Integrative Approach to Rhinosinusitis: An Update.

Rhinosinusitis is characterized by inflammation of the mucosa involving the paranasal sinuses and the nasal cavity and is one of the most common and significant health care problems, with significant impairment of quality of life. Current standard conventional management of rhinosinusitis commonly uses multiple therapeutic modalities to break the cycle of chronic disease. However, to date, there is no consensus as to the optimal treatment algorithm for patients with chronic rhinosinusitis. There is a growing interest in the use of complementary and integrative medicine for the treatment of rhinosinusitis. This article update focuses on an integrative approach to rhinosinusitis.

Acupuncture and the Otolaryngology-Head & Neck Surgery Patient.

The use of acupuncture among US adults was estimated at nearly 40% in 2012. A study from the United Kingdom in 2010 found 60% of otolaryngologic patients had used a form of complementary or integrative medicine, with greater than a third in the last year alone. Acupuncture, a therapeutic modality of traditional Chinese medicine, has been used for millennia in Asian countries. Within otolaryngology, acupuncture has been used for a variety of conditions encompassing otology, laryngology, rhinology, and pediatrics. Herein, we review the current literature on the applications of acupuncture for a range of ENT disorders.

Integrative care of the patient with head and neck cancer.

OBJECTIVE: To review the literature on integrative care of the patient with head and neck cancer. METHODS: A review of the English language literature for articles relating to integrative care of patients with head and neck cancer, focusing on treatment of sequelae of surgery and chemoradiation. RESULTS: Many studies show a significant utilization of nontraditional (complementary/integrative) treatments by patients in dealing with head and neck cancer. Treatment of head and neck cancer entails potentially debilitating consequences of surgery and/or chemoradiation on cosmesis, speech, swallowing, breathing, and quality of life. While complementary/integrative treatments for head and neck cancer are not established as effective therapies, their use for relieving sequelae of treatment, improving quality of life, and providing potential chemoprevention is well documented. CONCLUSION: Given the landscape of increasing use of nontraditional methodologies by patients with head and neck cancer and the complexity of care, the head and neck cancer surgeon should be aware of the uses and abuses of complementary/integrative medicine by patients as they navigate their care. LEVEL OF EVIDENCE: 5.

Integrative Medicine as a Bridge to Physician Wellness.

Burnout is increasingly recognized as an issue of major importance affecting physicians of all ages and disciplines and thereby patients, systems, and health care in general. At the 2017 American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting, the scope of burnout in medicine was addressed, along with systematic issues that remain. While changing the culture of medicine and health systems to address this is needed, what strategies can health care providers use in their everyday lives to lessen the impact of burnout? Integrative medicine with its focus on wholeness of patient care, including the emotional, mental, social, and spiritual domains of health, is uniquely positioned in arming physicians with sets of tools to help them navigate patients to better health and healing. These very same methods are invaluable for personal self-care, as we are all potential patients. Integrative medicine is a pathway to improving one's own self-care and, thereby, improving patient care.

Effect of prestorage UV-A, -B, and -C radiation on fruit quality and anthocyanin of 'Duke' blueberries during cold storage.

Ultraviolet (UV)-A, -B, and -C were radiated to full-ripe blueberries (cv. 'Duke'), and their effects on fruit qualities and phytonutrients during subsequent cold storage were investigated. The blueberries were exposed to each UV light at 6 kJ/m(2) and then stored at 0 °C for 28 days. Weight loss and decay of the fruits after UV treatment were significantly decreased during the cold storage. The total phenolics and antioxidant activities of blueberries after UV-B and -C treatments were always higher than those of the control and UV-A treatment. Individual anthocyanins were markedly increased during the 3 h after the UV-B and -C treatments. The correlation matrix between total phenolics, anthocyanins, and antioxidant activity measured by the 2,2'-azinobis(3-ethylbenzthiazoline-6-sulfonic acid) assay indicated a significantly close correlation with the individual anthocyanin contents. It was confirmed that the prestorage treatments of UV-B and -C increased the storability and phytochemical accumulation of the full-ripe 'Duke' blueberries during cold storage.

Betalain and betaine composition of greenhouse- or field-produced beetroot ( Beta vulgaris L.) and inhibition of HepG2 cell proliferation.

The composition of betalain, red or yellow pigments, and betaine (trimethylglycine or glycinebetaine) of nine beetroot ( Beta vulgaris L.) cultivars produced in the greenhouse or field was studied. Inhibition of HepG2 cell proliferation by betanin and betaine was also tested. Four predominant betalains, two betacyanins (betanin and isobetanin) and two betaxanthins (vulgaxanthin I and miraxanthin V), were isolated and quantified. Betanin and vulgaxanthin I were the major compounds in red and yellow beetroot extracts, respectively, and they comprised >90% of the betalain content in the tested cultivars. The total betalain content of beetroots produced from the field was between 650 and 800 µg/g fresh weight, approximately 25% higher than those from the greenhouse. The betaine content of the beetroot grown in the field was between 3.0 and 4.8 mg/g fresh weight, approximately 20% higher than in plants from the greenhouse. There was great variation among the cultivars with respect to their contents of betalains and betaine. In vitro cancer cell cytotoxicity was evaluated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay on HepG2 cells after exposure to betanin and betaine at concentrations ranging from 0 to 400 µg/mL and from 0 to 800 µg/mL for 48 h, respectively. Betanin resulted in a 49% inhibition of HepG2 cell proliferation at 200 µg/mL, and betaine yielded a 25% inhibition at 800 µg/mL, implying a higher cytotoxicity of betanin compared with betaine. The results indicated that the contents of health-beneficial compounds in beetroots, betalains and betaine, could be increased by modifying the growing conditions and that betanin and betaine extracted from beetroots had some anticancer effects against HepG2 cells.

Complementary and integrative treatments: atypical facial pain.

This article presents an overview of atypical facial pain for the practicing otolaryngologist. Discussion includes the definition of persistent idiopathic facial pain and its pathophysiology, clinical features, demographics, lack of findings on physical examination, use of imaging modalities and consultations, differential diagnosis, treatment, and prognosis within the framework of an holistic approach.

Complementary and integrative treatments: balance disorders.

This article presents an overview of balance disorders for the practicing otolaryngologist. The demographics of balance disorders, anatomy and physiology of human balance, clinical features, differential diagnosis, and treatment, within the framework of an holistic approach, are discussed.

Complementary and integrative treatments: rhinosinusitis.

Rhinosinusitis is characterized by inflammation of the mucosa involving the paranasal sinuses and the nasal cavity and is one of the most common health care problems, with significant impairment of quality of life. There is a growing amount of interest in the use of complementary and integrative medicine for the treatment of rhinosinusitis. This article focuses on an integrative approach to rhinosinusitis.