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1.
Explore (NY) ; 17(1): 60-69, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32798173

RESUMO

OBJECTIVE: To design a set of measures which were portable and cost-effective that scientists could use to determine competence of Energy Practitioners so that qualified practitioners could be employed in improving ongoing research accuracy. DESIGN: This was a prospective study with sample of convenience. SUBJECTS: 213 subjects, 185 women and 28 men, were tested in this study. OUTCOME MEASURES: Empirical outcome measures included Triaxial Extra Low Frequency Magnetic Field meter, Data Logging Multimeter, RF Field Spectrum Analyzer, Acoustimeter, Broadcast Frequency counter, digital pH meter, digital TDS meter, GDV and physiology suite including heart rate variability, galvanic skin response, respiration, EMG, EKG, temperature and blood volume pulse. Additional questions on ethics and body reading were included in the test. RESULTS: Results suggest a range of tests which could be used to determine practitioner competence. Many of the energy practitioners tested consistently produced changes in the areas being measured past the error rate of the devices being used. Across the 13 measures, practitioner success ranged from 56.8% on the Acoustimeter to 100% on the Broadcast Frequency Counter measures with 95% CI. Tri Axial ELF magnetic field meter showed significance with practitioners producing oscillations of amplitude from the L hand at p< 0.01 with and effect size D of 1.5 and R hand p< 0.001 and an effect size D of 1.6. Practitioners demonstrated the ability to produce a change in pH beyond ±.1pH in 10 minutes at a Mean of 0.5 and a SD of 0.4 at a 95% CI of 0.48-0.58 and changes in TDS beyond+/-2% at a Mean of 36.7 and a SD of 35.2 at a 95% CI of 31.9-41.5. Other measures are discussed in detail. CONCLUSIONS: This test presents a possible way to demonstrate a level of practitioner competence and improve the selection of energy practitioners for use in scientific studies of energy healing in the areas of full spectrum healing, laying-on-of-hands healing, Reiki, Qi Gong and Tai Chi.


Assuntos
Mãos , Toque Terapêutico , Feminino , Frequência Cardíaca , Humanos , Masculino , Terapias Mente-Corpo , Estudos Prospectivos
2.
J Behav Med ; 42(1): 5-11, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30825085

RESUMO

The year 2017 was the 40th anniversary of the convening of the Yale Conference on Behavioral Medicine (Schwartz and Weiss, 1977). In honor of this defining moment in the history of the birthing of behavioral medicine as a formal integrative field of biobehavioral theories, research and applications, we were invited by the editors to take a retrospective and prospective look at the field. Recognizing that much has been written about this history over the years, we decided to write about the "back-channel," presenting never-before shared events associated with the birthing and evolution of the field in a way that would be fun to write and read. In the process we look back at the evolving definitions of behavioral medicine in light of contemporary advances and controversies in science. Our review includes a discussion of some of the present challenges/opportunities, and then considers the future with some "outside the box" possibilities. We outline some of the enormous advances which have taken place in technology since the 1970s and consider how such technologies can be transformative in redefining our field.


Assuntos
Medicina do Comportamento/tendências , Humanos
4.
Jt Comm J Qual Patient Saf ; 42(7): 303-10, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27301833

RESUMO

BACKGROUND: Despite colorectal cancer (CRC) screening and survival rates exceeding national averages in the United States, Kaiser Permanente Southern California (KPSC) aimed to identify system-level improvement opportunities to further reduce mortality from CRC. METHODS: To examine modifiable factors contributing to CRC mortality, a structured hybrid electronic/manual mor- tality review was used to examine 50 randomly selected cases among 524 individuals aged 25-75 years diagnosed with stage II, III, or IV CRC after July 2008 who subsequently died. Physicians conducted chart reviews using a standardized data extraction tool based on evidence-based best practices. RESULTS: Eighty-six percent (43) of the 50 decedents were initially diagnosed with stage III or IV CRC; two cases of appendiceal cancer were excluded. Thirty-one percent (15) of the remaining 48 cases presented with no history of screening; 15% (7) had documented iron deficiency anemia and abdominal pain or rectal bleeding; and 6% (3) had no follow-up colonoscopy after positive screening. Eleven (52%) of the 21 patients with initial stage II-III CRC received appropriate surveillance after curative surgery; 57% (12) developed metastases. Adjuvant chemotherapy was offered to 88% (14/16) of patients with stage III (node-positive) CRC; chemotherapy initiation was delayed in 6 patients. Missed opportunities for surgical oncology evaluation occurred among 61% (11/18) of patients with liver metastases at diagnosis. Failure to report clinically significant features on pathology occurred in 2 patients; they received appropriate treatment for other reasons. CONCLUSIONS: Improvement opportunities existed at multiple stages of care, including screening, evaluation of symp toms, timeliness of care, use of adjuvant chemotherapy, and surgical oncology practices.


Assuntos
Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/terapia , Detecção Precoce de Câncer/estatística & dados numéricos , Adulto , Idoso , Quimioterapia Adjuvante , Neoplasias Colorretais/patologia , Prática Clínica Baseada em Evidências , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Qualidade da Assistência à Saúde/organização & administração , Fatores de Tempo , Estados Unidos
6.
Homeopathy ; 104(2): 123-38, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25869977

RESUMO

Multiple studies have demonstrated that traditional homeopathic manufacturing reagents and processes can generate remedy source and silica nanoparticles (NPs). Homeopathically-made NPs would initiate adaptive changes in an organism as a complex adaptive system (CAS) or network. Adaptive changes would emerge from several different endogenous amplification processes that respond to exogenous danger or threat signals that manufactured nanomaterials convey, including (1) stochastic resonance (SR) in sensory neural systems and (2) time-dependent sensitization (TDS)/oscillation. SR is nonlinear coherent amplification of a weak signal by the superposition of a larger magnitude white noise containing within it the same frequencies of the weak signal. TDS is progressive response magnitude amplification and oscillatory reversal in response direction to a given low dose at physiological limits with the passage of time. Hormesis is an overarching adaptive phenomenon that reflects the observed nonlinear adaptive dose-response relationship. Remedies would act as enhanced micro- and nanoscale forms of their source material via direct local ligand-receptor interactions at very low potencies and/or by triggering systemic adaptive network dynamical effects via their NP-based electromagnetic, optical, and quantum mechanical properties at higher potencies. Manufacturing parameters including dilution modify sizes, shapes, and surface charges of nanoparticles, thereby causing differences in physico-chemical properties and biological effects. Based on surface area, size, shape, and charge, nanoparticles adsorb a complex pattern of serum proteins, forming a protein corona on contact that constitutes a unique biological identity. The protein corona may capture individualized dysfunctional biological mediator information of the organism onto the surfaces of the salient, i.e., resonant, remedy nanostructures. SR would amplify this weak signal from the salient remedy NPs with protein corona adsorbed, leading to sensitized nonlinear dynamical modulation of gene expression and associated changes in biological signaling pathways. When the system reaches its physiological limits during a homeopathic aggravation or the natural disease state, the amplified remedy signal triggers a nonlinear reversal in dynamical direction back towards health.


Assuntos
Homeopatia/métodos , Nanopartículas/química , Nanotecnologia/métodos , Farmacopeias Homeopáticas como Assunto , Hormese , Humanos , Projetos de Pesquisa
8.
Artigo em Inglês | MEDLINE | ID: mdl-24327820

RESUMO

Two forms of energy healing, Reconnective Healing (RH) and Reiki, which involve light or no touch, were tested for efficacy against physical therapy (PT) for increasing limited range of motion (ROM) of arm elevation in the scapular plane. Participants were assigned to one of 5 groups: PT, Reiki, RH, Sham Healing, or no treatment. Except for no treatment, participants were blinded as to grouping. Range of Motion, self-reported pain, and heart rate variability (HRV) were assessed before and after a 10-minute session. On average, for PT, Reiki, RH, Sham Healing, and no treatment, respectively, ROM increased by 12°, 20°, 26°, 0.6°, and 3° and pain score decreased by 11.5%, 10.1%, 23.9%, 15.4%, and 0%. Physical therapy, Reiki, and RH were more effective than Sham Healing for increasing ROM (PT: F = 8.05, P = 0.008; Reiki: F = 10.48, P = 0.003; RH: F = 30.19, P < 0.001). It is possible that this improvement was not mediated by myofascial release because the subjects' HRV did not change, suggesting no significant increase in vagal activity. Sham treatment significantly reduced pain compared to no treatment (F = 8.4, P = 0.007) and was just as effective as PT, Reiki, and RH. It is the authors' opinion that the accompanying pain relief is a placebo effect.

9.
Explore (NY) ; 9(6): 372-6, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24199777

RESUMO

We aim to report the case of a 38-year-old male with suggestive past-life memories during a regression session and to show how these memories were related to unusual medical conditions: (1) isolated obstruction of the right coronary artery in a young patient, (2) omental infarction, and (3) right aortic arch with isolation of the left subclavian artery. These conditions were related to the following suggestive past-life memories: (1) a priest who committed suicide with a crucifix nailed to his chest and (2) a medieval weapon (skull flail) hitting his cervical and left back region. There was an intriguing relation between the patient's suggestive past-life memories and rare medical conditions. In this article, the authors highlight possible explanations, rarity of findings, and similarities/differences from previous cases and potential pitfalls in this area.


Assuntos
Memória , Doenças Raras , Espiritualidade , Doenças Vasculares , Adulto , Humanos , Masculino
10.
Eur J Integr Med ; 5(2): 126-140, 2013 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-23795222

RESUMO

INTRODUCTION: Infectious diseases present public health challenges worldwide. An emerging integrative approach to treating infectious diseases is using nanoparticle (NP) forms of traditional and alternative medicines. Advantages of nanomedicine delivery methods include better disease targeting, especially for intracellular pathogens, ability to cross membranes and enter cells, longer duration drug action, reduced side effects, and cost savings from lower doses. METHODS: We searched Pubmed articles in English with keywords related to nanoparticles and nanomedicine. Nanotechnology terms were also combined with keywords for drug delivery, infectious diseases, herbs, antioxidants, homeopathy, and adaptation. RESULTS: NPs are very small forms of material substances, measuring 1-100 nanometers along at least one dimension. Compared with bulk forms, NPs' large ratio of surface-area-to-volume confers increased reactivity and adsorptive capacity, with unique electromagnetic, chemical, biological, and quantum properties. Nanotechnology uses natural botanical agents for green manufacturing of less toxic NPs. DISCUSSION: Nanoparticle herbs and nutriceuticals can treat infections via improved bioavailability and antiinflammatory, antioxidant, and immunomodulatory effects. Recent studies demonstrate that homeopathic medicines may contain source and/or silica nanoparticles because of their traditional manufacturing processes. Homeopathy, as a form of nanomedicine, has a promising history of treating epidemic infectious diseases, including malaria, leptospirosis and HIV/AIDS, in addition to acute upper respiratory infections. Adaptive changes in the host's complex networks underlie effects. CONCLUSIONS: Nanomedicine is integrative, blending modern technology with natural products to reduce toxicity and support immune function. Nanomedicine using traditional agents from alternative systems of medicine can facilitate progress in integrative public health approaches to infectious diseases.

11.
Altern Ther Health Med ; 19(1): 46-57, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23341426

RESUMO

BACKGROUND: Homeopaths report that individuals with heightened self-reported environmental chemical intolerance (CI) exhibit increased reactivity to homeopathic remedies. Persons high in CI sensitize their electroencephalographic (EEG) alpha responses to repeated intermittent chemical exposures. PRIMARY STUDY OBJECTIVE: The present feasibility study explored interactions between CI and one of two specific homeopathic remedies over time (Sulphur or Pulsatilla nigricans [Pulsatilla]). DESIGN: This study used a two-arm, double-blind, placebo-controlled repeated measures design. Intervention Participants underwent a series of three once-weekly sessions during which they repeatedly sniffed one remedy (6c, 12c, 30c; one potency per week) matched to their Homeopathic Constitutional Type Questionnaire (CTQ) type and two solvent controls (distilled water and a waterethanol [95%] solution). Within sessions, remedies and control solvents were administered via 2-second sniffs (eight sniffs of each of four different succussion levels per potency, in randomized order). PARTICIPANTS: Participants were college student volunteers (N = 96, ages 18-30, both sexes), screened for good health and relatively elevated Sulphur or Pulsatilla symptom pattern scores on the Homeopathic Constitutional Type Questionnaire (CTQ). Participants also completed a validated trait CI scale. PRIMARY OUTCOME MEASURES: Average 19-lead relative EEG alpha power (alpha 1 8-10 Hz; alpha 2 10-12 Hz). RESULTS: Trait CI interacted significantly with time factors for each remedy (both over visit weeks and over sniff cycles during sessions). The patterns were nonlinear and differed between the two remedies. Individuals high in CI showed greater variability over time in remedy EEG alpha effects than did those low in CI. CONCLUSION: The data suggest that CI, with an underlying susceptibility to time-dependent sensitization and oscillatory responses, could contribute to nonlinear dose-response patterns and inconsistent reproducibility of homeopathic clinical care and research.


Assuntos
Eletroencefalografia/efeitos dos fármacos , Homeopatia , Materia Medica/administração & dosagem , Sensibilidade Química Múltipla , Olfato/efeitos dos fármacos , Administração Intranasal , Adulto , Método Duplo-Cego , Estudos de Viabilidade , Feminino , Humanos , Masculino , Extratos Vegetais/administração & dosagem , Pulsatilla , Autorrelato , Enxofre/administração & dosagem , Adulto Jovem
12.
Front Biosci (Schol Ed) ; 5(2): 685-708, 2013 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-23277079

RESUMO

This paper presents an evidence-based model for the nature and mode of action of homeopathic remedies. Recent studies reveal that homeopathic remedies contain nanoparticles (NPs) of source materials formed by "top-down" mechanical grinding in lactose and/or succussion (forceful agitation) in ethanolic solutions. Silica nanostructures formed during succussions in glass and/or biosynthesized by specific plant extract tinctures also may acquire and convey epitaxial information from remedy source materials into higher potencies. NPs have enhanced bioavailability, adsorptive capabilities, adjuvant reactivity, electromagnetic and quantum properties compared with their bulk forms. NPs induce adaptive changes in the organism at nontoxic doses (hormesis), serving as salient, low level danger signals to the biological stress response network. Activation of stress response effectors, including heat shock proteins, inflammasomes, cytokines and neuroendocrine pathways, initiate beneficial compensatory reactions across the interconnected networks of the organism as a complex adaptive system. Homeopathic remedies act by stimulating hormetic adaptive rather than conventional pharmacological effects. Updating terminology from "homeopathy" to "adaptive network nanomedicine" reflects the integration of this historical but controversial medical system with modern scientific findings.


Assuntos
Homeopatia/métodos , Nanomedicina/métodos , Humanos
13.
J Altern Complement Med ; 19(6): 518-26, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23210468

RESUMO

OBJECTIVES: The study objective was to determine whether Reiki practice increases the electromagnetic field strength from the heart and hands of Reiki practitioners. RATIONALE: This study repeated experiments performed 20 years ago that detected exceptionally high-strength electromagnetic fields (100 nT) from the hands of several energy healers. The equipment used was far more sensitive than in the original studies. DESIGN: Using a Magnes 2500 WH SQUID, the electromagnetic field from the hands and heart of each of 3 Reiki masters was measured when they were (1) not practicing Reiki, (2) sending Reiki to a distant person, and (3) sending Reiki to a person in the room. Similar measurements were made on 4 Reiki-naïve volunteers before and after they received a Reiki training/attunement enabling them to self-administer Reiki. SETTING/LOCATION: The study setting was the Scripps Institute, San Diego, CA. OUTCOME MEASURES: Magnetic field intensity of hands and heart recorded over 5-minute sessions with corresponding frequency spectra. RESULTS: For all subjects, under all conditions, sensors closest to the heart and the hands produced spikes of 2 pT corresponding to the heartbeat. Recordings from 2 Masters and 1 volunteer showed a low-intensity sine wave oscillation of 0.25-0.3 Hz (intensity 0.1-0.5 pT) whether or not they were practicing Reiki. This oscillation probably reflected respiratory sinus arrhythmia, judged by comparison with recent previous studies. These signals were not detected in the original studies. In the current study, no electromagnetic field intensities greater than 3 pT were observed in any of the recordings. CONCLUSIONS: Practicing Reiki does not appear to routinely produce high-intensity electromagnetic fields from the heart or hands. Alternatively, it is possible that energy healing is stimulated by tuning into an external environmental radiation, such as the Schumann resonance, which was blocked in the present study by the strong magnetic shielding surrounding the SQUID.


Assuntos
Campos Eletromagnéticos , Mãos/fisiologia , Coração/fisiologia , Toque Terapêutico , Humanos
14.
Complement Ther Med ; 20(5): 299-305, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22863644

RESUMO

OBJECTIVE: The physiological status of energy healers during self-practice (activating the healing state without the presence of a recipient) has rarely been examined. This study assessed self practice-related changes in autonomic nervous system (ANS) activity in Reiki Masters and advanced Reconnective Healers. DESIGN: Measurements of heart rate (HR), heart rate variability (HRV) and cutaneous blood perfusion of the fingers, of 31 Reiki masters and 50 experienced Reconnective Healers were made before, during and after self-practice. Corresponding measurements were made on 32 control subjects, who gazed at a calming picture in place of self-practice. SETTING: Experiments were conducted in a laboratory setting. RESULTS: During self-practice by Reconnective Healers, the average HR did not change significantly compared to control subjects but the average HRV and the root mean square of successive differences in inter-beat interval (RMSSD) decreased by 11ms (95% CI 0.6, 4.6, p=0.009) and 13ms (95% CI 0.2, 4.1, p=0.031) more than in control subjects, respectively, indicating reduced parasympathetic nervous activity. Reiki Masters showed no significant change in HR, HRV or RMSSD compared to control subjects. Cutaneous blood perfusion increased during self-practice relative to control subjects in both Reconnective Healers (6.5%; p=0.012) and Reiki Masters (13.7%; p<0.001). CONCLUSION: Contrary to expectations, neither Reconnective Healers nor Reiki practitioners appear to enter a more physiologically relaxed state during self-practice although there is a local peripheral vasodilatation that is probably mediated by humoral agents.


Assuntos
Pessoal de Saúde , Frequência Cardíaca , Sistema Nervoso Parassimpático/fisiologia , Relaxamento/fisiologia , Autocuidado , Toque Terapêutico , Adulto , Idoso , Feminino , Dedos/irrigação sanguínea , Humanos , Masculino , Pessoa de Meia-Idade , Pele/irrigação sanguínea , Vasodilatação
15.
J Altern Complement Med ; 18(5): 445-53, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22594648

RESUMO

OBJECTIVES: Electroencephalography (EEG) offers psychophysiologic tools to improve sensitivity for detecting objective effects in complementary and alternative medicine. This current investigation extended prior clinical research studies to evaluate effects of one of two different homeopathic remedies on resting EEG cordance after an olfactory activation protocol on healthy young adults with remedy-relevant, self-perceived characteristics. METHODS: Ninety-seven (7) young adults (N=97, mean age 19 years, 55% women) with good self-rated global health and screened for homeopathic constitutional types consistent with one of two remedies (either Sulphur or Pulsatilla) underwent three weekly laboratory sessions. At each visit, subjects had 5-minute resting, eyes-closed EEG recordings before and after a placebo-controlled olfactory activation task with their constitutionally relevant verum remedy. One remedy potency (6c, 12c, or 30c) used per week, was presented in a randomized order over the 3 sessions. Prefrontal resting EEG cordance values at Fp1 and Fp2 were computed from artifact-free 2-minute EEG samples from the presniffing and postsniffing rest periods. Cordance derives from an algorithm that incorporates absolute and relative EEG values. RESULTS: The data showed significant two-way oscillatory interactions of remedy by time for ß, α, θ, and δ cordance, controlling for gender and chemical sensitivity. CONCLUSIONS: EEG cordance provided a minimally invasive technique for assessing objective nonlinear physiologic effects of two different homeopathic remedies salient to the individuals who received them. Time factors modulated the direction of effects. Given previous evidence of correlations between cordance and single-photon emission computed tomography, these findings encourage additional neuroimaging research on nonlinear psychophysiologic effects of specific homeopathic remedies.


Assuntos
Ondas Encefálicas/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Homeopatia , Materia Medica/farmacologia , Olfato/fisiologia , Adolescente , Adulto , Algoritmos , Encéfalo/fisiologia , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Pulsatilla , Valores de Referência , Descanso/fisiologia , Enxofre , Fatores de Tempo , Adulto Jovem
16.
Homeopathy ; 100(4): 203-11, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21962194

RESUMO

INTRODUCTION: Homeopathic pathogenetic trials usually rely on symptom self report measures. Adding objective biomarkers could enhance detection of subtle initial remedy effects. The present feasibility study examined electroencephalographic (EEG) effects of repeated olfactory administration of two polycrest remedies. METHODS: College student volunteers (ages 18-30, both sexes) from an introductory psychology course were screened for good health and relatively elevated Sulphur or Pulsatilla symptom scores on the Homeopathic Constitutional Type Questionnaire (CTQ). Subjects underwent a series of 3 once-weekly double-blind sessions during which they repeatedly sniffed the remedy matched to their CTQ type and solvent controls. Each remedy was given in a 6c, 12c, and 30c potency, one potency per week, in randomly assigned order. Solvent controls included both plain distilled water and a water-ethanol (95%) solution. All sniff test solutions were further diluted just prior to laboratory sessions (0.5 ml test solution in 150 ml distilled water). Within a session, remedies and control solvents were administered via 2-s sniffs (8 sniffs of each of 4 different succussion levels for the potency in randomized order). Primary outcome variable was relative EEG power (alpha 1 8-10 Hz; alpha 2 10-12 Hz) averaged over 19 electrode sites, including all succussions for a given potency. RESULTS: Mixed-effect models revealed significant main effects for remedy type (Sulphur >Pulsatilla) in both alpha bands, controlling for gender, baseline resting EEG alpha, and solvent control responses. Additional analyses showed significant nonlinear interactions between dilution and time (weekly session) in alpha 2 for both remedies and alpha 1 for Sulphur. CONCLUSION: EEG alpha offers an objective biomarker of remedy effects for future studies and potential method for distinguishing time-dependent effects of specific remedies and remedy potencies from one another.


Assuntos
Ritmo alfa/efeitos dos fármacos , Fitoterapia , Extratos Vegetais/administração & dosagem , Pulsatilla , Enxofre/administração & dosagem , Administração Intranasal , Adolescente , Adulto , Eletroencefalografia/efeitos dos fármacos , Estudos de Viabilidade , Feminino , Homeopatia , Humanos , Masculino , Extratos Vegetais/farmacologia , Enxofre/farmacologia , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
17.
Explore (NY) ; 7(3): 148-54, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21571233

RESUMO

OBJECTIVE: A clinical trial reported in JAMA (Shay et al, 1998), involving acupuncture and amitriptyline in HIV-infected patients, concluded that there was no effect for either acupuncture or amitriptyline on neuropathic pain. However, a recent reassessment of this study showed that there were really three different and independent clinical trials, each with a different research design, which had been combined into a single database and consequently analyzed with a relatively insensitive statistics. When only the first substudy, factorially crossed design involving acupuncture and amitriptyline, was reanalyzed by itself using more powerful statistics, it was found that acupuncture and amitriptyline both worked independently to reduce pain, but also that acupuncture worked best in the absence of amitriptyline, and that there may have been adverse events associated with the combination of the two treatments. The present study reports the reanalysis of the second of the original independent studies involving only acupuncture and sham acupuncture, to determine whether the results confirm acupuncture-related findings from the first substudy. PARTICIPANTS: Subjects were 114 HIV-infected men with pain associated with peripheral neuropathy in the early 1990s, when antiretroviral drug cocktails were just beginning to be available in experimental form. RESEARCH DESIGN: The second of the independent studies in the original report by Shlay et al involved a single factor with two levels: a 14-week standardized acupuncture regimen and its control (off-point sham acupuncture). In addition, physical functioning at baseline (high or low, based on the Karnofsky scale), was factorially crossed with the acupuncture factor in our analyses. Primary data were reanalyzed using repeated-measures ANCOVA in an intention-to-treat procedure, and categorical data were analyzed by the Pearson chi-square test. OUTCOME MEASURE: Pain intensity, pain relief, mortality, and attrition. RESULTS: Whereas the results were inconclusive for the pain measures, acupuncture had a strong and positive effect on attrition and mortality. These results were most pronounced among patients with poorest physical functioning at the beginning of the study. Overall, acupuncture was associated with lower attrition rate (27.6% vs. 44.6%, P = .058), and a zero mortality rate (0% vs. 12.5%, P = .047). This protective effect of acupuncture was visible primarily in subjects in poorer health (0% vs. 23.8%, P = .047). CONCLUSIONS: Acupuncture was clearly effective in reducing attrition and mortality in this sample, especially when health status was taken into account, but results for pain relief were mixed. These results add further evidence that the use of the most sensitive statistics available increases the chance of detecting actual effects due to acupuncture (and other treatments as well). Moreover, these results replicated most of the findings that did not involve the presence of amitriptyline from the initial independent study in this research project. The combined results of these two studies strongly support the importance of recognizing that interactions involving acupuncture and other treatments, may positively as well as negatively modify main effect results in clinical trials, and thus must be recognized and systematically explored. Findings are discussed in terms of their implications for moving toward a whole-systems approach to biomedical research.


Assuntos
Terapia por Acupuntura , Infecções por HIV/complicações , HIV , Manejo da Dor , Doenças do Sistema Nervoso Periférico/terapia , Adolescente , Adulto , Análise de Variância , Distribuição de Qui-Quadrado , Infecções por HIV/mortalidade , Infecções por HIV/terapia , Nível de Saúde , Humanos , Análise de Intenção de Tratamento , Masculino , Dor/etiologia , Medição da Dor , Doenças do Sistema Nervoso Periférico/complicações
18.
Explore (NY) ; 6(4): 246-55, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20633839

RESUMO

OBJECTIVE: The aim of this study was to determine, using analysis of covariance, whether a statistical reanalysis of a previously published study on neuropathic pain would reveal undetected significant effects of acupuncture and amitriptyline on pain, attrition, and mortality in HIV-infected patients. BACKGROUND: Shlay et al published an article in the Journal of the American Medical Association (1988) reporting that neither acupuncture nor amitriptyline had effects on pain in HIV-infected patients. However, they failed to perform a factorial analysis of variance (ANOVA) or covariance (ANCOVA) reflective of their core research design. Instead, research design problems necessitated the use of a relatively insensitive statistic. METHODS: The originally planned study employed a completely crossed 2 x 2 design involving acupuncture and amitriptyline and their controls. Reanalyses performed on the raw data involved ANCOVA and Pearson chi-square tests. SUBJECTS AND SETTING: The factorial option consisted of 125 HIV-infected men with peripheral neuropathic pain, being treated at health clinics in 10 different cities. OUTCOME MEASURES: Outcome measures were pain intensity, global pain relief, attrition, and mortality. RESULTS: In contrast to the originally reported findings, the interactions of amitriptyline and acupuncture over time on pain intensity and pain relief were statistically significant. There were also significant effects for acupuncture and amitriptyline on attrition and mortality, particularly when baseline health was poor. Acupuncture by itself was associated with greater pain relief, whereas the combination of acupuncture and amitriptyline was associated with a reduced level of pain relief. Acupuncture without amitriptyline was associated with substantially reduced attrition and, importantly, decreased mortality. Effects involving acupuncture tended to be magnified in patients in poor health. The combination of acupuncture and amitriptyline resulted in an adverse treatment interaction on mortality, especially in patients in poor health (53% death rate for the combination of acupuncture and amitriptyline vs 11% death rate for acupuncture only). CONCLUSIONS: Trials of acupuncture and other treatments should use efficient statistical techniques to assure detection of significant effects. Interactions involving various combinations of acupuncture and amitriptyline, which were undetectable in the original analytical approach, revealed previously undetected beneficial, as well as adverse, effects.


Assuntos
Terapia por Acupuntura , Amitriptilina/uso terapêutico , Interpretação Estatística de Dados , Infecções por HIV , Manejo da Dor , Pacientes Desistentes do Tratamento , Doenças do Sistema Nervoso Periférico/terapia , Terapia por Acupuntura/efeitos adversos , Adulto , Amitriptilina/efeitos adversos , Análise de Variância , Distribuição de Qui-Quadrado , Terapia Combinada/efeitos adversos , Feminino , Infecções por HIV/complicações , Infecções por HIV/mortalidade , Infecções por HIV/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/tratamento farmacológico , Dor/etiologia , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Doenças do Sistema Nervoso Periférico/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
19.
J Altern Complement Med ; 14(4): 417-22, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18435597

RESUMO

OBJECTIVES: To determine whether application of Reiki to noise-stressed rats can reduce their heart rates (HRs) and blood pressures. RATIONALE: In a previous study, we showed that exposure of rats to 90 dB white noise for 15 minutes caused their HRs and blood pressures to significantly increase. Reiki has been shown to significantly decrease HR and blood pressure in a small group of healthy human subjects. However, use of humans in such studies has the disadvantage that experimental interpretations are encumbered by the variable of belief or skepticism regarding Reiki. For that reason, noise-stressed rats were used as an animal model to test the efficacy of Reiki in reducing elevated HR and blood pressure. DESIGN: Three unrestrained, male Sprague-Dawley rats implanted with radiotelemetric transducers were exposed daily for 8 days to a 15-minute white noise regimen (90 dB). For the last 5 days, the rats received 15 minutes of Reiki immediately before the noise and during the noise period. The experiment was repeated on the same animals but using sham Reiki. SETTING/LOCATION: The animals were housed in a quiet room in University of Arizona Animal Facility. OUTCOME MEASURES: Mean HRs and blood pressure were determined before Reiki/sham Reiki, during Reiki/sham Reiki, and during the noise in each case. RESULTS: Reiki, but not sham Reiki, significantly reduced HR compared to initial values. With Reiki, there was a high correlation between change in HR and initial HR, suggesting a homeostatic effect. Reiki, but not sham Reiki, significantly reduced the rise in HR produced by exposure of the rats to loud noise. Neither Reiki nor sham Reiki significantly affected blood pressure. CONCLUSION: Reiki is effective in modulating HR in stressed and unstressed rats, supporting its use as a stress-reducer in humans.


Assuntos
Pressão Sanguínea , Exposição Ambiental/prevenção & controle , Frequência Cardíaca , Homeostase , Toque Terapêutico/métodos , Animais , Metabolismo Energético , Exposição Ambiental/efeitos adversos , Masculino , Ruído/efeitos adversos , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Projetos de Pesquisa
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