OBJECTIVES: To evaluate effects of touch massage (TM) on stress responses in healthy volunteers. METHODS: A crossover design including twenty-two (mean age=28.2) healthy volunteers (11 male and 11 female) cardiac autonomic tone was measured by heart rate (HR) and heart rate variability (HRV). Stress hormone levels (cortisol) were followed in saliva. We also measured blood glucose and serum insulin. Extracellular (ECV) levels of glucose, lactate, pyruvate and glycerol were followed using the microdialysis technique (MD). TM was performed on hands and feet for 80 min, during control, participants rested in the same setting. Data were collected before, during, and after TM and at rest. Saliva cortisol, serum glucose, and serum insulin were collected before, immediately following, and 1 h after intervention or control, respectively. RESULTS: After 5 min TM, HR decreased significantly, indicating a reduced stress response. Total HRV and all HRV components decreased during intervention. Saliva cortisol and insulin levels decreased significantly after intervention, while serum glucose levels remained stable. A similar, though less prominent, pattern was seen during the control situation. Only minor changes were observed in ECV levels of glucose (a decrease) and lactate (an increase). No significant alterations were observed in glycerol or pyruvate levels throughout the study. There were no significant differences between groups in ECV concentrations of analyzed substances. CONCLUSIONS: In healthy volunteers, TM decreased sympathetic nervous activity, leading to decreased overall autonomic activity where parasympathetic nervous activity also decreased, thereby maintaining the autonomic balance.

Auton Neurosci. 2010 Dec 8;158(1-2):105-10. Lindgren L, Rundgren S, Winsö O, Lehtipalo S, Wiklund U, Karlsson M, Stenlund H, Jacobsson C, Brulin C. Department of Nursing, Umeå University, Sweden. lenita.lindgren@nurs.umu.se

Hyperemesis gravidarum--severe and persistent nausea and vomiting during pregnancy--can lead to serious negative health consequences for both mother and fetus. Appropriate evidence-based treatment for this illness is paramount. Studies describing hypnosis in the treatment of hyperemesis gravidarum (HG) were reviewed. A literature search was carried out using Cochrane, PsycINFO, PsycARTICLES, and Web of Knowledge databases. A total of 45 studies were identified by the search. Six studies fulfilled the inclusion criteria. Studies were reviewed in terms of study design, methodological quality, intervention and outcomes. Methodology between the studies differed but all reported encouraging positive outcomes. However, the quality of current evidence, based on the studies reviewed in this study, is not sufficient to establish if hypnosis is an effective treatment for HG. To be able to accurately assess the efficacy of hypnosis for HG, it is recommended that well-designed studies, e.g. randomised control trials, be carried out.

J Obstet Gynaecol. 2010;30(7):647-53. McCormack D. Department of Perinatal Clinical Psychology, Royal Jubilee Maternity Hospital and School of Psychology, The Queen's University of Belfast, Northern Ireland. dmccormack04@qub.ac.uk

OBJECTIVE: Biofeedback is today a recognized treatment method for a number of physical and psychological problems. Experienced clinicians often achieve good results in these areas and their success largely builds on many years of experience and often thousands of treated patients. Unfortunately many of the areas where biofeedback is used are very complex, e.g. diagnosis and treatment of stress. Less experienced clinicians may even have difficulties to initially classify the patient correctly. Often there are only a few experts available to assist less experienced clinicians. To reduce this problem we propose a computer-assisted biofeedback system helping in classification, parameter setting and biofeedback training. METHODS: The decision support system (DSS) analysis finger temperature in time series signal where the derivative of temperature in time is calculated to extract the features. The case-based reasoning (CBR) is used in three modules to classify a patient, estimate parameters and biofeedback. In each and every module the CBR approach retrieves most similar cases by comparing a new finger temperature measurement with previously solved measurements. Three different methods are used to calculate similarity between features, they are: modified distance function, similarity matrix and fuzzy similarity. RESULTS AND CONCLUSION: We explore how such a DSS can be designed and validated the approach in the area of stress where the system assists in the classification, parameter setting and finally in the training. In this case study we show that the case based biofeedback system outperforms trainee clinicians based on a case library of cases authorized by an expert.

Artif Intell Med. 2010 Oct 14. Ahmed MU, Begum S, Funk P, Xiong N, von Scheele B. School of Innovation, Design and Engineering, Mälardalen University, P.O. Box 883, SE-721 23, Västerås, Sweden.

Full Title: A randomised, placebo-controlled trial of manual and electrical acupuncture for the treatment of tinnitus.

The aim of this study was to examine the effects of manual/electrical acupuncture treatment on tinnitus in a randomised, single-blinded, placebo-controlled design. Fifty patients (46 males, 4 females) suffering from tinnitus were investigated. The patients were randomly assigned to three groups: a manual acupuncture group (MA), an electrical acupuncture group (EA), and a placebo group (PL). The frequency of tinnitus occurrence, tinnitus intensity, and reduction of life quality were recorded before treatment (Baseline), after 6 treatments (After-Treatment), and 1 month after the completion of treatment (1-Month-After). Standard audiometric tests were conducted on each patient at Baseline and After-Treatment. The patients also provided an overall subjective evaluation of treatment effectiveness at each stage. Eight to ten acupoints were selected at each treatment by an experienced acupuncturist. Six treatments were performed, each separated by an interval of 1 week. Analysis of variance and t-tests were used to statistically compare the data. The frequency of tinnitus occurrence and the tinnitus loudness were significantly decreased After-Treatment compared with Baseline in the EA group (P<0.009). Life quality was improved After-Treatment and at 1-Month-After compared with Baseline in both MA and EA groups (P<0.038). However, no significant differences were detected among the three groups (P>0.079). The audiogram did not show any significant changes after treatment in either group (P>0.091). The overall subjective evaluation indicated significant improvements After-Treatment compared with Baseline in both MA and EA groups (P<0.011). Furthermore, After-Treatment subjective evaluation was significantly better in the EA group compared with either the MA or PL group (P<0.011). These results indicate that there is no statistically significant differential effect of manual or electrical acupuncture on tinnitus treatment efficacy, however, electrical acupuncture does confer some relative advantages.

Complement Ther Med. 2010 Dec;18(6):249-55. Wang K, Bugge J, Bugge S. Center for Sensory-Motor Interaction, Orofacial Pain Laboratory, Aalborg University, Fredrik Bajers Vej 7 D-3, DK-9220 Aalborg, Denmark. kelun@smi.auc.dk

Full Title: Acupuncture for promoting intelligence of children--an observation on 37 cases with mental retardation.

OBJECTIVE: To observe the effect of acupuncture on intelligence quotient (IQ) in children with mental retardation (MR). METHODS: One hundred children with MR were randomly divided into an acupuncture group and a control group, 50 in each. There were 37 and 36 cases with complete data in the former and latter group respectively. Four-week treatment constituted a course, the comprehensive therapeutic effect of two groups was compared after 3 courses of treatment, and the influence of acupuncture on IQ was estimated. RESULTS: The total effective rate in the acupuncture group was 78.4%, better than 30.56% in the control group, the difference being significant (P < 0.01). Both groups were improved in IQ but the effect of the former group was better than that of the latter group (P < 0.05). CONCLUSION: Acupuncture can obviously improve IQ of children suffering from MR.

J Tradit Chin Med. 2010 Sep;30(3):176-9. Tian YP, Qi R, Li XL, Wang YL, Zhang Y, Ji T, Hou CY, Wang LJ. Affiliated Hospital of Gansu College of TCM, Lanzhou, Gansu 730020, China. tianypw@126.com

BACKGROUND: Hypnotherapy is widely promoted as a method for aiding smoking cessation. It is proposed to act on underlying impulses to weaken the desire to smoke or strengthen the will to stop. OBJECTIVES: To evaluate the efficacy of hypnotherapy for smoking cessation. SEARCH STRATEGY: We searched the Cochrane Tobacco Addiction Group Specialized Register and the databases MEDLINE, EMBASE, AMED, SCI, SSCI using the terms smoking cessation and hypnotherapy or hypnosis. Date of most recent searches July 2010. There were no language restrictions. SELECTION CRITERIA: We considered randomized controlled trials of hypnotherapy which reported smoking cessation rates at least six months after the beginning of treatment. DATA COLLECTION AND ANALYSIS: Three authors independently extracted data on participant characteristics, the type and duration of the hypnotherapy, the nature of the control group, smoking status, method of randomization, and completeness of follow up. They also independently assessed the quality of the included studies.The main outcome measure was abstinence from smoking after at least six months follow up. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. Those lost to follow up were considered to be smoking. We summarised effects as risk ratios (RR). Where possible, we performed meta-analysis using a fixed-effect model. We also noted any adverse events reported. MAIN RESULTS: Eleven studies compared hypnotherapy with 18 different control interventions. There was significant heterogeneity between the results of the individual studies, with conflicting results for the effectiveness of hypnotherapy compared to no treatment, or to advice, or psychological treatment. We did not attempt to calculate pooled risk ratios for the overall effect of hypnotherapy. There was no evidence of a greater effect of hypnotherapy when compared to rapid smoking or psychological treatment. Direct comparisons of hypnotherapy with cessation treatments considered to be effective had confidence intervals that were too wide to infer equivalence. AUTHORS' CONCLUSIONS: We have not shown that hypnotherapy has a greater effect on six-month quit rates than other interventions or no treatment. There is not enough evidence to show whether hypnotherapy could be as effective as counselling treatment. The effects of hypnotherapy on smoking cessation claimed by uncontrolled studies were not confirmed by analysis of randomized controlled trials.

Cochrane Database Syst Rev. 2010 Oct 6;(10):CD001008. Barnes J, Dong CY, McRobbie H, Walker N, Mehta M, Stead LF. School of Pharmacy, University of Auckland, Private Bag 92019, Grafton Campus, Auckland, New Zealand. Update of: Cochrane Database Syst Rev. 2000;(2):CD001008.

OBJECTIVE: To explore the characteristics of patients and their gender influences concerning the use of homeopathic medicine, visiting both homeopathic and conventional medicine (allopathic) clinics. METHODS: This cross sectional study was carried out on 200 patients who attended private and public homeopathic and allopathic clinics or hospitals in Karachi using a pre-tested self-administered questionnaire. Data for demographic variables of frequencies and associations between variables were analyzed on SPSS version 12.0. Significance level was p < 0.05. RESULTS: Out of the total, 64.5% respondents, more among females than males (p < 0.01) believed in homeopathy. Although slightly more than a quarter preferred homeopathic treatment than allopathic treatment, 67.5% participants had had homeopathic consultation and treatment in the past. Amongst participants who had opted for homeopathy in any of their illnesses, the majority had it for chronic conditions which included skin lesions and problems of rheumatology. CONCLUSION: In this modern era, where people have the choice to decide newer and advanced forms of medical treatment and scientific methods, a large proportion of people still rely on alternative forms of treatment like homeopathy. More awareness regarding use of homeopathic treatment is needed among general population.

J Pak Med Assoc. 2010 Aug;60(8):667-70. Shah SF, Mubeen SM, Mansoor S. Department of Community Health Sciences, Hamdard College of Medicine & Dentistry, Karachi.

FULL TITLE: Efficacy of music therapy treatment based on cycles of sessions: a randomised controlled trial.

We undertook a randomised controlled trial to assess whether a music therapy (MT) scheme of administration, including three working cycles of one month spaced out by one month of no treatment, is effective to reduce behavioural disturbances in severely demented patients. Sixty persons with severe dementia (30 in the experimental and 30 in the control group) were enrolled. Baseline multidimensional assessment included demographics, Mini Mental State Examination (MMSE), Barthel Index and Neuropsychiatry Inventory (NPI) for all patients. All the patients of the experimental and control groups received standard care (educational and entertainment activities). In addition, the experimental group received three cycles of 12 active MT sessions each, three times a week. Each 30-min session included a group of three patients. Every cycle of treatment was followed by one month of wash-out. At the end of this study, MT treatment resulted to be more effective than standard care to reduce behavioural disorders. We observed a significant reduction over time in the NPI global scores in both groups (F(7,357) = 9.06, p < 0.001) and a significant difference between groups (F(1,51) = 4.84, p < 0.05) due to a higher reduction of behavioural disturbances in the experimental group at the end of the treatment (Cohen's d = 0.63). The analysis of single NPI items shows that delusions, agitation and apathy significantly improved in the experimental, but not in the control group. This study suggests the effectiveness of MT approach with working cycles in reducing behavioural disorders of severely demented patients.

Aging Ment Health. 2010 Nov;14(8):900-4. Raglio A, Bellelli G, Traficante D, Gianotti M, Ubezio MC, Gentile S, Villani D, Trabucchi M. Sospiro Foundation, Cremona, Italy. raglioa@tin.it Comment in: Aging Ment Health. 2010 Nov;14(8):891-9.

PSGR and PCA3 as biomarkers for the detection of prostate cancer in urine.

BACKGROUND: Several studies have demonstrated the usefulness of monitoring an RNA transcript in urine, such as PCA3, for prostate cancer (PCa) diagnosis. PCa screening would benefit from additional biomarkers of higher specificity and could be used in conjunction with prostate-specific antigen (PSA) testing, in order to better determine biopsy candidates. METHODS: We used urine sediments after prostate massage (PM) from 215 consecutive patients, who presented for prostate biopsy. We tested whether prostate-specific G-protein coupled receptor (PSGR), a biomarker previously described to be over-expressed in PCa tissue, could also be detected by quantitative real-time PCR in post-PM urine sediment. We combined these findings with prostate cancer gene 3 (PCA3), the current gold standard for PCa diagnosis in urine, to test if a combination of both biomarkers could improve the sensitivity of PCA3 alone. RESULTS: By univariate analysis we found that PSGR and PCA3 were significant predictors of PCa. Receiver operator characteristic curve analysis and its multivariate extension, multivariate ROC (MultiROC), were used to assess the outcome predictive values of the individual and the paired biomarkers. We obtained the following area under the curve values: PSA (0.602), PSGR (0.681), PCA3 (0.656), and PSGRvPCA3 (0.729). Then, we tested whether a combination of PSGR and PCA3 could improve specificity by fixing the sensitivity at 95%. We obtained specificities of 15% (PSGR), 17% (PCA3), and 34% (PSGRvPCA3). CONCLUSIONS: A multiplexed model including PSGR and PCA3 improves the specificity for the detection of PCa, especially in the area of high sensitivity. This could be clinically useful for determining which patients should undergo biopsy.

Prostate. 2010 Dec 1;70(16):1760-7. Rigau M, Morote J, Mir MC, Ballesteros C, Ortega I, Sanchez A, Colás E, Garcia M, Ruiz A, Abal M, Planas J, Reventós J, Doll A. Biomedical Research Unit, Research Institute, Vall d'Hebron UniversityHospital, Barcelona, Spain.

FULL TITLE: Mind-body connection, parapsychological phenomena and spiritual healing. A review.

Evidence regarding the influence of the mind on the body is abundant. Several mind-body healing procedures are currently being used, among them hypnosis, biofeedback, meditation, visualizations, management of emotions and prayer. Since the Big Bang, we are entangled with everything. This interaction would let individuals to communicate with the minds and bodies of others. The field of parapsychological research has provided a lot of information about significant events, including apparitions, communications with the dead, near-death experiences and out of the body experiences. It looks apparently evident, that consciousness can persist in the absence of brain function. According to the model that assumes that it is consciousness and not matter, the base of everything that exists, what survives after death is the "quantum monad" or spirit. It is said that spiritual cures are practiced by discarnate physicians who diagnose and prescribe conventional treatments, but very often they use unknown procedures based on the management of energy fields that are currently being studied by many physicists. Representative examples of the practice of spiritual medicine were the mediums Ze Arigo, George Chapman, Barbara Guerrero (Pachita) and presently the Brazilian medium John of God. Case reports of paranormal phenomena observed and studied by honest and serious scientists are very important for the advancement of parapsychology, because it has not been clearly established which approach, the qualitative or the quantitative, is more useful for the development of this field.

Invest Clin. 2010 Jun;51(2):209-38. Bonilla E. Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia y Centro de Investigaciones Biomédicas IVIC-Zulia. Maracaibo, Venezuela. embonilla2008@yahoo.com

This study investigated the potential for the aromas of the essential oils of Salvia species to affect cognition and mood in healthy adults. Research has demonstrated that orally administered Salvia officinalis and Salvia lavandulaefolia are capable of modulating cognition and mood. The active compounds in the herbal products might also be present in the aromas and so produce similar effects. In an independent groups design, three conditions, S. officinalis aroma, S. lavandulaefolia aroma and no aroma were employed. One hundred and thirty-five healthy volunteers acted as participants, with 45 in each condition. Cognitive performance was assessed via the Cognitive Drug Research (CDR) System. Bond-Lader mood scales measured the participants' mood on three dimensions before and after the cognitive tasks. Data analysis revealed that the S. officinalis aroma group performed significantly better than the control group on the quality of memory and secondary memory primary outcome factors from the test battery. The Alert mood measure displayed significant differences between both aromas and the control condition. These findings suggest that the aromas of essential oils of Salvia species reproduce some but not all of the effects found following oral herb administration, and that interesting dissociations occur between subjective and objective responses.

Hum Psychopharmacol. 2010 Jul;25(5):388-96. Moss L, Rouse M, Wesnes KA, Moss M. Department of Psychology, Brain, Performance and Nutrition Research Centre, Northumbria University, Newcastle upon Tyne, United Kingdom.

by Graham Howes

Stories: As far back as I can remember I have heard or seen or experienced or, if I am writing, imagining new stories. was told stories to entertain me or jokes which werestories with a punchline or at a Sunday School a teacher endeavoured to instruct me as Jesus had instructed his disciples using story, parable, metaphor and simile, in the hope that I would see the light and become one of the Faithful. I read stories in novels. When I became an actor I told stories in many different ways. As a Hypnotherapist I use the power of stories to make a point and reframe a perception. Milton Erickson would help someone move on with their life by telling a tale of My Friend John and how he had to move House and realised that his house was full of clutter and in order to move he had to clear the clutter away – especially in the attic – and only take with him what he really needed. I paraphrase, of course, but doesn't every good story teller embellish or fit the story to their needs?

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by Tim Brunson, PhD

Nobel laureate and quantum physicist Niels Bohr once said, "Prediction is very difficult, especially about the future." Attempting to look over the horizon toward the future of clinical hypnotherapy – as well as its implication concerning the totality of human transformation – is indeed a very difficult task. This is even more so as hypnotherapy is still an emerging field, which is far from receiving the cultural authority presently accorded professions such as medicine and psychology. Regardless, our value is rapidly gaining ground at the same time as scientific theory and technological innovations are revolutionizing how humans think and interact.

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FULL TITLE: A comparative study of complementary and alternative medicine use among heterosexually and lesbian identified women: data from the ESTHER Project

OBJECTIVES: The prevalence of complementary and alternative medicine (CAM) use among women in the United States is high. Little is known about how CAM use may differ based on sexual orientation. Study aims were to measure the prevalence of CAM use in a community sample of women, explore differences in CAM use patterns by sexual orientation, and identify correlates of CAM use. DESIGN/SUBJECTS: Analyses were based on women (Total N?=?879; n?=?479 lesbians) enrolled in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project, a cross-sectional heart-disease risk-factor study. SETTINGS/LOCATION: Data were collected through convenience sampling of adult females in Pittsburgh, PA (2003-2006). OUTCOME MEASURES: Main outcome measures included lifetime and past 12-month CAM use, and types of CAM modalities used in the past 12 months. RESULTS: The prevalence of having ever used CAM was 49.8%, with 42% having reported CAM use within the past 12 months. Lesbians had greater odds of having ever used CAM (adjusted odds ratio [AOR]?=?1.68 [95% confidence interval (CI): 1.23, 2.28]) and of having used CAM in the past 12 months (AOR?=?1.44 [CI: 1.06, 1.97]) than heterosexuals. In multivariate analyses, correlates of lifetime and past 12-month CAM use included being lesbian, white, higher educated, and a large-city resident; experiencing perceived discrimination in a health care setting; and having a greater spirituality rating and a history of a diagnosed mental health disorder. Past 12-month CAM use was also associated with having a provider of usual health care. Among women who used CAM within the past 12 months, heterosexuals had significantly higher yoga participation rates than lesbians. CONCLUSIONS: Sexual orientation is important in understanding lifetime and past 12-month CAM use. Because of the high prevalence of CAM use found in this study, medical practitioners should inquire about the CAM practices of female patients, particularly lesbians.

(Pittsburgh, PA, 2003-2006). J Altern Complement Med. 2010 Nov;16(11):1161-70. Smith HA, Matthews A, Markovic N, Youk A, Danielson ME, Talbott EO. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 230 McKee Street, Pittsburgh, PA 15213, USA. Smithha@upmc.edu

Jules Bernard Luys (1828-1897) is a relatively unknown figure in 19th century French neuropsychiatry. Although greatly influenced by Jean-Martin Charcot (1825-1893), Luys worked in the shadow of the 'master of La Salpêtrière' for about a quarter of a century. When he arrived at this institution in 1862, he used microscopy and photomicrography to identify pathological lesions underlying locomotor ataxia and progressive muscular atrophy. He later made substantial contributions to our knowledge of normal human brain anatomy, including the elucidation of thalamic organization and the discovery of the subthalamic nucleus. Luys's name has long been attached to the latter structure (corps de Luys), which is at the center of our current thinking about the functional organization of basal ganglia and the physiopathology of Parkinson's disease. As head of the Maison de santé d'Ivry, Luys developed a highly original view of the functional organization of the normal human brain, while improving our understanding of the neuropathological and clinical aspects of mental illnesses. In 1886, Luys left La Salpêtrière and became chief physician at La Charité hospital. Following Charcot, whom he considered as the father of scientific hypnotism, Luys devoted the last part of his career to hysteria and hypnosis. However, Luys ventured too deeply into the minefield of hysteria. He initiated experiments as unconventional as the distant action of medication, and became one of the most highly caricatured examples of the fascination that hysteria exerted upon neurologists as well as laypersons at the end of the 19th century.

Front Neurol Neurosci. 2011;29:125-36. Epub 2010 Oct 7. Parent M, Parent A. Department of Psychiatry and Neuroscience, Faculty of Medecine, Université Laval, and Centre de Recherche Université Laval Robert-Giffard, Québec City, Que., Canada.

FULL TITLE: Utilizing molecular details of the pain system to illustrate biochemical principles.

To capture student interest and show clinical relevance, molecular details from the pain system can be used as supplemental examples to basic biochemistry lectures. Lecture topics include glutamate, substance P, calmodulin-dependent protein kinase II, synaptic proteases, calcitonin gene-related peptide, and neuronal protein synthesis. These topics are utilized to illustrate basic biochemical issues and are linked to pain-related topics such as pain transmission, synaptic plasticity, long-term potentiation, and central sensitization. For analysis, a brief survey was administered to evaluate student attitudes toward a representative lecture segment. Survey results support the premise that utilizing the pain system is an effective tool to engage chiropractic students during basic biochemistry lectures.

J Chiropr Educ. 2010 Fall;24(2):187-93. Boal R, Gillette RG, Borman WH. University of Western States.

OBJECTIVE: To evaluate the effect of non-invasive biofeedback electrical stimulation on symptomatic abnormal skin scars. METHOD: Thirty patients with over 140 scars with long-term pain and itch were recruited into the study. Patients monitored the intensity of symptoms (pain and itching) on a numerical rating scale. In addition, a modified Manchester scar scale was used to objectively assess digital photographs of each scar in terms of colour, contour, distortion and texture, while a non-invasive spectrophotometric intracutaneous analysis was used to monitor the scars' physical characteristics. RESULTS: The electrical stimulation device resulted in a clinically and statistically significant (p < 0.05) reduction of symptoms and scar scores. Pain and itch scores were both reduced to a median score of 0 by 2 months, from a baseline of 7 and 6 respectively. Scar scores were reduced from a baseline of 14 to a median score of 11 by 2 months. CONCLUSION: These results give a preliminary indication of the potential role of non-invasive biofeedback electrical stimulation in the management of chronic scar pain and itch. However, further large scale controlled studies are warranted to elucidate its overall efficacy and mechanistic action. CONFLICT OF INTEREST: Funding was provided from Fenzian Ltd for this study.

J Wound Care. 2010 Oct;19(10):447-53. Perry D, Colthurst J, Giddings P, McGrouther DA, Morris J, Bayat A. School of Translational Medicine, University of Manchester, UK.

Full Title: Acupuncture reduces symptoms of dry eye syndrome: a preliminary observational study.

OBJECTIVE: The aim of this study was to evaluate the effect of acupuncture treatment on dry eye syndrome. DESIGN: This was a prospective observational study. SETTING: The study was conducted at a clinical evaluation center for acupuncture and moxibustion of the Korean Institute of Oriental Medicine, Republic of Korea. SUBJECTS: The subjects were patients with dry eye disease (N?=?36), defined by Schirmer test scores of <10?mm/5?min and tear film break-up times (BUTs) of <10 seconds. TREATMENTS: Participants were treated with acupuncture three times per week for 4 weeks. MEASURE OF EFFECTIVENESS: Schirmer test scores, BUTs, symptom scores, ocular surface disease index (OSDI) scores and dry eye symptom questionnaires were compared before and after treatment to evaluate the efficacy of acupuncture treatment. RESULTS: After treatment, symptom scores, OSDI scores and the number of dry eye symptoms were all significantly lower (p? J Altern Complement Med. 2010 Dec;16(12):1291-4. Jeon JH, Shin MS, Lee MS, Jeong SY, Kang KW, Kim YI, Choi SM. Acupuncture, Moxibustion, and Meridian Research Center, Korea Institute of Oriental Medicine, Daejeon, South Korea.

Full Title: A study on the basic drugs and points for point application in summer to treat the diseases with attacks in winter.

OBJECTIVE: To study the basic prescriptions of drugs and points for point application in summer to treat the diseases with attacks in winter and the law governing their compatibility. METHODS: A database was set up by collecting and sorting out the relevant literature, and the analysis was made with the complex network. RESULTS: It was found that Bai Jie Zi (Semen Sinapis Albae), Xi Xin (Herba Asari), Gan Sui (Radix Euphorbiae Kansui) and Yan Hu Suo (Rhizoma Corydalis) were used as the basic prescriptions of drugs, Feishu (BL 13), Dazhui (GV 14) and Shanzhong (CV 17) were selected as the basic prescription of points. CONCLUSION: The knowledge obtained from the complex networks on the basic prescriptions of drugs and points for point-application in summer to treat diseases with attacks in winter can provide a data support for working out operation norms and carrying on verification research.

J Tradit Chin Med. 2010 Sep;30(3):180-4. Fang YG, Zhou XZ, Liu BY, Wang YY. Institute of TCM China Clinical Basic Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.

Standard care of burn wounds consists of cleaning and debridement (removing devitalized tissue), followed by daily dressing changes. Children with burns undergo multiple, painful and anxiety-provoking procedures during wound care and rehabilitation. The goal of procedural sedation is safe and efficacious management of pain and emotional distress, requiring a careful and systematic approach. Achieving the best results needs understanding of the mechanisms of pain and the physiologic changes in burn patients, frequent evaluation and assessment of pain and anxiety, and administration of suitable pharmacological and nonpharmacological therapies. Pharmacological therapies provide the backbone of analgesia and sedation for procedural pain management. Opioids provide excellent pain control, but they must be administered judiciously due to their side effects. Sedative drugs, such as benzodiazepines and propofol, provide excellent sedation, but they must not be used as a substitute for analgesic drugs. Ketamine is increasingly used for analgesia and sedation in children as a single agent or an adjuvant. Nonpharmacological therapies such as virtual reality, relaxation, cartoon viewing, music, massage and hypnosis are necessary components of procedural sedation and analgesia for children. These can be combined with pharmacological techniques and are used to limit the use of drugs (and hence side effects), as well as to improve patient participation and satisfaction. In this article, we review the pathophysiologic changes associated with major thermal injury in children, the options available for sedation and analgesia for wound care procedures in these children and our institutional guidelines for procedural sedation.

Expert Rev Neurother. 2010 Nov;10(11):1747-59. Bayat A, Ramaiah R, Bhananker SM. Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Full Title: Pre-trial beliefs in complementary and alternative medicine: whose pre-trial belief should be considered?

Subjective probabilities play a significant role in the assessment of evidence: in other words, our background knowledge, or pre-trial beliefs, cannot be set aside when new evidence is being evaluated. Focusing on homeopathy, this paper investigates the nature of pre-trial beliefs in clinical trials. It asks whether pre-trial beliefs of the sort normally held only by those who are sympathetic to homeopathy can legitimately be disregarded in those trials. The paper addresses several surprisingly unsuccessful attempts to provide a satisfactory justification for ignoring the pre-trial beliefs of the homeopathic community. The ensuing diagnosis of the difficulties here emphasizes that the reason the arguments for choosing the pre-trial beliefs of the conventional community seem insufficient is not the arguments per se. It is rather that there is no cogent argument for choosing the conventional stance which would at the same time rationally persuade a member of the homeopathic community. The paper concludes that, once we understand that this is the predicament, there is no genuine reason to doubt the reasoning that leads us to reject the pre-trial beliefs of the homeopathic community.

Med Health Care Philos. 2010 Sep 6. Hansen K, Kappel K. Department of Public Health, Section for Health Services Research, Unit of Medical Philosophy and Clinical Theory, University of Copenhagen, Øster Farimagsgade 5, Building 5, P.O. Box 2099, 1014, Copenhagen K, Denmark, kirstenhansen100@gmail.com.

FULL TITLE: Back massage therapy promotes psychological relaxation and an increase in salivary chromogranin A release.

Massage therapy promotes psychosocial relaxation, reduces stress and has been reported to improve the immune function. As such, massage therapy is currently used in palliative care for the relief of anxiety and pain. Although psychosocial status has been evaluated using subjective psychological tests, such as State-Trait Anxiety Inventory (STAI), subjective psychological tests are of limited value if the subjects fail to report reliably. Salivary biomarkers have been recently suggested as useful objective markers for assessing psychosocial status. To determine whether salivary biomarkers are useful objective indices for assessing the effects of back massage on the mental status of 25 young healthy female volunteers, we measured heart rate and salivary biomarkers (?-amylase activity, cortisol, and chromogranin A) and assessed the STAI score before and after the back massage. Back massage significantly reduced the heart rate and STAI; however, salivary amylase and cortisol levels did not change. In contrast, the level of salivary chromogranin A significantly increased. We therefore conclude that changes in the salivary biomarkers tested here may not indicate changes in psychological status following massage therapy. However, the increase in chromogranin A release may contribute to the immunologically beneficial effects of massage therapy as chromogranin A has antibacterial and antifungal activity.

J Anesth. 2010 Dec;24(6):955-8. Noto Y, Kudo M, Hirota K. Department of Nursing, Hirosaki University Graduate School of Health Sciences, Hirosaki 036-8563, Japan.

It has been reported for more than 100 years that patients with severe nonfluent aphasia are better at singing lyrics than they are at speaking the same words. This observation led to the development of melodic intonation therapy (MIT). However, the efficacy of this therapy has yet to be substantiated in a randomized controlled trial. Furthermore, its underlying neural mechanisms remain unclear. The two unique components of MIT are the intonation of words and simple phrases using a melodic contour that follows the prosody of speech and the rhythmic tapping of the left hand that accompanies the production of each syllable and serves as a catalyst for fluency. Research has shown that both components are capable of engaging fronto-temporal regions in the right hemisphere, thereby making MIT particularly well suited for patients with large left hemisphere lesions who also suffer from nonfluent aphasia. Recovery from aphasia can happen in two ways: either through the recruitment of perilesional brain regions in the affected hemisphere, with variable recruitment of right-hemispheric regions if the lesion is small, or through the recruitment of homologous language and speech-motor regions in the unaffected hemisphere if the lesion of the affected hemisphere is extensive. Treatment-associated neural changes in patients undergoing MIT indicate that the unique engagement of right-hemispheric structures (e.g., the superior temporal lobe, primary sensorimotor, premotor and inferior frontal gyrus regions) and changes in the connections across these brain regions may be responsible for its therapeutic effect.

Future Neurol. 2010 Sep;5(5):657-665. Schlaug G, Norton A, Marchina S, Zipse L, Wan CY. Department of Neurology, Music, Neuroimaging & Stroke Recovery Laboratories, Beth Israel Deaconess Medical Center & Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.

FULL TITLE: Use of complementary and alternative medical interventions for the management of procedure-related pain, anxiety, and distress in pediatric oncology: an integrative review.

This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL, PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind-body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology.

J Pediatr Nurs. 2010 Dec;25(6):566-79. Epub 2010 Mar 12. Landier W, Tse AM. School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI, USA. landier@hawaii.edu