cam evidence base

Ostermann T, Raak C, Büssing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer. 2009 Dec 18;9:451. PMID: 20021637

Researchers from the University of Witten/Herdecke searched recognized databases for clinical studies of Iscador (extracts produced by fermentation of plant material) of Viscum album, the European white-berry mistletoe, with parameters associated with survival in cancer patients.

While noting significant limitations of their study, the authors found evidence that adjuvant treatment with Iscador was associated with a significant overall enhancement of survival rates in clinical trials.

From the conclusion:

“Pooled analysis of clinical studies suggests that adjuvant treatment of cancer patients with Iscador is associated with a reduction in mortality rates. Having in mind the limitations found here, future studies evaluating the effects of Iscador should continue to address this question, with a particular focus on a transparent design and description of endpoints in order to provide greater insight into a treatment often being depreciated as ineffective. The information and considerations from this analysis should be taken seriously not only for a better study quality but also to provide the best possible care for cancer patients.”

The US National Cancer Institute maintains a summary of research on mistletoe extracts here.

CAM evidence base: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine ethnobotany

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Moshi MJ, Otieno DF, Mbabazi PK, Weisheit A. The ethnomedicine of the Haya people of Bugabo ward, Kagera Region, north western Tanzania. J Ethnobiol Ethnomed. 2009 Aug 31;5:24. PubMed PMID: 19715617

As this article demonstrates, the Haya people in Bugabo are custodians of a rich heritage of traditional medicine knowledge. Researchers documented 94 plant species representing 84 genera and 43 families found to be commonly used in the treatment of a variety of human ailments.

From the conclusion:

From this study it is quite clear that the Haya people in Bugabo are custodians of a rich heritage of traditional medicine knowledge. This calls for more initiatives to conserve this knowledge alongside the rich repository of medicinal plants found in the study area. Also, in the light of the therapeutic claims made on many of the plants documented in this study, some of which are validated by literature reports, there is need to conduct phytochemical and biological activity studies on the plants occurring in Bugabo to generate information that could be used in future drug development.

Read the full text.

CAM evidence base: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine ethnobotany

Comments and Links Appreciated!

Bekalo TH, Woodmatas SD, Woldemariam ZA. An ethnobotanical study of medicinal plants used by local people in the lowlands of Konta Special Woreda, southern nations, nationalities and peoples regional state, Ethiopia. J Ethnobiol Ethnomed. 2009 Sep 24;5:26. PubMed PMID: 19775482.

An important survey of a threatened ecosystem, yielding 120 plant species used for medicinal purposes. From the conclusion:

Konta Special Woreda is an important area for medicinal plants and associated local knowledge; the natural vegetation being the most important reservoir for the majority of the medicinal plants. Environmental and cultural changes are in the process of threatening the resources and this signals the need for serious efforts to create public awareness so that measures are taken to conserve the medicinal plants in the natural ecosystems and other suitable environments.

Read the full text.

CAM evidence base: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine ethnobotany

Comments and Links Appreciated!

Kaptchuk TJ, Shaw J, Kerr CE, et al. “Maybe I made up the whole thing”: placebos and patients’ experiences in a randomized controlled trial. Cult Med Psychiatry. 2009 Sep;33(3):382-411. PubMed PMID: 19597976; PubMed Central PMCID: PMC2716443

Noting that patients frequently report relief in the placebo-control arms of clinical trials, researchers at Harvard Medical School and the University of California at San Diego interviewed 12 patients in a placebo-controlled randomized clinical trial (RCT) of acupuncture treatment for irritable bowel syndrome (IBS) who underwent and completed placebo treatment.

The study was embedded in a 6-week, three-arm, single-blind randomized clinical trial (n = 262) “designed to test the hypothesis that the magnitude of the placebo response could be systematically augmented by progressively combining three components of the response to placebo”:

1. the patients’ experience of observation/assessment
2. the performance of a therapeutic ritual (placebo treatment)
3. an augmented patient–practitioner relationship—in a manner resembling a graded escalation of “dose” (analogous to dose dependency).

Most of the 12 patients reported modest to dramatic improvement in their IBS symptoms. From the Discussion:

“The placebo response of each patient was an idiosyncratic, variable and unstable construction, undertaken in the novel context of an RCT composed of specialized and authoritative procedures (i.e., informed consent, the knowledge of randomization, the delivery of the treatment under conditions of “blinding,” interrogation by social scientists). From the patient’s viewpoint, the treatment they received was inherently ambiguous with regard to its potential to heal. From the researcher’s point of view, that uncertainty was the raison d’être for the blinded clinical trial. Yet from the patients’ side, the same carefully devised blend of doubt and concealment was a potent obstacle to the stability of any attempt to construe the treatment’s effect on their illness. What we have highlighted here and sought to understand, however imperfectly, are their descriptions of those often inconclusive, self-contradictory or vacillating attempts to cast the hints of “change” or “no change” into a convincing and stable account of how the treatments were affecting them. This “symbolic work” was interminable, not because of the obdurate nature of the patients’ illness, but, at least for the duration of the trial, by design.”

A thoughtful paper on an endlessly fascinating phenomenon. Read the full text.

CAM evidence base: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine placebo effect

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