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Biomedical subjects

B M Berman

Publications and source records attributed to B M Berman.

At least 37 records · Page 2Linked to original sources
PubMed1999

Are psychosocial factors related to response to acupuncture among patients with knee osteoarthritis?

CONTEXT: Acupuncture has been found to be beneficial in the treatment of patients with knee osteoarthritis. However, response among such patients is highly variable. Identification of subjects with greater response would facilitate a more rational use of acupuncture. OBJECTIVE: To examine the relationship between demographic and psychosocial variables and response to acupuncture as defined by reduction in pain and disability at the end of an 8-week course of treatment. DESIGN: Retrospective study. SETTING: Outpatients attending rheumatologists or primary care physicians. PATIENTS: 37 patients with symptomatic knee osteoarthritis who had previously participated in a controlled trial using acupuncture were recalled for an interview approximately 1 year later. INTERVENTION: Structured interview, questionnaire completion, and an examination. MAIN OUTCOME MEASURES: Depression, anxiety, helplessness, self-efficacy, and fatigue were measured by standard instruments. Knee examination and assessment of pain threshold were measured by dolorimetry. RESULTS: Response at 8 weeks was significantly related to duration of symptoms. A statistically nonsignificant trend was found for older and more educated subjects to have a better response; anxiety and fatigue were found to be inversely related to response (also statistically nonsignificant). Subjects with localized medial pain had significantly better response in terms of pain and disability than did subjects with generalized knee pain. CONCLUSION: Other than a weak relationship with anxiety (at 8 weeks only), no evidence of a link between psychosocial variables and response to acupuncture was found. Prospective studies are needed to confirm these results.

Acupuncture Therapy↗
PubMed1999

Complementary and alternative medicine: herbal therapies for diabetes.

Interest in and use of complementary and alternative medicine have increased in recent years, with as much as 40% of the general population having used some form of complementary and alternative medicine in the past year. Although recent national surveys have not adequately assessed the use of complementary and alternative medicine in minority populations, its use in many minority populations is at least equal to and possibly greater than that in the general population. One condition for which minority populations are likely to use complementary and alternative medicine therapies is diabetes, which is particularly prevalent in Mexican-American and Native-American communities. Many minority cultures have a long history of using herbal preparations to treat diabetes, and recent research suggests that some herbal therapies may have a role in the treatment of this complex disease. However, many questions remain regarding the proper use of herbal therapies for diabetes, particularly in regard to dosage and contaminants. Therefore, physicians who work with minority populations should ask patients about their use of these therapies and must become knowledgeable about their safety and efficacy.

Diabetes Mellitus, Type 2↗
PubMed1998

Incidence of premenstrual syndrome and remedy usage: a national probability sample study.

CONTEXT: Premenstrual syndrome is believed to affect 30% to 80% of women. Studies in various cultures have used a variety of methodologies to determine prevalence, symptom profile, and effectiveness of available treatments. This study was designed to provide information on incidence of PMS and therapies used based on a national probability sample of US women. METHOD: In 1996 a national probability sample (N = 1052) of women aged 21 to 64 years was surveyed by telephone using random digit dial methods. The survey included demographic information, questions concerning respondent knowledge of premenstrual syndrome, incidence rates of common premenstrual syndrome symptoms, and any remedies that were used to control the symptoms. RESULTS: Forty-one percent of the women responded "yes" to the question, "Do you suffer from premenstrual syndrome?" An additional 17% indicated that they experienced symptoms prior to their menstrual cycle that are commonly associated with premenstrual syndrome (e.g., pain, bloating, feeling more emotional, weight gain, food cravings), though without associating these symptoms with premenstrual syndrome explicity. The most frequently noted severe symptom was that of "[feeling] more emotional." Of those reporting premenstrual syndrome symptoms, approximately 42% took either prescription or over-the-counter medications to relieve them. Eighty percent of the women taking any type of medication relied on over-the-counter medications. Prescription drug use for premenstrual syndrome symptoms focused on medications to control pain; hormone supplements were the second most frequently prescribed rugs. Fewer than 3% of the respondents used prescription medications. Respondents were asked to indicate whether they had used a complementary medical therapy to control symptoms. Exercise was used most frequently (18%), and acupuncture was the least frequently used. Although only a small percentage of women used complementary therapies, for most of these therapies a near-perfect concordance was found between usage and belief in efficacy. CONCLUSIONS: Women were aware of symptoms related to premenstrual syndrome more frequently than they recognized a formalized medical syndrome. Less than half of the women reporting symptoms had taken either over-the-counter or prescription drugs. Those who tried complementary therapies generally found them to be effective.

Adult↗
PubMed1998

A pilot study of cognitive behavioral therapy in fibromyalgia.

BACKGROUND: Fibromyalgia is a syndrome characterized by widespread musculoskeletal pain and multiple tender points as well as high levels of self-reported disability and poor quality of life. OBJECTIVES: In this pilot study, a mind-body approach (cognitive-behavioral therapy) was tested that has been successful in treating chronic back pain patients to determine whether it would improve function, decrease perceived pain, and improve mood state for fibromyalgia patients. PARTICIPANTS: 28 patients recruited from the greater Baltimore area. INTERVENTION: Eight weekly sessions, 2 1/2 hours each, with three components: an educational component focusing on the mind-body connection, a portion focusing on relaxation response mechanisms (primarily mindfulness meditation techniques), and a qigong movement therapy session. MAIN OUTCOME MEASURES: Data collection instruments were the Fibromyalgia Impact Questionnaire, the Health Assessment Questionnaire, the Beck Depression Inventory, the Coping Strategies Questionnaire, the helplessness subscale of the Arthritis Attitudes Index, the Medical Outcomes Study Short Form General Health Survey, and a double-anchored 100-mm visual analog scale to assess sleep. RESULTS: Twenty patients completed the study. Standard outcome measures showed significant reduction in pain, fatigue, and sleeplessness; and improved function, mood state, and general health following an 8-week intervention. CONCLUSION: A mind-body intervention including patient education, meditation techniques, and movement therapy appears to be an effective adjunctive therapy for patients with fibromyalgia.

Cognitive Behavioral Therapy↗
PubMed1998

Issues in the use of complementary/alternative medical therapies for low back pain.

Unfortunately, current conventional medical treatments for low back pain are not managing the problem effectively. Standard approaches to treatment, particularly surgery, may even be exacerbating the problem and causing additional pain and suffering. In this context, it is understandable that LBP patients often go outside of the conventional medical system seeking other treatment options. Conventional medical physicians who treat low back pain patients, therefore, need to become more aware of the fact that their patients may be using complementary/alternative medical therapies.

Complementary Therapies↗
PubMed1997

Biphasic emetic response of cyclophosphamide in the ferret.

Cyclophosphamide (177 mg/kg, IV: n = 8) produced a biphasic emetic response in the ferret with a mean +/- SE of 23.3 +/- 4.0 emetic episodes during a 4-h observation period. The emetic profile of cyclophosphamide showed a first phase with 18.6 +/- 3.9 episodes and a second phase with 4.7 +/- 1.2 episodes. Ondansetron (0.07 and 0.13 mg/kg, IV) and droperidol (0.25 and 0.79 mg/kg, IV) significantly reduced the number of emetic episodes in the first phase. Metoclopramide (2.24, 4.08, and 7.07 mg/kg, IV) also significantly reduced the number of emetic episodes in the first phase, and the dose of 7.07 mg/kg completely prevented emetic episodes in the second phase. In addition, ondansetron-treated ferrets (0.04, 0.07, and 0.13 mg/kg, IV) had a significant increase in the number of emetic episodes in the second phase.

Animals↗
PubMed1997

Establishing a research agenda for investigating alternative medical interventions for chronic pain.

This article describes the University of Maryland School of Medicine's Center for Complementary Medicine Research approach to developing an agenda for investigating alternative medical treatments for chronic pain syndromes. This agenda includes conducting extensive literature searches and analyses to form a knowledge base for making clinical decisions on which chronic pain syndromes are in greatest need of better therapies, as well as which alternative medical therapies offer the greatest therapeutic promise for these specific chronic pain syndromes. To date, the Center has identified back pain, arthritis, and fibromyalgia as the chronic pain syndromes that contribute the greatest clinical and economic burden to overall chronic pain statistics. Not coincidentally, patients with these diagnoses are the greatest users of alternative therapies. The Center has identified acupuncture, homeopathy, manual/manipulative therapies, and mind-body therapies as the alternative medical therapies offering the greatest clinical potential for these three general chronic pain diagnoses. Preliminary data from the Center's ongoing clinical trials programs are presented.

Chronic Disease↗
PubMed1993

Rehabilitation of the elderly patient with arthritis.

The rehabilitation of an elderly patient with arthritis involves a cooperative effort on the part of patients and their caregivers, therapists, and physicians. If treatment is begun early in the course of the disease, the onset of functional decline and disability may be delayed or prevented. It may be useful for patients to contact the American Arthritis Foundation for further information and referral to support groups. Older people with arthritis must be included at a societal decision-making level in helping plan, design, and monitor community projects where handicap access questions arise. A major problem for people with disability is often the barriers they encounter in the environment and the attitudes of society. Treatment goals should be discussed and agreed on, and education and psychologic support should be provided for patients and their families. Each case must be individually assessed and a set of tailor-made rehabilitation interventions prescribed. Rest, exercise (active or passive), joint splinting, massage, heat (moist or dry heat), cold, pharmacotherapy, joint injection, surgery, and complementary treatment modalities such as homeopathy, acupuncture, education, and psychosocial support all have their role in the rehabilitation of the elderly patient with arthritis. For most patients, the course and prognosis are excellent. In general strength, ROM, and joint function can be preserved or improved to the point that participation in normal activities of daily living is possible.

Activities of Daily Living↗
PubMed1984

Modification of Cloward cervical retractor. Technical note.

A modification of a Cloward lateral cervical retractor with sharp blades is described. The purpose of the adaptation is to help prevent injuries to soft tissues of the neck and to facilitate placement during anterior cervical discectomy and fusion.

Humans↗
PubMedDate not supplied

Primary care physicians and complementary-alternative medicine: training, attitudes, and practice patterns.

BACKGROUND: Physician interest in complementary medicine is widely documented in many Western countries. The extent of level of training, attitudes toward legitimacy, and use of complementary therapies by US primary care physicians has not been extensively surveyed. We conducted a national mail survey of primary care physicians to explore these issues. METHODS: Primary care specialties represented were family and general practice, internal medicine, and pediatrics. A total of 783 physicians responded to the survey. For the multivariate analysis, sample weights were assigned based on specialty. Assessments were done for training, attitudes, and usage for complementary medicine. Additional data collected included years in practice, specialty, and type of medical degree. RESULTS: Biofeedback and relaxation, counseling and psychotherapy, behavioral medicine, and diet and exercise were the therapies in which physicians most frequently indicated training, regarded as legitimate medical practice, and have used or would use in practice. Traditional Oriental medicine, Native American medicine, and electromagnetic applications were least accepted and used by physicians. CONCLUSIONS: Many psychobehavioral and lifestyle therapies appear to have become accepted as part of mainstream medicine, with physicians in this study having training in and using them. Such therapies as chiropractic and acupuncture appear to be gaining in acceptance despite low training levels among physicians. Those in practice more than 22 years had the least positive attitudes toward and use of complementary therapies. Osteopathic physicians were more open than medical physicians to therapies that required administering medication or a procedural technique. In the multivariate analysis, attitude and training were the best predictors of use.

Attitude of Health Personnel↗
PubMedDate not supplied

Clinical decisions in the use of acupuncture as an adjunctive therapy for osteoarthritis of the knee.

OBJECTIVE: To determine whether demographic, medical history, or arthritis assessment data may influence outcome and rate of decay for patients with osteoarthritis treated with acupuncture. DESIGN: Seventy-three persons with symptomatic osteoarthritis of the knee were recruited for this randomized controlled trial. Both treatment and crossover control groups received acupuncture treatments twice weekly for 8 weeks. Patients self-scored on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Lequesne Algofunctional Index at baseline and 4, 8, and 12 weeks. Sample size for this outcome analysis was 60 patients at 4 weeks, 58 at 8 weeks, and 52 at 12 weeks. RESULTS: Patients' scores on both indexes improved at 4, 8, and 12 weeks. Scores were stable regardless of the baseline severity of the osteoarthritis. Despite some decay in outcomes at week 12, measures were significantly improved over baseline. With WOMAC scores partitioned into equal quartiles, a strong effect on outcome was apparent at 12 weeks (4 weeks after treatment) related to initial WOMAC scores. The group with the least disability and pain rebounded to original levels to a greater degree than did those who initially were more disabled. The more disabled groups retained the benefits of acupuncture treatment through the 12-week period. CONCLUSION: Acupuncture for patients with osteoarthritis of the knee may best be used early in the treatment plan, with a methodical decrease in frequency in treatment once the acute treatment period is completed to avoid a rebound effect. Demographic and medical history data were not mediating variables.

Acupuncture Therapy↗