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1.
Int J Clin Pract ; 64(11): 1496-1502, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20698902

RESUMEN

OBJECTIVES: In many countries, recent data on the use of complementary and alternative medicine (CAM) are available. However, in England, there is a paucity of such data. We sought to determine the prevalence and predictors of CAM use in England. DESIGN: Data were obtained from the Health Survey for England 2005, a national household survey that included questions on CAM use. We used binary logistic regression modelling to explore whether demographic, health and lifestyle factors predict CAM use. RESULTS: Data were available for 7630 respondents (household response rate 71%). Lifetime and 12-month prevalence of CAM use were 44.0% and 26.3% respectively; 12.1% had consulted a practitioner in the preceding 12 months. Massage, aromatherapy and acupuncture were the most commonly used therapies. Twenty-nine percent of respondents taking prescription drugs had used CAM in the last 12 months. Women (OR 0.491, 95% CI: 0.419, 0.577), university educated respondents (OR 1.296, 95% CI: 1.088, 1.544), those suffering from anxiety or depression (OR 1.341, 95% CI: 1.074, 1.674), people with poorer mental health (on GHQ: OR 1.062, 95% CI 1.026, 1.100) and lower levels of perceived social support (1.047, 95% CI: 1.008, 1.088), people consuming ≥ 5 portions of fruit and vegetables a day (OR 1.327, 95% CI: 1.124, 1.567) were significantly more likely to use CAM. CONCLUSION: Complementary and alternative medicine use in England remains substantial, even amongst those taking prescription drugs. These data serve as a valuable reminder to medical practitioners to ask patients about CAM use and should be routinely collected to facilitate prioritisation of the research agenda in CAM.


Asunto(s)
Terapias Complementarias/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Anciano , Escolaridad , Empleo , Inglaterra , Femenino , Encuestas Epidemiológicas , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Análisis de Regresión , Clase Social , Encuestas y Cuestionarios
2.
Clin Rheumatol ; 26(5): 736-8, 2007 May.
Artículo en Inglés | MEDLINE | ID: mdl-16941201

RESUMEN

Back pain is the most common reason for using complementary therapies. This analysis of the trial evidence is aimed at determining whether the evidence base for or against complementary therapies for back pain is getting stronger. Two series of systematic reviews conducted with the same methodology 5 years apart were compared. The results suggest that the weight of the evidence has increased between 2000 and 2005 for a number of interventions. The direction of the evidence, however, remained unchanged for all but one therapy. We conclude that the value of complementary therapies in the management of back pain remains encouraging but not fully convincing.


Asunto(s)
Dolor de Espalda/terapia , Terapias Complementarias/tendencias , Medicina Basada en la Evidencia , Humanos
3.
Am J Chin Med ; 35(1): 21-5, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17265547

RESUMEN

The effectiveness of acupuncture remains a controversial issue. The aim of this article is to evaluate trends over time in the development of the evidence-base of acupuncture. A comparison of two series of systematic reviews was conducted. The first related to the evidence-base in 2000, the second related to 2005. Both employed virtually the same methodology and criteria for evaluation. The results indicate that the evidence base has increased for 13 of the 26 conditions included in this comparison. For 7 indications it has become more positive (i.e. favoring acupuncture) and for 6 it had changed in the opposite direction. It is concluded, that acupuncture research is active. The emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions.


Asunto(s)
Acupuntura/tendencias , Medicina Basada en la Evidencia/tendencias , Actitud , Humanos , Literatura de Revisión como Asunto
4.
Complement Ther Clin Pract ; 11(1): 17-20, 2005 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-15984219

RESUMEN

Research into complementary and alternative medicine (CAM) is not as new as it might appear from a U.K. perspective. Most continental European countries have a long tradition in CAM research. Many studies of homoeopathy, for instance, were published decades ago in languages other than English [The trials of homeopathy. Origins, structure and development. Stiftung: Essen, Karl und Veronica Carstens, 2004]. However, it is probably true to say that, in the English speaking world and particularly in the U.K., CAM has become a respectable area of scientific investigation only during the last decade. In this article, we review the 10 years of CAM research in Britain.


Asunto(s)
Ensayos Clínicos como Asunto/tendencias , Terapias Complementarias/normas , Medicina Basada en la Evidencia/tendencias , Revisión de la Investigación por Pares/tendencias , Apoyo a la Investigación como Asunto/tendencias , Humanos , Publicaciones Periódicas como Asunto/tendencias , Política , Reino Unido
5.
Complement Ther Med ; 11(3): 165-7, 2003 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-14659380

RESUMEN

A custom-made questionnaire was sent to all UK medical charities in 1999 and again in 2002. Its primary aim was to assess the commitment of these institutions towards funding research in complementary and alternative medicine (CAM). Sixty-two (1999) and 60 (2002) answers were received corresponding to response rates of 62% and 55%. The total CAM research funds have increased from pound 70,000 in 1999 to pound 412,755 in 2002. In terms of total research budgets, this amounts to 0.05% and 0.31%, respectively. The number of CAM research projects has increased but so has the number of charities who do not fund CAM research. We conclude from these data that CAM research funding by UK medical charities has increased. In relative terms it does, however, remain low and out of proportion to the prevalence of CAM use in the UK.


Asunto(s)
Organizaciones de Beneficencia/economía , Terapias Complementarias/economía , Apoyo a la Investigación como Asunto/estadística & datos numéricos , Agencias Voluntarias de Salud/estadística & datos numéricos , Organizaciones de Beneficencia/estadística & datos numéricos , Recolección de Datos , Apoyo Financiero , Estudios de Seguimiento , Humanos , Reino Unido , Agencias Voluntarias de Salud/economía
7.
Rheumatology (Oxford) ; 46(8): 1223-33, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17522095

RESUMEN

OBJECTIVE: To systematically review the evidence from randomized clinical trials (RCTs) for the effectiveness of the antioxidant vitamins A, C, E or selenium or their combination in the treatment of arthritis. METHODSL: A systematic search of computerized databases from inception to September 2006 for relevant RCTs, application of pre-defined inclusion/exclusion criteria and independent data extraction by two authors. Methodological quality was assessed using the Jadad scale. RESULTS: The searches identified 20 unique RCTs meeting the inclusion criteria: 11 in inflammatory arthritis and 9 in osteoarthritis (OA). The studies included are generally of poor quality. They fall into three main clusters: selenium for rheumatoid arthritis (n = 5); vitamin E for inflammatory arthritis (n = 5) and vitamin E for OA (n = 7). One RCT suggests superiority of vitamin E over placebo and three RCTs suggest equivalence between vitamin E and diclofenac in the treatment of inflammatory arthritis. In OA, four RCTs compared vitamin E with placebo. Two shorter-term studies were positive and two longer-term studies were negative. Two further RCTs suggest equivalence between vitamin E and diclofenac in the treatment of OA. Findings for selenium, vitamin A and a combination product in inflammatory arthritis and for vitamin A, and a combination product in OA were negative. An isolated positive result for vitamin C in OA is of doubtful clinical significance. CONCLUSIONS: Clinical trials testing the efficacy of vitamin E in the treatment of OA and inflammatory arthritis have been methodologically weak and have produced contradictory findings. There is presently no convincing evidence that selenium, vitamin A, vitamin C or the combination product selenium ACE is effective in the treatment of any type of arthritis.


Asunto(s)
Antioxidantes/uso terapéutico , Artritis/tratamiento farmacológico , Vitaminas/uso terapéutico , Ácido Ascórbico/uso terapéutico , Medicina Basada en la Evidencia , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Selenio/uso terapéutico , Resultado del Tratamiento , Vitamina A/uso terapéutico , Vitamina E/uso terapéutico
8.
Support Care Cancer ; 15(5): 565-8, 2007 May.
Artículo en Inglés | MEDLINE | ID: mdl-17093910

RESUMEN

AIM: The aim of this article is to compare the evidence relating to the effectiveness of complementary/alternative medicine (CAM) in palliative cancer care as it existed in 2000 and 2005. METHODS: Our comparison is based on systematic reviews using the same methodology at these two points in time. RESULTS: The results reveal a buoyant research activity in this sector. Consequently, new evidence for 19 CAM modalities has emerged between 2000 and 2005. For some treatments, the evidence is encouraging but for very few, it is as yet fully convincing. CONCLUSION: It follows that further research is warranted, particularly in areas where the data already looks encouraging.


Asunto(s)
Terapias Complementarias/estadística & datos numéricos , Medicina Basada en la Evidencia , Neoplasias/terapia , Humanos , Resultado del Tratamiento , Reino Unido
9.
J Rheumatol ; 28(3): 496-501, 2001 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11296948

RESUMEN

OBJECTIVE: To investigate the effect of in vivo treatment with methotrexate (MTX) on the regulation of ex vivo interleukin 10 (IL-10) production by peripheral blood mononuclear cells (PBMC) derived from patients with rheumatoid arthritis (RA). METHODS: Spontaneous as well as lipopolysaccharide (LPS) and phytohemagglutinin (PHA) induced IL-10 release was assessed by a specific immunoassay in culture supernatants of PBMC derived from 32 patients with active RA before and 6, 12, and 24 weeks after MTX treatment. IL- 10 production was correlated to the clinical response. As a control, IL-10 release from PBMC of 7 healthy blood donors was determined. RESULTS: PBMC of patients with RA showing > 50% improvement of the Paulus index after 3 and 6 months of MTX treatment (responders; n = 18) exhibited significantly enhanced IL-10 production after in vitro stimulation with LPS, whereas constitutively released IL-10 was below the detection limit of the immunoassay in all patients and controls. In contrast, IL-10 release from LPS stimulated PBMC of RA patients who showed < 20% improvement by Paulus index (nonresponders; n = 14) or who even deteriorated compared to baseline disease activity was markedly downregulated during MTX treatment in vivo. PHA-induced IL-10 release from PBMC in vitro was not significantly affected by MTX in vivo whether RA patients responded or not to MTX. CONCLUSION: Enhanced ex vivo LPS induced IL-10 production by PBMC of patients with RA is associated with a favorable therapeutic response to MTX treatment, whereas reduced production coincides more closely with disease deterioration or insufficient response. This may reflect both disease outcome upon treatment and/or the mode of the antiinflammatory action of MTX in RA. Because the LPS--but not the PHA--induced ex vivo IL-10 production by PBMC was stimulated by MTX in vivo, monocytes seem to be the prominent target cells for this drug mediated antiinflammatory cytokine regulation.


Asunto(s)
Antirreumáticos/administración & dosificación , Artritis Reumatoide/tratamiento farmacológico , Interleucina-10/biosíntesis , Leucocitos Mononucleares/metabolismo , Metotrexato/administración & dosificación , Adulto , Artritis Reumatoide/inmunología , Sedimentación Sanguínea , Femenino , Humanos , Técnicas In Vitro , Leucocitos Mononucleares/efectos de los fármacos , Leucocitos Mononucleares/inmunología , Lipopolisacáridos/farmacología , Masculino , Persona de Mediana Edad , Fitohemaglutininas/farmacología , Estudios Retrospectivos , Resultado del Tratamiento
10.
Schmerz ; 16(2): 129-39, 2002 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-11956898

RESUMEN

BACKGROUND: Acupuncture is commonly used to treat back pain. A meta-analysis of clinical trials of acupuncture for this condition came to a positive conclusion whilst a qualitative review was negative. AIM: To compare our meta-analysis of trials of acupuncture for the treatment of back pain with a qualitative review and the most recent studies on the subject. METHODS: A systematic literature search was conducted to retrieve all randomised controlled trials of any form of acupuncture for any type of back pain in humans. The adequacy of the acupuncture was assessed by consulting six experienced acupuncturists. The main outcome measure for the meta-analysis was numbers of subjects who where improved at the end of treatment. These data are discussed in relation to the qualitative review and the most recent studies. RESULTS: Twelve studies were included of which nine presented data suitable for meta-analysis. The odds ratio of improvement with acupuncture compared with control intervention was 2.30 (95% confidence interval 1.28 to 4.13). For sham-controlled, evaluator-blinded studies, the odds ratio was 1.37 (95% confidence interval, 0.84-2.25). The results from the majority of the most recent studies also support the effectiveness of acupuncture in the treatment of back pain. CONCLUSIONS: Collectively, these data imply that acupuncture is superior to various control interventions, although there is insufficient evidence to state whether it is superior to placebo.


Asunto(s)
Analgesia por Acupuntura/métodos , Dolor de Espalda/terapia , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
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