Essential oil inhaler (AromaStick®) improves heat tolerance in the Hot Immersion Test (HIT). Results from two randomized, controlled experiments.

BACKGROUND: A recent review article on an aromatherapeutic inhaler demonstrated clinical effects on a number of bodily systems, like the cardiovascular system, the respiratory system, the nervous system and the endocrine system. OBJECTIVE: This paper extends these findings and investigates whether specially designed essential oils inhalers are capable to counter experimentally induced stressful heat sensations. METHOD: Two prospective, randomized, controlled experiments using the Hot Immersion Test Paradigm (HIT) were conducted to investigate whether deep odor inhalations increase heat tolerance. RESULTS: In both experiments, the inhaler strongly prolonged pain tolerance and increased blood oxygenation (1 < d < 1.3). In the second experiment, the inhaler also increased heart rate variability (d = 1.3) as a mechanism to cope with heat stress. CONCLUSION: The ability to resist a stressful thermal stimulus can be exogenously improved by short and deep inhalations of essential scents directly delivered to the olfactory system.

Low-frequency vibrotherapy considerably improves the effectiveness of manual lymphatic drainage (MLD) in patients with lipedema: A two-armed, randomized, controlled pragmatic trial.

Purpose: Although the exact prevalence of lipedema is unknown the number of women suffering from this condition is ever-growing. When treated conservatively, manual lymphatic drainage is regarded the gold standard. However, the rate of its effectiveness varies considerably with some women showing minimal to no improvement depending on severity of the disease and medical history. Methods: Thirty female patients diagnosed with lipedema stage 2-3 referred to physiotherapeutic treatment were randomly allocated to either six treatments of MLD or to six treatments of combined MLD and vibrotherapy treatment. Outcome parameters were the volume of lipedema at four locations of either the lower (n = 29) or the upper extremities (n = 1), as well as quality of life. Findings: A very large superiority of effectiveness was found for the combined treatment. Reduction of the sizes of lipedema varied between 1.1 < d < 3.2. These patients' quality of life was also considerably better (d = 1.0). Conclusions: Combining MLD with vibrotherapy treatment drastically enhances the effectiveness of treating lipedema.

Evaluation of a real-time magnetic resonance imaging-guided electrophysiology system for structural and electrophysiological ventricular tachycardia substrate assessment.

AIMS: Potential advantages of real-time magnetic resonance imaging (MRI)-guided electrophysiology (MR-EP) include contemporaneous three-dimensional substrate assessment at the time of intervention, improved procedural guidance, and ablation lesion assessment. We evaluated a novel real-time MR-EP system to perform endocardial voltage mapping and assessment of delayed conduction in a porcine ischaemia-reperfusion model. METHODS AND RESULTS: Sites of low voltage and slow conduction identified using the system were registered and compared to regions of late gadolinium enhancement (LGE) on MRI. The Sorensen-Dice similarity coefficient (DSC) between LGE scar maps and voltage maps was computed on a nodal basis. A total of 445 electrograms were recorded in sinus rhythm (range: 30-186) using the MR-EP system including 138 electrograms from LGE regions. Pacing captured at 103 sites; 47 (45.6%) sites had a stimulus-to-QRS (S-QRS) delay of ≥40 ms. Using conventional (0.5-1.5 mV) bipolar voltage thresholds, the sensitivity and specificity of voltage mapping using the MR-EP system to identify MR-derived LGE was 57% and 96%, respectively. Voltage mapping had a better predictive ability in detecting LGE compared to S-QRS measurements using this system (area under curve: 0.907 vs. 0.840). Using an electrical threshold of 1.5 mV to define abnormal myocardium, the total DSC, scar DSC, and normal myocardium DSC between voltage maps and LGE scar maps was 79.0 ± 6.0%, 35.0 ± 10.1%, and 90.4 ± 8.6%, respectively. CONCLUSION: Low-voltage zones and regions of delayed conduction determined using a real-time MR-EP system are moderately associated with LGE areas identified on MRI.

Medical aromatherapy revisited-Basic mechanisms, critique, and a new development.

OBJECTIVE: According to a series of recent meta-analyses and systematic reviews, aromatherapy has shown to be effective in treating patients with different medical conditions. However, many of the clinical studies are of rather low methodological quality. Moreover, there is much conceptual ambiguity with regard to what aromatherapy actually constitutes. METHOD: In this paper, we discuss the conditions under which aromatherapy is most likely to be of medical value by outlining the workings of the olfactory system and the necessary requirements of odors to be therapeutic. We then introduce an aromatherapeutic inhaler that was tested in a series of studies involving 465 participants. RESULTS: This inhaler (AromaStick®) produced large to very large effects across a variety of physiological target systems (e.g., cardiovascular, endocrine, blood oxygenation, and pain), both short term and long term. DISCUSSION: Inhalation of volatile compounds from essential oils yields almost immediate, large, and clinically relevant effects as long as the scents are delivered highly concentrated from an appropriate device. The changes caused in the body seem side effect-free and can be sustained when inhalation is repeated.

Epicardial electroanatomical mapping, radiofrequency ablation, and lesion imaging in the porcine left ventricle under real-time magnetic resonance imaging guidance-an in vivo feasibility study.

Aims: Magnetic resonance imaging (MRI) is the gold standard for defining myocardial substrate in 3D and can be used to guide ventricular tachycardia ablation. We describe the feasibility of using a prototype magnetic resonance-guided electrophysiology (MR-EP) system in a pre-clinical model to perform real-time MRI-guided epicardial mapping, ablation, and lesion imaging with active catheter tracking. Methods and results: Experiments were performed in vivo in pigs (n = 6) using an MR-EP guidance system research prototype (Siemens Healthcare) with an irrigated ablation catheter (Vision-MR, Imricor) and a dedicated electrophysiology recording system (Advantage-MR, Imricor). Following epicardial access, local activation and voltage maps were acquired, and targeted radiofrequency (RF) ablation lesions were delivered. Ablation lesions were visualized in real time during RF delivery using MR-thermometry and dosimetry. Hyper-acute and acute assessment of ablation lesions was also performed using native T1 mapping and late-gadolinium enhancement (LGE), respectively. High-quality epicardial bipolar electrograms were recorded with a signal-to-noise ratio of greater than 10:1 for a signal of 1.5 mV. During epicardial ablation, localized temperature elevation could be visualized with a maximum temperature rise of 35 °C within 2 mm of the catheter tip relative to remote myocardium. Decreased native T1 times were observed (882 ± 107 ms) in the lesion core 3-5 min after lesion delivery and relative location of lesions matched well to LGE. There was a good correlation between ablation lesion site on the iCMR platform and autopsy. Conclusion: The MR-EP system was able to successfully acquire epicardial voltage and activation maps in swine, deliver, and visualize ablation lesions, demonstrating feasibility for intraprocedural guidance and real-time assessment of ablation injury.

There Is Something in the Air: Testing the Efficacy of a new Olfactory Stress Relief Method (AromaStick®).

In recent years, aromatherapy has become increasingly popular for clinical treatment and therapeutic management of both acute and chronic stress. It targets distinct and unique neurobiological characteristics of the olfactory system, which is tightly linked to emotions and information processing as well as the autonomous nervous system. Yet, depending on the mode of application, aromatherapeutic interventions show varying degrees of therapeutic effectiveness. In a series of five experiments, the effects of a new mode of aromatherapeutic application (inhaler) was investigated, which is specifically designed to directly stimulate the olfactory system and to reduce the activity of the sympathetic nervous system. Overall, the application of the inhaler showed consistent and large psychological and physiological effects. It also clearly outperformed other stress management techniques, like progressive muscle relaxation, Bach flowers or passive resting periods (natural control). The effects occurred shortly after very few inhalations, drastically reduced stress related biomarkers (i.e. blood pressure, heart rate and cortisol) and considerably enhanced well-being. Copyright © 2015 John Wiley & Sons, Ltd.

Bioenergetics of the calf muscle in Friedreich ataxia patients measured by 31P-MRS before and after treatment with recombinant human erythropoietin.

UNLABELLED: Friedreich ataxia (FRDA) is caused by a GAA repeat expansion in the FXN gene leading to reduced expression of the mitochondrial protein frataxin. Recombinant human erythropoietin (rhuEPO) is suggested to increase frataxin levels, alter mitochondrial function and improve clinical scores in FRDA patients. Aim of the present pilot study was to investigate mitochondrial metabolism of skeletal muscle tissue in FRDA patients and examine effects of rhuEPO administration by phosphorus 31 magnetic resonance spectroscopy (31P MRS). Seven genetically confirmed FRDA patients underwent 31P MRS of the calf muscles using a rest-exercise-recovery protocol before and after receiving 3000 IU of rhuEPO for eight weeks. FRDA patients showed more rapid phosphocreatine (PCr) depletion and increased accumulation of inorganic phosphate (Pi) during incremental exercise as compared to controls. After maximal exhaustive exercise prolonged regeneration of PCR and slowed decline in Pi can be seen in FRDA. PCr regeneration as hallmark of mitochondrial ATP production revealed correlation to activity of complex II/III of the respiratory chain and to demographic values. PCr and Pi kinetics were not influenced by rhuEPO administration. Our results confirm mitochondrial dysfunction and exercise intolerance due to impaired oxidative phosphorylation in skeletal muscle tissue of FRDA patients. MRS did not show improved mitochondrial bioenergetics after eight weeks of rhuEPO exposition in skeletal muscle tissue of FRDA patients. TRIAL REGISTRATION: EU Clinical Trials Register2008-000040-13.

Homeopathic pathogenetic trials produce specific symptoms different from placebo.

INTRODUCTION: Homeopathy uses information gathered from healthy volunteers taking homeopathic substances (pathogenetic trials) for clinical treatment. It is controversial whether such studies produce symptoms different from those produced by placebo. OBJECTIVE: To test whether homeopathic preparations produce different symptoms than placebo in healthy volunteers. METHODS: Three armed, double-blind, placebo controlled randomised experimental pathogenetic study in 25 healthy volunteers who took either one of two homeopathic remedies, Natrum muriaticum and Arsenicum album in 30CH or identical placebo. Main outcome parameter was the number of remedy-specific symptoms per group. RESULTS: On average, 6 symptoms typical for Arsenicum album were experienced by participants taking arsenicum album, 5 symptoms typical for Natrum muriaticum by those taking natrum muriaticum, and 11 non-specific symptoms by those in the placebo group. Differences were significant overall (Kruskall Wallis test, p = 0.0002,) and significantly different from placebo (Mann-Whitney test, p = 0.001). CONCLUSION: Homeopathic remedies produce different symptoms than placebo.

Randomized double-blind pilot study on psychological effects of a treatment with 'instrumental biocommunication'.

BACKGROUND AND OBJECTIVE: Computerized systems using instrumental biocommunication for treatment claim beneficial health effects. We set out a pilot study to test whether individuals treated with a program called QUANTEC report improvements in well-being, health, and fulfillment of prerecorded wishes. MATERIALS AND METHODS: 34 volunteers from the University Hospital Freiburg participated in the study. Before treatment, baseline measures were taken (self-report on wishes, well-being, and health). Participants were then randomly and blindly allocated to two groups. In the first treatment phase of 3 months duration, only half of the participants were treated (group 1). Upon the end of the first treatment phase, post-treatment measures were taken. Participants were then unblinded as to group allocation and group 2 was treated. Finally, the second post-treatment measures were taken. RESULTS: Data exploration revealed that individuals' need for health improvement and blinding may be important psychological prerequisites for a treatment with instrumental biocommunication to be beneficial. CONCLUSIONS: Treatments with QUANTEC may be accompanied by beneficial health effects. The latter do not necessarily bear on postulated causative mechanisms of treatments with instrumental biocommunication but might instead be purely psychological in nature. However, there are a number of limitations as to the quality and quantity of such effects which calls for further investigation.

Effects of expectation and caffeine on arousal, well-being, and reaction time.

The objective of this study is to determine the impact of expectation associated with placebo and caffeine ingestion. We used a three-armed, randomized, double-blind design. Two three-armed experiments varying instruction (true, false, control) investigated the role of expectations of changes in arousal (blood pressure, heart rate), subjective well-being, and reaction time (RT). In Experiment 1 (N = 45), decaffeinated coffee was administered, and expectations were produced in one group by making them believe they had ingested caffeinated coffee. In Experiment 2 (N = 45), caffeinated orange juice was given in both experimental groups, but only one was informed about the true content. In Experiment 1, a significant effect for subjective alertness was found in the placebo treatment compared to the control group. However, for RT and well-being no significant effects were found. In Experiment 2, no significant expectancy effects were found. Caffeine produced large effects for blood pressure in both treatments compared to the control group, but the effects were larger for the false information group. For subjective well-being (alertness, calmness), considerable but nonsignificant changes were found for correctly informed participants, indicating possible additivity of pharmacologic effect and expectations. The results tentatively indicate that placebo and expectancy effects primarily show through introspection.