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Objective. This overview is to evaluate the current evidence from systematic reviews (SRs) of Danhong injection (DHI) for ischemic stroke (IS). Methods. SRs of randomized controlled trials (RCTs) concerning DHI and IS were searched in six databases without language restrictions until September 2015. Assessment of multiple systematic reviews (AMSTAR) was used to evaluate the methodological quality of all included SRs. Result. A total of 8 articles were included. After the administration of DHI, clinical efficiency and neurological deficits score have marked advantages over those of the control group. However, the overall poor quality of meta-analysis and original studies affected the reliability of the results. Evaluation of methodological quality found that no one paper meets the requirements of all 11 items. The main flaws of the methodology quality included the following: not providing “a priori” design and reasonable objectives, duplicate study selection not given enough attention, performing an incomprehensive literature search, not paying attention to publication bias and other bias reports, characteristics of included studies not provided in detail, and ignoring clinical heterogeneity when performing meta-analyses. Conclusion. The current published SRs suggest DHI appears to be a safe and effective way for IS treatment in general. However, it lacks a high quality systematic evaluation and analysis. The quality of SRs should be improved. Further large sample-size and well-designed RCTs are needed. [ABSTRACT FROM AUTHOR]

Background: Chronic migraine is a disabling condition that impacts multiple aspects of migraineurs' lives. Although pharmacological treatments can help to treat the pain associated with migraine headache, chronic migraineurs often experience side-effects of pharmacological treatments. Those experiences may contribute to the observed growth in complementary and alternative medicine (CAM) use among migraineurs. Relatively little is known about the patterns of CAM treatment and the characteristics of chronic migraineurs. Therefore, the purpose of the present study is to investigate the characteristics of chronic migraineurs who use CAM treatment and the relationship among satisfaction with current CAM use, negative life impact, migraine outcomes, and psychiatric comorbidities among chronic migraineurs. Methods: 2907 participants were recruited from a well-known online migraine headache resource. All participants were US adults aged 18 years or older. Migraineurs are referred to this website through various routes (e.g., referral from healthcare providers, internet search, obtaining information from research papers, personal invitation from other users, and information shared on social media etc.). Participants completed a 30-min self-report-survey in the spring of 2014. Results: Almost half of the participants reported that they are currently using more than three different CAM treatments even though the majority of the participants reported neutral or dissatisfied with their current CAM treatment. Chronic migraineurs who use CAM treatments were more likely to experience prolonged or frequent migraine headaches (p = .018, η = .0021), and experience greater negative life impact from their headaches (p = .000, η = .0172) compared to non-CAM users. CAM treatment satisfaction was inversely related to the number of psychiatric comorbidities, frequency of migraines, and number of migraine symptoms (p's < .05). However, CAM treatment satisfaction was more strongly correlated with migraine outcomes than psychiatric comorbidities. Conclusions: Chronic migraineurs often pursue multiple CAM treatments in spite of low levels of satisfaction with those treatments. Patients who experience relief from traditional treatments are less likely to seek the out additional CAM treatments. Thus it is often the sicker migraine patients who use CAM. More attention is needed to consider migraine treatment resistance, and psychological factors in planning the treatment of chronic migraineurs as those factors may play an important role in treatment choices by patients. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this survey was to evaluate attitudes toward acupuncture among pain medicine fellowship directors. Additional goals were to assess the availability of acupuncture at academic medical centers and ascertain the inclusion of this modality in fellowship curricula. Methods. Electronic and paper surveys were distributed to the 97 American College of Graduate Medical Education pain medicine fellowship directors during January and February, 2014. Directors were queried about their referral patterns to acupuncture, as well as their perceptions of the utility of acupuncture for common pain conditions. They were asked about the availability of acupuncture at their institution, and whether acupuncture was included in the fellowship curriculum. Results. Sixty-seven percent of fellowship directors (65/97) completed the questionnaire. A majority of directors (83%) reported acupuncture is available to patients at their institution, and reported that acupuncture is a modality that they discuss with patients when creating a treatment plan for chronic pain (72%). The majority of programs include acupuncture as part of didactic (63%) and clinical (52%) education. Time constraints, lack of qualified teaching personnel, and cost to patients were cited as barriers to inclusion. The majority of fellowship directors considered acupuncture a safe and worthwhile option for common pain conditions. Conclusion. Results from this survey indicate that acupuncture is widely available to patients at academic medical centers, integrated into many pain fellowship curricula, and considered a useful modality by physician leaders in the field of pain medicine. This sentiment, paired with the flexibility of national guidelines for pain fellowship curricula, suggests a trend toward greater inclusion of this modality in academic medicine. [ABSTRACT FROM AUTHOR]

We examined the National Health Interview Survey (NHIS) 2012 to explore how US adult consumers of CAM differ by gender in terms of their sociodemographic characteristics, current health conditions, and perceived benefits of CAM. All individuals who completed the adults core interviews (N = 34,525) were included. CAM use, major sociodemographic variables, perceived benefits of using CAM, and top ten reported health conditions for which CAM was used were selected and analyzed by Stata. Findings revealed that 29.6% (n = 10,181) reported having used at least one form of CAM in the previous 12 months. Compared to male CAM users, female CAM users were more likely to have a bachelor degree, to be divorced/separated or widowed, and less likely to earn $75,000 or more. Back pain/problem was the most common problem reported by both male and female CAM users (32.2% and 22.6%, resp.). A higher proportion of female CAM users reported using CAM for perceived benefits such as general wellness or general disease prevention. This paper provides foundation information regarding gender differences in CAM use and is a platform for further in-depth examination into how and why males and females differ in their reasons for CAM use. [ABSTRACT FROM AUTHOR]

We examined the National Health Interview Survey (NHIS) 2012 to explore how US adult consumers of CAM differ by gender in terms of their sociodemographic characteristics, current health conditions, and perceived benefits of CAM. All individuals who completed the adults core interviews (M = 34,525) were included. CAM use, major sociodemographic variables, perceived benefits of using CAM, and top ten reported health conditions for which CAM was used were selected and analyzed by Stata. Findings revealed that 29.6% (n = 10,181) reported having used at least one form of CAM in the previous 12 months. Compared to male CAM users, female CAM users were more likely to have a bachelor degree, to be divorced/separated or widowed, and less likely to earn $75,000 or more. Back pain/problem was the most common problem reported by both male and female CAM users (32.2% and 22.6%, resp.). A higher proportion of female CAM users reported using CAM for perceived benefits such as general wellness or general disease prevention. This paper provides foundation information regarding gender differences in CAM use and is a platform for further in-depth examination into how and why males and females differ in their reasons for CAM use. [ABSTRACT FROM AUTHOR]

Many Americans, not completely satisfied with traditional western medicine, have turned to alternative and complementary medicine which explains the increasing popularity of the herbal products and the Chinese herbal medicine. The lack of government regulations and the increasing advertisements by the manufactures have created an impression to the common public that the natural herbal remedies are inherently safer and cheaper than conventional medicine. The skyrocketing rise of healthcare cost and the adverse reaction and side effects incurred from the prescribed drugs have both reinforced such an impression. Herbs in the USA and in many European countries have been prepared as capsules, tablets, teas, lozenges, juice extracts, tincture, and ointments. Most of the herbs are administered as a single herb in the USA and Europe. However, the traditional Chinese herbal medicine contains multiple active ingredients from various herbs and is prepared as concoctions by simmering them for hours to produce pharma-therapeutic properties useful for the treatment of a particular disease. Those prepared concoctions are taken gingerly with specific treatment purposes. In the USA and some European counties, herbs are distributed and labeled as dietary supplements and are taken by many individuals for a long period of time creating some medical and dental complex problems among them, especially in terms of anesthesia-surgery complications. This paper provides insight into basic differences in how herbs are prepared before administration to the patients in China versus a single unprepared herb sold in the USA and Europe. Also addressed are the interdisciplinary issues with health professionals, the proper regulations for better quality control of imported herbs, and the proper warning on the labels of the herbs. [ABSTRACT FROM AUTHOR]

The article discusses studies on chronic pain selected by the members of the Society of General Internal Medicine. It says that the papers were chosen for their potential to change generalist care of patients with chronic pain. The articles include one on the assessment of pain intensity and interference, a randomized trial on optimized antidepressant therapy and pain self-management to improve pain and depression outcomes, and one on the trends in opioid use in patients with non-cancer pain.

Background: Low back pain (LBP) is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care. An integrative model that includes both complementary and alternative medicine (CAM) and conventional therapies, while also incorporating patient choice, has yet to be tested for chronic LBP. The primary aim of this study is to determine the relative clinical effectiveness of 1) monodisciplinary chiropractic care and 2) multidisciplinary integrative care in 200 adults with non-acute LBP, in both the short-term (after 12 weeks) and long-term (after 52 weeks). The primary outcome measure is patient-rated back pain. Secondary aims compare the treatment approaches in terms of frequency of symptoms, low back disability, fear avoidance, self-efficacy, general health status, improvement, satisfaction, work loss, medication use, lumbar dynamic motion, and torso muscle endurance. Patients' and providers' perceptions of treatment will be described using qualitative methods, and cost-effectiveness and cost utility will be assessed. Methods and Design: This paper describes the design of a randomized clinical trial (RCT), with cost-effectiveness and qualitative studies conducted alongside the RCT. Two hundred participants ages 18 and older are being recruited and randomized to one of two 12-week treatment interventions. Patient-rated outcome measures are collected via self-report questionnaires at baseline, and at 4, 12, 26, and 52 weeks post-randomization. Objective outcome measures are assessed at baseline and 12 weeks by examiners blinded to treatment assignment. Health care cost data is collected by self-report questionnaires and treatment records during the intervention phase and by monthly phone interviews thereafter. Qualitative interviews, using a semi-structured format, are conducted with patients at the end of the 12-week treatment period and also with providers at the end of the trial. Discussion: This mixed-methods randomized clinical trial assesses clinical effectiveness, cost-effectiveness, and patients' and providers' perceptions of care, in treating non-acute LBP through evidence-based individualized care delivered by monodisciplinary or multidisciplinary care teams. Trial registration: ClinicalTrials.gov NCT00567333 [ABSTRACT FROM AUTHOR]

Objective: This paper presents the origins and development of the organized chiropractic orthopedics movement in the United States from 1954-1973. Methods: Hand searches of early periodicals were performed and information was organized chronologically to create a timeline. Context for the timeline was provided by extracting pertinent information from audio recordings of interviews. Relevant background information was located using the cumulative index of the journal Chiropractic History and searching the MANTIS database. Historical Features: After World War I, The advent of third party reimbursement for health care created a new environment for health care practitioners. For doctors of chiropractic, this event provided the impetus to begin the postgraduate chiropractic orthopedics program over 50 years ago. In 1954, Alvin A. Hancock, DC and F. Maynard Lipe, DC successfully launched an active orthopedics movement after several earlier attempts failed during the 1940s and early 1950s. The movement generated from the desire to train and certify chiropractors to manage personal injury and workers' compensation low back injuries. In addition to developing interdisciplinary educational programs, the chiropractic orthopedics group was responsible for producing a research agenda, some of the profession's early orthopedic-focused research, and for starting the National Council on Chiropractic Orthopedics of the National Chiropractic Association, which later became the American Chiropractic Association Council on Orthopedics. These organizations produced thousands of specialists in chiropractic orthopedics, later known as Diplomates of the American Board of Chiropractic Orthopedists. Conclusion: Several orthopedics interest groups were formed and credentialing processes were created to qualify doctors as recognized chiropractic orthopedics specialists. The popularity of this movement resulted in the inclusion of orthopedics into core chiropractic college curricula and the production of various research studies before the development of the modern science of chiropractic. [ABSTRACT FROM AUTHOR]

There is a growing recognition in the United States and Europe that health care is driven to a significant extent by an emphasis on consumer choice and demand. As consumers, people regularly choose their own solutions for health promotion and maintenance, solutions which may or may not be sanctioned by mainstream medicine. Radioactive radon therapy exemplifies a non-sanctioned treatment eagerly sought by certain patients, but scorned or dismissed by many physicians. This is certainly the case in the United States, where well-publicized Environmental Protection Agency (EPA) warnings portray radon as a potential carcinogen. Between 1997 and 2001, I worked with a population of arthritis sufferers who expose themselves to radon gas in Montana radon health mines in order to alleviate their symptoms. In this paper I discuss the decision-making process involved in using radon, and compare the Montana radon health mine facilities with selected radon mines and spas in Europe. [ABSTRACT FROM AUTHOR]