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Adv Parasitol ; 107: 201-282, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32122530


The use of chemotherapeutic drugs is the main resource against clinical giardiasis due to the lack of approved vaccines. Resistance of G. duodenalis to the most used drugs to treat giardiasis, metronidazole and albendazole, is a clinical issue of growing concern and yet unknown impact, respectively. In the search of new drugs, the completion of the Giardia genome project and the use of biochemical, molecular and bioinformatics tools allowed the identification of ligands/inhibitors for about one tenth of ≈150 potential drug targets in this parasite. Further, the synthesis of second generation nitroimidazoles and benzimidazoles along with high-throughput technologies have allowed not only to define overall mechanisms of resistance to metronidazole but to screen libraries of repurposed drugs and new pharmacophores, thereby increasing the known arsenal of anti-giardial compounds to some hundreds, with most demonstrating activity against metronidazole or albendazole-resistant Giardia. In particular, cysteine-modifying agents which include omeprazole, disulfiram, allicin and auranofin outstand due to their pleiotropic activity based on the extensive repertoire of thiol-containing proteins and the microaerophilic metabolism of this parasite. Other promising agents derived from higher organisms including phytochemicals, lactoferrin and propolis as well as probiotic bacteria/fungi have also demonstrated significant potential for therapeutic and prophylactic purposes in giardiasis. In this context the present chapter offers a comprehensive review of the current knowledge, including commonly prescribed drugs, causes of therapeutic failures, drug resistance mechanisms, strategies for the discovery of new agents and alternative drug therapies.

Resistência a Medicamentos , Giardíase/tratamento farmacológico , Terapias Complementares/tendências , Biologia Computacional/tendências , Descoberta de Drogas/tendências , Giardíase/terapia , Humanos
Complement Ther Med ; 49: 102352, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32147074


OBJECTIVE: To examine the prevalence, patterns, and factors associated with CAM use among children with ADHD. METHOD: We used data from the 2012 and 2017 National Health Interview Survey. Descriptive statistics, Wald F chi-square test, and multivariable logistic regression were performed. RESULTS: Approximately 8.4 % of U.S. children had ADHD in 2017. Children with ADHD had greater CAM use than those without (p < 0.05). Meditation (10.8 %), yoga (9.6 %), and deep breathing (7.3 %) were the most commonly used mind-body CAM modalities in ADHD children in 2017, with their use increased 468 %, 433 %, and 192 %, respectively, since 2012. Nearly all children experiencing ADHD (91.9 %) have comorbid psychiatric disorders, and they are more likely to use CAM than those without comorbidities (p < .0001). Less than one-third of the respondents disclosed children's CAM use to their medical doctors. Among children with ADHD, CAM use is generally not correlated with conventional medical care use, except for a significant inverse relationship between CAM use and use of prescription medication for more than three months. CONCLUSION: The use of mind-body CAM modalities has substantially increased among children with ADHD, compared to those without ADHD, from 2012 to 2017. Parents' reasons for the use of CAM among their children with ADHD included their unique function in reducing ADHD symptoms and their lack of unwanted side-effects. It is imperative to improve effective communication between health care providers and ADHD patients and their parents, in order to understand patients' values and preferences for using CAM therapies as a natural holistic therapy for ADHD.

Transtorno do Deficit de Atenção com Hiperatividade/terapia , Terapias Complementares/métodos , Terapias Complementares/tendências , Adolescente , Criança , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Estados Unidos
Holist Nurs Pract ; 33(5): 303-311, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31415010


The purpose of this study is to assess the rate of women receiving treatment of infertility who use complementary and alternative medicine (CAM), CAM methods, and the effect of these methods on their quality of life. This cross-sectional and descriptive study was conducted with 797 women applying to the in vitro fertilization center of a private hospital located in Istanbul, Turkey. The data were collected using the Personal Information Form and the "Fertility Quality of Life Questionnaire." Fertility Quality of Life Questionnaire is scored between 0 and 100. High scores signify high quality of life. The data were assessed by using mean, standard deviation, number, percentage, t test, and 1-way analysis of variance test. It was found that 36.9% of the women used CAM and 17.9% used CAM along with the infertility treatment. Educational level of infertile women, educational level of their husbands, income level, regular drug use, infertility factor, the use of CAM, and the use of CAM and infertility treatment statistically significantly affected the quality of life (P < .05). The mostly preferred CAM was prayer/worship (25.1%) and phytotherapy (15.2%). The participants had a mean score of 68.79 ± 12.99 from overall Fertility Quality of Life Questionnaire questionnaire. The quality of life of the participants was at a good level. The use of acupuncture and phytotherapy significantly affected the quality of life. Since phytotherapy may interact with the drugs, it is important for nurses to routinely ask patients about their use of phytotherapy. Further evidence-based studies on these practices need to be conducted.

Terapias Complementares/normas , Infertilidade Feminina/tratamento farmacológico , Qualidade de Vida/psicologia , Adulto , Terapias Complementares/métodos , Terapias Complementares/tendências , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/psicologia , Inquéritos e Questionários , Turquia
Medicina (Kaunas) ; 55(7)2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31277309


Background and objectives: The inadequate knowledge of complementary and alternative medicine (CAM) among health professionals may put their clients at risk because clients would then find information about CAM from unreliable sources. Clinical psychologists (CPs), as health professionals, also have the opportunity to provide psychoeducation on the latest scientific CAM research for their clients. The current study aimed to explore knowledge and educational needs regarding CAM among CPs in Indonesia because previous studies on exploring CAM knowledge and educational needs regarding CAM were primarily conducted in Western countries. Materials and Methods: Data were collected through semi-structured face-to-face interviews with 43 CPs in public health centers (PHCs) in Indonesia. Most interviews were conducted at the PHCs where the participants worked and lasted for 55 minutes on average. The interview recordings were transcribed and were analyzed using deductive thematic analysis. Results: Five main themes emerged within participants' responses regarding CAM knowledge and educational needs. First (CAM understanding), participants' responses ranged from those with little or no prior knowledge of CAM treatments and uses, to those with much greater familiarity. Second (source of knowledge), participants' access ranged widely in terms of references, from popular to scientific literature. Third (why is it important?), participants identified CAM as an essential part of Indonesian culture and considered it therefore crucial to have this cultural knowledge. Fourth (the challenges and what is needed?), the challenges for improving participants' knowledge came from personal and institutional levels. Fifth (what and how to learn?), participants advised that only CAM treatments that fit in brief psychotherapy sessions should be introduced in professional training. Conclusions: This qualitative study discovered that CAM was neither well-known nor understood widely. Participants advised that professional associations and health institutions should work together in enhancing knowledge of CAM and incorporating CAM education into psychology education.

Terapias Complementares/métodos , Competência Profissional/normas , Psicologia/normas , Terapias Complementares/tendências , Humanos , Indonésia , Entrevistas como Assunto/métodos , Determinação de Necessidades de Cuidados de Saúde , Competência Profissional/estatística & dados numéricos , Psicologia/estatística & dados numéricos , Pesquisa Qualitativa , Inquéritos e Questionários
World J Gastroenterol ; 25(24): 2973-2976, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31293334


Until recently, with the exception of coeliac disease, gastroenterologists have not been particularly interested in the role of diet in the management of gastrointestinal disorders. However, patients have always felt that diet must play a part in their symptoms and, in the absence of any medical interest, have turned to alternative dietary practitioners for help, which can often have no evidence base. Fortunately, with the advent of the FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) and the realisation that diet can have a profound effect on the microbiome, medical opinion is now changing. Nevertheless, research on the various diets that are now available is often completely lacking. Lectins are carbohydrate binding proteins which are widely distributed in nature and are found in a whole variety of commonly consumed foods. It seems likely that the exclusion of lectins from the diet could become the next "food fashion" for alternative practitioners to promote, especially as there is some evidence to suggest that certain lectins may be harmful to health. It is, therefore, the purpose of this viewpoint to try and stimulate research on the dietary effects of lectins, which is currently minimal, so that we can pre-empt a situation where we are unable to give patients or the public evidence based advice on this topic.

Dietas da Moda , Dieta com Restrição de Proteínas/efeitos adversos , Proteínas na Dieta/efeitos adversos , Gastroenteropatias/dietoterapia , Lectinas/efeitos adversos , Terapias Complementares/métodos , Terapias Complementares/tendências , Dieta com Restrição de Carboidratos/efeitos adversos , Dieta com Restrição de Carboidratos/métodos , Dieta com Restrição de Proteínas/métodos , Proteínas na Dieta/administração & dosagem , Glutens/administração & dosagem , Glutens/efeitos adversos , Humanos , Lectinas/administração & dosagem , Monossacarídeos/administração & dosagem , Monossacarídeos/efeitos adversos , Oligossacarídeos/administração & dosagem , Oligossacarídeos/efeitos adversos
Pain Manag Nurs ; 20(3): 207-213, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31097374


Complementary therapies provide cancer survivors and clinicians with options for managing chronic pain. Recent published clinical guidelines and research findings support the use of relaxation therapy for managing chronic pain in cancer survivors. However, translating research findings into clinical practice remains a challenge. Using theory to guide implementation of a new practice can increase the likelihood of successful adoption. This article uses relaxation therapy for cancer survivors to describe how clinicians could use Rogers' Diffusion of Innovation Theory and the related Collaborative Research Utilization Model to implement a complementary therapy and ensure that it becomes standard practice.

Teoria de Enfermagem , Manejo da Dor/métodos , Terapia de Relaxamento/normas , Terapias Complementares/métodos , Terapias Complementares/normas , Terapias Complementares/tendências , Humanos , Manejo da Dor/tendências
J Urol ; 202(4): 689-695, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31091175


PURPOSE: We explored the prevalence and trends of self-reported complementary and alternative medicine use among patients with prostate cancer using CaPSURE™ (Cancer of the Prostate Strategic Urologic Research Endeavor). MATERIALS AND METHODS: A total of 7,989 CaPSURE participants completed questionnaires between 1996 and 2016 on the use of nearly 70 complementary and alternative medicine types. Participants were defined as users if they indicated that they had ever used complementary and alternative medicines. To evaluate trends among 7,696 patients with newly diagnosed prostate cancer we considered complementary and alternative medicine use within 24 months of diagnosis and calculated the percent change in complementary and alternative medicine use between groups defined by the year of diagnosis. RESULTS: Of patients with prostate cancer 56% reported complementary and alternative medicine use on at least 1 questionnaire. Multivitamin and omega-3 fatty acid use was common at 40% and 24% of patients, respectively. Compared to nonusers greater proportions of complementary and alternative medicine users were college educated, had a higher household income and lived in the West and Midwest. Median prostate specific antigen at diagnosis was 5.8 (IQR 4.4-8.4) and 6.2 ng/ml (IQR 4.7-10.1) among users and nonusers, respectively (p <0.01). Between those diagnosed in 1996 to 2000 and 2011 to 2016, complementary and alternative medicine use increased 128% from 24% to 54%. When comparing participants diagnosed in 2006 to 2010 with those diagnosed in 2011 to 2016, a 108% increase was seen in supplemental vitamin D use and a -48% decrease was seen in supplemental vitamin E use. CONCLUSIONS: Many patients with prostate cancer reported complementary and alternative medicine use. Multivitamins and omega-3 fatty acids were commonly ingested and vitamin D use increased dramatically from 2006 to 2010 compared to 2011 to 2016. These data can guide clinical discussions and decision making such as nutritionist referral and help prioritize future research.

Terapias Complementares/tendências , Neoplasias da Próstata/terapia , Idoso , Tomada de Decisão Clínica , Terapias Complementares/estatística & dados numéricos , Ácidos Graxos Ômega-3/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Nutricionistas , Encaminhamento e Consulta , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos , Vitamina D/administração & dosagem
J Integr Med ; 17(3): 147-149, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30956142


The prevalence of use of traditional and complementary medicine in the Saudi Arabia population has reached 75%. The most used therapies are religious healing, herbal medicine and cupping therapy. The National Center for Complementary and Alternative Medicine is the Saudi national reference for all activities regarding complementary medicine. This article briefly highlights the current state of complementary medicine regulation in Saudi Arabia.

Terapias Complementares/legislação & jurisprudência , Acupuntura/educação , Acupuntura/legislação & jurisprudência , Acupuntura/tendências , Terapias Complementares/educação , Terapias Complementares/tendências , Humanos , Licenciamento , Medicina Tradicional/tendências , Arábia Saudita
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 582-587, abr.-maio 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-987537


Objetivo: Descrever os benefícios da capoterapia como meio de inclusão social para idosos. Métodos: estudo descritivo e transversal, com abordagem qualitativa, realizado com 15 idosos que praticavam regularmente a capoterapia em um Centro de Convivência. Realizaram-se entrevistas mediante um roteiro semiestruturado, em outubro e novembro de 2014. A análise dos dados ocorreu por meio do Discurso do Sujeito Coletivo. Resultados: a prática regular da capoterapia foi uma motivação para a realização de atividades físicas e proporcionou a redução de dores decorrentes de condições crônicas associadas ao envelhecimento; além da formação de novas amizades e aprendizado de conhecimentos sobre o envelhecimento com saúde. Conclusão: é necessário estimular a realização de pesquisas relacionadas aos benefícios de inclusão para idosos em meio social por meio da capoterapia, para ampliar a visibilidade de órgãos públicos e serviços de saúde para cuidado de idosos

Objective: The study's purpose has been to describe the benefits of capoterapia as a means of social inclusion for elderly people. Methods: It is a descriptive and cross-sectional study with a qualitative approach, which was carried out with 15 elderly people who regularly have practiced capoterapia in an Elderly Experience Sharing Center. Interviews were performed through a semi-structured script over the period from October to November 2014. Data analysis occurred through the Collective Subject Discourse. Results: The regular practice of capoterapia was a motivation for the accomplishment of physical activities, and also provided the reduction of pains due to chronic conditions associated with aging; furthermore, it provided the formation of new friendships and learning experiences about healthful aging. Conclusion: It is necessary to stimulate the realization of research related to the benefits of including elderly people in the social environment through the capoterapia, aiming to increase the visibility of public agencies and health services towards the elderly careperspective with regards to the elderly people bearing this pathology

Objetivo: Describir los beneficios de capoterapia como medio de inclusión social para los ancianos. Método: estudio descriptivo transversal, con un enfoque cualitativo, realizado con 15 ancianos que practican con asiduidad capoterapia en un Centro de Convivencia. Las entrevistas se realizaron a través de un cuestionario semi-estructurado, en octubre y noviembre de 2014. El análisis de datos fue el Discurso del Sujeto Colectivo. Resultados: la práctica regular de capoterapia fue una motivación para las actividades físicas y siempre que la reducción del dolor resultante de condiciones crónicas asociadas con el envejecimiento; además de la formación de nuevas amistades y aprender conocimientos sobre el envejecimiento saludable. Conclusión: es necesario estimular el desarrollo de la investigación relacionada con los beneficios de la inclusión de las personas mayores en el entorno social a través de capoterapia para aumentar la visibilidad de los organismos públicos y los servicios de atención de salud para los ancianos

Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Terapias Complementares/métodos , Terapias Complementares/tendências , Terapias Complementares/estatística & dados numéricos , Envelhecimento Saudável , Saúde do Idoso
Aliment Pharmacol Ther ; 49(9): 1134-1172, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30924176


BACKGROUND: Functional dyspepsia, consisting of epigastric pain syndrome and postprandial distress syndrome, is a prevalent functional gastrointestinal disorder. To date, only limited treatment options are available and conflicting results in terms of efficacy have been reported. Consequently, nonpharmacological treatment options are increasingly being explored for functional dyspepsia. AIM: To provide an overview of current pharmacological and nonpharmacological treatment options for functional dyspepsia. METHODS: A literature search was conducted on Pubmed and other sources to identify relevant studies. RESULTS: Acid suppressive therapy reduced symptoms in 30%-70% of the patients, with higher benefit in epigastric pain syndrome and superior effectiveness for proton pump inhibitors compared to H2 -antagonists. Prokinetic agents, primarily used to treat postprandial distress syndrome, showed variable efficiency: 59%-81% responder rate for dopamine receptor antagonists, 32%-91% for serotonin-4-receptor agonists and 31%-80% for muscarinic receptor antagonists. H Pylori eradication, recommended in infected patients, was effective in 24%-82%. Refractory symptoms are addressed with neuromodulators. However, their efficacy in functional dyspepsia remains incompletely elucidated, available data showing symptom reduction in 27%-71% of the patients. Regarding herbal agents, peppermint oil reduced symptoms in 66%-91%, rikkunshito in 29%-34% and iberogast in 20%-95%. Lastly, acupuncture, cognitive behavioural therapy and hypnotherapy may help to provide symptom control, but research on their efficacy remains sparse. CONCLUSIONS: None of the available therapies is effective in the majority of patients without being associated with major side effects. Developing new treatment options is challenging due to the heterogeneity of functional dyspepsia, the lack of readily identified target mechanisms and the poor association between pathophysiological disturbances and symptoms.

Dispepsia/terapia , Dor Abdominal/terapia , Anti-Infecciosos/uso terapêutico , Terapias Complementares/métodos , Terapias Complementares/tendências , Dispepsia/diagnóstico , Dispepsia/fisiopatologia , Gastrite/microbiologia , Gastrite/fisiopatologia , Gastrite/terapia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Antagonistas dos Receptores Histamínicos H2/uso terapêutico , Humanos , Manejo da Dor/métodos , Fitoterapia/métodos , Fitoterapia/tendências , Período Pós-Prandial/efeitos dos fármacos , Inibidores da Bomba de Prótons/uso terapêutico
Sociol Health Illn ; 41(5): 831-851, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30793332


Complementary and alternative medicine (CAM) has developed into a complex and formidable commercial, sociocultural and political force in Australia, and given its influence, it is a relevant subject for scholars, health practitioners, health communicators, journalists, policy-makers, and consumers of healthcare products and services. This research will consider a relative newcomer to the claims-making space about CAM in the Australian health media-scape; the Friends of Science in Medicine (FSM), an activist group of medical practitioners, researchers, and scientists, founded in late 2011. Using content analysis supported by NVivo, I searched for articles specifically referring to FSM and measured the patterns and frequencies of media frames, intonation and sources that are featured in Australian mainstream news reports between December 2011 and April 2017. The negative headlining and intonation of reports predominated, along with framing CAM as part of a lucrative, undisciplined and unethical industry as well as an illegitimate healthcare approach, more broadly. The findings offer insight into how journalists respond, replicate or reconstruct the framings that are provided by an influential and elite group of medical practitioners and scientists, and readdresses issues surrounding the need for more critical health reporting in Australia.

Terapias Complementares/tendências , Meios de Comunicação de Massa/tendências , Médicos , Ciência , Atitude Frente a Saúde , Austrália , Terapias Complementares/efeitos adversos , Humanos , Jornais como Assunto/tendências , Política , Opinião Pública
Rev. pesqui. cuid. fundam. (Online) ; 11(2, n. esp): 464-469, jan. 2019. il
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-969918


Objective: Herein, the goal has been to know the perceptions of nursing undergraduate student about receiving the Therapeutic Touch. Methods: It is a descriptive-exploratory research with a qualitative approach, which was carried out with 10 nursing students from a Federal University from the Southern region of Brazil. For data collection, which was performed over October 2015, a semi-structured interview was used and the data were analyzed according to the discursive textual analysis. As a result, the following category emerged: The importance of caring for oneself and for others. Conclusion: The students reported a reduction of the signs of stress and pain, and an improvement in the sleep quality, leading to greater well-being. Hence, when people begin to consider subtler instances of life, it is possible to use strategies, such as the Therapeutic Touch, in order to provide a better quality of life for themselves, and later for the other

Objetivo: Conhecer as percepções de estudantes de graduação em enfermagem acerca do recebimento do Toque Terapêutico. Método: Pesquisa qualitativa, com abordagem descritiva exploratória, realizada com 10 estudantes de Enfermagem de uma Universidade Federal do sul do Brasil. Para a coleta de dados, realizada em outubro de 2015, utilizou-se uma entrevista semiestruturada e os dados foram analisados de acordo com a análise textual discursiva. Como resultado emergiu a categoria: A importância de cuidar de si e do outro. Conclusão: O relato dos estudantes evidenciou redução dos sinais de estresse e dor, melhora na qualidade sono, acarretando em maior bem-estar. Logo, quando as pessoas passam a considerar instâncias mais sutis da vida é possível utilizar estratégias, como o toque terapêutico, a fim de proporcionar maior qualidade de vida para si e posteriormente para o outro

Objetivo: Conocer las percepciones de los universitarios sobre la recepción de Toque Terapéutico. Método: La investigación cualitativa con enfoque exploratorio descriptivo, realizado con 10 estudiantes de enfermería de la Universidad Federal del Sur de Brasil. Para recopilar los datos, llevadas en octubre el año 2015, se utilizó una entrevista semiestructurada y los datos se analizaron de acuerdo con el análisis textual discursiva. Como resultado surgió la categoría: La importancia de cuidar de sí mismos y entre sí. Conclusión: El informe de los estudiantes mostró signos de reducción de estrés y el dolor, mejorar la calidad del sueño, lo que resulta en un mayor bienestar. Así que cuando la gente viene a considerar más sutiles instancias de la vida se puede utilizar estrategias como el toque terapéutico, con el fin de proporcionar una mayor calidad de vida para ellos y luego hacia el otro

Humanos , Masculino , Feminino , Adulto , Estresse Psicológico/terapia , Estudantes de Enfermagem , Terapias Complementares/estatística & dados numéricos , Estresse Psicológico/prevenção & controle , Terapias Complementares/tendências