respiratory symptoms described in the epidemiological bulletins presented by the Health Surveillance Secretariat of the Ministry of Health of Brazil, as these symptoms are the most serious of the disease. After repertorization, it was confirmed in the Materia Medica that Ant-t has a high degree of similarity with these respiratory symptoms, including the most serious situations, of COVID-19. Homeopathic Ant-t is thus a possible prophylactic genus epidemicus in the COVID-19 epidemic; further studies are needed to test this conclusion.

In Vitro Assessment of Cytoprotective Effects of CANOVA against Cell Death Induced by the Anti-malarial Artesunate - A Preliminary Experiment.

BACKGROUND: Artesunate (ATS) is a semi-synthetic compound derived from artemisinin, which is widely accepted in the treatment of malaria. However, there is evidence that ATS, under certain in vitro conditions, induces several impairments to normal cell functions. Canova (CA) is a Brazilian homeopathic formulation indicated for patients with depressed immune system. CA shows both in vitro and in vivo protective effects against mutagenic/carcinogenic compounds. Therefore, we aimed to assess in vitro the cytoprotective effects of CA against the cytotoxicity of ATS in Vero cells. METHODS: Viability of Vero cells exposed to ATS was assessed by MTT assay, whereas the anti-cytotoxic effect of CA was evaluated by apoptosis and necrosis quantification with fluorescent dyes. RESULTS: After 24 hours of ATS treatment, a reduction in cell viability was observed at 32 and 64 µg/mL, the latter being statistically significant (p < 0.05) in relation to the negative control. The concentration of 64 µg/mL was chosen for the subsequent experiments. ATS significantly induced both apoptosis and necrosis in Vero cells in relation to controls (p < 0.01). We also observed a statistically significant decrease in the number of apoptotic cells observed in the CA 16% + ATS co-treatment compared with ATS treatment (p < 0.01). Treatment with CA alone also had no influence on either type of cell death. CONCLUSION: Our results demonstrated that ATS is cytotoxic in the assessed conditions. However, such cytotoxicity was attenuated when the cells were treated simultaneously with ATS and CA.

Correlation of Covid-19 With Stomatognathic System With Homeopathic Proposal for Adjunct Treatment to Increase Oral and General Health.

CONTEXT: SARS-CoV-2 is a new virus responsible for the outbreak of COVID-19. Studies have shown that the expression of ACE2 was found in the smaller salivary glands was higher than that in the lungs, suggesting that salivary glands may be a potential target of the virus. This may indicate that one of the main gateways to coronavirus infection is the oral cavity. OBJECTIVE: This review intended to evaluate the comorbidities of the oral cavity and their relationships to COVID-19 and to show the benefits of homeopathic therapies as adjuvant treatments to increase oral and general health and mitigate the devastating effects of the coronavirus. DESIGN: The authors conducted a narrative review of articles published in indexed journals and websites of dental institutions and the WHO. They were selected oral pathological manifestations, sleep disorders, mood, orofacial pain and bruxism, associated with the oral-facial manifestations of Covid-19 and articles of evidence of homeopathy in dentistry. SETTING: Study done in Brazil with research professors in Homeopathy and Periodontics in universities. RESULTS: Some studies report that patients who are more susceptible to anxiety and stress during the pandemic, due to social confinement, may have disorders in the stomatognathic system such as: neuralgic pain in the face and teeth, fractures of teeth and dental prostheses, nibbled mucosa, stomatitis, ulcers, pain in the Temporal Mandibular Joint, otalgias, dental tightening, bruxism, xerostomia, peeling of the mucous membranes and skin, facial paralysis. CONCLUSIONS: The researchers concluded that homeopathy is a safe and viable therapy for the control of COVID-19 symptoms, as scientific evidence has proven its benefits through clinical trials and use in previous epidemics. In dentistry, this therapy allows the dentist to act fully in the promotion of oral health and in the prevention of oral and systemic diseases.

Current Status of Expiry of Homeopathic Medicines in Brazil, Germany, India and the United States: A Critical Review.

BACKGROUND: Assignment of expiry date to homeopathic medicines is a subject of important concern to its pharmacists and practitioners. This study compares the regulatory framework for the expiry of homeopathic medicines in four countries: Brazil, Germany, India and the United States. FINDINGS: Different or no expiry periods are variously followed. Whereas Germany, with some exceptions, employs a maximum expiry of 5 years for both potencies and finished products, Brazil adopts a 5-year expiry for finished products only, potencies used in manufacture being exempted from an assigned expiry date. In India, all homeopathic medicines except dilutions and back potencies have a maximum of 5 years' shelf-life, including those supplied to consumers. In the United States, homeopathic medicines are exempted from expiry dates. COMMENTS: There is neither a rational basis nor scientific evidence for assigning a short (3-5 years) expiry period for homeopathic medicines as followed in some of the countries, particularly in light of the fact that some studies have shown homeopathic medications to be effective even after 25 years. Homeopathic ultra-dilutions seem to contain non-material activity that is maintained over time and, since these exhibit different chemical properties compared to the original starting material, it is quite possible they possess properties of longer activity than conventional medicines. Regulators should acknowledge this feature and differentiate expiry of homeopathic medicinal products from that of conventional drugs.

Effect of Homeopathic Medicines and a Nosode on Larvae of Cochliomyia hominivorax (Diptera: Calliphoridae).

BACKGROUND: Cochliomyia hominivorax is the major fly causing primary myiasis in livestock animals in Brazil; its larvae develop in the host's living tissues, causing mutilations, which can even lead to death. In conventional treatments of myiasis, chemo-synthetic insecticides have been employed directly on larvae present in the wounds. Homeopathy may represent a healthy and sustainable alternative both to prevent and to treat myiasis in animals and humans. The current study evaluated how the emergence of adult insects is affected by the use of the homeopathic medicines Sulfur 12cH and Pyrogenium 12cH, and the nosode produced from C. hominivorax larvae at potencies 8cH and 12cH, on third-stage larvae of a C. hominivorax colony. MATERIALS AND METHODS: The homeopathic medicines and the nosodes were produced according to the Brazilian Homeopathic Pharmacopoeia. Control groups were distilled water, alcohol, no substance, and the organophosphate insecticide trichlorfon. For each group, 10 replicates were performed. Emergence rate of adult insects was evaluated by descriptive statistics followed by analysis of variance. Homogeneity of variances was verified by F-test and group means were compared with Tukey's test. RESULTS: Mortality rates in control groups were 2.7% for 30% (v/v) alcohol, 4.3% for distilled water, 3.2% for no substance (p > 0.05). In the trichlorfon group, the mortality rate of larvae was 90.8%. For Sulfur 12cH, the mortality of larvae was 94.6%, and for Pyrogenium 12cH it was 98.6%. The latter three means were not statistically different from each other or from the mean found for the trichlorfon group. The mortality rates of larvae were 61.3% and 66.6% for nosode C. hominivorax 8cH and 12cH, respectively (p > 0.05). CONCLUSIONS: Results suggest that homeopathy could be used therapeutically to prevent and treat animals and humans with myiasis caused by C. hominivorax.

Homeopathic treatment as an alternative prophylactic to minimize bacterial infection and prevent neonatal diarrhea in calves.

Bovine neonatal diarrhea is common due low immunity in newborn calves, poor management (or absence) of sanitary barriers, and other factors. Newborn calves with diarrhea in the first days of life suffer failure to thrive and may die if left untreated. The aim of this study was to evaluate whether prophylactic administration of a homeopathic product (Dia 100®) can control bovine neonatal diarrhea in calves born on a farm with substantial sanitary challenges. We counted total bacteria and protozoan parasites in fecal samples. We measured serum glucose, total protein, globulin, albumin, cholesterol and triglycerides on days 1, 7 and 14 of life. Twenty newborn calves were maintained in individual stalls, and were divided in two groups: ten untreated animals (control) and ten animals treated with Dia 100®. Fecal consistency was evaluated daily. We diagnosed diarrhea in five animals in the treated group, and in all animals from the control group. Infections with Escherichia coli and Giardia duodenalis were identified as the responsible organisms. The E. coli count was low in the treatment group on day 7 of life compared with the control group. Antibiotics were given to eight animals in the control group, and to two animals in the treatment group. On day of life 7, serum levels of total protein and globulins were higher in the control group, but were lower on day 14. Serum levels of glucose and triglycerides were greater in treated animals on days 7 and 14, suggesting that the homeopathic product contributes to improvement of intestinal health and absorption and nutrients. We conclude that Dia 100® controls diarrhea with 50% of efficacy, and reduces antibiotic utilization.

Homeopathic Treatment of Overweight and Obesity in Pregnant Women With Mental Disorders: A Double-blind, Controlled Clinical Trial.

Context • Worldwide, 35 million people suffer from obesity. Mental disorders have been associated with being overweight or obese. Considerable evidence has shown a correlation between stress and the use of homeopathy and stress and obesity. However, few studies have examined the relationship between weight loss and homeopathic treatment of obesity. Objective • The study intended to evaluate the efficacy of a homeopathic treatment in preventing excessive weight gain during pregnancy in overweight or obese women who were suspected of having a common mental disorder. Design • The study was a randomized, controlled, double-blinded clinical trial. Setting • The study took place at the Center for the Social Support of Motherhood (São Paulo, Brazil). Participants • Participants were pregnant women who were enrolled at the center. Intervention • For the homeopathic group, 9 drugs were preselected, including (1) Pulsatilla nigricans, (2) Sepia succus, (3) Lycopodium clavatum, (4) sulphur, (5) Lachesis trigonocephalus, (6) Nux vomica, (7) Calcarea carbonica, (8) phosphorus; and (9) Conium maculatum. From those 9 drugs, 1 was prioritized for administration for each participant. After the first appointment, a reselection or selection of a new, more appropriate drug occurred, using the list of preselected drugs. The dosage was 6 drops orally 2 ×/d, in the morning and at night, on 4 consecutive days each wk, with an interval of 3 d between doses, up until the next appointment medical appointment. The control group received the equivalent placebo drug. Both groups also received a diet orientation. Outcome Measures • We evaluated pregnant women who were overweight or had class 1 or 2 obesity and were suspected of having a common mental disorder, with no concomitant diseases, in 2 groups: those receiving a placebo (control group, n = 72); and those receiving homeopathic treatment (homeopathy group, n = 62). Weight change during pregnancy was defined as the difference between the body mass index (BMI) at the initial evaluation and that recorded at the final evaluation, adjusted for 40 wk of gestation. In addition, the APGAR index in the newborn was evaluated as a possible complication. Results • The mean variation between baseline BMI and BMI at week 40 of gestation was +4.95 kg/m2 in the control group and +5.05 kg/m2 in the homeopathy group. The difference between the 2 groups was not significant (P = .815; 95% confidence interval [CI], -0.916 to 0.722). APGAR 10 at 5 min (59.6%in homeopathy group and 36.4% among control) was statistically significant (P = .016). Conclusions • Homeopathy does not appear to prevent excessive body mass gain in pregnant women who are overweight or obese and suspected of having a common mental disorder. Homeopathy did not change the APGAR score to modified clinical attention at delivery room. However, the evidence observed at APGAR 10 at minute 5 suggests that homeopathy had a modulating effect on the vitality of newborns, warranting further studies designed to investigate it.

What do homeopathic doctors think of vaccines? An international online survey.

BACKGROUND AND OBJECTIVES: Parental refusal to vaccinate is a cause of serious concern. Use of homeopathy is believed to be a relevant reason for parents to refuse to vaccinate. However, vaccination is one of the main gaps dividing between medically qualified or not homeopathic practitioners. The present study sought to investigate the attitude of homeopathic doctors towards vaccination and associated variables. METHODS: An international online survey was conducted with homeopathic doctors by means of an anonymous self-reported questionnaire in Portuguese or Spanish. Questions investigated sociodemographic and professional characteristics, overall opinion on vaccination and on some specific vaccines. RESULTS: A total of 512 responses were obtained, 77.5% of respondents were from Latin American countries, 16.8% from Spain, with small numbers from several other countries. About 75.6% of the respondents considered vaccination safe, effective and necessary, while 12.5% stated they would not recommend vaccination under any circumstance. The variables significantly correlated with positive attitude towards vaccination were: working in the public health system (p=0.04) and homeopathy not the main medical activity (p=0.005). Homeopaths from Brazil, where homeopathy is officially accredited, were more favorable to vaccination compared to respondents from countries where homeopathy has inferior status (p<0.001). CONCLUSION: The results show that there is no contradiction between homeopathy and primary prevention by means of vaccination.

Homeopathic medicines for prevention of influenza and acute respiratory tract infections in children: blind, randomized, placebo-controlled clinical trial.

BACKGROUND: Influenza and its complications are common at all ages, especially in children. Vaccines and anti-influenza drugs aim to prevent it. Preventative approaches with favorable risk profiles should be considered for flu, particularly since the evidence of the efficacy of anti-viral drugs is debated. METHODS: This pragmatic clinical trial was conducted in the Brazilian Public Health System in Petrópolis (BPHSP) with children aged from 1 to 5 years old. The medications used were mainly selected based on in vitro experiments (InfluBio), and in successful qualitative clinical experiences (Homeopathic Complex). Following informed parental consent, subjects were randomly distributed, in a blind manner, to three experimental groups: Homeopathic Complex, Placebo, and InfluBio. BPHSP health agents collected flu and acute respiratory infection symptomatic episodes monthly following the established protocol. The number of these episodes was registered in one year (2009-2010). RESULTS: Out of the 600 children recruited, 445 (74.17%) completed the study (149: Homeopathic complex; 151: Placebo; 145: InfluBio). The number of flu and acute respiratory infection symptomatic episodes detected in this clinical trial was low; however, it was different between homeopathic groups and placebo (p < 0.001). In the first year post-intervention, 46/151 (30.5%) of children in the placebo group developed 3 or more flu and acute respiratory infection episodes, while there was no episode in the group of 149 children who used Homeopathic Complex, and only 1 episode in the group of 145 (1%) children who received InfluBio. CONCLUSION: These results suggested that the use of homeopathic medicines minimized the number of flu and acute respiratory infection symptomatic episodes in children, signalizing that the homeopathic prophylactic potential should be investigated in further studies.

Strategies used by dairy family farmers in the south of Brazil to comply with organic regulations.

The aims of this study were to investigate the environmental, feeding, and health management of organic (ORG) family dairy farms in the south of Brazil in comparison with conventional (CONV) farms, and to assess their degree of compliance with Brazilian organic legislation and the strategies they adopt to accomplish this (n=17 per group). During 2 visits to each farm in March and September, 2010, observations were made on the environment, feed, and health management, followed by bulk milk testing, clinical evaluation, and breed assessment of each individual cow, and an evaluation of diseases and treatments reported within the period. Additional data were collected directly from the farmers through direct interviews. The number of lactating cows was, on average, 11 (range 5 to 19) in the ORG and 16 (range 7 to 42) in the CONV herds. The ORG herds presented a lower percentage of the Holstein breed; whereas CONV herds were predominantly Holstein, in the ORG herds, only 2 herds were 100% Holstein and the remaining herds were crosses of Holstein, Jersey, and Gir (Bos indicus) cattle. Milk production per cow was lower (10.2 vs. 15.1 ± 1.22 L/cow, respectively) in ORG than in the CONV farms. The ORG farms offered less concentrate feed than CONV farms and had better pasture management. Organic farmers reported using phytotherapic and homeopathic products, and pasture management as a strategy to keep infection levels of endo- and ectoparasites low, whereas CONV farmers regularly used anthelmintics and acaricides. Milk production was lower in ORG than in CONV farms, but cow health and condition scores were broadly similar, indicating that the with these strategies ORG farms were able to secure levels of animal welfare comparable with CONV farms while complying with organic regulation, although at the cost of lower cow productivity.

Homeopathy and health related Quality of Life: a patient satisfaction survey in six European countries and Brazil.

BACKGROUND: Many patients throughout the world consult homeopathic medical doctors. Using a similar methodology as in a first survey published in 2002 a second survey was done including 919 adults receiving homeopathic treatment in six European countries and Brazil aimed to look at who are they, their reasons for consultations and expectations and satisfaction with homeopathy prescribed by a homeopathic doctor after a follow-up time of six months. METHOD: An initial questionnaire included demographic information and questions for assessing health-related Quality of Life (QoL). A follow-up questionnaire collected data on changes in QoL. RESULTS: 77% patients had initially used conventional treatments and 23% other non-conventional treatments. Satisfaction of patients with the medical homeopathic consultation is high. The difference between the final QoL scores after six months and the baseline are positive. Reported differences between baseline and final index range from 3.87 to 10.41 depending on diagnosis. Taking 7% as a reference value for 'minimal clinically significant difference', this is reached for 3 of 8 conditions. Changes in complaint limitations visual scales are positive. Conclusions on clinical impact must be cautious. 6% of the patients experienced side-effects which they attributed to homeopathic treatment. 7.8% of the patients reported significant aggravation at the beginning of the homeopathic treatment and 26.2% slight aggravation of symptoms. CONCLUSIONS: The satisfaction of patients using a medical homeopathic approach is linked to the perceived competence of the doctor homeopath, the perceived improvement of the main complaints limitations and the time dedicated to them by the doctor.

Modulation of inflammation response to murine cutaneous Leishmaniasis by homeopathic medicines: Antimonium crudum 30cH.

BACKGROUND: Leishmaniasis is a zoonotic disease caused by protozoan parasites of the mononuclear phagocytic system. The modulation activity of these cells can interfere in the host/parasite relationship and influences the prognosis. METHODS: We evaluated the effects of the homeopathic preparation Antimonium crudum 30cH on experimental infection induced by Leishmania (L.) amazonensis. Male Balb/c mice were inoculated with 2 × 10(6)Leishmania (L.) amazonensis promastigotes into the footpad and, after 48 h (acute phase) or 60 days (chronic phase), cell population of lymphocytes and phagocytes present in the peritoneal washing fluid and spleen were analyzed by flow cytometry and histopathology, with histometry of the subcutaneous primary lesion, local lymph node and spleen. Immunohistochemistry was performed to quantify CD3 (T lymphocyte), CD45RA (B lymphocyte) and CD11b (phagocytes) positive cells. RESULTS: In treated mice, during the acute phase, there was significant increase of the macroscopic lesion, associated to inflammatory edema, as well increase in the number of free amastigotes and B lymphocytes inside the lesion. Increase of B lymphocytes (predominantly B-2 cells) was also seen in the local lymph node, spleen and peritoneum. In the chronic phase, the inflammatory process in the infection focus was reduced, with reduced phagocyte migration and peritoneal increase of B-1a cells (precursors of B-2 immunoglobulin producers cells) and T CD8+ cells. CONCLUSION: The treatment of mice with Antimonium crudum 30cH induced a predominantly B cell pattern of immune response in Leishmania (L.) amazonensis experimental infection, alongside the increase of free amastigote forms number in the infection site. The clinical significance of this study is discussed, further studies are suggested.