Tratamiento homeopático de niños discapacitados. Revisión de una serie de 40 casos / Homeopathic treatment of disabled children. Review of a series of 40 cases

Se presentan los resultados de un total de 55 consultas para dar atención a 40 casos de niños de una escuela y guardería. Los medicamentos se seleccionaron mediante repertorización computarizada y se verificaron frente al tipo constitucional de los niños. El resultado se evaluó en referencia a síntomas blanco preseleccionados. De los 40 niños, 18 respondieron bien a todos los síntomas blanco; 11 mostraron mejoría en algunos síntomas blanco; siete no respondieron al tratamiento, y en cuatro no se evaluó el resultado. Los niños con daño orgánico cerebral, autismo y síndromes definidos respondieron bien. Aquellos cuyo impedimento se debió a una privación social, generalmente fallaron a la respuesta. Las respuestas mayores fueron un incremento en el impulso y mejoría en el comportamiento hiperactivo y agresivo, los cuales permitieron a los niños beneficiarse más de su educación. También mejoraron síntomas físicos como la enuresis y el tartamudeo.

Childhood eating and weight in eating disorders: a multi-centre European study of affected women and their unaffected sisters.

BACKGROUND: Previous studies have suggested that childhood eating and weight problems may be risk factors for eating disorders. Robust evidence is still lacking. AIMS: To investigate whether childhood eating and weight problems increase the risk of eating disorders in affected women compared to their unaffected sisters. METHODS: Women (150) with anorexia (AN) or bulimia nervosa (BN) recruited from clinical and community samples were compared to their unaffected sister closest in age on maternal reports of childhood eating and weight. RESULTS: Women with BN were significantly more overweight at the ages of 5 and 10 (both OR = 2.8, p < 0.01), ate a lot (OR = 1.3, p < 0.01), were less picky (OR = 0.6, p < 0.05) and ate quickly (OR = 2.3, p < 0.05) between the ages of 6 and 10 compared to their healthy sisters. Significantly more women with AN were described as having a higher weight at 6 months (OR = 0.8, p < 0.01) and 1 year (OR = 0.6, p < 0.01) compared to their healthy sisters. Childhood eating was comparable in the women with AN and their unaffected sisters. CONCLUSIONS: Traits of childhood overeating were more common in bulimic women compared to their unaffected siblings. Subjects with AN did not differ from their sisters on eating variables. The increased risk of BN due to childhood overweight suggests that prevention strategies for childhood obesity and overweight may therefore be applicable in BN.

Treatment effect and safety of EPs 7630-solution in acute bronchitis in childhood: report of a multicentre observational study.

An open post-marketing surveillance study was conducted to examine the treatment effect and safety of EPs 7630-solution in the treatment of acute bronchitis in children. This study included a total of 742 children (aged between 0 and 12 years) with acute bronchitis (83.4%) or acute exacerbations of chronic bronchitis (14.3%), who were treated with different doses of the herbal drug for up to 14 days. Five bronchitis specific symptoms (BSS) were summed up to give an overall measure of disease severity. Non-specific disease symptoms (loss of appetite, diarrhoea, headache, vomiting, and fever) were also recorded, together with adverse events and overall ratings of efficacy and tolerability. The overall BSS score decreased during treatment from 6.0+/-3.0 points at baseline to 2.7+/-2.5 points after 7 days and to 1.4+/-2.1 points after 14 days. Remission or improvement in at least 80% of patients was recorded for all the individual component symptoms. The proportion of patients suffering from non-specific symptoms also substantially improved during treatment. For example, loss of appetite was present in 65.8% of patients at study begin, but only in 27.6% at the time point of last observation visit. In 88.3% of cases, the responsible physician rated the treatment as successful. Adverse events were minor and transitory. In conclusion, EPs 7630-solution was shown to be a safe and an effective treatment option for acute bronchitis or acute exacerbations of chronic bronchitis in children.

Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit.

BACKGROUND: Mortality in patients with severe sepsis remains high despite the development of several therapeutic strategies. The aim of this randomized, double-blind, placebo-controlled trial was to evaluate whether homeopathy is able to influence long-term outcome in critically ill patients suffering from severe sepsis. METHODS: Seventy patients with severe sepsis received homeopathic treatment (n = 35) or placebo (n = 35). Five globules in a potency of 200c were given at 12h interval during the stay at the intensive care unit. Survival after a 30 and 180 days was recorded. RESULTS: Three patients (2 homeopathy, 1 placebo) were excluded from the analyses because of incomplete data. All these patients survived. Baseline characteristics including age, sex, BMI, prior conditions, APACHE II score, signs of sepsis, number of organ failures, need for mechanical ventilation, need for vasopressors or veno-venous hemofiltration, and laboratory parameters were not significantly different between groups. On day 30, there was non-statistically significantly trend of survival in favour of homeopathy (verum 81.8%, placebo 67.7%, P= 0.19). On day 180, survival was statistically significantly higher with verum homeopathy (75.8% vs 50.0%, P = 0.043). No adverse effects were observed. CONCLUSIONS: Our data suggest that homeopathic treatment may be a useful additional therapeutic measure with a long-term benefit for severely septic patients admitted to the intensive care unit. A constraint to wider application of this method is the limited number of trained homeopaths.

Pretreatment with thyroxine (10-(8) parts by weight) enhances a 'curative' effect of homeopathically prepared thyroxine (10-(13)) on lowland frogs.

We studied the influence of a moderate homeopathically prepared thyroxine dilution (final concentration in the basin water 10-(13) parts by weight) on the metamorphosis of lowland Rana temporaria which had been hyperstimulated with thyroxine. Two groups of animals were pretreated by immersing them in a molecular thyroxine dilution (10-(8) parts by weight). This pretreatment speeds up development, as is well known. In accordance with the homeopathic/isopathic idea of detoxication or cure, the same hormone was then diluted and agitated in successive steps for further treatment. This homeopathically prepared dilution was administered at 24-hour intervals to one of the groups. An analogously prepared blank solution was used for the control group. Our hypothesis, which was derived from earlier studies, was that animals treated with the test solution would metamorphose more slowly than the control animals, i.e. that the homeopathically prepared thyroxine would have a 'curative' effect. In this new series of experiments this hypothesis was examined by 3 independent researchers. In the experiments carried out by 2 of the 3 researchers the number of animals that reached the four-legged stage at defined points in time was smaller in the group treated with homeopathically prepared thyroxine. In the third laboratory no difference was found between the groups. However, the overall inhibiting effect was statistically significant and more pronounced than in earlier, less promising studies and in parallel experiments in which nonprestimulated animals had been used. Other studies carried out by the 3 researchers involved animals from highland biotopes, where the natural environment probably induces a greater sensitivity towards thyroxine or higher thyroxine levels. These animals reacted to the homeopathically prepared thyroxine with a slowing down of metamorphosis, even when they had not been prestimulated with a molecular dose of the hormone. This effect was observed in all 3 laboratories and is consistent with the results of previous studies.

[Subjective family image in anorexia nervosa and bulimia nervosa in adolescence: a controlled study]. / Subjektives Familienbild bei Anorexia nervosa und Bulimia nervosa im Jugendalter: Eine kontrollierte Studie.

OBJECTIVES: The family environments of patients with eating disorders have been studied extensively in recent decades. The "Subjective Family Image Test" is an instrument developed especially to measure differential perceptions by family members. Assessments of subjective family image in families of adolescents by means of this test have been carried out in only a few samples. METHODS: We aimed first to investigate subjective perceptions by adolescents of their family relations in a larger clinical sample of female adolescents (n = 118) suffering from anorexia nervosa of either subtype or from bulimia nervosa and to compare these perceptions with those of healthy controls (n = 96). Second we investigated intra-familial differences in perception. RESULTS: The main findings were that bulimia nervosa patients perceived lower individual autonomy and lower emotional connectedness than all other groups, the adolescents with bulimia perceived significantly lower autonomy and emotional connectedness within the family than their fathers, and the restrictive anorexia nervosa patients perceived higher connectedness than their fathers. The relevance of these findings for understanding family dynamics are discussed.

Homeopathy and conventional medicine: an outcomes study comparing effectiveness in a primary care setting.

BACKGROUND: Recent meta-analyses of randomized controlled trials in homeopathy have suggested that homeopathy is more than a placebo response. OBJECTIVE: Comparison of the effectiveness of homeopathy in primary care with conventional medicine in primary care for three commonly encountered clinical conditions. DESIGN: An international multicenter, prospective, observational study in a real world medical setting comparing the effectiveness of homeopathy with conventional medicine. PARTICIPANTS: Thirty (30) investigators with conventional medical licenses at six clinical sites in four countries enrolled 500 consecutive patients with at least one of the following three complaints: (1) upper respiratory tract complaints including allergies; (2) lower respiratory tract complaints including allergies; or (3) ear complaints. MAIN OUTCOME MEASURES: The primary outcomes criterion was the response to treatment, defined as cured or major improvement after 14 days of treatment. Secondary outcomes criteria were: (1) rate of recovery; (2) occurrence of adverse events; (3) patient satisfaction; and (4) length of consultation. RESULTS: Four hundred and fifty-six (456) patient visits were compared: 281 received homeopathy, 175 received conventional medicine. The response to treatment as measured by the primary outcomes criterion for patients receiving homeopathy was 82.6%, for conventional medicine it was 68%. Improvement in less than 1 day and in 1 to 3 days was noted in 67.3% of the group receiving homeopathy and in 56.6% of those receiving conventional medicine. The adverse events for those treated with conventional medicine was 22.3% versus 7.8% for those treated with homeopathy. Seventy-nine percent (79.0%) of patients treated with homeopathy were very satisfied and 65.1% of patients treated with conventional, medicine were very satisfied. In both treatment groups 60% of cases had consultations lasting between 5 and 15 minutes. CONCLUSIONS: Homeopathy appeared to be at least as effective as conventional medical care in the treatment of patients with the three conditions studied.

International integrative primary care outcomes study (IIPCOS-2): an international research project of homeopathy in primary care.

OBJECTIVE: The primary objective is to evaluate the effectiveness of homeopathic treatment compared to conventional treatment for respiratory and ear complaints commonly seen in the primary care setting: runny nose, sore throat, ear pain, sinus pain, and cough. METHOD: This study is an international, multi-center, prospective, outcomes study on the effectiveness of homeopathic treatment compared to conventional treatment. The participating investigators will be divided into three groups: * Homeopathic treatment; * Homeopathic or conventional treatment according to the patient's preference, either randomized or non-randomized; * Conventional treatment. A total of 2400 patients will be recruited. Consecutive patients, age one month or older, presenting with one of the five chief complaints, and onset of symptoms less than seven days will be included into the study. Prior to enrolment into the trial each patient must provide written informed consent. Patient outcome will be measured using the Integrative Medicine Outcomes Scale (IMOS) at 7-, 14- and 28-d telephone follow-up. In addition, covariate data related to the following will be collected: patient demographics and medical history, patient preference for treatment and willingness to be randomized, health-related quality of life, primary treatment and adjunctive therapies prescribed, adverse events, type and length of consultation, follow-up recommendation, patient compliance, patient satisfaction with treatment, and patient willingness to choose therapy and health care provider again. The main outcome criterion will be the response rate according to the IMOS after 14 days of treatment. RESULTS: Preliminary interim results will be presented. CONCLUSIONS: Lessons learned from the study will be discussed.

[Accessory mitral valve tissue as a rare cause of subaortic stenosis and valvular aortic insufficiency]. / Akzessorisches Mitralklappengewebe als seltene Ursache einer Subaortenstenose und valvulären Aorteninsuffizienz.

An unusual case of subaortic stenosis and aortic regurgitation caused by accessory mitral valve tissue in a 10 year old boy is reported. Two-dimensional and Doppler echocardiography revealed the characteristic feature of a mobile, parachute-like mass in the left ventricular outflow tract pro-lapsing into the aortic valve during systole and, thus, producing a systolic pressure gradient of 70 mm Hg between the left ventricle and aorta and causing mild aortic regurgitation. The accessory valve tissue was completely excised via an aortotomy without injury to the normal mitral and aortic valves. Two dimensional echocardiography provides excellent morphological information about the relationship between the accessory mitral valve tissue and the mitral and aortic valves, respectively. Accurate preoperative evaluation by two-dimensional echocardiography facilitates the successful surgical management of this rare condition.

Perinatal manifestations of idiopathic long QT syndrome.

A neonate who had presented with sustained irregular heart rate during labor was found to have QT prolongation and repetitive polymorphic ventricular tachycardia (torsades de pointes) postnatally. Propranolol and propafenone successfully controlled the ventricular arrhythmias. Follow-up electrocardiograms and Holter records show persistent QT prolongation, bizarre T waves, and intermittent episodes of T wave alternans. On propranolol monotherapy the boy is thriving and completely free of ventricular arrhythmias. In the rare case of long QT syndrome in the neonate, early detection and therapy are mandatory to prevent ventricular arrhythmias and sudden death.

Homoeopathic versus placebo therapy of children with warts on the hands: a randomized, double-blind clinical trial.

BACKGROUND: Despite the wide practical application of homoeopathy, scientific proof of its effectiveness and mechanisms is still lacking, and sound, placebo-controlled studies are scarce. OBJECTIVE: The purpose of our study was to evaluate the efficacy of homoeopathy in a prospective, double-blind randomized trial. METHODS: 60 children aged 6-12 years with common warts on the back of the hands were treated either with an individually selected homoeopathic preparation (n = 30) of at least a 1:1,012 dilution or with pure placebo in the form of saccharose globuli (n = 30) under double-blind conditions. The area occupied by warts was measured by computerized planimetry before and after 8 weeks of treatment. Reduction of the warty area by at least 50% was considered a response. RESULTS: There were a total of 16 responders: 9 of 30 patients in the homoeopathic therapy group and 7 of 30 patients in the placebo group (chi 2 = 0.34, p = 0.56). Total cure of warts occurred in 5 patients in the treated group and in 1 patient in the placebo group (chi 2 = 1.46, p = 0.22). CONCLUSION: There was no apparent difference between the effects of homoeopathic therapy and placebo in children with common warts under the conditions of this study.

[Balloon dilatation of postoperative and congenital aortic isthmus stenoses]. / Ballondilatation postoperativer und nativer Aortenisthmusstenosen.

From July 1987 to December 1992, 52 patients underwent balloon-angioplasty of aortic coarctation at three units of pediatric cardiology in Austria (Graz = 35 patients, Innsbruck = 15 patients, and Vienna = 2 patients). 35 patients had postoperative and 17 had native coarctation. Mean age at intervention was 7 10/12 years with 2 patients under 1 year and 5 patients over 18 years old. The mean relation balloon diameter-coarctation diameter was 2.6 +/- 0.9. The blood pressure gradient between upper and lower extremities decreased from a mean of 44 +/- 16 mm Hg to 15 +/- 13 mm Hg (p < 0.0001). The diameter of the stenosed segment was increased from 5 +/- 3 mm to 8.5 +/- 3.5 mm (p < 0.0001). Native coarctation showed a significantly better result in respect to decrease of the gradient (36 +/- 12 mm Hg) than did postoperative coarctations (25 +/- 19 mm Hg) (p < 0.03). 13 patients did not respond adequately to angioplasty. 10 patients out of this group had tubular narrowings and belonged to the group of postoperative coarctations, whereas localized stenoses in native coarctations gave the best results. Localized wall irregularities were found in 4 patients with native coarctation. Balloon angioplasty of postoperative and native coarctations in childhood and adolescence is a secure and effective means of treatment and should be considered as therapy of first choice. The best results can be found in the group of the circumscript type of stenoses in native coarctation, whereas long and tubular stenoses in the group of postoperative coarctations give less satisfying results.

[Work and life style of homeopathic physicians in Austria. A descriptive study]. / Arbeits- und Lebensweise von homöopathisch tätigen Arztinnen und Arzten in Osterreich. Eine deskriptive Studie.

This study is based on a survey involving 117 physicians in Austria, working in private practice and under the National Health Plan on a homeopathic basis. The questionnaire covered such topics as socio-demographic data, individual methods of working, office organization, application of alternative therapies, health awareness, and perception of the general acceptance of homeopathy. The results showed that considerably more time is taken for treating patients homeopathically than for patients treated traditionally under the National Health Plan. More than half the physicians use homeopathic remedies exclusively, whereas homeopathic combination remedies were rarely administered. Neural therapy, microbiological therapy (bacterial immunostimulation) and phytotherapy are those alternative therapies most frequently used in addition. A spiritual approach seems to be a significant component of the working methods of these doctors. Their working method is generally traditional: exact medical history and physical examination are ranked high, whereas biochemical data are regarded to be less important for diagnosis.

[Clinical medicine and homeopathy]. / Klinische Medizin und Homöopathie.

A growing number of physicians in everyday practice use homoeopathy not as an alternative but rather as a supplementation to conventional medicine. A whole number of trials concerning both basic and clinical research have given evidence of the efficacy of homoeopathy and of the way it works. Nevertheless, in order to draw definite conclusions, the methodological quality of the trials will have to be improved. The evidence accumulated so far justifies the planning of further studies in collaboration between homoeopathic practitioners and clinicians. In order to achieve relevant results further studies have to be designed according to the principles of homoeopathy, especially the individual prescription of remedies.

[Alternative treatment possibilities of atopic diseases]. / Alternative Behandlungsmöglichkeiten atopischer Erkrankungen.

Families of children with atopic diseases often seek so-called alternative treatment as supplementation, not as real alternative to clinical medicine (complementary instead of alternative treatment). Clinical studies on the efficiency of acupuncture in the treatment of bronchial asthma gave contradictory results. The author's own uncontrolled experience in asthmatic children using a simple acupuncture scheme is rather good and a controlled clinical trial seems justified. In atopic dermatitis treatment comprises a mixture of acupuncture, homeopathy and dietary regimes and the therapeutic results have to be viewed against the possibility of spontaneous remissions. A controlled clinical trial seems impossible.

Pre- and perinatal risk factors in the etiology of infantile cerebral palsy.

In order to specify the influence of pre- and perinatal factors in the etiology of the different forms of congenital cerebral palsy the anamnestic data of 178 children born between 1962 and 1976 were analysed. The main adverse factors for the whole group were perinatal asphyxia (40%), prematurity (37%) and bleeding in the first trimenon (11%). As expected asphyxia was of foremost importance in spastic tetraplegia and prematurity in spastic diplegia. No complications of pregnancy and delivery were found in 44% of the congenital hemiplegias and in 34% of the ataxic syndromes. Obviously a major part of the congenital hemiplegias is not caused by birth injury but is the consequence of prenatally acquired brain lesions. This group cannot be diminished by perinatal intensive care and early detection by risk programs is difficult since no risk factors exist.

[Valproic acid -- clinical efficiency and serum concentration in the treatment of petit mal epilepsy in childhood (author's transl)]. / Dipropylacetat -- klinische Wirksamkeit und Plasmaspiegel bei der Behandlung kindlicher Petit-mal-Epilepsien.

28 children with Petit mal epilepsy were treated with valproic acid either as drug of primary choice or because of resistance to other antiepileptic drugs. Efficacy of treatment was measured by reduction of seizure frequency and EEG-recordings. Serum concentration of valproic acid was measured in all patients. The best clinical efficacy was found in children with absence seizures, who also required the lowest dosages. Side effects of therapy were (in most cases) transitory.

[Bio-availability of phenytoin free-acid serum level determinations whilst using a lactose-based tablet-preparation (author's transl)]. / Bioverfügbarkeit von Diphenylhydantoin -- Freie Säure -- Serumspiegeluntersuchungen eines Präparates mit Laktose als Tablettenbasis.

Phenytoin serum levels were determined in 103 children during the steady state of phenytoin therapy using a radio-immuno-assay. 94% of the patients had been treated as outpatients, 54% received phenytoin in combination with other antiepileptic drugs. The preparation used was phenytoin as free acid in lactose tablets (Epilan D). A therapeutic serum level of 10-20 mcg/ml was reached by an oral intake of 6,1 +/- 1,6 mg/kg/d. 27 children had plasma levels above 20 mcg/ml, their oral dose was 7,1 +/- 1,8 mg/kg/d. Most of these children showed clinical signs of intoxication. The bioavailability of phenytoin preparations is not only depended on the type of the substance used (salt, free acid), but also on the excipients used for the preparation of tablets. Therefore, general dosage recommendations are useless and even dangerous, unless the preparations used are extensively specified.