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PubMed2000

[Complementary therapies. Phytotherapy].

This article provides insight into the concept of phytotherapy, analyzing the generic term from a pharmaceutical viewpoint and explaining what the "totum" of a plant is. This article also mentions the role of phytotherapy over the course of medical history, what the correct criteria are for preparing a medicinal drink, bearing in mind very practical aspects for all of us, such as: the number of plants to include in a medicinal drink, the manner to prepare one, dosage, toxicity, effectiveness, time period to drink one over, etc. This article is of interest to health professionals and to all those who are drawn to the medicinal, healthy power plants possess.

Humans↗
PubMed2002

Toxicity and adverse effects of herbal complementary therapy.

As with any therapy, herbal preparations have the potential to do harm as well as good. Nurses must be aware of the risks and benefits of herbal remedies, when used either separately or in combination with conventional medicine. They need to encourage patients to understand the possible effects of the herbal preparations that they may choose to use.

Humans↗
PubMed2002

The use of leukotriene receptor antagonists (LTRAs) as complementary therapy in asthma.

The cysteinyl-leukotrienes (cysLTs: LTC4, LTD4 and LTE4) have an important pathophysiological role in asthma. They are not only extremely potent bronchoconstrictors, but are also involved in the central mechanisms of the asthmatic inflammation and the subsequent remodelling of the airways. Allergen-induced bronchoconstriction as well as spontaneous exacerbations of asthma are associated with increased secretion of LTE4 in urine. This increase does not seem to be affected by high doses of inhaled or systemic corticosteroids. On the contrary, both in vivo and in vitro experiments indicate that corticosteroids to a certain degree may even upregulate the cysLTs synthesis. Moreover, inhaled medication may not get as far as the small airways, which are affected by inflammatory changes in asthma. Hence, the combination of an oral leukotriene receptor antagonist (LTRA) with an inhaled corticosteroid (ICS) seems a rational therapeutic approach to achieve a more complete control of the inflammatory mechanisms in asthma. The additive effects by combining an LTRA with an ICS have been investigated in adults as well as in children from 6-14 years of age. The addition of LTRA improves lung function, and reduces day and night time symptoms in all age groups. More importantly, the combination has also been found to decrease the exacerbation rates in all age groups. More recently, a few studies have compared the effect of additive therapy with LTRA and ICS versus long-acting beta 2-agonists (LABAs) and ICS in asthmatics. Depending on the patient and outcome parameters preselection, some studies found that addition of LABA to ICS resulted in a better lung function and a better overall disease control. Yet one--unsponsored-study, comparing the protective effects of LABA versus LTRA on inflammatory outcome parameters in asthma, found a significant protection against airway hyperresponsiveness to adenosine monophosphate (AMP), together with significant decreases in exhaled nitric oxide (NO) and sputum eosinophils following one week treatment with LTRA, whereas the initial protection by LABA on the AMP responsiveness was lost after one week, and no anti-inflammatory effects could be observed. Similar beneficial effects from LTRA therapy are expected in patients with nocturnal asthma, in whom a decreased responsiveness to corticosteroids has been demonstrated. The choice of either combination therapy has clinical implications. It seems that especially patients with a suboptimal lung function and a significant beta 2-agonist reversibility will benefit from the addition of a LABA, whereas asthmatics with mainly exercise-induced asthma, nocturnal symptoms, or a frequent worsening due to low tolerance to provocative stimuli, may mostly benefit by adding an LTRA to ICS. However, it remains to be determined which combination has the most profound effect on the inflammatory process and the structural changes in asthma.

Adrenal Cortex Hormones↗
PubMed2002

Complementary therapy for severe Rh-alloimmunization.

PURPOSE OF INVESTIGATION: This report describes successful treatment, using invasive and noninvasive techniques, of a 36-year-old woman (gravida 10, para 0) referred to our center at 13 weeks' gestation for severe Rh alloimmunization. Pre-pregnancy indirect Coombs titers ranged from 1:1024-2048. All nine past pregnancies (conceived with three different partners) had ended in abortion, intrauterine death or neonatal death METHODS: The patient was treated with a single session of plasmapheresis (week 14) immediately followed by five days of immunoglobulin therapy and immunosuppressive therapy based on azathioprine and prednisone (weeks 15-22). Seven fetal transfusions (one intraperitoneal, six intravascular) were performed beginning at 16 weeks. RESULTS: The pregnancy, which was characterized by insulin-dependent gestational diabetes, spontaneously resolving polyhydramnios and peak indirect Coombs titers of 1:65,536, ended at 27 weeks with cesarean section delivery of a viable female weighing 1,000 g. In spite of numerous neonatal complications, the child is physically well at age 3, with normal intellectual and psychomotor development. CONCLUSION: In light of the negative outcomes of the patient's nine past pregnancies, our experience suggests that the early initiation of an integrated approach based on noninvasive and invasive techniques can play a potentially decisive role in the management of severe Rh-alloimmunization.

Adult↗
PubMed1992

[Directional atherectomy and coronary angioplasty: a therapy complementary to myocardial revascularization surgery].

A white male patient, 59 years old, with two prior surgical myocardial revascularization and unstable angina, was submitted to coronary arteriography that showed: all the saphenous vein grafts patent and obstruction of 75% in the saphenous vein graft to the second marginal branch of left circumflex artery. Left internal mammary artery (LIMA) was angiographically normal and 80% stenosis was detected in the distal segment of the left anterior descending coronary artery (LAD). The patient was submitted to directional coronary atherectomy for saphenous vein graft and coronary angioplasty for distal-LAD. Both procedures were successfully performed.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Complementary therapy: using music in hospital settings.

The therapeutic use of music in hospitals has been explored within the context of highly specific situations. Here, the author explores the place of music in improving the general ambience of the clinical scene, and investigates the sometimes conflicting results from research into its physiological benefits to patients. Music in hospitals, he argues, is an area ripe for further exploration.

Critical Care↗