Alternative medicine and the conventional practitioner.
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Complementary Therapies↗
Biomedical subjects
W Jonas
Publications and source records attributed to W Jonas.
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↗
How should we research unconventional therapies? A panel report from the Conference on Complementary and Alternative Medicine Research Methodology, National Institutes of Health.
Research in unconventional medicine requires a number of different questions to build up a "mosaic" of evidence. Choice of research design depends on the question being asked and is independent of the therapy under investigation. Despite the doubts of some practitioners, randomized trials are of value for determining certain questions in alternative medicine.
Complementary Therapies↗
Alternative medicine instruction in medical schools and family practice residency programs.
BACKGROUND AND OBJECTIVES: The use of medical therapies outside of mainstream Western medicine, referred to as complementary medicine or alternative medicine (CAM), is rapidly increasing in the United States. Despite evidence of physician interest and willingness to refer to CAM providers, there is currently little information regarding medical education in these practices. This survey assessed the frequency and nature of alternative medicine instruction in US medical schools and family practice residency programs. METHODS: Society of Teachers of Family Medicine staff mailed a 16-question survey to all US medical school family medicine department chairs and non-university-based family practice residency program directors about existing instruction in alternative medicine, planned instruction, and educational programs under consideration. RESULTS: The overall response rate was 77.9% (364/467), with 29.7% (108/364) of all respondents currently teaching, 6.0% (22/364) starting to teach, and 6.3% (23/364) considering teaching some form of alternative medicine. CAM instruction is most common in the Northeast and Rocky Mountain regions. The instruction is predominantly elective (72.2%). Instructional content and methodologies vary widely. CONCLUSIONS: Alternative medicine has begun to establish a presence in US medical schools and family practice residency programs. Offerings in this diverse subject vary widely in content and format.
Career Choice↗
Drug-abbreviated infections and development of immunity against Trichostrongylus colubriformis in sheep.
A protective immune response without liveweight loss can be induced in sheep against T. colubriformis but results depend on the anthelmintic used and duration of immunizing infections. More than 90% protection was achieved in sheep immunized by three 15- or 7-day oxfendazole abbreviated infections or three 21-day nonabbreviated infections. Only 41% protection was induced by 3-day oxfendazole abbreviated infections. Significantly higher worm burden and faecal egg counts were present after challenge in sheep immunized by 7-day levamizole abbreviated infections compared to 7-day oxfendazole abbreviated infection. Liveweight gains of sheep immunized by 15- and 7-day abbreviated infections were not significantly different than non infected controls. Liveweight loss seemed to be associated with high activity of mucus peroxidase and high numbers of eosinophils in the intestinal lumen. High parasite numbers seemed to be associated with low activity of alkaline phosphatase in mucus. Mucus peroxidase, arylsulphatase, larval migration inhibition of mucus, mucus or serum antibody against L3 excretory/secretory antigen or somatic L3, L4 and adult antigen were not associated with protection.
Alkaline Phosphatase↗
Supravital staining of eosinophils.
Live eosinophils when mixed with Acridine Orange solution and viewed microscopically using u.v. light show very intense colours of their granules (yellow, orange and red) and green nuclear staining. Their active movement, translocation of granules and degranulation can be observed in vitro. Using this method, live eosinophils can be easily differentiated and enumerated.
Acridine Orange↗
Wayne Jonas, MD: at the helm of the OAM. Interview by Bonnie Horrigan.
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Complementary Therapies↗
Immune responsiveness of Romney sheep selected for resistance or susceptibility to gastrointestinal nematodes: field studies.
Long-term selection of sheep for resistance to parasite infections may be jeopardized if animals do not retain their normal ability to respond to non-parasite antigens. Therefore the antibody responses to ovalbumin (OVA) and human red blood cells (HRBC), and kinetics of peripheral blood lymphocyte phenotypes were examined in mature grazing sheep, genetically resistant or susceptible to gastrointestinal nematodes. In both lines the HRBC antibody response peaked 2 weeks after the primary injection, 1 week after the second injection and 3 weeks after the second OVA injection. The antibody titres of the resistant line sheep decreased sooner after both primary and secondary injections. The resistant line sheep had higher percentages of CD5+ and CD4+ cells than the susceptible sheep. Two injections of OVA and HRBC did not result in significant alterations in percentages of CD5+, CD4+, CD8+ and CD45R+ lymphocytes in either line. In both lines, the control groups showed a steady increase of 0.29% per week in percentages of T19+ (gamma delta) T cells which was significantly higher than in the antigen injected sheep.
Animals↗
Guinea pig antibody to C3 component of the sheep complement produced by immunization with a heat-inactivated sheep serum--alcian blue complex.
Normal sheep serum or serum heated at 56 degrees C for 30 min were added to alcian blue solutions. The optical density of alcian blue-heated sheep serum complexes formed were 2-4 times greater than those obtained with unheated serum. Most guinea pigs immunized with alcian blue-heated sheep serum complexes produced antibodies that precipitated the third component (C3) of sheep complement (C') from electrophoresed sheep serum. These antisera also hemagglutinated sheep erythrocyte--rabbit antibody complexes treated with sheep serum (C'). Guinea pigs immunized with alcian blue-normal sheep serum complexes did not react with electrophoresed sheep serum nor with sheep C' in the hemagglutination test.
Alcian Blue↗
Inhibitory activity of soluble material from sheep eosinophils for sheep complement.
Soluble material from frozen and thawed sheep eosinophils and sonicated extracts of eosinophils or their granules inhibited the alternative activation pathway dependent action of sheep complement for human erythrocytes sensitized by sheep antibody. Sephadex G-50 fractions of the sonicated eosinophil and granule extracts showed that inhibitory activity was associated with the void volume fraction, the fraction possessing the eosinophil peroxidase activity.
Animals↗
Patent infections of Ascaris suum in pigs: effect of previous exposure to multiple, high doses of eggs and various treatment regimes.
Fifty-four crossbred, 4-week-old pigs divided into nine equal groups were used to test whether multiple inoculations with high numbers of A. suum eggs with or without anthelmintic would result in patent infections. All pigs exposed to multiple prechallenge inoculations of 500, 1000, 2000, 5000, 10,000 and 20,000 and challenged orally 2 weeks later with 10,000 eggs harboured adult worms. When prechallenge infections were removed by pyrantel tartrate treatment the animals were more susceptible to challenge than controls not previously exposed to infections. The same drug used from 2 days before until 10 days after the last prechallenge infection eliminated that effect. Pigs subjected to the same multiple egg dosing regimen but given feed containing fenbendazole immediately before, during and for 10 days after multiple dosing developed significantly more adult intestinal worms after challenge than any other group. These worms were, however, significantly shorter than those that developed in any group of pigs. Adult worms from all these groups produced eggs that after embryonation were infective to mice.
Animals↗
Effect of age on homovanillic and 4-hydroxy-3-methoxymandelic acid levels in plasma.
The plasma levels of homovanillic and 4-hydroxy-3-methoxymandelic acids have been determined in 524 normal subjects ranging from birth to 49 years of age using a mass fragmentographic method. The mean concentration of homovanillic acid in plasma declines exponentially from the age of 1 day (X = 2342.0 nmol/l, 426.6 ng/ml) to adulthood (X = 60 nmol/l, 10.9 ng/ml). 4-Hydroxy-3-methoxymandelic acid behaves in a similar although not so extreme manner (392 nmol/l, 77.6 ng/ml-50 nmol/l, 10 ng/ml).
Adolescent↗
Sheep serum complement sensitisation of sheep erythrocyte-rabbit antibody complexes for haemolysis by guinea-pig complement plus EDTA or Mg2+-EGTA.
Sheep erythrocyte (E)-rabbit antibody (A) complexes incubated with sheep serum diluted up to 1:5120 or 1:20480 and washed can be haemolysed by guinea-pig (g-p) serum (complement, C) containing EDTA or Mg2+-EGTA respectively as haemolytic finishing reagents. Sheep E carrying a high dose of rabbit A were necessary for this reaction, particularly with g-p C-EDTA. G-p serum (stored by freezing) was active as a haemolytic finishing reagent with both EDTA and Mg2+-EGTA. Reconstituted freeze-dried g-p serum (also stored by freezing) was haemolytically active with Mg2+-EGTA only. G-p serum preserved by Richardson's method did not function as a finishing reagent with EDTA or Mg2+-EGTA. A non-haemolytic prozone occurred with sheep E-rabbit A treated with dilutions of sheep serum or body fluid up to 1:160, particularly when g-p C (frozen)-EDTA was used as the finishing reagent. Sheep E-rabbit A were sensitized by serum, foetal lamb serum, pericardiac-, synovial- or ovarian follicle-fluids colostrum or milk for haemolysis by g-p C (frozen)-EDTA or -Mg2+-EGTA. With the C3 inhibitors cobra venom factor or salicylaldoxime, serum sensitisation of sheep E-rabbit A for haemolysis by g-p C (frozen)-EDTA or -Mg2+-EGTA was not blocked. Sensitisation by serum heated at 50 degrees C for 30 min (partial inactivation of C2) was incomplete. Inhibitors of C1 (antrypol, chelators of Ca2+ or heating serum at 56 degrees C for 30 min) partially or fully blocked sensitisation for haemolysis by both g-p C (frozen)-EDTA or -Mg2+-EGTA. These results show that at a minimum, components C1, C4 and C2 are present and functionally active in serum and some body fluids of sheep.
Animals↗
Agglutination of sheep erythrocyte-rabbit antibody complexes treated with sheep serum by a rabbit antiserum specific for the third component (C3) of sheep complement.
Sheep E-rabbit A incubated with sheep serum for up to 20 min at 39 degrees C and washed were agglutinated by a rabbit antiserum (anti-inulin-foetal lamb serum) that was specific for sheep C3. If incubated for longer than 20 min at 39 degrees C, there was less sensitisation. Such a complex was not readily generated at 17 degrees C whereas there was no reaction if incubated at 2 degrees C. Once the sheep E-rabbit A-sheep C complex had been generated at 39 degrees C and washed free of sheep serum, it could still be agglutinated after overnight storage at 4 degrees C. Addition of chelators of Ca2+ and/or Mg2+ or antrypol or cobra venom factor (a specific inhibitor of C3) prevented sensitisation of sheep E-rabbit A by sheep serum for agglutination. These results show that sheep serum C3 was taken up by sheep E-rabbit A and its presence on this indicator demonstrated by agglutination using a rabbit antiserum specific for sheep C3.
Animals↗
Variations in sheep serum conglutinating complement activity and pathway involved in reactivity with sheep erythrocytes sensitized by rabbit antibody.
Based on conglutination tests with the sheep E-rabbit A indicator system, three types of sheep sera were encountered. Type 1 sera failed to directly conglutinate or sensitize sheep E-rabbit A for conglutination by bovine conglutinin. Type 2 sera also failed to directly conglutinate sheep E-rabbit A but sensitized the indicator for conglutination by bovine conglutinin. Type 3 sera both directly conglutinated and sensitized sheep E-rabbit A for conglutination. Changes in serum type were induced in sheep by venepuncture (type 1 to type 2) or venepuncture and an intraperitoneal injection of yeast cells (type 2 to type 3). Direct conglutinating activity of type 3 sera was inhibited by heating serum at 50 degrees C for 30 min and was not restored by alternative activation pathway factor B. Chelation of Ca2+ in type 2 and 3 sera blocked sensitization of sheep E-rabbit A for conglutination by bovine conglutinin, indicating that the classical activation pathway was involved.
Acetylglucosamine↗
Electrophoretic and serological analysis of mouse and rabbit antisera to zymosan or inulin treated with foetal lamb serum.
Most mouse antisera raised to zymosan treated with FLS containing Ca2+ and Mg2+ precipitated C3 and two other proteins from electrophoresed sheep serum. Rabbit antisera to zymosan-FLS precipitated C3 and three sheep serum proteins. All these antisera agglutinated sheep E-rabbit A complexes sensitized with sheep C at room temperature. Mouse antisera to zymosan treated with FLS containing Mg2+-EGTA and mouse antisera to inulin treated with FLS containing Ca2+ and Mg2+ or Mg2+-EGTA, precipitated only C3 from electrophoresed sheep serum, but did not agglutinate sheep E-rabbit A-sheep C. These results, together with antiglobulin studies indicate that zymosan, probably through a reaction with natural antibody in the FLS can activate sheep C by a mechanism that involves a Ca2+ and Mg2+-dependent pathway. In the presence of Mg2+-EGTA, zymosan and inulin activate sheep C via a Mg2+-dependent pathway. The results also show that antisera that will precipitate sheep C3 from electrophoresed sheep serum can be raised by immunizing mice and rabbits with inulin that has been treated with FLS or zymosan treated with FLS containing Mg2+-EGTA.
Animals↗
Variations in sheep serum conglutinating and haemolytic activity for sheep erythrocytes sensitized by rabbit antibody.
Based on conglutinating and haemolytic reactions with sheep erythrocytes (E) sensitized by rabbit antibody (A), three types of sheep sera were encountered. Type 1 sera do not conglutinate or haemolyse sheep E-rabbit A. Type 2 sera failed to conglutinate or haemolytically active. Type 3 sera have both activities. Serum from one type 1 sheep still failed to conglutinate 5 days after venepuncture but was not haemolytically active (i.e., type 2). Some sheep that initially had type 2 sera had, five days after an intraperitoneal injection of yeast cells, sera with conglutinating activity (type 3 sera). Type 1, 2 and 3 sera all had haemolytic activity with human E-sheep A indicator cells. Pooled type 3 sera have the highest conglutinating titres with sheep E-rabbit A after 10 min incubation at 39 degrees C. At this stage, the haemolytic titres were very low. From 10 min, the conglutinating titres decreased whereas the haemolytic titres gradually increased until 80 min. Optimal conglutinating activity required less rabbit A to sensitize sheep E than did haemolytic activity.
Animals↗
Conglutination and haemolysis of unsensitized human erythrocytes by bovine serum complement.
Unsensitized human erythrocytes (E) were haemolyzed by bovine serum to a titre of 1:16-1:32. In the single dilution beyond the haemolytic endpoint, the cells were conglutinated. In dilutions in which haemolysis occurred, cells were conglutinated before being lyzed. With no or minimal haemolysis, conglutination to 1:32-1:64 occurred in tests using insulin-absorbed serum, serum heated at 50 degrees C for 30 min and in tests incubated at 4 degrees C for 30 min. In two-stage tests, EDTA and Mg2+-EGTA prevented bovine C sensitization of human E for conglutination by bovine serum heated at 56 degrees C for 30 min. EDTA prevented haemolysis, but haemolysis to 1:16-1:32 occurred with serum dilutions containing Mg2+-EGTA. Haemolytic activity was restored to serum heated at 50 degrees C by a factor B-containing fraction. Conglutination and haemolysis were blocked by heating serum at 56 degrees C for 30 min and were reduced to low titres by absorbing serum with zymosan. These results strongly suggest that the conglutination reaction involved the classical activation pathway whereas the haemolytic reaction involved the alternative activation pathway. Thus, with dilutions of untreated or treated bovine serum, two C-dependent reactions and the pathways involved can be demonstrated by using unsensitized human E as an indicator system.
Agglutination↗