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Maintaining homeostasis requires that the body continuously monitor its internal conditions.
In order to set the system in motion, a stimulus must drive a physiological parameter beyond its normal range (that is, beyond homeostasis). Humans have a similar temperature regulation feedback system that works by promoting either heat loss or heat gain ([link]b). Blood vessels in the skin begin to dilate allowing more blood from the body core to flow to the surface of the skin allowing the heat to radiate into the environment. The depth of respiration increases, and a person may breathe through an open mouth instead of through the nasal passageways. In contrast, activation of the brain’s heat-gain center by exposure to cold reduces blood flow to the skin, and blood returning from the limbs is diverted into a network of deep veins. Positive feedback intensifies a change in the body’s physiological condition rather than reversing it. Homeostasis is the activity of cells throughout the body to maintain the physiological state within a narrow range that is compatible with life. After you eat lunch, nerve cells in your stomach respond to the distension (the stimulus) resulting from the food. Which of the following is an example of a normal physiologic process that uses a positive feedback loop? Identify the four components of a negative feedback loop and explain what would happen if secretion of a body chemical controlled by a negative feedback system became too great. The four components of a negative feedback loop are: stimulus, sensor, control center, and effector.
What regulatory processes would your body use if you were trapped by a blizzard in an unheated, uninsulated cabin in the woods? Thu vi?n H?c li?u M? Vi?t Nam (VOER) du?c tai tr? b?i Vietnam Foundation va v?n hanh tren n?n t?ng Hanoi Spring. We will be provided with an authorization token (please note: passwords are not shared with us) and will sync your accounts for you. Patients with metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) have high risk of microcirculation complications and microangiopathies.
Metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) are the factors of cardiovascular risk.
Several publications provide evidence of putative interrelations between the MetS components and blood platelet count.
There is evidence (Idrisova et al., 2007) that spontaneous platelet aggregation, estimated based on the sizes of the formed aggregates, was significantly higher in MetS patients compared with healthy volunteers. The experimental studies demonstrated that C-peptide in vitro modulates thrombogenesis (Lindenblatt et al., 2006). Some data suggest that hyperglycemia contributes to platelet aggregation whereas normalization of glucose concentration attenuates this process (Dandona and Aljada, 2004). The molecule of NO is a universal regulator in the cardiovascular, immune, and nervous systems of the organism. Activation of iNOS results in synthesis of high NO concentrations enough to stimulate T-cell-mediated immunity and exert cytotoxic effects. NO stimulates synthesis of endothelial growth factor, but suppresses smooth muscle cells proliferation and migration thus preventing neointima formation and vascular hypertrophy.
The ability of NO to directly interact with iron mediates many physiological and toxic effects. The activating effects of NO on cADP-ribosyltransferase through the cGMP-dependent mechanisms were also demonstrated. There is evidence of decrease in the insulin-stimulated NO production by the endothelial and smooth muscle cells in the presence of insulin resistance (Bondarenko et al., 2002). Human platelet aggregation is also modulated by NO and prostacyclin (PGI2) released from the endothelium. In our study, N-monomethyl-L-arginine (L-NMMA), a blocker of eNOS and iNOS, was used for evaluation of the involvement of NOS into antiplatelet effects of insulin. Hyperhomocysteinemia is often associated with T2DM and represents a risk factor for cardiovascular catastrophes (Boushey et al., 1995). Human platelets express insulin receptors on the cell surface, suggesting possible involvement of insulin in the platelet regulation.
From body temperature to blood pressure to levels of certain nutrients, each physiological condition has a particular set point. A sensor, also referred to a receptor, is a component of a feedback system that monitors a physiological value. As the sweat evaporates from the skin surface into the surrounding air, it takes heat with it. A person’s body retains very tight control on water levels without conscious control by the person. A deviation from the normal range results in more change, and the system moves farther away from the normal range.
Homeostasis is regulated by negative feedback loops and, much less frequently, by positive feedback loops. If too great a quantity of the chemical were excreted, sensors would activate a control center, which would in turn activate an effector. This would reduce blood flow to your skin, and shunt blood returning from your limbs away from the digits and into a network of deep veins. Cac tai li?u d?u tuan th? gi?y phep Creative Commons Attribution 3.0 tr? khi ghi chu ro ngo?i l?.
This means that you will not need to remember your user name and password in the future and you will be able to login with the account you choose to sync, with the click of a button. This page doesn't support Internet Explorer 6, 7 and 8.Please upgrade your browser or activate Google Chrome Frame to improve your experience. An increase in thrombogenic risk is associated with platelet hyperaggregation, hypercoagulation, and hyperfibrinolysis.
MetS comprises an array of pathogenetically interrelated metabolic and clinical abnormalities (insulin resistance, arterial hypertension, and dyslipidemia) and increases risk of atherosclerotic damage of blood vessels. The curves of the mean aggregate sizes and light transmission characteristics suggested that the rates of collagen-induced aggregation of isolated platelets in MetS patients significantly exceeded the corresponding values in group of healthy volunteers (Idrisova et al., 2007). Low concentration of this molecule attenuate whereas high concentration stimulate apoptosis and suppress extracellular matrix synthesis thus maintaining normal structure of the vascular wall (Malakhov et al., 2009).
NO reversibly binds to heme iron of guanylate cyclase, cyclooxygenase, catalase, lipoxygenases, NOSs, cytochrome P450, peroxidases, and cytochromes of mitochondrial respiratory electron transport chain as well as to heme iron of oxyhemoglobin.
Synthesis of cADP-ribose, an agonist of ryanodine receptors, augments Ca2+ release from endoplasmic reticulum. Endothelial dysfunction, accompanying the insulin resistance syndrome, attenuates NO and PGI2 production in the endotheliocytes (Dandona and Aljada, 2004).
Both in healthy volunteers and patients with MetS, the collagen-induced platelet aggregation did not change in response to insulin. Homocysteine affects blood vessels through the active oxygen forms, decrease in endothelial NO production, and augmentation of smooth muscle cell proliferation (Welch and Loscalzo, 1998). Homeopathic individualized medicines versus fluoxetine for moderate to severe depression: double-blind, randomized non-inferiority trial.
For example, in the control of blood glucose, specific endocrine cells in the pancreas detect excess glucose (the stimulus) in the bloodstream. If heat loss is severe, the brain triggers an increase in random signals to skeletal muscles, causing them to contract and producing shivering.
The cervix contains stretch-sensitive nerve cells that monitor the degree of stretching (the sensors).
Less blood circulating means reduced blood pressure and reduced perfusion (penetration of blood) to the brain and other vital organs. Both have the same components of a stimulus, sensor, control center, and effector; however, negative feedback loops work to prevent an excessive response to the stimulus, whereas positive feedback loops intensify the response until an end point is reached.
Your brain’s heat-gain center would also increase your muscle contraction, causing you to shiver. Factors leading to platelet activation in MetS and T2DM comprise insulin resistance, hyperglycemia, non-enzymatic glycosylation, oxidative stress, and inflammation.
These positive correlations suggest interplay between the elevated basal C-protein blood level and platelet aggregation in T2DM.
The enzyme is activated by cytokines or bacterial antigens in inflammation as well as by ultraviolet, ozone, nicotinic acid, and hormones affecting cAMP synthesis (adrenalin, glucagon). Altered activity of NOS in platelets from patients with MetS can play the key role in onset of the platelet hyperactivation and development of macro- and micro-angiopathies.
Effects of NO and PGI2 on the platelets are mediated by the adenylate and guanylate cycases that synthesize cAMP and cGMP. These data agree with the hypothesis suggesting absence of NOS in platelets (Kawamato et al., 2002). Ubiratan Cardinalli Adler, UNIFESP (Federal University of SA?o Paulo, Brazil), Av Rouxinol, 1041 cj.
The control center is the component in a feedback system that compares the value to the normal range. These pancreatic beta cells respond to the increased level of blood glucose by releasing the hormone insulin into the bloodstream. These nerve cells send messages to the brain, which in turn causes the pituitary gland at the base of the brain to release the hormone oxytocin into the bloodstream. This review discusses the role of nitric oxide (NO) in the regulation of platelet adhesion and aggregation processes. Apparently, insulin resistance, hyperglycemia, and elevated non-enzymatic protein glycosylation in T2DM are the factors causing increased platelet sensitivity to the inductors of platelet aggregation (Gruzdeva et al., 2008). Inhibition of NOS in healthy volunteers significantly increases blood clotting time and worsens other coagulogram indices (Malakhov et al., 2009).
Due to binding of NO to Fe2+ of the guanylate cyclase porphyrin ring, the activity of the enzyme increases by a factor of hundreds. Additionally, protein kinases G upregulate protein phosphatase activating K+-channels by dephosphorylation. One of the explanations of this phenomenon is organospecificity, related, in particularly, to diverse development of the endoplasmic reticulum and plasma membrane as well as peculiarities of the intracellular metabolism in different cell types. Studies of NO production in the platelets showed decreased basal NO production in all groups of MetS patients compared with healthy donors.
Similarly to its macrophage form, iNOS was found on the mitochondrial inner membrane (Joannides et al., 1995).
Data show that anti-aggregation effects of insulin can be mediated through different intracellular mechanisms.
If the value deviates too much from the set point, then the control center activates an effector.
The insulin signals skeletal muscle fibers, fat cells (adipocytes), and liver cells to take up the excess glucose, removing it from the bloodstream.
The brain triggers the thyroid gland in the endocrine system to release thyroid hormone, which increases metabolic activity and heat production in cells throughout the body.
Enormous changes in the mother’s body are required to expel the baby at the end of pregnancy. Oxytocin causes stronger contractions of the smooth muscles in of the uterus (the effectors), pushing the baby further down the birth canal. The body responds to this potential catastrophe by releasing substances in the injured blood vessel wall that begin the process of blood clotting.
Your body would also produce thyroid hormone and epinephrine, chemicals that promote increased metabolism and heat production. NO is synthesized both in endotheliocytes, smooth muscle cells, macrophages, and platelets. Activation of platelets can play an important role in progression of heart failure due to a formation of the microthrombi in the myocardial microcirculation (Serebruany et al., 2002). Strong positive correlation between blood platelet count and the number of present MetS components was documented upon adjustment for a variety of biosocial factors (age, smoking, alcohol use, and physical activity).
The very elevated glycosylation of the platelet membrane proteins, rather than molar ratio of cholesterol and phospholipids, can decrease platelet membrane fluidity in diabetic patients (Muratova, 2004; Vinik and Erbas, 2013). This result is confirmed by the increased interaction of platelets with collagen, elevated expression of activation-associated platelet antigen, and augmented urinary excretion of 1-dehydro-TxB2, the marker of platelet activation (Gresele et al., 2010). This molecule has the highest diffusion coefficient compared with other molecules (O2 and CO2) in the organism and freely penetrates cellular membranes (Malakhov et al., 2009). Our study demonstrated an increased basal NO production by monocytes isolated from MetS patients perhaps due to the iNOS activation (Suslova et al., 2005).
As a result, synthesized cyclic guanosine monophosphate regulates the vascular tone, immune reactions, neuronal mediation, platelet aggregation, platelet-endothelial interactions, and functioning of the diverse muscle cell types between other processes.
Moreover, the lowest rates of NO synthesis were observed in patients with decompensated T2DM (Ogurkova et al., 2007). Platelets contain significant amount of mitochondria and, therefore, iNOS can be present in these organelles. There is a need for large-scale longitudinal data on treatment utilization and outcomes, stress, emotion, and pain. Control centers in the brain play roles in regulating physiological parameters and keeping them within the normal range. An effector is the component in a feedback system that causes a change to reverse the situation and return the value to the normal range. The brain also signals the adrenal glands to release epinephrine (adrenaline), a hormone that causes the breakdown of glycogen into glucose, which can be used as an energy source. And the events of childbirth, once begun, must progress rapidly to a conclusion or the life of the mother and the baby are at risk.
Modification of platelet NO-synthase (NOS) activity in MetS patients can play a central role in the manifestation of platelet hyperactivation.
The study also demonstrated an increase in the mean platelet diameter in T2DM patients (Pavlishchuk et al., 2007). Therefore, thrombocytosis can partially explain the augmented cardiovascular risk in MetS patients (Muratova, 2004; Berkovskaya and Butrova, 2009). Unlike guanylate cyclase, inhibition of all other heme-containing enzymes does not depend on heme iron valence in their active site when they interact with NO (Malakhov et al., 2009).
Cyclic nucleotides stimulate cAMP-dependent PKA and cGMP-dependent protein kinase G (PKG) that, in turn, phosphorylate broad range of proteins.
At the same time, NO production after incubation with homocysteine is lower in cells from diabetic patients than in healthy individuals.
As the body works to maintain homeostasis, any significant deviation from the normal range will be resisted and homeostasis restored through a process called negative feedback.
The breakdown of glycogen into glucose also results in increased metabolism and heat production.
The extreme muscular work of labor and delivery are the result of a positive feedback system ([link]). The cycle of stretching, oxytocin release, and increasingly more forceful contractions stops only when the baby is born.
Metabolic changes, accompanying T2DM, can lead to an abnormal NOS expression and activity in platelets.
According to other study, the platelet size and cell volume do not differ between T2DM patients and healthy volunteers (Schaeffer et al., 1999).


In particular, possible glycosylation of calmodulin that modulates activity of nitric oxide synthase (NOS) results in the decreased synthesis of nitric oxide (NO) (Kutti et al., 1986). Reduced basal formation of NO by the cells from MetS patients can be caused by various reasons.
Phosphorylation results in an inactivation of small G proteins that belong to Ras and Rho families, inhibition of Ca2+ release from the intracellular stores, and modulation of actin cytoskeleton (Smolenski, 2012). Randomized long-term trial of camel milk as an adjunct to insulin therapy in type-1 diabetes.
Negative feedback is a mechanism that prevents a physiological response from going beyond the normal range by reversing the action once the normal range is exceeded. Clotting is contained in a local area based on the tightly controlled availability of clotting proteins. Hyperhomocysteinemia, often accompanying T2DM, is a risk factor for cardiovascular accidents. The presence of hyperglycemia due to glucose autoxidation contributes to the formation of superoxide anion interacting with NO and mediating formation of the peroxinitrite attenuating NO content (Schaeffer et al., 1999).
Data demonstrated that homocysteine causes atherogenic effects in diabetic patients due to decreased platelet NO production with following augmentation of platelet activity and aggregation (Mutus et al., 2001). Moreover, the isoforms of constitutive NOSs are considered to be parts of two signaling pathways in the cell (Malakhov et al., 2009). There is evidence that platelets express functional Ca2+-calmodulin-dependent constitutive NOS.
De novo protein synthesis in platelets is significantly limited due to the absence of nucleus. It is possible, that NOSs are present in younger platelets, but, due to rapid degradation of the enzymes and small lifetime of the platelets, NOSs are impossible to detect. Patients are recruited from web sites for patient advocacy and health enhancement programs. Decrease in a number and sensitivity of the insulin receptors on platelets in T2DM can cause platelet hyperactivation. Therefore this long-term study was undertaken to assess the efficacy, safety and acceptability of camel milk as an adjunct to insulin therapy in type 1 diabetic patients. The experimental and clinical studies suggest that prolonged hyperglycemia contributes to the activation of the polyol pathway of glucose metabolism with depletion of NADP which is an obligatory cofactor of eNOS (Bondarenko et al., 2002). According to literature, platelets from patients with diabetes have decreased sensitivity to NO and PGI2. Methods: In this 2-year randomized clinical parallel design study, 24 patients with type 1 diabetes were enrolled and divided in 2 groups.
When eNOS is expressed in plasma membrane of the endotheliocytes (EC) and colocalized with caveolin, its activity is very low. In vitro and in vivo studies demonstrated that oxidized low-density lipoproteins suppress platelet NO synthesis and stimulate platelet aggregation and formation of thromboxane A2 and serotonin (Malakhov et al., 2009).
In diabetes mellitus, the number of PGI2 receptors is not decreased suggesting that the defect is downstream of the receptor. Group I (n=12) received usual care (ie, diet, exercise, and insulin), and group II (n=12) received 500 mL camel milk in addition to diet, exercise, and insulin.
The review presents data suggesting an ability of platelets to synthesize humoral factors stimulating thrombogenesis and inflammation. Proinflammatory cytokines are considered as markers of T2DM and cardiovascular complications and are involved in the development of dyslipidemia and insulin resistance.
Free fatty acids that are often elevated in obesity inhibit eNOS in vitro (Scherrer and Sartori, 1997). The article provides an evaluation of NO-mediated signaling pathway in the effects of cytokines on platelet aggregation.
According to some studies, platelet eNOS activity is lower in diabetic patients compared with healthy individuals (Randriamboavonjy and Fleming, 2005).
Some studies demonstrated elevated activity of cGMP-dependent phosphodiesterase eventually leading to decrease in sensitivity to NO (Vinik and Erbas, 2013). The effects of the proinflammatory cytokines on functional activity of platelets are demonstrated.
Available literature highlights the fact that platelet eNOS can be activated by β2-adrenoceptors that activate adenylate cyclase. Inhibitors of NOS do not affect human platelet activation at all and there are no differences between the agonist-induced platelet aggregation in wild type and NOS-deficient mice. The hypothesis, based on this fact, states that some platelet agonists directly affect soluble guanylate cyclases triggering NO-independent activation of cGMP-dependent signaling pathway (Naseem and Riba, 2008).
Though NOS regulation in platelets is currently under discussion, the insulin-induced cGMP synthesis is decreased and agonist-induced platelet aggregation is insensitive to NOS inhibitors in T2DM patients (Randriamboavonjy and Fleming, 2009).
Previous studies have found that between 30% and 60% of pediatric neurology patients have used CAM at some point in their lives. Whereas, the effect of vitamin C on conventional photodynamic therapy (PDT) of tumor cells has been documented, the mechanism of vitamin C induced increase in tumor cell response to PDT is unclear. In this report we demonstrate the presence of vitamin C during photo-oxidation of MC540 significantly increases its apoptotic activity in tumor cells.
Interestingly, we observed that the presence of vitamin C during photo-oxidation of MC540 only and not its addition to a prior photo-exposed mixture to MC540 is critical for its enhanced sensitivity.
These findings provide impetus to the approach in developing ROS generating small molecule compounds with potent apoptosis inducing activity. These data could have implications in the use of vitamin C in photo-sensitizer-mediated reactions with the view to favorably tailoring the cancer cell milieu for efficient apoptotic execution. Many patients are still not discussing their CAM use with their doctors and are using CAM alongside their conventional medicines, thereby increasing the likelihood for potential interactions.
One limitation of this study is that our ability to determine between-site differences is limited by the difference in sample size. Electrodermal measures as clinical markers: Jing-point electrical impedance in adolescent women with chronic pelvic pain. Consequently, skin electrical measures at Jing points are commonly obtained and interpreted for diagnostic purposes. Denise Adams, University of Alberta, 1047 RTF Building, University of Alberta, Edmonton, AB, T6G 2E1, Canada. The objective of this study is to determine whether electrodermal measures at Jing-points are associated with clinical outcomes in adolescents with chronic pelvic pain in a randomized, sham-controlled acupuncture trial. Methods: We recruited 18 adolescent women aged 13 to 22 years of age suffering from chronic pelvic pain and laparoscopically diagnosed with Stage I-III endometriosis.
Using a Hibiki-7 device, normalized electrical impedance values were obtained at all 24 Jing-points for each treatment session. Phase II: CAM research networks in Canada and the US will notify CAM providers of this study, so they may alert patients. Left-right asymmetry and measures for statistical dispersion (standard deviation and Gini coefficient) of Jing-point impedance values were calculated.
Parents or legal guardians may self-identify and reply on behalf of patients under 18 year of age if they meet the criteria for Phase I. With a generalized estimating equation method, we evaluated the association between the electrodermal-derived measures and clinical outcomes while accounting for treatment designation and time. Phase III: The methods for phase II were utilized but CAM associations and training organizations were substituted for CAM research networks. The majority of the cases involved the use of Traditional Chinese Medicine to improve quality of life. Preliminary analyses indicate that, over time, subjects in the active acupuncture arm were more likely to have reduced left-right asymmetry and statistical dispersion of Jing-point measures compared to subjects in the sham-control arm.
Further analyses with multivariable models will be performed to assess whether this difference is statistically significant for each electrodermal measure. The chiropractic care of children with otitis media: a systematic review of the literature utilizing whole systems research evaluation and meta-synthesis. Joel Alcantara, International Chiropractic Pediatric Association, 327 N Middletown Rd, Media, PA 19063. Key words were otitis media and related words (ie, acute otitis media, otitis media with effusion, ear infections, etc) AND chiropractic. A narrative review of the literature was performed and augmented with a meta-synthesis of the literature with a focus on chiropractic management and the application of a whole systems research (WSR) evaluation. Results: Our systematic review revealed 20 articles consisting of 6 case reports, 5 case series, 1 retrospective cohort, 2 prospective cohorts, 2 reviews of the literature, 2 commentaries, 1 survey study and 1 prospective, parallel-group, observer-blinded, randomized feasibility study. Due to the lack of higher-level research design, a meta-analysis of the literature was not possible. This included the use of otoscopy and tympanogram to provide objective pretreatment and comparative outcome measures.
Eighty-nine percent of respondents reported treating pediatric patients; patients under the age of 17 made up 12% of chiropractic and 20% of both naturopathic and osteopathic patients.
Activator, Gonstead, Toftness, Chiropractic Biophysics, and Diversified Techniques were utilized with an emphasis on the upper cervical spine (the C1 or C2 vertebral bodies). Approximately two-thirds of both osteopaths and naturopaths disagree or strongly disagree that immunizations are safe compared to one-third of chiropractors. One paper described utilization of cranial technique, 2 papers described a dietary intervention, and 2 papers utilized soft-tissue massage to augment spinal manipulative therapy. Fifteen studies were amenable to the WSR evaluation resulting in a score of 7.06 from a maximum of 11. The immunizations of most concern to the 3 professions included MMR, varicella, influenza, DPTP, and hepatitis. The most common reasons for concern were related to safety, including that vaccines may contain dangerous ingredients, may produce side effects, and may be linked to future problems such as neurological damage.
Conclusion: This systematic review highlights the need for more higher-level research designs in addition to incorporating new methodologies (ie, whole systems research) reflective of the holistic and vitalistic clinical and theoretical framework of chiropractic. The chiropractic care of children with enuresis: a systematic review of the literature utilizing whole systems research evaluation. Significantly more naturopaths advised parents against vaccinations (27%), compared to 10% of chiropractors, and 12% of osteopaths (P=.0002).
Joel Alcantara, International Chiropractic Pediatric Association, 327 North Middletown Rd, Media, PA 19063. There was no significant difference between groups for those advising parents in favor of vaccinations (15% C, 14% N, 6% O) (P=.1143). Key words were enuresis, nocturnal enuresis, bedwetting as well as related words AND chiropractic. A narrative review of the literature was performed and augmented with an evaluation using WSR evaluation.
Results: Our systematic review revealed 7 articles meeting the eligibility criteria for review. Four of the 7 papers involve case reports describing the care of children aged 8 to 14 years with primary complaints of nocturnal enuresis. Spinal manipulative therapy involved the use of Toggle recoil, Sacro-Occipital Technique, Activator Methods, Gonstead Technique, and Diversified Technique to address primarily segmental dysfunctions in the lumbosacral spine.
We conducted a systematic review to assess the nature and severity of adverse events associated with pediatric acupuncture. A large prospective cohort study (N=171) demonstrated improvement in wet nights per week from baseline following 2 weeks of care. In a randomized clinical trial, within-group comparison of pretreatment and comparative rates of enuresis subjects demonstrated an improvement.
However, the study was fraught with research design issues such as randomization and biostatistics.
Six of the 7 studies were amenable to WSR evaluation and resulted in a scoring of 7.33 from a maximum possible score of 11 points.
One reviewer screened all articles, while the second reviewed all excluded articles to ensure that no article was inappropriately excluded. Full articles of potentially relevant references were retrieved and assessed by two independent reviewers. The use of Whole Systems Research provides promise in contributing to evidence-based practice and reflects the holistic and vitalistic chiropractic approach to patient care.
Results: Seven thousand, two hundred sixty-two potentially relevant articles were identified. Eleven of these studies included adults as the majority of patients; for these studies the age of the patient experiencing the adverse event was never reported. Most of the adverse events that have been identified in children were mild and included pain, bruising, and worsening of symptoms.
The few adverse events rated as moderate or serious included one pneumothorax, 2 infections, and 2 cases of complications from needles left in the body.
Methods: This study was approved by the Institutional Review Board of Life University (Atlanta, Georgia). A 26-item questionnaire was sent to 9000 subscribers of an online newsletter from Midwifery Today Magazine. The first domain identified demographics (midwife credentials, age, years in practice, and place of practice).
The second domain queried participants regarding their formal and postgraduate training on the subject of chiropractic. The third domain attempted to identify their experience (ie, positive or negative experience) with chiropractic personally and professionally as it pertains to pregnancy and infant care. The fourth domain asked their opinion about the safety of chiropractic care for pregnant and pediatric patients. The fifth domain surveyed their knowledge regarding the scope of practice of chiropractic for pregnant and pediatric patients. The respondent ranged in age from 41 to 50 years with practice experience ranging from 6 to 10 years.
With respect to their training on chiropractic, 31% (n=57) reported receiving formal education (ie, during midwifery education) on the subject of chiropractic. Fifty-five of the 157 who did not indicated receiving some education on chiropractic through continuing education seminars. With respect to the midwife responders’ experience with chiropractic, 95% (n=176) admitted to making a professional referral to a chiropractor with 73% (n=137) having referred an infant to a chiropractor.
Ninety-two percent (n=171) reported being chiropractic patients with another 58% (n=124) presenting their child for chiropractic care. Over 90% indicated experiencing a positive experience as patients and with their child’s care.
All of the respondents perceived chiropractic was safe for pregnant patients, while only 97% considered chiropractic safe for children. An overwhelming majority of the responders (98%) indicated that chiropractors work with birth professionals, while 92% indicated that they were knowledgeable about the role of chiropractic in prenatal care. Lastly, 75% indicated interest in learning more about chiropractic, with 86% wanting more evidence-based practice chiropractic. From the 809 articles reviewed, 18 articles met the full inclusion criteria and proceeded to data extraction.
Identified adverse events include local pain or soreness, swelling, mild fevers, and skin rashes. Thus far, the majority of adverse events reported have been mild with few moderate or serious adverse events occurring in pediatric patients.


Total weight and body composition changes in response to weight reduction diets of varied protein content in midlife women. Age-related changes in body composition for women include loss of lean mass and gains in total weight, fat mass and central fat deposition. There is growing evidence that diets with low-to-moderate carbohydrate and fat content and increased levels of high-quality protein are effective for weight loss. Greater subjective satiety is reported by subjects following test meals containing whey protein compared to other protein sources.
The beneficial effects of whey protein on satiety, thermogenesis, and lean body mass protection suggest that whey may be a preferred protein source for weight loss treatment.
The specific aims of this study are to assess weight loss in subjects receiving energy-reduced dietary regimens and to evaluate parameters of weight and body mass change between the 3 treatment groups. Study Design: We are conducting a randomized, controlled pilot feeding study to evaluate the effect of different dietary protein sources on weight loss. Endpoint measures include body weight and body composition data obtained at baseline and at 8 weeks for dietary treatment.
The HP diet and the WP diet produced greater total fat loss and less total lean tissue loss than the CD.
Conclusions: Preliminary data shows that across treatment groups, the high-protein diets conserved lean tissue and promoted reduction of fat tissue.
Trials investigating TCM must be conducted with increased methodological rigor to be of value in evaluations. The single included study suggesting that acupuncture may be safe and efficacious in CFS is limited in applicability by the use of sham acupuncture as the control.
Integration and interface between naturopaths and conventional rural care: empirical findings from a grass-roots research project.
The worsening epidemic of DM in the United States, along with the increasing prevalence of obesity, insulin resistance, and IGT, render the identification of promising interventions for these states a matter of some urgency. Jon Adams, University of Queensland, School of Population Health ,University of Qld, Herston, Queensland, 4006, Australia.
While lifestyle interventions based on dietary pattern and physical activity can delay or prevent the onset of diabetes and reduce cardiovascular risk, adherence at the population level is severely limiting. Pharmacotherapy offers promise for diabetes prevention, but with associated high costs, unacceptability to many patients, and potential toxicity. In this context, the potential role of chromium (Cr), an insulin cofactor, in IGT is of great interest.
Proposed, therefore, is a randomized, double-blind, placebo-controlled pilot trial conducted at the Yale Prevention Research Center to investigate the effects of daily Cr for 6 months at 2 dose levels on serum measures of glucose tolerance and on endothelial function in adults with IGT, IFG, and IR. The study is powered to detect a clinically meaningful effect of Cr supplementation at either dose on glucose control, and to compare the two doses for equivalence. The study will investigate effects of Cr on both measures of glucose tolerance (glucose, insulin, OGTT) and brachial artery endothelial function, thus combining serum measures with a physiologic test of Cr effects on the vasculature. The proposed study will generate much needed data regarding the efficacy of Cr in those at risk for type 2 diabetes and offers the promise of guiding practice, as well as directing future study.
By contributing to knowledge related to potential diabetes prevention strategies, this study addresses one of the more pressing public health issues in the United States today. Risk to human subjects in this study is a minor increment over minimal due to the administration of nitroglycerin as a control in BARS testing. Secondary outcomes: (4) It will show improved well-being, as measured by elevated melatonin and DHEA.
Unlike many relaxation therapies, energy healing requires no participation by the patient, a feature that makes it particularly attractive in the hospital setting, where patients are often anxious, depressed, in pain, or sedated. Despite the increasing use of energy healing, few studies have looked at its benefits and even fewer at its underlying mechanisms of action. In this pilot study, we examined the effects of an energy healing modality known as Reiki on the autonomic nervous system (ANS) and the hypothalamus-pituitary-adrenal (HPA) axis, both of which participate in the stress response and stress-induced pain and disease progression.
Subjects rested for 10 min before baseline heart rate and blood pressure were measured and blood was drawn to determine cortisol, ACTH, and DHEA levels, using commercial immunoassay kits.
Subjects then received a 30- to 45-min Reiki or Pretend Reiki session followed immediately by post-session heart rate and blood pressure measurements and at 2h by blood draws.
When asked whether they thought they were in the Reiki or Pretend Reiki group, about 70% of the participants reported that they believed that they had received a true Reiki session.
This suggests that the beneficial effects of Reiki on physiology, as compared to the Pretend Reiki, cannot be explained solely by the placebo effect. Issac Amponsah, Faculty of Pharmacy Kwame Nkrumah University of SC, Knust, Kumasi, 233, Ghana.
Effects of ultra-low dilutions of sabal serrulata on human prostate cancer growth: mechanistic studies. Hakima Amri, Georgetown University, Basic Science Bldg, 3900 Reservoir Rd NW, Washington, DC 20007. Finally, serum protein differential expression was carried out using 2-dimensional gel electrophoresis followed by mass spectrometry analysis. Effect of mind-body medicine skills on elements of emotional intelligence in medical students. Yet studies have reported that traits such as altruism and empathy tend to decline throughout medical school training. In an effort to foster medical student self-awareness and mindfulness, which may improve their EI, Georgetown University School of Medicine (GUSOM) offers an experiential course to undergraduate medical students in mind-body medicine skills. The purpose is to expose students to a variety of mind-body approaches including meditation, imagery, as well as group sharing and listening generously for self-awareness and reflection. The aim of this study was to assess the impact of the Mind Body Medicine Skills (MBS) course on perceived stress, mindfulness, and elements of EI including intrapersonal capacities (attention to feelings, mood repair, clarity of feelings) and interpersonal capacities (perspective-taking, empathetic concern, and personal distress in response to distress in others).
The intervention group (n=30) was comprised of first year medical students who self-selected to participate in this elective.
The control group (n=36) included students from the first year class who completed the surveys but did not take the MBS course. Four questionnaires were completed at the start and end of the spring semester by all study participants: the Perceived Stress Scale (PSS), the Mindful Attention Awareness Scale (MAAS), and a survey of EI developed by Stratton et al (2005) comprised of the Trait Meta-Mood Scale and the Interpersonal Reactivity Index. ANCOVA was used to compare the MBS and the control groups at the end of the semester, controlling for beginning scores.
Patient perspectives of integrative and primary care management of back and neck paina€”qualitative findings from a randomized clinical trial. These conditions are additionally some of the most common reasons why patients use complementary therapies, often without dialogue with conventional care providers. The focus groups were conducted separately for those in the integrative vs the conventional treatment groups.
The interview data were transcribed ad verbatim and analyzed utilizing inductive content analysis technique. Eliane Angst, UCLA Center for Excellence in Pancreatic Diseases, 675 Charles E Young Drive South, Los Angeles, CA 90095.
A significant reduction in cell numbers was seen with quercetin concentrations of ~30 AµM and a maximum effect at ~75 AµM. In MIA PaCa-2 cells a ~65% reduction in cell number was seen with 75 AµM of quercetin after 48 hours. Starved BxPC-3 cells treated with 75 AµM quercetin showed a ~95% reduction in cell number after 48 hours. Conclusion: These results suggest that quercetin has a potent growth-inhibitory effect in pancreatic cancer cells in vitro. Additional experiments to investigate the underlying mechanism of growth inhibition and animal studies are underway. Flovanoids may reveal to be potent anticancer drugs found in our daily food, leading to specific diet recommendations. These can be taken together to qualify as an academic minor in many of the conventional MA or PhD programs, often forming the basis of a thesis or dissertation required for the terminal degree. In the fall of 2009, the university will launch a doctorate of nursing practice with a focus in integrative health and healing. Georgetown University developed a concentration of CAM within its Masters in Physiology program in 2003. We address the multicultural perspective, comparing data collected in Canada and Europe to those in the United States.
The reason for this is that results on the health-promoting effects of spirituality and religiosity cannot easily be transferred from the United States to countries with different cultural and religious backgrounds. Thus, one has to recognize different concepts of spirituality, different attitudes towards its utilization, and objections against the implementation of it in a particular medical system.
In Germany, 3 colleagues have founded the Transdisciplinary Working Group on Spirituality and Health, and in Canada the Canadian Research Network on Spirituality and Health has been active for a couple of years.
Data and approaches from these different networks will be combined into this symposium.Dr BA?ssing is an associate professor at the University of Witten, Herdeckea€™s Faculty of Medicine, where he directs the research group Spirituality and Health. The effect of a€?acupuncture for losing weighta€? on the level of blood sugar: a survey on the mechanism. Hoda Azizi, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, Beijing, Beijing, 100029, China. Material and Methods: In this clinical trial study, 66 patients were included in case and control groups.
Blood sugar was examined just before inserting needles and immediately after withdrawal of needles. Conclusion: Our results suggest that the mechanism of acupuncture in losing weight is significantly related to making an increase in BS.
John Balletto, Center for Muscular Therapy, Inc, 545 Pawtucket Avenue, Mailbox 304, Pawtucket, RI 02860-6046. As with business startups that begin informally and successfully mature into larger enterprises, growth brings new organizational challenges, together with greater visibility and opportunity.
The maturation of massage as a healthcare profession increases the need for a process to formalize the synthesis of massage therapy knowledge from clinical experience and research—to collect what we know and to make such baseline knowledge widely available to practitioners, consumers, and other healthcare stakeholders. The present paper lays out the motivations and framework for creating massage therapy guidelines that are informed both by research and by clinical experience. It also acts as a report to the massage therapy profession and to other stakeholders about the work of the Best Practices Committee of the Massage Therapy Foundation since 2006. And it has the additional goal of providing a healthcare literature basis for future academic discussions of massage.
The discussion here is based on a definition from the Institute of Medicine and on research into the nature of expertise. Topics addressed include guideline creation, credentialing of complementary and alternative medicine practitioners, definition of competence, and the increasing role of technology (that is, informatics) in managing training and task-necessary competencies. The roles of transparency and a wide and open peer review are emphasized as essential to the usability and credibility of guidelines.
Health Canada issues consumer advisories regarding the safety of marketed health products, yet the criteria for issuing advisories have not been evaluated for consistency or objectivity.
The Causality Algorithm used by Health Canada was used to rate degree of association between the adverse events (AEs) and the products.
The Severity of Adverse Events Scale, developed by the National Cancer Institute, was used to determine the severity of the AEs.
Most NHP AWRs were issued based on potential AEs from contamination and adulteration, whereas most of the AWRs for therapeutic drugs were issued due to actual AEs.
Of the 6 NHP AWRs issued for actual AEs, 3 (50%) were unassessable for severity, whereas of the 28 AWRs issued for actual therapeutic drug AEs, 1 (3%) was unassessable for severity.
The origin of reports for NHPs tended to be from foreign sources or Health Canada, whereas reports for therapeutic drugs were mostly issued by Health Canada in conjunction with drug manufacturers.
The potential of a mistletoe (Viscum album L) extract to alleviate adverse effects of cancer chemotherapy: an in vitro study.
Stephan Baumgartner, University of Bern, Institute of Complementary Medicine KIKOM, Inselspital, Bern, BE, 3010, Switzerland. We investigated the effect of a mistletoe extract on PBMC with and without concomitant treatment with cyclophosphamide and compared viability and replication of normal PBMC with that of a T-cell leukemia cell line.
The results motivate further preclinical and clinical investigations of mistletoe extracts as an adjuvant medication in cancer therapy to alleviate side effects of conventional therapy. Stephan Baumgartner, Institute of Complementary Medicine KIKOM, University of Bern, Inselspital, Imhoof-Pavillon, Bern, BE, 3010, Switzerland. We investigated the potential of a commonly used plant pathogen–system, Arabidopsis thaliana infected with the virulent bacteria Pseudomonas syringae (pv tomato strain DC3000), regarding its response towards a homeopathic treatment. Compared to Bion (a common SAR inducer used as positive control), the magnitude of the treatment effect of Biplantol was about 50%. None of the other tested preparations yielded significant effects in the overall evaluation. The purpose of this study was to determine remedy effects on a common quantitative measure of complexity, the correlation dimension (D2), of human sleep electroencephalography (EEG).
High Hostile subjects increased complexity at C3 and Pz, but decreased complexity at O2 during stage 3 sleep on CC. In the high Anxiety-Sensitive subjects, CC caused significant increases in complexity at Pz and O1 during stage 3 sleep and at C3, C4, and Pz during stage 4 sleep. CC increased complexity significantly at Cz, C4, and O2 during REM sleep in only the high Anxiety-Sensitive subjects. The purpose of the present study was to determine whether or not the objective measure of polysomnographically-recorded all-night sleep recordings can distinguish verum homeopathic remedies from placebo in human subjects.
NV produced more marked effects on increased shifts in sleep stages, with a growth in effects from night 22 to 23. This study examined the effects of olfactory administration of a polycrest homeopathic remedy Sulphur on heart rate variability (HRV). The Sulphur was given at dilution factors used for preparing 6c, 12c, and 30c potencies (1 potency per session, with potency order randomized), but for each potency, the test solutions were succussed to different degrees (stirred without shaking, 10, 20, or 100 succussions). Homeopathic remedies increase spectral electroencephalographic power during sleep in healthy young adults. The purpose of the present study was to assess the effects of verum vs placebo homeopathic remedies on spectral qEEG measures of polysomnographically-recorded all-night sleep recordings. Evaluating a nonlinear dynamical model for human flourishing: Relationship of PANAS positive-to-negative-affect ratio and global health and well-being.
The purpose of the present study was to compare global physical health (GPH) and well-being ratings of young adults whose P:N mood ratios fell above vs below the Losada line.
Despite higher (MCSD) scores in PF, a small sex and age difference between groups, ANCOVAs controlling for MCSD, sex, and age still showed statistical significance of the above PF vs PL group differences. Gurjeet Birdee, Osher Research Center Harvard Medical School, 401 Park Drive, Suite 22-A West, Boston, MA 02215. We identified the prevalence of CAM modalities used and the characteristics of users among the pediatric population.



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