Anti-microbial Activity of Urine after Ingestion of Cranberry: A Pilot Study

We explore the anti-microbial activity of urine specimens after the ingestion of a commercial cranberry preparation. Twenty subjects without urinary infection, off antibiotics and all supplements or vitamins were recruited. The study was conducted in two phases: in phase 1, subjects collected the first morning urine prior to ingesting 900 mg of cranberry and then at 2, 4 and 6 h. In phase 2, subjects collected urine on 2 consecutive days: on Day 1 no cranberry was ingested (control specimens), on Day 2, cranberry was ingested. The pH of all urine specimens were adjusted to the same pH as that of the first morning urine specimen. Aliquots of each specimen were independently inoculated with Escherichia coli, Klebsiella pneumoniae or Candida albicans. After incubation, colony forming units/ml (CFU ml−1) in the control specimen was compared with CFU ml−1 in specimens collected 2, 4 and 6 h later. Specimens showing ≥50% reduction in CFU ml−1 were considered as having ‘activity’ against the strains tested. In phase 1, 7/20 (35%) subjects had anti-microbial activity against E. coli, 13/20 (65%) against K. pneumoniae and 9/20 (45%) against C. albicans in specimens collected 2–6 h after ingestion of cranberry. In phase 2, 6/9 (67%) of the subjects had activity against K. pneumoniae. This pilot study demonstrates weak anti-microbial activity in urine specimens after ingestion of a single dose of commercial cranberry. Anti-microbial activity was noted only against K. pneumoniae 2–6 h after ingestion of the cranberry preparation

Searching biomedical databases on complementary medicine: the use of controlled vocabulary among authors, indexers and investigators

BACKGROUND: The optimal retrieval of a literature search in biomedicine depends on the appropriate use of Medical Subject Headings (MeSH), descriptors and keywords among authors and indexers. We hypothesized that authors, investigators and indexers in four biomedical databases are not consistent in their use of terminology in Complementary and Alternative Medicine (CAM). METHODS: Based on a research question addressing the validity of spinal palpation for the diagnosis of neuromuscular dysfunction, we developed four search concepts with their respective controlled vocabulary and key terms. We calculated the frequency of MeSH, descriptors, and keywords used by authors in titles and abstracts in comparison to standard practices in semantic and analytic indexing in MEDLINE, MANTIS, CINAHL, and Web of Science. RESULTS: Multiple searches resulted in the final selection of 38 relevant studies that were indexed at least in one of the four selected databases. Of the four search concepts, validity showed the greatest inconsistency in terminology among authors, indexers and investigators. The use of spinal terms showed the greatest consistency. Of the 22 neuromuscular dysfunction terms provided by the investigators, 11 were not contained in the controlled vocabulary and six were never used by authors or indexers. Most authors did not seem familiar with the controlled vocabulary for validity in the area of neuromuscular dysfunction. Recently, standard glossaries have been developed to assist in the research development of manual medicine. CONCLUSIONS: Searching biomedical databases for CAM is challenging due to inconsistent use of controlled vocabulary and indexing procedures in different databases. A standard terminology should be used by investigators in conducting their search strategies and authors when writing titles, abstracts and submitting keywords for publications

Group medical visits as a teaching tool in a family medicine clerkship.

We sought to determine medical students' learning outcomes following exposure to a 4-hour group medical visit (GMV) curriculum that focused on Spanish-speaking patients who had diabetes. The GMV was part of a 4-week block family medicine clerkship for third-year medical students.We conducted a 1-year longitudinal, prospective study using a before and after survey and a qualitative analysis of end-of-clerkship reflective essays. Eleven survey questions captured change in knowledge about GMV resources, cultural knowledge, and attitudes toward the GMV model.Ninety students completed the surveys. Fifty students chose to write about the GMV experience in their reflective essays. On the survey, a significant change was found in students' knowledge about culture-specific diabetic resources, cultural knowledge, and self-reported knowledge and attitude about GMVs. Qualitative analysis of the narratives and essays supported and strengthened this finding of positive attitudes about the importance of cultural competency and physician role modeling in the context of the patient-doctor relationship.Exposure to a 4-hour GMV curriculum is associated with knowledge gain. It is also associated with a positive attitude change, congruent with learning about the relevance of patient-doctor relationship within a cross-cultural setting

Group medical visits as a teaching tool in a family medicine clerkship.

We sought to determine medical students' learning outcomes following exposure to a 4-hour group medical visit (GMV) curriculum that focused on Spanish-speaking patients who had diabetes. The GMV was part of a 4-week block family medicine clerkship for third-year medical students.We conducted a 1-year longitudinal, prospective study using a before and after survey and a qualitative analysis of end-of-clerkship reflective essays. Eleven survey questions captured change in knowledge about GMV resources, cultural knowledge, and attitudes toward the GMV model.Ninety students completed the surveys. Fifty students chose to write about the GMV experience in their reflective essays. On the survey, a significant change was found in students' knowledge about culture-specific diabetic resources, cultural knowledge, and self-reported knowledge and attitude about GMVs. Qualitative analysis of the narratives and essays supported and strengthened this finding of positive attitudes about the importance of cultural competency and physician role modeling in the context of the patient-doctor relationship.Exposure to a 4-hour GMV curriculum is associated with knowledge gain. It is also associated with a positive attitude change, congruent with learning about the relevance of patient-doctor relationship within a cross-cultural setting

S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: A double-blind cross-over trial. [ISRCTN36233495]

Background: S-Adenosylmethionine (SAMe) is a dietary supplement used in the management of osteoarthritis (OA) symptoms. Studies evaluating SAMe in the management of OA have been limited to Non Steroidal Anti-inflammatory Drugs ( NSAIDs) for comparison. The present study compares the effectiveness of SAMe to a cyclooxygenase-2 (COX-2) inhibitor ( celecoxib) for pain control, functional improvement and to decrease side effects in people with osteoarthritis of the knee. Methods: A randomized double-blind cross-over study, comparing SAMe ( 1200 mg) with celecoxib ( Celebrex 200 mg) for 16 weeks to reduce pain associated with OA of the knee. Sixty-one adults diagnosed with OA of the knee were enrolled and 56 completed the study. Subjects were tested for pain, functional health, mood status, isometric joint function tests, and side effects. Results: On the first month of Phase 1, celecoxib showed significantly more reduction in pain than SAMe ( p = 0.024). By the second month of Phase 1, there was no significant difference between both groups ( p < 0.01). The duration of treatment and the interaction of duration with type of treatment were statistically significant (ps ≤ 0.029). On most functional health measures both groups showed a notable improvement from baseline, however no significant difference between SAMe and celecoxib was observed. Isometric joint function tests appeared to be steadily improving over the entire study period regardless of treatment. Conclusion: SAMe has a slower onset of action but is as effective as celecoxib in the management of symptoms of knee osteoarthritis. Longer studies are needed to evaluate the long-term effectiveness of SAMe and the optimal dose to be used