Systematic reviews of complementary therapies – an annotated bibliography. Part 3: Homeopathy

Background Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with homeopathy. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of homeopathy; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pretested form and summarized descriptively. Results Eighteen out of 22 potentially relevant reviews preselected in the screening process met the inclusion criteria. Six reviews addressed the question whether homeopathy is effective across conditions and interventions. The majority of available trials seem to report positive results but the evidence is not convincing. For isopathic nosodes for allergic conditions, oscillococcinum for influenza-like syndromes and galphimia for pollinosis the evidence is promising while in other areas reviewed the results are equivocal. Interpretation Reviews on homeopathy often address general questions. While the evidence is promising for some topics the findings of the available reviews are unlikely to end the controversy on this therapy

Choosing between NSAID and arnica for topical treatment of hand osteoarthritis in a randomised, double-blind study

The use of topical preparations for symptom relief is common in osteoarthritis. The effects of ibuprofen (5%) and arnica (50g tincture/100g, DER 1:20), as gel preparations in patients with radiologically confirmed and symptomatically active osteoarthritis of interphalangeal joints of hands, were evaluated in a randomised, double-blind study in 204 patients, to ascertain differences in pain relief and hand function after 21days' treatment. Diagnosis was according to established criteria; primary endpoints were pain intensity and hand function; statistical design was as per current regulatory guidelines for testing topical preparations. There were no differences between the two groups in pain and hand function improvements, or in any secondary end points evaluated. Adverse events were reported by six patients (6.1%) on ibuprofen and by five patients (4.8%) on arnica. Our results confirm that this preparation of arnica is not inferior to ibuprofen when treating osteoarthritis of hand

Trends of Medicinal Plant Use over the Last 2000 Years in Central Europe

Medicinal plant knowledge in Central Europe can be traced back from the present to antiquity, through written sources. Approximately 100 medicinal plant taxa have a history of continuous use. In this paper, we focus on use patterns over time and the link between historical and traditional uses with the current scientific evidence. We discuss our findings against the backdrop of changing eras and medicinal concepts. Based on use-records from totally 16 historical, popular and scientific herbals, we analyze how use categories of 102 medicinal plant taxa developed over time. Overall, 56 of the 102 taxa maintained continuous use throughout all time periods. For approximately 30% of the continuous uses, scientific evidence supporting their use exists, compared to 11% for recently added uses and 6% for discontinuous uses. Dermatology and gastroenterology are use categories that are relevant across all time periods. They are associated with a high diversity of medicinal taxa and continuously used medicinal species with scientific evidence. Antidotes, apotropaic (protective) magic, and humoral detoxification were important use categories in the past. New applications reflecting biomedical progress and epidemiological challenges are cardiovascular and tonic uses. Changes in medicinal concepts are mirrored in plant use and specifically in changes in the importance of use categories. Our finding supports the concept of social validation of plant uses, i.e., the assumption that longstanding use practice and tradition may suggest efficacy and safety

München als 8. bayerischer Regierungsbezirk?! Überlegungen und Vorschläge zu einer Verwaltungsstrukturreform auf der mittleren staatlichen Ebene in Oberbayern

Im vorliegenden Positionspapier geht es um die Abgrenzung der Großstadtregion München sowie die Teilung des Regierungsbezirks Oberbayern vor dem Hintergrund der Optimierung des Verwaltungshandelns in den aktuellen Aufgabenbereichen einer Regierung in Bayern

Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial

Background: Frailty is expressed by a reduction in physical capacity, mobility, muscle strength, and endurance. (Pre-) frailty is present in up to 42% of the older surgical population, with an increased risk for peri- and postoperative complications. Consequently, these patients often suffer from a delayed or limited recovery, loss of autonomy and quality of life, and a decrease in functional and cognitive capacities. Since frailty is modifiable, prehabilitation may improve the physiological reserves of patients and reduce the care dependency 12 months after surgery. Methods: Patients >= 70 years old scheduled for elective surgery or intervention will be recruited in this multicenter, randomized controlled study, with a target of 1400 participants with an allocation ratio of 1:1. The intervention consists of (1) a shared decision-making process with the patient, relatives, and an interdisciplinary and interprofessional team and (2) a 3-week multimodal, individualized prehabilitation program including exercise therapy, nutritional intervention, mobility or balance training, and psychosocial interventions and medical assessment. The frequency of the supervised prehabilitation is 5 times/week for 3 weeks. The primary endpoint is defined as the level of care dependency 12 months after surgery or intervention. Discussion: Prehabilitation has been proven to be effective for different populations, including colorectal, transplant, and cardiac surgery patients. In contrast, evidence for prehabilitation in older, frail patients has not been clearly established. To the best of our knowledge, this is currently the largest prehabilitation study on older people with frailty undergoing general elective surgery

Insight into the proteome of the hyperthermophilic Crenarchaeon Ignicoccus hospitalis: the major cytosolic and membrane proteins

Ignicoccus hospitalis, a hyperthermophilic, chemolithoautotrophic Crenarchaeon, is the host of Nanoarchaeum equitans. Together, they form an intimate association, the first among Archaea. Membranes are of fundamental importance for the interaction of I. hospitalis and N. equitans, as they harbour the proteins necessary for the transport of macromolecules like lipids, amino acids, and cofactors between these organisms. Here, we investigated the protein inventory of I. hospitalis cells, and were able to identify 20 proteins in total. Experimental evidence and predictions let us conclude that 11 are soluble cytosolic proteins, eight membrane or membrane-associated proteins, and a single one extracellular. The quantitatively dominating proteins in the cytoplasm (peroxiredoxin; thermosome) antagonize oxidative and temperature stress which I. hospitalis cells are exposed to at optimal growth conditions. Three abundant membrane protein complexes are found: the major protein of the outer membrane, which might protect the cell against the hostile environment, forms oligomeric complexes with pores of unknown selectivity; two other complexes of the cytoplasmic membrane, the hydrogenase and the ATP synthase, play a key role in energy production and conversion

Herbalists of today’s Switzerland and their plant knowledge: a preliminary analysis from an ethnobotanical perspective

Background: Herbal medicine is a popular part of primary health care in Switzerland. Following an ethnobotanical approach, in this study we seek to identify Swiss herbalists with broad, empirical medicinal plant knowledge and use. We aim to consider different areas of the medicinal landscape including biomedicine, complementary and alternative medicine, and self-medication. Material and Methods: A total of 61 expert interviews were conducted from February 2010 to November 2011. The transfer of knowledge was analyzed according to a Switzerland-related selection of historical and recent popular as well as scientific herbal books. Results: A total of 254 medicinal plant species, belonging to 218 genera and 87 families, were recorded in 934 use reports. Predominantly leaves and flowers are used for the treatment of dermatological, respiratory, nervous, and gastrointestinal problems. Recent to historical herbal books are an important source of plant knowledge. Conclusions: Medicinal plants are used for self-medication and professional health care and despite different underlying medicinal concepts and philosophies, herbalists largely agree on the most important medicinal plant species

Die Naturheilpraktikerin Pauline Felder – eine biographische Annäherung an schweizerische Volksmedizin im 20. Jahrhundert

Die franziskanische Ordensschwester Pauline Felder (1925-2007) ist eine der bekanntesten schweizerischen Naturheilkundlerinnen der jüngsten Vergangenheit. An ihrem Beispiel wird exemplarisch aufgezeigt, dass die schweizerische Volksmedizin eine lebende Tradition ist, die komplementär zu naturwissenschaftlichen Methoden der Biomedizin einen wichtigen Beitrag zur ganzheitlichen Gesundheitsversorgung der lokalen Bevölkerung beiträgt. Dieser Artikel beleuchtet Schwester Paulines familiäre und religiöse Sozialisation, ihre berufliche Ausbildung zur Hebamme, ihr gewähltes Leben als Nonne sowie ihren Werdegang zur Naturheilpraktikerin. Ihre therapeutischen Anwendungen basierten vornehmlich auf mündlich tradiertem phytotherapeutischen Wissen, welches ihr als integraler Teil der Gesundheitsversorgung während ihrer Kindheit und Jugend vermittelt worden war, weiter auf ihrer medizinischen Fachausbildung in den 1940er-Jahren, die nach wie vor naturheilkundliche Pflegeanwendungen lehrte, sowie literarischen und praktischen Fortbildungen. Ab den 1980er-Jahren erweiterte sie ihre phyto- und hydrotherapeutische Arbeitsweise mit zum Teil unorthodoxen Methoden. In zahlreichen Vorträgen, Kursen, Interviews, schriftlichen Erzeugnissen sowie als Mentorin von Praktikantinnen und Praktikanten verbreitete sie ihr Wissen und trug damit zur Erhaltung der schweizerischen Volksmedizin bei. Ihre jährlich selbst zubereiteten Heilmittel, die sie mittels traditioneller Sammel- und Verarbeitungsregeln herstellte, hatten bei ihrer Kundschaft die Reputation, von besonders guter Qualität zu sein. Der langjährige Erfolg ihrer Gesundheitsberatungsstelle zeigt beispielhaft, dass parallel zur Schulmedizin Heilmittel der Traditionellen Europäischen Medizin bei Patientinnen und Patienten erwünscht sind. Er illustriert auch, dass psychosoziale Aspekte für eine erfolgreiche Behandlung von elementarer Bedeutung sind. The Franciscan nun Sister Pauline Felder (1925-2007) is one of the most well-known Swiss natural medicine practitioners of the recent past. Her example demonstrates that Swiss folk medicine is a living tradition that complements the natural science methods of biomedicine and offers an important contribution to the holistic healthcare of the local population. The article illustrates her familial and religious socialisation, her professional education as a midwife, her chosen life as a nun as well as her career as a natural medicine practitioner. Her therapeutic applications were mainly based on orally transmitted knowledge of phytotherapy, to which she was exposed during her childhood and adolescence as an integral part of contemporary healthcare. They were further grounded in her medical training in the 1940s when naturopathic care was still taught, and fostered during her further literary and practical education. From 1980 onwards she expanded her phyto- and hydrotherapeutic practices to include some unorthodox methods. In numerous lectures, seminars, interviews, written documents, and as a mentor of interns she disseminated her knowledge and contributed to the preservation of Swiss folk medicine. Her remedies, which she prepared annually employing traditional rules of collection and compounding, had the reputation among her clientele as being of particularly good quality. The enduring success of her advice centre for natural healthcare confirms that parallel to biomedicine, patients seek remedies from Traditional European Medicine. It also illustrates that psychosocial aspects of the therapeutic encounter are additionally of elemental significance for healing