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David Riley

Publications and source records attributed to David Riley.

At least 19 recordsLinked to original sources
PubMed2005

A review of the use and role of low potencies in homeopathy.

BACKGROUND: The issue of potency choice in homeopathy has always been controversial. In "high" potencies there are no molecules of the starting substance remaining and in low potencies (including tinctures) the line between homeopathy and herbal medicine is blurred. METHOD: The literature on potency selection is reviewed, including the use of low potencies and their effects on organ physiology. This article attempts to examine the overlapping boundaries between homeopathy and herbal medicine in clinical practice and basic research. FINDINGS: Both low and high potencies are utilized in all areas of homeopathy ranging from prescribing for acute or chronic diseases to constitutional treatment. Low dilutions play a role in homeopathic prescribing, and are particularly prominent in systems of homeopathy focusing on the organotropic effects of homeopathic medicinal products integrated with conventional medicine diagnosis and treatment. (Mother) tinctures may be employed in homeopathy as well as in herbal medicine. The distinction between the two is based on the clinical context, the rationale behinds its use, and the production method of the tincture. Data available from basic research on low and high potencies do not suggest a superiority of low potencies over high potencies or vice versa. CONCLUSION: Low potency homeopathic medications (with detectable concentrations of the starting material) and high potency homeopathic medications (with no detectable amount of the starting material in the finished product) have been available since the beginning of homeopathy. Given that both groups of homeopathic medications have shown effectiveness in clinical trials and in the absence of a definitive mechanism of action for homeopathy (including the possibility that there may be multiple mechanisms of action present) this wide of range of potencies for homeopathic medicines should be maintained, ranging from mother tinctures to homeopathic medicinal products with no measurable concentration.

Dose-Response Relationship, Drug↗
PubMed2005

Anthroposophic vs. conventional therapy of acute respiratory and ear infections: a prospective outcomes study.

CONTEXT: Acute respiratory and ear symptoms are frequently treated with antibiotics. Anthroposophic treatment of these symptoms relies primarily on anthroposophic medications. OBJECTIVE: To compare anthroposophic treatment to conventional treatment of acute respiratory and ear symptoms regarding clinical outcome, medication use and safety, and patient satisfaction. DESIGN: Prospective, non-randomised comparison of outcomes in patients self-selected to anthroposophic or conventional therapy under real-world conditions. SETTING: 29 primary care practices in Austria, Germany, Netherlands, UK, and USA. PARTICIPANTS AND THERAPY: 1016 consecutive outpatients aged > or = 1 month, consulting an anthroposophic (n = 715 A-patients) or conventional physician (n = 301 C-patients) with a chief complaint of acute (< or = 7 days) sore throat, ear pain, sinus pain, runny nose or cough. Patients were treated according to the physician's discretion. PRIMARY OUTCOME: Patients' self-report of treatment outcome (complete recovery/major improvement/slight to moderate improvement/no change/deterioration) at Day 14. RESULTS: Most common chief complaints were cough (39.9% of A-patients vs. 33.9% of C-patients, p = 0.0772), sore throat (26.3% vs. 23.3%, p=0.3436), and ear pain (20.0% vs. 18.9%, p=0.7302). Baseline chief complaint severity was severe or very severe in 60.5% of A-patients and 53.3% of C-patients (p=0.0444), mean severity (0-4) of complaint-related symptoms was 1.3 +/- 0.7 vs. 1.2 +/- 0.6 (p=0.5197). During the 28-day follow-up antibiotics were prescribed to 5.5% of A-patients and 33.6% of C-patients (p<0.0001), anthroposophic medicines were prescribed to all A-patients and no C-patient. OUTCOMES: Improvement within 24 hours occurred in 30.9% (221/715) of A-patients and 16.6% (50/301) of C-patients (p<0.0001), improvement within 3 days in 73.1% and 57.1% (p<0.0001). At Day 7 complete recovery or major improvement was reported by 77.1% of A-patients and 66.1% of C-patients (p=0.0004), at Day 14 by 89.7% and 84.4% (p=0.0198). Complete recovery rates at Day 7 were 30.5% and 23.3% (p<0.0001); at Day 14 they were 64.2% and 49.5% (p<0.0001). 69.9% of A-patients and 60.5% of C-patients were very satisfied with their physician (p=0.0043); 95.7% and 83.4% would choose the same therapy again for their chief complaint (p<0.0001). After adjustment for country, gender, age, chief complaint, duration of complaint, previous episode of complaint within last year, and baseline symptom severity, odds ratios favoured the A-group for all these outcomes. Adverse drug reactions were reported in 2.7% of A-patients and 6.0% of C-patients (p=0.0157). CONCLUSION: Compared to conventional treatment, anthroposophic treatment of primary care patients with acute respiratory and ear symptoms had more favourable outcomes, lower antibiotic prescription rates, less adverse drug reactions, and higher patient satisfaction.

Acute Disease↗
PubMed2005

Developing a self-report outcome measure for complementary and alternative medicine.

OBJECTIVE: Our objective was to develop a pilot measure of subjective outcomes of complementary and alternative medicine (CAM). Current options for assessing subjective outcomes in CAM are either too burdensome or fail to represent diverse outcomes. A single measure specifying common, patient-reported outcomes of CAM would be of value. DESIGN: We conducted a three-phase instrument development study. In phase I, 30 CAM-receiving patients and 12 CAM practitioners completed a battery of standardized measures. Participants identified those standardized items relevant to CAM outcome and suggested additional outcome issues. In phase II, 20 CAM-receiving patients completed a Q-sort to determine which items from phase I were most relevant to CAM outcome. In phase III, five experts reviewed the items from phase II for content validity. SETTING: An integrative medicine clinic at a private, Midwest US hospital. PARTICIPANTS: CAM patients, practitioners, and researchers and an outcomes measurement specialist. RESULTS: In phase I, 30 standardized items were judged relevant to CAM outcome, and 8 additional items were suggested. In phase II, 29 of the 38 phase I items were deemed at least "moderately relevant" to CAM outcome. In phase III, experts added 15 items, dropped 9 items, and altered 3 items. The 35 resulting items were classified into content domains, forming a testable, pilot version of the instrument.

Adult↗
PubMed2005

Homeopathy study.

Explore the source record for details and available documents.

Homeopathy↗
PubMed2004

Pramipexole vs levodopa as initial treatment for Parkinson disease: a 4-year randomized controlled trial.

BACKGROUND: The best way to initiate dopaminergic therapy for early Parkinson disease remains unclear. OBJECTIVE: To compare initial treatment with pramipexole vs levodopa in early Parkinson disease, followed by levodopa supplementation, with respect to the development of dopaminergic motor complications, other adverse events, and functional and quality-of-life outcomes. DESIGN: Multicenter, parallel-group, double-blind, randomized controlled trial. SETTING: Academic movement disorders clinics at 22 sites in the United States and Canada. PATIENTS: Patients with early Parkinson disease (N = 301) who required dopaminergic therapy to treat emerging disability, enrolled between October 1996 and August 1997 and observed until August 2001. INTERVENTION: Subjects were randomly assigned to receive 0.5 mg of pramipexole 3 times per day with levodopa placebo (n = 151) or 25/100 mg of carbidopa/levodopa 3 times per day with pramipexole placebo (n = 150). Dosage was escalated during the first 10 weeks for patients with ongoing disability. Thereafter, investigators were permitted to add open-label levodopa or other antiparkinsonian medications to treat ongoing or emerging disability. MAIN OUTCOME MEASURES: Time to the first occurrence of dopaminergic complications: wearing off, dyskinesias, on-off fluctuations, and freezing; changes in the Unified Parkinson's Disease Rating Scale and quality-of-life scales; and adverse events. RESULTS: Initial pramipexole treatment resulted in a significant reduction in the risk of developing dyskinesias (24.5% vs 54%; hazard ratio, 0.37; 95% confidence interval [CI], 0.25-0.56; P<.001) and wearing off (47% vs 62.7%; hazard ratio, 0.68; 95% CI, 0.49-0.63; P =.02). Initial levodopa treatment resulted in a significant reduction in the risk of freezing (25.3% vs 37.1%; hazard ratio, 1.7; 95% CI, 1.11-2.59; P =.01). By 48 months, the occurrence of disabling dyskinesias was uncommon and did not significantly differ between the 2 groups. The mean improvement in the total Unified Parkinson's Disease Rating Scale score from baseline to 48 months was greater in the levodopa group than in the pramipexole group (2 +/- 15.4 points vs -3.2 +/- 17.3 points, P =.003). Somnolence (36% vs 21%, P =.005) and edema (42% vs 15%, P<.001) were more common in pramipexole-treated subjects than in levodopa-treated subjects. Mean changes in quality-of-life scores did not differ between the groups. CONCLUSIONS: Initial treatment with pramipexole resulted in lower incidences of dyskinesias and wearing off compared with initial treatment with levodopa. Initial treatment with levodopa resulted in lower incidences of freezing, somnolence, and edema and provided for better symptomatic control, as measured by the Unified Parkinson's Disease Rating Scale, compared with initial treatment with pramipexole. Both options resulted in similar quality of life. Levodopa and pramipexole both appear to be reasonable options as initial dopaminergic therapy for Parkinson disease, but they are associated with different efficacy and adverse-effect profiles.

Aged↗
PubMed2004

Development of risk filter and risk assessment worksheets for HSE guidance--'Upper Limb Disorders in the Workplace' 2002.

Upper limb disorders (ULDs) in the workplace represent a significant cause of ill health in Great Britain. As part of the Health and Safety Commission's strategy for the prevention of musculoskeletal disorders (MSDs), the well known guidance document on ULDs--"Work-related Upper Limb Disorders: a Guide to Prevention" (HSG60), (HMSO, London.), has been extensively revised. This revision (Upper limb disorders in the workplace. HSG60 (rev), HSE Books, Sudbury.) includes the development of new risk assessment tools that can be used by employers to identify ULD risk factors in work activities and more importantly to take action to reduce or eliminate ULD risks. The risk assessment tools form part of a seven stage management approach that underpins the new guidance. This paper outlines the development of the risk assessment tools contained in the revised guidance.

Ergonomics↗
PubMed2003

Epidemiology of dermatophyte infection in Auckland, New Zealand.

This report describes the epidemiology of culture-proven dermatophyte infection in Auckland, New Zealand. The authors undertook a retrospective review of laboratory data for the period from June 1999 to July 2002. There were 10 004 dermatophyte isolates. The most common isolates were Trichophyton rubrum (69%) and Trichophyton mentagrophytes (19%). Microsporum canis was mainly isolated from children. The prevalence of T. mentagrophytes increased with patient age (P < 0.001). Trichophyton rubrum was most common in those aged between 20 and 59 years. The incidence of culture-proven dermatophyte infection was 2.9/1000 population for the year 2000, and the incidence increased with patient age (P < 0.001). It is concluded that dermatophytes causing superficial mycoses in the Auckland region are essentially similar to Australia and other Western countries, although some new organisms are seen as a result of the migration of people from other countries. The incidence of local dermatophyte infection increases with age.

Adolescent↗
PubMed2003

Nitrate in public water supplies and risk of bladder cancer.

BACKGROUND: Nitrate is a precursor compound in the formation of N-nitroso compounds, most of which are potent animal carcinogens. N-nitroso compounds and their precursors have not been extensively evaluated as bladder cancer risk factors. METHODS: We conducted a population-based case-control study of bladder cancer in Iowa. Cases were men and women newly diagnosed with bladder cancer in 1986-1989. Nitrate data for Iowa public water supplies were sparse before the 1960s. To reduce misclassification by unknown nitrate levels, we included only those who used public supplies with nitrate data for 70% or more of their person-years since 1960 (808 cases, 1259 controls). RESULTS: Among controls, the median average nitrate level for their Iowa residences with public water supplies was 1.3 mg/liter nitrate-nitrogen (interquartile range = 0.6-3.0). After adjustment for confounders, we found no increased risk of bladder cancer with increasing average nitrate levels in drinking water; the highest quartile odds ratio for women was 0.8 (95% confidence interval = 0.4-0.8), and for men 0.5 (0.4-0.8). We observed no association among those with high water nitrate exposure (>median) and low (<median) vitamin C intake compared with those who had low water nitrate and high vitamin C intake. CONCLUSIONS: Our data suggest that long-term exposure to nitrate in drinking water at levels in this study (90th percentile 5.5 mg/liter nitrate-nitrogen) is not associated with risk of bladder cancer.

Adult↗
PubMedDate not supplied

Interprofessional referral patterns in an integrated medical system.

OBJECTIVE: To determine the interreferral patterns among physicians and complementary and alternative medicine (CAM) providers in an independent practice association integrated medical system. METHOD: Data from a 1-year period were collected on referral patterns, diagnosis, number of visits, cost, and qualitative aspects of patient care. The independent practice association provided care for approximately 12,000 patients. RESULTS: In the selected integrative network, there are those primary care physicians (PCPs) who refer and those who do not. Among those PCPs that refer to CAM, a preference is shown for a limited number of providers to whom they refer. Although doctors of chiropractic get more referrals, they are also more concentrated among selected providers than are doctors of oriental medicine. CONCLUSION: This study shows the interreferral patterns among the PCP and CAM providers working within an integrated medical system. One effect of being in the network for doctors of chiropractic and doctors of oriental medicine might be the possible interreferrals between each other.

Chiropractic↗