Center for Integrative Complementary Medicine

West Jerusalem, Israel

Center for Integrative Complementary Medicine

West Jerusalem, Israel
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Yaal-Hahoshen N.,Tel Aviv University | Maimon Y.,Tel Aviv Sourasky Medical Center | Maimon Y.,Refuot Integrative Medical Center | Siegelmann-Danieli N.,Maccabi Healthcare Services | And 6 more authors.
Oncologist | Year: 2011

Background. This prospective, controlled study evaluated the safety, tolerability, and efficacy of the mixture of botanical compounds known as LCS101 in preventing chemotherapy-induced hematological toxicity in breast cancer patients. Methods. Female patients diagnosed with localized breast cancer were randomly allocated to receive treatment with either LCS101 or placebo capsules, in addition to conventional chemotherapy. The study intervention was initiated 2 weeks prior to the initiation of chemotherapy and continued until chemotherapy was completed, with participants receiving 2 g of LCS101 capsules thrice daily. Subjects were assessed for the development of hematological and nonhematological toxicities, as well as the tolerability and safety of the study intervention. Results. Sixty-five breast cancer patients were recruited, with 34 allocated to LCS101 and 31 allocated to placebo treatment. Patients in the treatment group developed significantly less severe (grades 2-4) anemia (p <.01) and leukopenia (p <.03) when comparing grades 0-1 with grades 2-4, with significantly less neu-tropenia (p <.04) when comparing grades 0-2 with grades 3-4. This effect was more significant among patients undergoing a dose-dense regimen. No statistically significant effect was found with respect to nonhemato-logical toxicities, and side effect rates were not significantly different between the groups, with no severe or life-threatening events observed in either group. Conclusion. The addition of LCS101 to anthracycline-and taxane-based chemotherapy is safe and well tolerated, and may significantly prevent some chemotherapy-induced hematological toxicities in early breast cancer patients. These results should encourage further larger and more extensive clinical trials. © AlphaMed Press.

Samuels N.,Center for Integrative Complementary Medicine | Zisk-Rony R.Y.,Hebrew University of Jerusalem | Singer S.R.,Center for Integrative Complementary Medicine | Dulitzky M.,Chaim Sheba Medical Center | And 3 more authors.
American Journal of Obstetrics and Gynecology | Year: 2010

Objective: The objective of the study was to evaluate the use and attitudes of nurse-midwives in Israel toward complementary and alternative medicine (CAM). Study Design: In a cross-sectional study, nurse-midwives from 5 Israeli medical centers completed the CAM Health Belief Questionnaire, a validated tool examining data regarding personal health behavior, use of CAM therapies, and attitudes toward CAM. Results: One hundred seventy-three of 238 potential respondents completed the questionnaires (72.7%). Most (87.3%) reported using CAM (67.1% massage, 48.6% herbal medicine, 42.2% meditation, 40.5% touch therapies, and 39.9% prayer) and agree with many fundamental tenets of CAM such as the existence of energy forces, self-healing, and integrating patients' health beliefs and values into their care. Conclusion: The majority of nurse-midwives studied reported using and recommending CAM to their patients and believe that CAM can complement conventional medical therapies. Health care providers could benefit from education with regard to the efficacy and safety of CAM modalities during pregnancy and childbirth. © 2010 Mosby, Inc. All rights reserved.

Ben-Arye E.,Rothschild | Ben-Arye E.,Technion - Israel Institute of Technology | Polliack A.,Hebrew University of Jerusalem | Schiff E.,Bnai Zion Medical Center | And 3 more authors.
Journal of Pain and Symptom Management | Year: 2013

Context: Many cancer patients are using non-herbal nutritional supplements (NHNS), often without informing their oncologists. Objectives: To review the literature and summarize the beneficial effects and safety of NHNS in the prevention and reduction of treatment-related symptoms. Methods: Databases were searched for randomized, controlled clinical trials (Jadad score ≥ 2) using AltHealthWatch, Cochrane Database of Systematic Reviews, Embase, MEDLINE, Memorial Sloan-Kettering Integrative Medicine Service Database, Natural Standard Database, and PubMed. The key words searched were the following: alternative and/or complementary medicine, nutritional and/or dietary supplements, quality of life, symptoms and/or side effects, specific toxicities (e.g., neuropathy, mucositis), and specific supplements (e.g., vitamin E, glutamine, etc.). Results: A number of NHNS products were found to be effective. The incidence and severity of peripheral sensory neuropathy associated with taxane-agents such as paclitaxel can be reduced with vitamin E, glutamine, and acetyl-L-carnitine. Vitamin E and glutamine also have been shown to reduce oral mucositis resulting from radiation and chemotherapy, and glutamine and probiotics can reduce chemotherapy-induced diarrhea. Conclusion: There is a need to develop an open and nonjudgmental dialogue between oncologists and cancer patients, addressing the needs of the patient while dealing with issues related to the efficacy and safety of these products. Referral of patients to an integrative medicine consultant may help achieve these goals, providing both parties with the option of reaching an informed and respectful decision about treatment. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Oberbaum M.,Center for Integrative Complementary Medicine | Samuels N.,Center for Integrative Complementary Medicine | Ben-Arye E.,Technion - Israel Institute of Technology | Amitai Y.,Hebrew University of Jerusalem | And 2 more authors.
Human and Experimental Toxicology | Year: 2012

Background: A recent report showed increased frequency of apparent life-threatening events (ALTEs) in infants treated with the homeopathic medication GaliCol-Baby (GCB). The premise was that the ALTEs resulted from toxic effects of the drug's components. We examine an alternative explanation. Method: The toxicological literature was searched for known reactions to the various GCB components, noting doses and reported symptoms. Dosage quantities and severity of reaction to the GCB were ranked independently by two groups of physicians, and a dose-response curve was generated. Reported toxic doses and symptoms were compared with those of the GCB series. The homeopathic literature was searched as well to determine the propensity of the GCB components to cause ALTE symptoms, when given in homeopathic doses to healthy volunteers (proving). Results: Doses ingested in the GCB series were 10-13 orders of magnitude smaller than those reported to cause toxic reactions in humans. There was poor correlation between symptoms with GCB and toxic profiles of the components. A nonsignificant, inverse relationship between dose and severity of reaction was observed. Conversely, four GCB components (in homeopathic doses) had a high propensity to produce at least one of five symptoms which define ALTE, two of which had intermediate to high propensity to produce three symptoms. Conclusions: It is unlikely that the ALTE following ingestion of GCB was a toxic reaction to any of the drug's component. Homeopathic theory may explain this linkage, though further research is needed to understand the pathogenic effects of highly diluted homeopathic compounds. © 2012 SAGE Publications.

Samuels N.,Center for Integrative Complementary Medicine | Zisk-Rony R.Y.,Hebrew University of Jerusalem | Zevin S.,Shaare Zedek Medical Center | Becker E.L.,Center for Integrative Complementary Medicine | And 2 more authors.
Patient Education and Counseling | Year: 2012

Objective: To study non-vitamin, non-mineral (NVNM) supplements use and disclosure of among hospitalized internal medicine patients. Methods: A convenience sample of patients completed an interviewer-administered questionnaire examining use of and perceptions regarding NVNM supplements, and disclosure to medical personnel. Results: 280 patients were interviewed (54% female), 15.4% reporting NVNM supplement use. This practice was more prevalent among female patients (p=0.045), more educated (p<0.001) and patients with more impaired quality-of-life, measured by the SF-12 tool (p<0.020). The most common factor influencing NVNM supplement use was a physician's recommendation. Most (74%) patients using NVNM supplements reported having disclosed this practice to community-based physicians, with only 23.7% disclosing to hospital staff. Six patients reported using supplements at the exclusion of conventional medication, with potentially serious implications. Conclusion: While the majority of patients using NVNM supplements are sharing this information with their primary-care physicians, there is little disclosure of this practice to hospital staff. This may be due to a perceived negative attitude of medical professionals to complementary medicine, and a lack of awareness by hospital staff regarding such practices. Practice implications: Hospital-based medical professionals need to be aware of the use of NVNM supplements and the resulting implications by their internal medicine patients. © 2012 Elsevier Ireland Ltd.

PubMed | Royal London Hospital for Integrated Medicine, Veronica, University of Washington, Central Council for Research in Homeopathy and 9 more.
Type: | Journal: Complementary therapies in medicine | Year: 2016

To date, our programme of systematic reviews has assessed randomised controlled trials (RCTs) of individualised homeopathy separately for risk of bias (RoB) and for model validity of homeopathic treatment (MVHT).The purpose of the present paper was to bring together our published RoB and MVHT findings and, using an approach based on GRADE methods, to merge the quality appraisals of these same RCTs, examining the impact on meta-analysis results.Systematic review with meta-analysis.As previously, 31 papers (reporting a total of 32 RCTs) were eligible for systematic review and were the subject of study.For each trial, the separate ratings for RoB and MVHT were merged to obtain a single overall quality designation (high, moderate, low, very low), based on the GRADE principle of downgrading.Merging the assessment of MVHT and RoB identified three trials of high quality, eight of moderate quality, 18 of low quality and three of very low quality. There was no association between a trials MVHT and its RoB or its direction of treatment effect (P>0.05). The three high quality trials were those already labelled reliable evidence based on RoB, and so no change was found in meta-analysis based on best-quality evidence: a small, statistically significant, effect favouring homeopathy.Accommodating MVHT in overall quality designation of RCTs has not modified our pre-existing conclusion that the medicines prescribed in individualised homeopathy may have small, specific, treatment effects.

Mathie R.T.,British Homeopathic Association | Roniger H.,Royal London Hospital for Integrated Medicine | Van Wassenhoven M.,LMHI Research Secretariat | Frye J.,University of Maryland Baltimore County | And 8 more authors.
BMC Medical Research Methodology | Year: 2012

Background: A method for assessing the model validity of randomised controlled trials of homeopathy is needed. To date, only conventional standards for assessing intrinsic bias (internal validity) of trials have been invoked, with little recognition of the special characteristics of homeopathy. We aimed to identify relevant judgmental domains to use in assessing the model validity of homeopathic treatment (MVHT). We define MVHT as the extent to which a homeopathic intervention and the main measure of its outcome, as implemented in a randomised controlled trial (RCT), reflect 'state-of-the-art' homeopathic practice. Methods: Using an iterative process, an international group of experts developed a set of six judgmental domains, with associated descriptive criteria. The domains address: (I) the rationale for the choice of the particular homeopathic intervention; (II) the homeopathic principles reflected in the intervention; (III) the extent of homeopathic practitioner input; (IV) the nature of the main outcome measure; (V) the capability of the main outcome measure to detect change; (VI) the length of follow-up to the endpoint of the study. Six papers reporting RCTs of homeopathy of varying design were randomly selected from the literature. A standard form was used to record each assessor's independent response per domain, using the optional verdicts 'Yes', 'Unclear', 'No'. Concordance among the eight verdicts per domain, across all six papers, was evaluated using the kappa (κ) statistic. Results: The six judgmental domains enabled MVHT to be assessed with 'fair' to 'almost perfect' concordance in each case. For the six RCTs examined, the method allowed MVHT to be classified overall as 'acceptable' in three, 'unclear' in two, and 'inadequate' in one. Conclusion: Future systematic reviews of RCTs in homeopathy should adopt the MVHT method as part of a complete appraisal of trial validity. © 2012Mathie et al; licensee BioMed Central Ltd.

Samuels N.,Center for Integrative Complementary Medicine | Elstein D.,Shaare Zedek Medical Center | Lebel E.,Shaare Zedek Medical Center | Zimran A.,Shaare Zedek Medical Center | Oberbaum M.,Center for Integrative Complementary Medicine
Complementary Therapies in Medicine | Year: 2012

Objective: The purpose of this study was to examine the effect of acupuncture on bone/joint pain, headache and fatigue, as well as quality of life in patients with Gaucher disease (GD), within the framework of an integrated treatment programme. Methods: Patients with GD suffering from any of the above symptoms were offered a series of 10-12 weekly acupuncture treatment sessions. Prior to initiation of treatment, participants were asked to score the severity of pain, as well as to complete the Functional Assessment of Chronic Illness Therapy-Fatigue measure (FACIT-F) and the Medical Outcomes Study (MOS) Short-Form (SF) questionnaire. These tools were evaluated again at the end of the treatment period. Results: A total of 12 patients were evaluated. While the only pain outcome reduced by acupuncture was knee pain, a significant improvement was observed with respect to nearly all FACIT-Fatigue measures, including the Physical Well Being (PWB) subscales and the SF-12 Physical Composite Score (PCS), though not for the Mental Composite Score (MCS). Patients reported satisfaction with the treatment process, and no significant side effects were reported. Conclusion: Acupuncture may play a beneficial role for patients with GD when used in conjunction with conventional therapy, reducing fatigue and improving physical function. The preliminary finding of this observational study should encourage further research. © 2011 Elsevier Ltd.

Samuels N.,Center for Integrative Complementary Medicine
Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995) | Year: 2012

Gingivitis is a chronic inflammatory condition, resulting from gingival bacteria and bacterial byproducts. Antiplaque oral rinses reduce inflammation by removing or inhibiting plaque formation. The purpose of this pilot study was to examine the anti-inflammatory effects of HM-302, a mouth rinse based on natural products, on gingival inflammation. A prospective, double-blinded, randomized parallel-group controlled trial involving 62 patients was conducted to assess efficacy and safety. During a 2-week period with no dental hygiene, subjects were randomized to receive either the study rinse (HM-302); a cetylpyridinium chloride (CPC) rinse; an essential oils (EO) rinse; or a water-only preparation. The gingival index (GI), plaque index (PI), and number of bleeding sites were measured at baseline and at the end of the study period. Progression of gingival inflammation resulting from lack of dental hygiene was lowest in patients treated with the HM-302 rinse, and was significantly less marked than in patients treated with the water-only preparation. When compared to the CPC and EO treatments, HM-302 was the only mouth rinse that was significantlybetter than the control, with respect to both the change in absolute GI scores (p = .006) and to the percent increase in GI scores (p = .012). No serious adverse effects were noted in any of the study groups. HM-302 is a safe and effective treatment for preventing the development of gingival inflammation in an experimental gingivitis model. Further research is needed to evaluate its long-term effects.

Samuels N.,Center for Integrative Complementary Medicine
The American journal of clinical hypnosis | Year: 2011

Prurigo Nodularis (PN) is a chronic pruritic skin condition for which current conventional therapies are of limited benefit and with potentially toxic effects. Acupuncture--the insertion of thin needles at specific points on the skin--has been shown to alleviate itching through a number of itch-associated mediator effects. Hypnosis has been shown to modify and reduce the intensity of itching as well. A 44 year-old woman presented with a 30-year history of a diffuse itchy rash diagnosed as PN. She had tried various antihistamine and corticosteroid medications, to no avail. A treatment regimen using hypnosis and acupuncture (hypnopuncture) was initiated, with significant reduction in the itching, size and number of skin lesions. Hypnopuncture may offer a synergistic and augmented response to treatment, though further research is needed to understand the true benefits of this combined regimen.

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