Full title: Acupuncture for Chronic Low Back Pain: A Multicenter, Randomized, Patient-Assessor Blind, Sham-Controlled Clinical Trial.

Study Design. Multicenter, Randomized, Patient-Assessor Blind, Sham-Controlled Clinical Trial.Objective. To investigate the efficacy of acupuncture treatment with individualized setting for reduction of bothersomeness in participants with chronic low back pain (cLBP).Summary of Background Data. Low back pain is one of the main reasons of disability among adults of working age. Acupuncture is known as an effective treatment for chronic low back pain, but it remains still unclear whether acupuncture is superior to placebo.Methods. One hundred thirty adults aged 18-65 with non-specific LBP of lasting for at least the last 3 months was participated in the three Korean medical hospitals in Korea. Participants got individualized real acupuncture treatments or sham acupuncture treatments over 6 weeks (twice a week) from Korean medicine doctors. Primary outcome was change of Visual Analogue Scale (VAS) score for bothersomeness of cLBP. Secondary outcomes included VAS for pain intensity and questionnaires including Oswestry disability index (ODI), General health status (SF-36), and Beck's depression inventory (BDI).Results. There were no baseline differences observed between two groups except ODI. One hundred sixteen participants finished the treatments and 3-, 6-month follow ups with fourteen subjects' drop-out. Significant difference of VAS for bothersomeness and pain intensity of cLBP have been found between two groups (p<0.05) at the primary end point (8 week). In addition, those two scores have been improved continuously until 3-month follow up (p = 0.011, p = 0.005, respectively). ODI, BDI and SF-36 scores were also improved in both groups without group difference.Conclusion. This randomized sham-controlled trial suggests that acupuncture treatment show the better effects on the reduction of the bothersomeness and pain intensity than sham-control in participants with cLBP.

Spine (Phila Pa 1976). 2012 Sep 28. Cho YJ, Song YK, Cha YY, Shin BC, Shin IH, Park HJ, Lee HS, Kim KW, Cho JH, Chung WS, Lee JH, Song MY. 1Department of Oriental Rehabilitation Medicine, Kyung Hee University, Seoul, Korea 2Department of Oriental Rehabilitation Medicine, Kyung Won University, Sungnam, Korea 3Department of Oriental Rehabilitation Medicine, Sang Ji University, Wonju, Korea 4Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, Korea 5Department of Biomedical Statistics, Catholic University of Daegu, Daegu, Korea 6Department of Meridian and Acupoints, Kyung Hee University, Seoul, Korea.

To explore patients' perspectives towards integration of Complementary and Alternative Medicine (CAM) in primary care. A mixed-methods approach was used. This included a survey on use, attitudes and disclosure of CAM, an e-panel consultation and focus group among patients with joint diseases. A total of 416 patients responded to the survey who suffered from osteoarthritis (51%), rheumatoid arthritis (29%) or fibromyalgia (24%). Prevalence of CAM use was 86%, of which 71% visited a CAM practitioner. Manual therapies, acupuncture and homeopathy were most frequently used. A minority (30%) actively communicated CAM use with their General Practitioner (GP). The majority (92%) preferred a GP who informed about CAM, 70% a GP who referred to CAM, and 42% wanted GPs to collaborate with CAM practitioners. Similar attitudes were found in the focus group and upon e-panel consultation. Most patients in primary care want a GP who listens, inquires about CAM and if necessary refers to or collaborates with CAM practitioners. To meet needs of patients, primary care disease management would benefit from an active involvement of GPs concerning CAM communication/referral. This study presents a model addressing the role of patients and GPs within such an integrative approach.

Patient Educ Couns. 2012 Sep 29. pii: S0738-3991(12)00341-2. doi: 10.1016/j.pec.2012.08.013. Jong MC, van de Vijver L, Busch M, Fritsma J, Seldenrijk R. Department Healthcare and Nutrition, Louis Bolk Institute, Driebergen, The Netherlands; Department Health Sciences, Mid Sweden University, Sundsvall, Sweden; National Information and Knowledge Centre for Integrative Medicine (NIKIM), The Netherlands. Electronic address: m.jong@louisbolk.nl.

Full Title: The importance of supportive care in optimizing treatment outcomes of patients with advanced prostate cancer.

Optimal oncologic care of older men with prostate cancer, including effective prevention and management of the disease and treatment side effects (so-called best supportive care measures) can prolong survival, improve quality of life, and reduce depressive symptoms. In addition, the proportion of treatment discontinuations can be reduced through early reporting and management of side effects. Pharmacologic care may be offered to manage the side effects of androgen-deprivation therapy and chemotherapy, which may include hot flashes, febrile neutropenia, fatigue, and diarrhea. Nonpharmacologic care (e.g., physical exercise, acupuncture, relaxation) has also been shown to benefit patients. At the Georges Pompidou European Hospital, the Program of Optimization of Chemotherapy Administration has demonstrated that improved outpatient follow-up by supportive care measures can reduce the occurrence of chemotherapy-related side effects, reduce cancellations and modifications of treatment, reduce chemotherapy wastage, and reduce the length of stay in the outpatient unit. The importance of supportive care measures to optimize management and outcomes of older men with advanced prostate cancer should not be overlooked.

Oncologist. 2012;17 Suppl 1:23-30. Scotté F. Oncologie Médicale et Unité Fonctionnelle de Soins de Support, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France. florian.scotte@egp.aphp.fr.

by Tim Brunson PhD

Just a few years ago several of my colleagues and I were enthralled as Robert Otto gave us his normally charismatic pep talk concerning the wonderful powers of the "subconscious mind." As a well-trained and experienced advocate of hypnotherapy, he was faithfully following a tradition rooted in the works of Sigmund Freud and further expounded by other greats such as Ormond McGill, Milton H. Erickson, and David Elman. Nevertheless, I am proposing the heretical stance that our profession's fascination with the concept of the "subconscious mind" has retarded the acceptance of hypnosis and hypnotherapy as valid for clinical applications. This well-traveled path may have turned into a rut which we must transcend.

[More]