Complementary and alternative medical therapy utilization by people with chronic fatiguing illnesses in the United States

<p>Abstract</p> <p>Background</p> <p>Chronic fatiguing illnesses, including chronic fatigue syndrome (CFS), pose a diagnostic and therapeutic challenge. Previous clinical reports addressed the utilization of health care provided to patients with CFS by a variety of practitioners with other than allopathic training, but did not examine the spectrum of complementary and alternative medicine (CAM) therapies used. This study was designed to measure CAM therapy use by persons with fatiguing illnesses in the United States population.</p> <p>Methods</p> <p>During a random-digit dialing survey to estimate the prevalence of CFS-like illness in urban and rural populations from different geographic regions of the United States, we queried the utilization of CAM including manipulation or body-based therapies, alternative medical systems, mind-body, biologically-based, and energy modalities.</p> <p>Results</p> <p>Four hundred forty fatigued and 444 non-fatigued persons from 2,728 households completed screening. Fatigued subjects included 53 persons with prolonged fatigue, 338 with chronic fatigue, and 49 with CFS-like illness. Mind-body therapy (primarily personal prayer and prayer by others) was the most frequently used CAM across all groups. Among women, there was a significant trend of increasing overall CAM use across all subgroups (p-trend = 0.003). All categories of CAM use were associated with significantly poorer physical health scores, and all but one (alternative medicine systems) were associated with significantly poorer mental health scores. People with CFS-like illness were significantly more likely to use body-based therapy (chiropractic and massage) than non-fatigued participants (OR = 2.52, CI = 1.32, 4.82). Use of body-based therapies increased significantly in a linear trend across subgroups of non-fatigued, prolonged fatigued, chronic fatigued, and CFS-like subjects (p-trend = 0.002). People with chronic fatigue were also significantly more likely to use body-based therapy (OR = 1.52, CI = 1.07, 2.16) and mind-body (excluding prayer) therapy than non-fatigued participants (OR = 1.73, CI = 1.20 – 2.48).</p> <p>Conclusion</p> <p>Utilization of CAM was common in fatiguing illnesses, and was largely accounted for by the presence of underlying conditions and poor physical and mental health. Compared to non-fatigued persons, those with CFS-like illness or chronic fatigue were most likely to use body-based and mind-body therapies. These observations have important implications for provider education programs and development of intervention strategies for CFS.</p

Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia

© 2007 Reeves et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Complementary online aerosol mass spectrometry and offline FT-IR spectroscopy measurements: Prospects and challenges for the analysis of anthropogenic aerosol particle emissions

The aerosol mass spectrometer (AMS) is well established in investigating highly time-resolved dynamics of submicron aerosol chemical composition including organic aerosol (OA). However, interpretation of mass spectra on molecular level is limited due to strong fragmentation of organic substances and potential reactions inside the AMS ion chamber. Results from complementary filter-based FT-IR absorption measurements were used to explain features in high-resolution AMS mass spectra of different types of OA (e.g. cooking OA, cigarette smoking OA, wood burning OA). Using this approach some AMS fragment ions were validated in this study as appropriate and rather specific markers for a certain class of organic compounds for all particle types under investigation. These markers can therefore be used to get deeper insights in the chemical composition of OA based on AMS mass spectra in upcoming studies. However, the specificity of other fragment ions such as C2H4O2+ (m/z 60.02114) remains ambiguous. In such cases, complementary FT-IR measurements allow the interpretation of highly time-resolved AMS mass spectra at the level of molecular functional groups. Furthermore, this study discusses the challenges in reducing inorganic interferences (e.g. from water and ammonium salts) in FT-IR spectra of atmospheric aerosols to decrease spectral uncertainties for better comparisons and, thus, to get more robust results

Magnetic field distribution and signal decay in fMRI using the dipole model and Monte Carlo diffusion modeling

the presence of a susceptibility distribution. Dynamic processes (Brownian motion) are taken into account using additionally a Monte Carlo (MC) method for the positioning of the protons. Signal decay computation inside a model of brain parenchyma was found to depend on the evaluation procedure of the signal decay. MC modeling leads to signal decay characteristics depending on geometry and blood deoxygenation inside the vessel. Intra- and extravascular signal decay contributions can be determined individually

Numerical Simulations of Intra-voxel Dephasing Effects and Signal Voids in Gradient Echo MR Imaging using different Sub-grid Sizes

Signal void artifacts in gradient echo imaging are caused by the intra-voxel dephasing of the spins. Intra-voxel dephasing can be estimated by computing the field distribution on a sub-grid inside each picture element, followed by integration of all magnetization components. The strategy of computing the artifacts based on the integration of the sub-voxel signal components is presented here for different sub-grids. The coarseness of the sub-grid is directly related to computational effort. The possibility to save memory space and computing time for the dipole model by computing the field only on a sub-grid is addressed in the presented article. It is investigated as to how far computational time and memory space can be reduced by using an appropriate sub-grid. Numerical results for a model of a partially diamagnetically coated needle shaft are compared to experimental findings. In the case of a pure titanium needle, it is shown as being sufficient to compute the field distribution on a sub-grid that is at least four times coarser in each direction than the grid used to discretize the object in the related MR image. Due to three nested loops over the 3D grid, the need for memory space and time is saved by a factor 64. Deviations between measurements and simulations for the broad side of the artifact (uncompensated) and for the small side of the artifact (compensated) were 15.5, respectively, 19.1 for orientation parallel to the exterior field, and 22.7, respectively, 23.1 for orientation perpendicular to the exterior field

Biopsy needle tips with markers: MR compatible needles for high-precision needle tip positioning

Needle tip visualization is of high importance in magnetic resonance imaging (MRI) guided interventional procedures, for example for taking biopsies from suspicious lesions in the liver or kidney. The exact position of the needle tip is often obscured by image artifacts arising from the magnetic properties of the needle. The authors investigated two special biopsy needle tip designs using diamagnetic coatings. For common interventional MR sequences, the needle tip can be identified in the MR image by several equidistant dark spots arranged along a straight line. A dotted instead of a solid line allows for an improved control of the movement of the needle, not only if the needle is tilted toward the imaging plane, but also if the needle leaves an empty canal with signal extinction, which cannot be distinguished from the needle material itself. With the proposed design the position of the needle tip can be estimated with a precision of approximately 1 mm using conventional FLASH, FISP, and TSE sequences, as use d for interventional MR. Furthermore, the size of the biopsy probe can be estimated from the artifact. In using needles with a properly designed tip coating, taking biopsies under MR control is beginning to be greatly simplified. The approach to design artifacts using diamagnetic material in combination with paramagnetic material paves the way toward new instruments and implants, suitably tailored to the needs of the interventional radiologist