Category Archives: Integrative Medicine

SANTA ROSA, CA (April 4, 2022) In the course of the last four years, the Institute of OM Foundation has raised more than $2million to support rigorous, peer-reviewed scientific research into partnered stimulation and the physiological and psychological effects of Orgasmic Meditation (OM). These ongoing research programs continue to reveal that the practice of OM has promise as a potential treatment for depression, anxiety and trauma.

Among recent varieties of studies funded by the foundation is a project undertaken by Dr. Nicole Prause of UCLA and Dr. Greg Siegle of the University of Pittsburgh that is the very first partnered stimulation enquiry since William H. Masters and Victoria E. Johnsons pioneering research into human sexual response in the 1960s. This study, which included 125 volunteer couples in New York, Los Angeles and San Francisco, found that the practice of OM helps couples increase happiness, amusement, sexual arousal and closeness, while lowering anger and anxiety.Notably, the study found that these benefits were even more pronounced among people who had previously experienced sexual trauma.

My colleagues and I are extremely grateful for the role of The Institute of OM Foundation in supporting this trailblazing research, said Dr. Prause, Ph.D. Prause and Dr. Siegles study was published in the journal Sexual and Relationship Therapy in March of 2021. Ultimately, this research is about exploring the use of sexual stimulation to improve general health, she said.

The Foundation also provided support for a recent study conducted by Dr. Andrew Newberg, research director of the Department of Integrative Medicine and Nutritional Sciences at Thomas Jefferson University in Philadelphia. Dr. Newbergs study used functional magnetic resonance imaging (fMRI) technology to analyze 20 couples as they engaged in OM, and found changes in the frontal, parietal and temporal lobes of the brain among both male and female participants. The study was published in the journalFrontiers in Psychologyon Nov. 11, 2021.

This study suggests the possibility of an important link between sexuality and spirituality, said Dr. Newberg. It should also be emphasized that the findings may have implications for therapeutic applications in the future, helping with various neurological and psychological problems including emotional traumas, sexual dysfunction, and even depression.

In yet another study supported by the Foundation, researchers deployed a questionnaire developed to study mystical experience to determine how the practice of OM might trigger a substantial transcendent sensation in both participating partners, equivalent to a moderate dose of psilocybin, the hallucinogenic compound found in certain types of mushrooms. This study, published in July of 2021 in the journalF1000 Research, employed two different surveys.

The first survey included 780 participants who were asked to complete the questionnaire with a single powerful OM in mind. The second survey included 56 couples, who were asked to complete the survey immediately following an OM session. Respondents to both surveys reportedmoderate mystical experiences.

Given that OM apparently can trigger a mystical experience of similar power to psilocybin, and that psilocybin has shown promise in the treatment of mood and substance disorders, this study raises intriguing questions about whether OM might also be effective in the treatment of these disorders, said Vivian Siegel, Ph.D., the lead author of the study, and currently a lecturer in biology at MIT.

The Institute of OM Foundation is funded by gifts from several generous donors, including Ramani Ayer, a longtime practitioner of transcendental meditation and a retired executive from one of the nations oldest insurance companies.

I saw great changes in people as a result of their regular practice of OM, and I was inspired to support research exploring its potential health and wellness benefits, Ayer said. I have always believed in science, and I am proud to support this research into a promising area where there has not been a great deal of prior research.

In addition to these published studies, the foundation is continuing to support additional scientific research, including an upcoming study exploring the potential impact of OM on dopaminergic function in participants with Parkinsons disease, and a study exploring the impact of OM as a potential aide in the cessation of smoking tobacco.

FOR MORE INFORMATION, PLEASE CONTACT:

Allyson Gonzalez, Institute of OM

Email: Allyson@iomfoundation.org

Phone: 1.888.604.6636

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

See the rest here:
Institute of OM Foundation raises more than $2 million to support partnered stimulation practice research - EurekAlert

Throughout history, humans have been exploring the myth of eternal youth, while anti-aging has become a research topic of eternal interest. As one of the best achievements in emerging anti-aging research, NAD+ (nicotinamide adenine dinucleotide) is highly commercialized and the most well-known.

NAD+ is an essential substance in the human body. It is involved in thousands of redox enzyme reactions. Without it, wed be dead in only a few seconds. However, NAD+ levels drop dramatically with age. By age 40 to 60, at least 50% ofNAD+ is lost, resulting in accelerated aging and various diseases.

Therefore, on the frontiers of scientific research, the primary issue of restoring NAD+ levels has become an important research topic. Scientists are interested in preventing and treatingage-related diseases, as well as the restoration of health and vitality during the aging process.

With nearly 120 years of historical research since 1904, three scientists have won Nobel Prizes for their work on NAD+, and eight Nobel Laureates have publicly supported NAD+.

How to Supplement NAD+, the Nobel Winning Substance

According to conventional understanding, due to its large molecular weight, NAD+ is unstable in the air and difficult to enter the cell membrane, to be completely absorbed. The only way until now had been direct supplementation byintravenous injection, but this method was both invasiveandexpensive (about 5,000 / injection,continuous weekly injection) which made those who want to fight aging flinch.

In this regard, researchers began looking for ways to supplement NAD+ indirectly. For example, NMN and NA supplements became popular.These supplements of NAD+ have been hailed as anti-aging elixirs since their inception. Personalities from Warren Buffett to Li Ka-shing, as well as many big names in the business community,have endorsed them.

Arent there any direct and effective NAD+ supplementsbesides these?

Break the Technical Bottleneck and Make the Impossible Possible

In fact, scientists themselves have been studying effective ways to boost NAD+ levels by taking the supplements orally themselves.

In 2001, a biochemical research team at the University of Genova, Italy, found that connexin cx43 in half channels regulates the transmembrane flux of intact NAD+ by mediating calcium ions. However, these findings were not well received by the medical community. Most medical research was still focused on NAD precursor conversion.

During 2016-2018, the Australian Institute of Integrative Medicine proposed the direction of NAD development in the 21st century, namely, the formulation of optimal NAD+ compound supplements.The optimal NAD+ direct supplement formula can be obtained under the mediation of transmembrane proteins by combining the encapsulated and stable NAD+ molecules with the natural ingredients that can be effectively matched.

In 2018, a precise and complete pathway for NAD+ transmembrane proteinswas again proposed by Italian scientists. Meanwhile, a newly discovered transmembrane protein that can directly transport NAD+ into the mitochondria was also proposed.

At the same time, the VIIVA Global Product and Science Advisory Board began to conduct in-depth research on NAD+ supplementation when studying NMN. As the research progressed, scientists made a new discovery in order to break the technical bottleneck. The goal, of course, was to achieve direct NAD+ supplementation.

In 2020, the VIIVA Global Product and Science Advisory Board, the Australian Collegeof EasternMedicine, and the Australian Institute of Integrative Medicine jointly set out to develop a compound NAD+ that can be directly absorbed and utilized by the human body.

This is a fusion of Eastern and Western wisdom, the concept of homeopathy + the Oriental theory of compatibility-based compound formula, based on Western molecular medicine.Mr. Ashley Dayman, a scientist atthe Australian Collegeof EasternMedicine, has stated,On this basis, we have again made a breakthrough in compatibility research and developed the current optimal formula to upgrade it into an active superfood ingredient, VIIVA NAD+ DIRECT!I believe this will result in an innovative, even revolutionary product that changes the tide in the field of anti-aging!

As shown,these incremental steps in scientific research and technological development are only now beginning to reveal how we can make full use of its bountiful benefits for the sake of humanity.

Subversive Research Findings Start a New Era through Direct Supplementation

The result of VIIVAs latest research, NAD+ DIRECT, uses original DRT technology to innovatively solve the problem of oral NAD+ absorption.

NAD+ Direct was formulated by a team of trained Chinese Medical Doctors following the eternal principles of Traditional Chinese Medicine. The ingredients were chosen on the basis of their energy compatibility with the purpose of increasing the force of Blood and Chi in those people who use them.Western medical science was used to devise and develop a physical product thatcontained a supplement payload enveloped within multiple layers of lipids. The outermost layer is a preparation that is resistant to temperature fluctuations so the product can be stored safely at room temperature.

The second lipid capsule protects its contents against the action of stomach acid and intestinal digestive enzymes. At an ideal position in the small intestine, the second protective covering dissolves and opens to another third lipid layer which facilitates the uptake and transport of the capsule into, and then through the cells lining the intestine and into small blood vessels. Once in the bloodstream, the product, utilizing newly developed cell-penetrating technology, enters the cell with the NAD+ molecule unmodified from the NAD+ molecule which was taken orally.This total manufacturing process is innovative and patentable,because it, theoretically, does something no other supplement preparation can do; namely, allowsoral NAD+ to be conveyed intactly into the cells where it is used.Another ingredient PQQ,enters the cell separately from NAD+ and enhances the recycling of NAD+ in what is called a cytosol salvage pathway. The last major ingredient, Urolithin A, also enters the cell separately and helps with the recycling of mitochondria, the intracellular organelles which produce ATP, the energy of the body.

NAD+ is essential to the production of ATP by the mitochondria.NAD+ Direct is, therefore, a unique product where the Eastern Wisdom of Traditional Chinese Medicine has been integrated with the science of Western Medicine to form a potent NAD+ supplement which has a powerful impact on human health. proudly states chief advisor Dr. Fred Templeman of the VIIVA Global Product and Science Advisory Board.

VIIVA NAD+ DIRECT enables direct NAD+ supplementation through oral intake and directly supplies energy to the mitochondria in order to achieve the optimal balance of NAD+ levels in the human body. VIIVA launched this product to provide consumers with a new anti-aging approach. Considering direct NAD+ supplementation and the unique technology behind it, VIIVA NAD+ DIRECT will be a superior choice among all the other NAD+ supplements!

Media ContactCompany Name: Am-NewsContact Person: JANEEmail: Send EmailCountry: United StatesWebsite: http://www.am-news.com

Originally posted here:
Breaking the Technical Barriers to NAD+ Supplementation, VIIVA Leads the Global Anti-Aging Revolution with Its Scientific Expertise - Digital Journal

A couple of weeks ago, I likened ivermectin to acupuncture. The reason why the comparison came to me is because the reaction of those promoting ivermectin as a highly effective treatmentmiracle cure, evenfor COVID-19 is the approach to evidence. As more and more high-quality evidence from randomized clinical trials has failed to find a therapeutic effect from using ivermectin to treat COVID-19, increasingly its advocates point to positive studies that are less rigorous, such as observational and uncontrolled clinical studies. This is, more or less, exactly what acupuncture advocates have been doing as more and more high-quality studies with appropriate sham acupuncture placebo groups fail to find a detectable benefit for acupuncture for treating anything. Theyve been citing lower quality pragmatic studies, which might not be blinded (much less double-blinded), placebo-controlled, or, in some cases, even randomized. As I explain time and time again, though, citing pragmatic studies is putting the cart before the horse. Pragmatic studies are intended to see how well a treatment thats been shown to work in high quality randomized controlled clinical trials works out in the wild outside of clinical trials and all the rigid protocols and selection criteria, a situation where the indications for the treatment inevitably expand as well. Ivermectin advocates even use the same sorts of excuses, too, when randomized controlled trials (RCTs) fail to show a benefit when ivermectin is used to treat COVID-19, such as claiming that medicine is biased and there is a double standard. (There is a double standard, but it doesnt favor what acupuncture and ivermectin advocates think it does.)

In my post two weeks ago, I briefly mentioned an RCT of ivermectin for COVID-19 that was very much negative, but I didnt discuss it extensively because it had not yet been published and had only been publicized in a news report from The Wall Street Journal. It turns out that last Thursday the study was finally published, in The New England Journal of Medicine, and, as described, it was a resoundingly negative trial, without even a hint of a whiff of efficacy. Was it a perfect trial? Of course not. No trial is. It was, however, large and well-designed and showed zero detectable effect from the early treatment of COVID-19 with ivermectin on hospitalizations and emergency room monitoring. As such, it was just one more drop in the drip-drip-drip of negative RCTs for ivermectin. Along with the drip-drip-drip of evidence that the most famous and largest RCTs of ivermectin for COVID-19 were either incompetently carried out or even fraudulent, and, as I mentioned, ivermectin for COVID-19 is looking increasingly like acupuncture for, well, anything.

So why bring this up again so soon after writing about it? I started thinking (always a dangerous thing) about science-based medicine (SBM) and the very purpose of this blog, and it occurred to me that the case of ivermectin is a very good real-world example of the utility of SBM and why evidence-based medicine (EBM) can fail for so long in a case like that of this particular drug.

Lets go way, way back to the beginning, to explain the differences between EBM and SBM. Then Ill explain how these differences apply. The primary difference is that SBM takes into account prior probability of a treatment working in evaluating clinical evidence.

In the very first post ever on this blog all those years ago, SBM founder Dr. Steven Novella wrote:

All of science describes the same reality, and therefore it must (if it is functioning properly) all be mutually compatible. Collectively, science builds one cumulative model of the natural world. This means we can make rational judgments about what is likely to be true based upon what is already well established. This does not necessarily equate to rejecting new ideas out-of-hand, but rather to adjusting the threshold of evidence required to establish a new claim based upon the prior scientific plausibility of the new claim. Failure to do so leads to conclusions and recommendations that are not reliable, and therefore medical practices that are not reliably safe and effective.

This is why the authors of this blog strongly advocate for science-based medicine the use of the best scientific evidence available, in the light of our cumulative scientific knowledge from all relevant disciplines, in evaluating health claims, practices, and products.

What did Steve mean by prior scientific plausibility? In brief, its an estimate of how likely a proposed treatment, when tested in an RCT or other clinical study, is likely to produce a positive result; i.e., a result consistent with the treatment working for the indication against which it is being tested. More specifically, it is an estimate of the prior probability of a given hypothesis before a study is conducted (in the case of an RCT that the null hypothesis will be rejected and there will be a statistically significant difference between the treatment group and the placebo group, indicating that the treatment works). I realize that this is boiling it down a bit, but I am writing for a lay audience.

It turns out that clinical trials are imperfect and can have a lot of noise even when designed and carried out perfectly. It also turns out that, from a Bayesian perspective, the prior plausibility that a treatment works matters a lot in interpreting clinical trial results; i.e., posterior probability the probability that a positive result is a true positive depends on the prior plausibility. (Ill explain more in the next section what I mean by that.) Of course, in 2008, the original intent of SBM was to look at the evidence for treatments advocated as part of alternative medicine, complementary and alternative medicine (CAM), or, as CAM is now more frequently called, integrative medicine or integrative health, both modalities in which alternative medicine (i.e., quackery) is integrated into conventional EBM. As Ive argued, the newer names for CAM involving integration are nothing more than a rebranding of quackery.

Over the years, weve discussed many examples of alternative medicine with very low prior plausibility. Our favorite, as you might imagine, is homeopathy. The reason is simple. Based on homeopathys Law of Infinitesimals, which states states that the more you dilute a homeopathic remedy, the stronger it gets, we know that most homeopathic remedies are diluted to the point that it is unlikely that a single molecule of the original remedy is left. Homeopathy is thus arguably the purest example of a treatment with zero prior plausibility, given that most homeopathic remedies are is either water or another diluent. After all, as I like to say, for homeopathy to work for any disease or medical condition, several well-established laws of physics and chemistry would have to be not just wrong, but spectacularly wrong. It is, of course, true that there are other alternative medicine treatments that have a similar level of implausibilityimpossibility, reallybased on basic science considerations. (Energy healing comes to mind first.) However, homeopathy is so common and ubiquitous that it makes an excellent teaching example, which is why I use it so often. Also, Ive noticed that a lot of people dont even know what homeopathy is, including medical students and physicians. Many seem to think that homeopathy is just another form of herbal medicine. In any event, because many homeopathy remedies are just water used to make sugar pills, homeopathy is an excellent way to test the noise in clinical trials because its basically testing placebo vs. placebo.

So how does one consider prior plausibility in RCTs?

Weve long discussed the differences between EBM, which uses frequentist statistics, and SBM, which uses Bayesian reasoning that incorporates an estimate of prior plausibility

Ive long complained about methodolatry in EBM, defined as the obscene worship of the RCT as the only valid method of investigation in medicine. Its a term that I first learned in the context of countering misinformation about the H1N1 influenza vaccine back in 2009, taught to me by a senior epidemiologist. Theres a lot of methodolatry in EBM, and its part of the reason why treatments like acupuncture (whose prior plausibility, based on its pre-scientific concepts and mechanism of action is very, very low, albeit probably not zero) keep showing up as potentially workingor at least needing more studyto EBM practitioners. I would also like to take this opportunity right here to quote SBM co-founder and former regular Dr. Kimball Atwood, who discussed why EBM and SBM ought to be synonymous (but currently are not) and, more importantly why EBM is incomplete, and SBM is intended to complete it, or at least to fill in its blind spot. As Dr. Atwood put it, EBM should not be without consideration of prior probability, laws of physics, or plain common sense and SBM and EBM should not only be mutually inclusive, they should be synonymous.

Elsewhere, he argued:

That discussion made the point that EBM favors equivocal clinical trial data over basic science, even if the latter is both firmly established and refutes the clinical claim. It suggested that this failure in calculus is not an indictment of EBMs originators, but rather was an understandable lapse on their part: it never occurred to them, even as recently as 1990, that EBM would soon be asked to judge contests pitting low powered, bias-prone clinical investigations and reviews against facts of nature elucidated by voluminous and rigorous experimentation. Thus although EBM correctly recognizes that basic science is an insufficient basis for determining the safety and effectiveness of a new medical treatment, it overlooks its necessary place in that exercise.

You can see where Im going with this, I hope. In the post from which I drew that quote above, Dr. Atwood explained in more detail what Im talking about in terms of Bayesian theory. It also discusses how an estimate of prior probability affects the posterior probability that a given p-value in a clinical trial indicates a true result, or, as Steven Goodman and Sander Greenland put it in 2007 put it, the prior probability of a hypothesis is its probability before the study, and the posterior probability is its probability after the study.

In fact, I think Ill insert here a table that we at SBM like to cite to illustrate:

Goodman and Greenlands 2007 calculation for posterior probability based on prior probability.

This is Table 2 from the 2007 article by Goodman and Greenland that illustrates how prior probability affects posterior probability for given p-values. Notice one thing. The lower the prior probability, the much lower the posterior probability for a given p-value, such that if a prior probability is estimated to be 1%, then the posterior probability of a result for a standard p-value less than or equal to 0.05 is only 14%, meaning that its only ~14% likely that the result is not a false positive under the conditions specified, which are commonly used conditions in designing RCTs. Even results with fairly low p-values bear serious questioning in the case of a treatment with a very low prior probability/plausibility. (For those of you who are more knowledgeable, the mathematical formulas and reasoning used to derive these numbers are in the reference.)

For something like homeopathy, in which the prior probability based on its scientific impossibility under currently understood science is zero, the situation is, of course, far worse than in the table above. I will also quote Steve Novella and myself from a 2014 paper that we coauthored, in order to address a common criticism of our argument that RCTs of highly improbable/implausible treatments (like homeopathy) are akin to testing whether magic works as medicine:

It should also be noted that biologically plausible does not mean knowing the exact mechanism. What it does mean is that the mechanism should not be so scientifically implausible as to be reasonably considered impossible. In other words, the mechanism should not violate laws and theories in science that rest on far sturdier and longer established foundations than imperfect, bias-prone clinical trials. For example, homeopathy violates multiple laws of physics with its claims that dilution can make a homeopathic remedy stronger and that water can retain the memory of substances with which it has been in contact before [9]. Thus, treatments like homeopathy should be dismissed as ineffective on basic scientific grounds alone. That is why we propose the term science-based medicine (SBM) as opposed to evidence-based medicine (EBM). SBM restores basic science considerations to EBM and is what EBM should be.

Im assuming that most SBM readers accept that, for example, homeopathy or energy healing is so incredibly implausible/improbable from basic science considerations alone that basic science is all that is needed to reject it as a treatment. Im also assuming that most SBM readers will accept that, for example, acupuncture, although not as improbable/implausible as homeopathy, is still incredibly implausible, with a prior probability reasonably estimated as very much less than 1%. (Id say very much less than 0.0001%, even.) Ill also emphasize right here that, while basic science alone can in the cases under discussion here be enough to reject a proposed therapy as so implausible as to be impossible and not worth testing in RCTs, basic science is never enough to demonstrate that a treatment works, no matter how plausible the mechanism and compelling the preclinical data in cell culture and animals. Many are the treatments that appeared highly promising before being tested in humans, only to fail.

But what about ivermectin for COVID-19? That doesnt fall into the same categories as homeopathy or acupuncture, does it? Its an actual drug that is highly effective against diseases caused by roundworm infestations. Its discoverers even won the Nobel Prize for that indication! Is it so implausible that ivermectin might also work against a viral illness like COVID-19? There was even a proposed mechanism for its antiviral activity against SARS-CoV-2, the coronavirus that causes COVID-19. That mechanism was even based on in vitro cell culture studies!

All of these are reasonable considerations. So join me as I discuss them in the last two sections of this post, in which I hope to convince you that the prior probability for ivermectin was always very, very lownot homeopathy-level low, admittedly, but quite low.

So how did the idea come about that ivermectin might be an effective treatment for COVID-19 anyway? You might remember how the idea that repurposing hydroxychloroquine, an anti-malarial drug with immune modulating properties that make it useful as a mild immunosuppressive drug to use to treat autoimmune diseases, took hold early in the pandemic. In brief, Chinese physicians in Wuhan reported in early 2020 that none of a group of 80 patients with lupus erythematosus who were taking hydroxychloroquine went on to catch COVID-19. (Never mind that immunosuppressed patients were exactly the patients most likely to assiduously follow the recommendations of public health authorities during an epidemic.) A number of clinical trials were registered, and, based on anecdotal reports and small clinical trials (nearly all of which are as yet unpublished), in February the Chinese government published an expert consensus recommending CQ or HCQ for patients with COVID-19. Soon after, a number of nations followed suit. In addition, French scientist Didier Raoult started flogging hydroxychloroquine as a cure for COVID-19 and was soon joined by President Donald Trump and of course!Dr. Mehmet Oz. The rest, unfortunately, is history. Even though by late summer 2020, it was becoming quite clear that hydroxychloroquine was ineffective against COVID-19, a conspiracy theory of a suppressed cure had been born.

The idea that ivermectin could be repurposed to treat COVID-19 is similar, but based on even less evidence. I discussed this evidence several months ago, when a conspiracy theory was being spread that Pfizers new antiviral drug Paxlovid was Pfizermectin because both ivermectin and Paxlovid have protease inhibition activity. Ill just recap briefly.

Its been known for years that ivermectin can inhibit coronavirus replication through the inhibition of a protein called /1 importin, something reported a decade ago. This particular protein is involved in the transport of proteins into the nucleus from the cytoplasm. In the case of SARS-CoV-2 infection, the transport of certain proteins into the nucleus is important for completion of its lifecycle. Now heres the thing. Inhibition of this protein complex by ivermectin and preventing the replication of HIV and the Dengue virus requires fairly high concentrations (at least in terms of drug concentrations). The original Australian paper published in May 2020 that examined the ability of ivermectin to inhibit SARS-CoV-2 replication showed similar results, specifically the need for a very high concentration of drug to inhibit the importin that was needed for SARS-CoV-2 replication.

So whats the problem? Its basic pharmacology, as summarized in this review:

As noted, the activity of ivermectin in cell culture has not reproduced in mouse infection models against many of the viruses and has not been clinically proven either, in spite of ivermectin being available globally. This is likely related to the pharmacokinetics and therapeutic safety window for ivermectin. The blood levels of ivermectin at safe therapeutic doses are in the 2080ng/ml range [44], while the activity against SARS-CoV2 in cell culture is in the microgram range. Ivermectin is administered orally or topically. If safe formulations or analogs can be derived that can be administered to achieve therapeutic concentrations, ivermectin could be useful as a broad-spectrum antiviral agent.

Specifically, the IC50 (the concentration that produces 50% of maximal inhibition of a process) was in the 6 M. Given that the molecular weight of ivermectin is 875 g/mol, 6 M translates into ~5.25 mg/L or ~5.25 g/ml, a concentration that is roughly 66-fold higher than the upper end of the range of blood levels of ivermectin safely achievable in a humans bloodstream. Even this paper proposing ivermectin as a treatment for COVID-19 notes this serious problem:

A dose of 12 mg twice daily alone or in combination with other therapy for 57 days has been proposed as a safe therapeutic option for mild, moderate or severe cases of Covid-19 infection.10 The time to reach maximum plasma concentration of 2050 ng/ml, after a dose of 6 or 12 mg, respectively is approximately 4 h.

This is almost certainly the reason that ivermectin doesnt work against COVID-19 in spite of its activity in vitro against SARS-CoV-2. It requires a concentration roughly 66- to 197-fold higher than is safely achievable in the blood. Thats why the review concluded that maybe an ivermectin analogue that is either more active or can achieve a higher concentration safely in the bloodstream is worth investigating. Based on the proposed mechanism in the Australian paper, ivermectin was never a good candidate as a treatment for SARS-CoV-2. As I discussed for the claim that ivermectin should be considered a promising drug for COVID-19 based on its protease inhibitor activity, the situation is just as bad. Again, based on in vitro results, ivermectin was never a promising candidate as an antiviral drug to treat COVID-19.

But how do we translate this into prior probability? In the discussion of the NEJM trial to which I linked above, someone suggested what is probably an accurate assessment:

I think that a pretest probability of much less then 1% is accurate given in vitro results like the experiments that I described. I also noted on Thursday after seeing the NEJM study:

In other words, if ivermectin were to be actually useful against COVID-19, it would almost certainly have to work by a different molecular mechanism than the one described in the in vitro study cited because its known to be impossible to safely achieve ivermectin concentrations in human blood that are sufficient even to inhibit viral replication by 50%or even anywhere near such concentrations. Of course, its always possible that such a previously unknown mechanism was operative, but highly unlikely. Moreover, to consider that such a mechanism might be operative, the clinical trial results would have to be pristine in terms of very compelling results from very well-designed and executed clinical trials, or, as Steve Novella once put it, When the basic science dictates that a proposed treatment is highly implausible, the bar for clinical evidence should be raised proportionately.

This never applied to any clinical trial of ivermectin for COVID-19, not even the seemingly strongly positive ones, and thats even leaving aside the discovered incompetence and likely fraud in the largest positive trials, which led to falsely positive meta-analyses.

As I said, these negative results never surprised those of us with SBM tendencies. Given the very low prior probability that ivermectin is effective against COVID-19 based on in vitro data, even the best positive clinical trials likely had a low posterior probability. Moreover, they werent the only trials. Most trials were equivocal or negative, and, as is the case with acupuncture, the larger and better designed the study, the more likely it was to be negative, which leads me to an adage that I frequently use on Twitter (because its pithy) but have not yet (as far as I can recall) repeated here on SBM:

Very low prior plausibility

+

Equivocal clinical studies

=

Drug doesnt work for the proposed indication

Or at least, any effect observed will be too small and inconsistent to be clinically useful.

Its been a long time since weve discussed the difference between EBM and SBM in quite this much detail, discussions like this having been common here around 2008-2010, but I felt that a discussion like this was overdue. The reason, of course, has been the pandemic and how EBM has treated highly implausible COVID-19 therapies in the same way that its long treated highly implausible CAM therapies, through the lens of methodolatry, in which only RCTs matter for determining if a treatment does or doesnt work and in which even flawed RCTs trump basic scienceexcept that they dont, at least when Bayesian considerations are used.

What makes the discussion of ivermectin interesting to me in this context is that it is an example of why SBM matters in all areas of medicine, not just the consideration of integrative quackery. SBM mavens all immediately realized that, even if you accepted the rationale proposed at face value, ivermectin was incredibly implausible as an effective therapy for COVID-19 just based on the in vitro data alone. Its basic pharmacology. A drug that only inhibits the target protein at a concentration that is at least nearly 70-fold higher than the highest blood concentration of drug that can be safely achieved using standard dosing is incredibly unlikely to be an effective treatment. Its also a general principle that most highly effective drugs inhibit their target at nanomolar or ng/ml concentrations, not micromolar or g/ml concentrations. Candidate drugs that only inhibit their target at such high concentrations, in general, tend to be incredibly unlikely to be useful drugs.

Indeed, any pharmaceutical company that developed a drug just like ivermectin for COVID-19 would have abandoned it after in vitro testing showing that it required such a high concentration to inhibit the intended target. A drug company would have deemed such a candidate compound as not worth pursuing further, except maybe as a base molecule to chemically modify so that it either inhibits the desired target at a much lower concentration or becomes able to achieve much higher blood levels safely. Yet a number of scientists whom I respect were, until very recently, saying that ivermectin probably doesnt work or even saying that there was a strong developing evidence base; that is, until it all fell apart with the determinations that a couple of the largest, most positive studies couldnt possibly have been carried out as reported. Basic pharmacology matters.

I also realize that ivermectin believers wont accept an SBM-based argument against ivermectin any more than believers in acupuncture or homeopathy accept SBM-based Bayesian arguments against their favorite woo. Indeed, in reaction to the NEJM study, there were a lot of reactions like this:

And this:

All of them fell under the sorts of rationales as in this meme, which I most definitely am stealing:

However, remember that EBM arguments dont sway believers in homeopathy or acupuncture, either; so one should not expect that EBM or SBM arguments would sway ivermectin believers. My hope is that SBM thinking will be more likely to sway EBM adherents who dont really take into account prior plausibility in evaluating RCT evidence and therefore take much longer to reach a conclusion that is obvious to SBM about a treatment, in the case of ivermectin that it doesnt work against COVID-19. Indeed, at this stage I would argue that it is unethical to begin another RCT of ivermectin to treat COVID-19. Given how resoundingly negative the evidence is now, such a trial would be all risk with no realistic potential for any patient to benefit. Im not even sure whether its ethical to continue to recruit patients to RCTs of ivermectin still enrolling.

In future talks about the differences between SBM and EBM and how EBM should be (but still is not) synonymous with SBM, I plan on adding the example of ivermectin for COVID-19 to my long-used examples of homeopathy and acupuncture when I discuss Bayesian thinking and prior probability/plausibility because SBM isnt just for CAM any more. It never was, and never should have been. If Ive been guilty of not applying it to conventional medicine as much as I do to CAM, the case of ivermectin has shown me the error of my ways.

View original post here:
Science-based medicine isn't just for CAM. The case of ivermectin shows that it never was. - Science Based Medicine

Red Light Therapy or RLT as it is called helps skin, muscle tissue, and other parts of the body heal while relieving chronic pain. According to Dr. Delzells latest blog post, the way this works is to expose the body to low levels of infrared light. The light itself isnt visible to the naked eyes, but the heat from it can be felt. Thats why it is often referred to as low-level laser therapy, photobiomodulation, and low-power laser therapy. The therapy helps to promote blood flow and healing which eventually does away with the pain.

One of the benefits of light therapy is its ability to target the source of pain. LEDs or lasers used for this type of therapy are powerful and noninvasive. The lights frequency is adjustable and can be adapted to various areas of the body. The treatment may be more effective if several points along the nerve pathway are treated. Studies have also shown that light therapy reduces TMJ pain and works wonders for patients with back pain.

There are many other benefits to using light therapy for pain management. The infrared (IR) light, for instance, is shown to trigger the release of nitric oxide, the bodys natural vasodilator. The increased oxygen availability for the treated tissues results in less pain. Similarly, the presence of nitric oxide in the body improves immune cells ability to access the affected tissues. These benefits result in a reduction in pain.

It has long been established that Red Light Therapy (RLT) can help heal certain body parts like skin, muscle, and other parts. The therapy mainly works by exposing the affected parts of the body to very low levels of near-infrared light. While the naked eye cant see the light itself, the body feels the heat from the light. IR light treatment is referred to as low-level laser therapy or photobiomodulation. The deeper the light can penetrate, and the more focused, the more energy and blood flow it can lead to, which creates the most heat in the affected body part needed to promote healing in the spot.

While using Red/IR Light Therapy may come across as being simple enough, it does require a professional. A nurse or doctor needs to operate and understand how the treatment works to ensure the best results. That said, regular people can use more generalized light therapies like saunas, light blankets, and lamps.

Readers can read Dr. Patricia Delzells blog detailing the benefits of light therapy in its entirety by visiting the clinics official website at https://www.advancedmmc.com/post/light-therapy-benefits-on-chronic-pain.

Perhaps the most significant benefit of using IR light laser therapy apart from proven pain relief is that there are no adverse effects associated with its use. I have successfully used light therapy for chronic pain for several years and can attest that it can be life-changing when used correctly. However, the first step is to get your pain diagnosed. It is important for us to understand what is causing pain, and then that will tell us if light therapy will be effective in this instance. Said one of the doctors working at AMMC.

She added, We use the best light therapy devices which allows us to treat certain areas, allowing the light to penetrate deep within the soft tissue, which in some cases leads to ongoing pain relief for our patients.

About Advanced Musculoskeletal Medicine Consultants, Inc

Advanced Musculoskeletal Medicine Consultants, Inc (AMMC) is headed by Dr. Patricia Delzell, M.D, who is a world-renowned musculoskeletal ultrasound specialist. In addition, she is a fellowship-trained professional in integrative medicine with expertise in cross-section imaging. Since she is also a board-certified musculoskeletal radiologist, she has many years of experience with integrative treatment and chronic pain.

Advanced Musculoskeletal Medicine Consultants is a leader in integrative pain management with a focus on ultrasound diagnostic solutions, ultrasound-guided treatments of musculoskeletal scars, and therapies to provide relief from chronic musculoskeletal pain.

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Dr. Patricia Delzell, MD

Advanced Musculoskeletal Medicine Consultants, Inc.

Address: 8398 Kinsman Road Suite 1 Novelty, OH 44072

Phone: 440-557-5040

Email: [emailprotected]

Website: https://www.advancedmmc.com/

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AMMC's New Post Provides Insights on Benefits of Light Therapy On Chronic Pain - Digital Journal

In recent years, science has uncovered more and more evidence for the importance of the gut microbiome, the beneficial system of microorganisms in the stomach and intestines that have a role in immunity and overall health. But when something goes wrong in this intricate environmentsuch as the development of leaky gut syndromeit can cause uncomfortable symptoms and a wide range of health issues. These are the signs that you have leaky gut, according to physicians. Read on to find out moreand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

"Leaky gut describes the breakdown of the integrity of the gut lining," says Lynn K. Wagner, MD, an integrative medicine physician in La Pere, Wisconsin. "It occurs when the tight junctions between our intestinal cells are disrupted, creating gaps or holes in the gut. When this happens, undigested food particles, microorganisms and toxins can enter the bloodstream when they would normally be eliminated in your stool." This can cause a variety of systemic problems throughout the body.

"Initially, leaky gut can be silent, meaning you may not even know you have it," say Wagner. When symptoms of leaky gut appear, they commonly include:6254a4d1642c605c54bf1cab17d50f1e

RELATED: Doing This After Age 60 is "Unhealthy," Say Physicians

"Potential risks of leaky gut include malnutrition as the body's damaged gut lining is unable to absorb nutrients from the food we eat," says Jonathon Kung, MD, a gastroenterologist with Mount Sinai in New York City. "Malnutrition can manifest as changes in the skin, changes in vision acuity, weaker bones, changes in mood, and trouble concentrating, essentially a function of poorly absorbed essential vitamins. Other risks include ongoing fatigue affecting someone's ability to function properly at home or at work."

Leaky gut has been linked to autoimmune diseases, like Hashimoto's thyroid disease, says Wagner. "It can cause systemic inflammation, which can manifest as chronic aches and pains, generalized fatigue, and a higher risk of chronic disease states that are triggered by inflammation."

RELATED: Habits Secretly Increasing Your Blood Clot Risk, Say Physicians

According to Wagner, the best ways to avoid leaky gut include:

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"The medical community has worked for years on trying to reverse leaky gut by increasing intestinal permeability," says Kung. "Some have found that changes in diet and avoiding certain foods which cause changes in the gut flora have been helpful. The Low FODMAP diet is a good example of a diet good for the gut. Eating a diet rich in antioxidants such as strawberries, blueberries, raspberries, spinach, kale, green tea, and even dark chocolate may help prevent or decrease gut imbalances."

Probiotics can rebuild healthy gut flora, says Wagner. In some cases, it may be necessary to remove "bad" bacteria and pathogens from the gut with supplements, or in severe cases, antibiotic therapy. Supplements that target gut healing include zinc, carnosine, quercitin, L-glutamine, and aloe.

Kung recommends supplementing with liposomal bovine colostrum."It has been shown in clinical studies to balance intestinal permeability and its growth factors work to restore theintegrity of the tight junctions, making it a top superfood for remedying a leaky gut."

And to ensure your health don't miss these 101 Health Habits You Didn't Know Were Deadly.

Read this article:
Signs You Have "Leaky Gut," Say Physicians Eat This Not That - Eat This, Not That

Breast cancer is one of the most common cancers amongst women in the United States, second only to skin cancer [1]. Each year, about 255,000 new cases of breast cancer are diagnosed in the United States. Additionally, about 100,000 women go on to have some form of mastectomy each year either prophylactically or as a definitive treatment [2]. Unfortunately, these procedures can be very burdensome in terms of post-operative pain and emotional burden for patients. Breast biopsies alone have been shown to contribute to anxiety and depression in women both before and after the procedure due to fear of the procedure itself as well as fear of a potential cancer diagnosis [3]. Therefore, pain management and mental health support are crucial in achieving an optimal recovery [4].

The American Society of Breast Surgeons (ASBrS) has compiled a workgroup to encourage breast surgeons to consider the use of non-opioid alternatives to combat post-operative pain control and mitigate the current opioid crisis. This workgroup has recommended the use of a multidisciplinary approach in combination with standardized quantities of narcotics. It also strongly supports the use of the enhanced recovery after surgery (ERAS) protocol [5]. ERAS protocols have successfully implemented evidence-based practices to reduce post-operative pain, nausea, vomiting, opioid use, and length of hospital stay [6]. They aim to optimize patient outcomes during the pre-surgical, surgical, and post-surgical intervals. This can be accomplished through patient education and pre-surgical counseling, early transitions to oral pain medications post-operatively, and expedited post-procedure mobilization, for example [7]. Although ERAS protocols have been proven to lower both recovery time and post-operative complications in a cost-effective manner, compliance to all protocol items can be difficult to accomplish [8-10].

Gillis et al. conducted a patient-led narrative style study assessing the ERAS protocol patient experience, which brought to light several unaddressed patient needs. The success of ERAS protocols lies in the physical components of surgical recovery; however, these protocols lack to address patients emotional needs. In Gillis et al.s study, patients felt ill-equipped to resolve stressors on their own during the pre-surgical phase and they were not informed of available community resources by their healthcare providers [11].Importantly, patients with a higher psychological burden prior to undergoing a mastectomy faced poorer post-surgical outcomes, including a higher risk of complications, prolonged hospital stays, and increased costs of care [12].

Some women with breast cancer occasionally desire to utilize alternative remedies as a complement to traditional medications [13]. Many women who chose to use complementary therapies cited experiencing greater motivation to heal and an improved sense of control over their health [14].The therapies utilized included massage, meditation, hypnosis, music, myofascial release, aromatherapy, guided imagery, and electro-puncture. The goal of this paper is to provide a systematic review of the adjunctive therapies that have been implemented to augment post-operative recovery in breast surgery patients.

A systematic literature review was conducted in order to determine what non-pharmacologic treatments could be used to optimize breast cancer patient care pre-, peri-, or post-operatively.The search terms were as follows: (alternative medicine or complementary medicine or integrative medicine or holistic medicine or natural medicine or mediation or aromatherapy or music or art or reiki or massage) and (surgery) and (pain). All articles were uploaded from PubMed into COVIDENCE, an online software program used for the production of systematic reviews. Once imported into COVIDENCE, all abstracts underwent initial screening by members of the review team. Studies included in this review required at least one alternative medicine intervention and a description of a pre-, post-, or peri-operative surgical outcome (pain, opioid requirements, infection rate, wound healing, length of stay, hospital readmission, etc.). All systematic reviews, literature reviews, meta-analyses, opinion pieces, non-English, non-human, chronic pain studies, and studies on non-surgical screening techniques (ex: ultrasound, mammography, etc.) were excluded. Articles with a focus on medicationsincluding vitamins, herbs, and supplements were also excluded from this study. Following abstract screenings, the full text of each article was screened using the predetermined inclusion/exclusion criteria, and qualitative data was extracted from all articles which met this criterion. Additionally, the references of select articles were screened in order to identify and include any additional relevant studies.

The original search identified 1,645 total papers related to surgery and holistic medical interventions. Of that, 1,625 studies were excluded because they lacked a surgical intervention on the breast.Of the 20 remaining papers, two were excluded from being non-English studies.Thus, 18 met the criteria for review (Figure 1). The alternative medicine interventions identified in this review include massage therapy, meditation, hypnosis, music, myofascial release, aromatherapy, guided imagery, acupuncture, and electro-puncture.

Massage/Reflexology

Under the overarching term massage, several studies in this review covered subtypes of massage including reflexology, Swedish massage, and acupressure. Reflexology has been used since 2330 BCE to alleviate pain and stress [15,16]. The three main theories behind its efficacy are energy channeling, the breaking down of lactic acid build up and the utilization of the neuromatrix to prevent the transmission of pain [16]. Varying pressures are applied to different areas of the foot. The area that corresponds to the breast spans the distal, dorsal aspect of the foot, proximal to the phalanges. Acupressure is a similar form of therapy that utilizes manual pressure, commonly performed with the fingertips to specific points in the body with the goal of releasing muscle tension.

Three papers utilized foot reflexology as a form of massage. Ucuzal et al. specifically used reflexology in the experimental group in addition to analgesic therapy, while the control group was provided with analgesic therapy alone. This trial demonstrated a significant improvement in pain compared to the control group following reflexology as determined by the Short-Form McGill Pain Questionnaire [17].

The two other studies compared the effectiveness of massage therapy alone to a massage therapy in combination with other interventions. Dilaveri et al. studied breast cancer patients undergoing reconstructive surgery who were evaluated post operatively using visual analog scores (VAS) to determine pain, mood, energy, relaxation, insomnia, stress, anxiety, alertness, fatigue, and tension after massage alone or with the addition of acupuncture. The massage techniques utilized included foot reflexology and Swedish massage. Using the VAS scores, Dilaveri et al. determined that stress and anxiety decreased significantly, while relaxation increased in both treatment groups. Although both groups showed improvement, the massage-only group experienced a greater effect in all metrics [18]. Similarly, Dion et al. concluded that while massage and massage with the addition of meditation individually demonstrated a benefit, the addition of meditation to massage resulted in no additional change to VAS scores when compared to the massage-only group [19].

Thus, the use of massage alone as an adjunctive therapy to patients following breast procedures has shown to be beneficial and can reduce numerous post-operative symptoms including pain and anxiety.

Myofascial Release

Fascia is the connective tissue that encases various structures in the human body. It has tremendous tensile strength and any disruption in the fascial planes can cause dysfunction, pain, and discomfort. Myofascial release is the practice of placing direct pressure on the restricted fascia until a moment of release is felt. Serra-Ano et al. studied the effectiveness of myofascial release compared to placebo manual lymphatic drainage in patients who underwent breast cancer surgery. Fascial manipulation improved the range of motion in the shoulder determined by measuring the active angular reach via a goniometer. Pain severity, measured with VAS scores, was also decreased in patients undergoing myofascial manipulation with greater significance than those undergoing placebo manual lymphatic drainage [20].

Music

Music was first reported to aid in surgical procedures in 1914 [21]. Music can be incorporated into the pre-, peri-, and post-operative time periods with the goals of reducing pain, anxiety, and improving overall patient comfort. The pathophysiology behind its benefit is thought to be due to its ability to attenuate the neuroendocrine stress response to surgery [22]. The genre, dynamics, and duration of the music played is patient dependent, as long as it is used in an appropriate clinical setting.

Six studies evaluated the effect of music on breast-related surgical procedures. Tellez et al. aimed to determine the effect of music on breast biopsies. By analyzing VAS scores, the study concluded that when compared to a standard breast biopsy, the pre- or post-operative addition of music reduced stress, pain, and anxiety [3].

Deng et al. compared the effects of music and the combination of music and aromatherapy in the peri-operative treatment of breast cancer. Patients treated with music therapy demonstrated a reduction in pain intensity and anxiety when compared to standard therapy alone and the combination of music and aromatherapy demonstrated an even greater decrease in pain intensity and anxiety [23].

Soo et al. investigated the impact of relaxing music played during an image-guided core-needle breast biopsy. Using multiple questionnaires, there was a demonstrated reduction in anxiety, fatigue, and pain when compared to the standard care control [24]. Wren et al. studied the effects of music in patients undergoing breast biopsy or breast cancer surgery. There was a significant reduction in pain in those listening to pre-, peri-, and post-operative music compared to the control group [25]. Li et al. similarly demonstrated a reduction in pain for women undergoing radical mastectomy with music therapy [26]. Thus, the addition of music therapy in breast-related surgical procedures has been shown in numerous studies to improve anxiety, fatigue, pain, and stress in the post-operative period.

Aromatherapy

Aromatherapy is the use of essential oils that come from seeds, stems, leaves, needles, petals, flowers, rinds and fruits, woods and resins, roots and rhizomes, and grasses for medical purposes [27]. Four papers explored the use of aromatherapy in breast-related procedures. Chao et al. demonstrated that aromatherapy resulted in a decrease in pain, anxiety and levels of IL-6 and HMGB-1 compared to standard therapy. While the combination of aromatherapy and music therapy was superior to either intervention alone in reducing pain and anxiety, there was no significant difference between music-only and aromatherapy-only interventions [23].

Three papers explored the effect of lavender aromatherapy. Kim et al. investigated the addition of lavender to post-operative oxygen therapy. There was no difference in narcotic requirements or objective pain scores between control and intervention; however, patients in the lavender group reported a higher satisfaction rate with pain control than control patients [28].Franco et al. explored the addition of either lavender fleur oil (LFO) or unscented oil (UO) aromatherapy in the care of breast surgery patients. The study demonstrated that the addition of LFO significantly decreased post-operative anxiety relative to the control group [29]. Shammas et al. examined the effects of lavender oil on post-operative breast cancer outcomes but found no significant differences in peri-operative depression and anxiety scores, pain scores, or sleep scores between the control and intervention groups [30].

Overall, while there were no adverse effects of aromatherapy documented, the evidence supporting the benefits of aromatherapy was mixed in the studies analyzed.

Guided Imagery, Hypnosis, and Meditation

Guided imagery is a relaxation technique, also known as visualization, that involves creating specific conscious experiences, such as imagining oneself on a beach, without the use of external stimuli [31]. When fully immersed in this technique, one can truly perceive the event created by their thoughts [32,33]. According to the United States National Center for Health Statistics, approximately five million adults report using guided imagery to reduce stress and address health-specific complaints [32]. Guided imagery is often used in combination with mediation, hypnosis, and other relaxation exercises as all of these focus on profound thought formation [34,35].

Kwekkeboom et al. tested the efficacy of guided imagery in reducing post-operative pain in women with breast and gynecologic cancers. Participants who underwent breast surgery completed guided imagery tasks and returned pain diaries 48 hours after discharge. Though this study reported a high percentage of patients opting to implement nonpharmacological pain management strategies, pain-related intensity and distress remained similar among patients who used analgesics alone and those who used an analgesic in combination with a nonpharmacologic intervention, such as guided imagery, re-positioning, heat, music, or meditation [36].

Three papers examined the impact of meditation as an intervention, one in patients undergoing autologous tissue reconstruction and two in patients undergoing breast biopsies. Using various scales, both Soo et al. and Wren et al. found that guided meditation reduced pain and anxiety about both breast surgery and the potential cancer diagnosis. Additionally, Wren et al. demonstrated a significant improvement in self-compassion and heart rate over time compared to the control group. The papers differed in that Soo et al. saw a significant reduction in fatigue scores following biopsy, while Wren et al. demonstrated no difference in fatigue compared to controls [24].

Dion et al. analyzed patients who underwent autologous tissue reconstruction and were treated with either massage or massage in combination with mediation. There was no difference in stress, anxiety, relaxation, insomnia, alertness, fatigue, tension, pain, mood, and energy between the two cohorts [19].

In two studies comparing hypnosis to a control group, both demonstrated significant psychological benefits. Schnur et al. investigated the effects of presurgical hypnosis on psychological stress in patients undergoing excisional breast biopsy. Prior to surgery, the hypnosis group had significantly improved relaxation and anxiety and decreased emotional upset and depression compared to the control group [37].

Montgomery et al. investigated the effects of adding a 15-minute hypnotic session prior to a breast-related surgical intervention. Patients receiving required less propofol and lidocaine during the intervention and had decreased post-operative pain, discomfort, fatigue, and nausea [38].

Overall, in terms of pain management, patients who took analgesics experienced similar outcomes to those using guided imagery in combination with analgesics. However, hypnosis and meditation both independently demonstrated significant pain reduction and psychological benefits for patients.

Yoga Therapy

Yoga is a practice that combines a sequence of postures with purposeful breathing and heightened self-awareness in order to achieve a state of relaxation andincreased awareness of the mind, body, and spirit [39]. In recent years, yoga and meditation practices have become an increasingly popular and accepted practice in the United States. The health benefits of yoga practice are widespread. Notably, yoga has been shown to reduce stress, improve blood glucose, blood pressure, and cholesterol levels as well contribute to weight loss [40,41]. In western medicine, Hatha yoga, a commonly practiced form of yogaplaces emphasis on the physical component of the yoga practice [40].

Sudarshan et al. investigated the effects of 12 one-hour weekly Hatha yoga sessions on anxiety, depression, range of motion, and flexibility following breast surgery. The study showed that the Hatha yoga intervention significantly improved flexibility during right and left shoulder abduction, as well as range of motion during left shoulder flexion following breast surgery-related procedure [42].

Electro-Puncture and Acupuncture

Acupuncture is a form of traditional Chinese medicine that involves the stimulation of predefined acupoints on the body in order to stimulate the central nervous system. In the most commonly used form of acupuncture, needles are inserted into the acupoints and subsequently manually manipulated by lifting or twisting the needle. Electroacupunctureis a more recently established technique involving the insertion of two needles within acupoint sites. The two needles serve as electrodes to pass an electric current. One of the major benefits of electroacupuncture is the ability to objectively and quantifiably measure the intensity of the electrical stimulation, which is not possible with the traditional form of acupuncture [43].

Bosco et al. investigated the efficacy of combined electroacupuncture and homeopathic medicine (Arnica montana and Apis mellifica) in place of opioid use in two breast surgery candidates who could not tolerate the standard medications due to liver disease. This combination provided sufficient pain relief, maintained liver function, reduced time spent in the post-surgical recovery area, and total time spent in the hospital [44].

Dilaveri et al. demonstrated that acupuncture in combination with massage resulted in decreased levels of anxiety, relaxation, nausea, fatigue, pain, and mood following breast reconstructive surgery compared to baseline. Although the benefits of this intervention were similar to the benefits of massage-only intervention in regards to fatigue, anxiety, relaxation, nausea, pain, and mood scores, the massage plus acupuncture intervention increased stress levels compared to massage alone [18].

Overall, acupuncture and electro-puncture were able to improve post-surgery outcomes and demonstrated to be helpful alternatives or adjuncts to standard treatment options.

All articles incorporated into this review are summarized inTable 1.

ERAS protocols focus on reducing post-operative pain and improving the patients overall experience. In addition to the standard care addressed in ERAS protocols, a multitude of low-risk adjunctive options exist for increasing patient satisfaction, with the potential for creating superior outcomes. The alternative practices discussed in this review outline such benefits. However, patients are often unaware that complementary measures such as these exist and most physicians do not receive education regarding implementation of these therapies in the clinical setting. Complementary therapies can be tailed to the needs and interests of patients. For instance, patients with an interest in music may benefit more from music therapy compared with patients who lack this interest. Thus, physician and patient education are critical to ensure that patients have the empowering experience of choosing the adjunctive therapies that best fits their needs.

Alternative therapies can play a role in optimizing the surgical experience for patients undergoing breast procedures, but the intervention should be tailored to each patient. If a patient has the autonomy to select which interventions they choose to utilize based on their lifestyle and personal preferences, adherence may be improved. Most interventions are fairly easy to implement and do not add a lengthy teaching component to patient-provider encounters. Additionally, many can be self-administered and/or taught through self-help books, video recordings, and classes. Once introduced in the hospital setting, many interventions can be continued at home with little or no cost to the patient. Furthermore, alternative therapies are extremely low-risk and can be utilized in patients with contraindications to standard medications or those wishing to minimize their medication exposure.

The studies reviewed should be considered in light of limitations. One limitation in several of the papers was the small sample size which could affect the power of the studies. Further studies with a larger sample size are needed to furtherstrengthen the established relationship between alternative therapies and the reduction of post-operative complications.An additional limitation inherent to alternative therapy interventions is lack of concealment or blinding. Given the impossibility of blinding individuals to interventions including massage, meditation, hypnosis, music, myofascial release, aromatherapy, guided imagery, and electro-puncture, patients are aware of the interventions they are receiving. This can lead to a placebo bias that may sway is review [45]. Studies have demonstrated that several neurotransmitter systems, such as opiate and dopamine systems, are involved in the placebo effect, which may explain its impact on pain control [46]. However, these interventions pose essentially no risk relative to their potential benefits. Therefore, the potential benefits of placebo effects may add to the rationale for implementing these interventions.

Read the rest here:
Improving Breast Surgery Outcomes Through Alternative Therapy: A Systematic Review - Cureus

Dr. Charles Gant MD shares his optimistic outlook on the planet's prospects in "An Earthly Chance."

WASHINGTON, March 23, 2022 /PRNewswire/ -- Recognized as a leading medical authority in the field of integrative medicine, Dr. Charles Gant has extended his expertise to climate change in his eighth book, "An Earthly Chance."

"As a doctor, I care about the health and well-being of my patients and our planet. The time has come to assert our political resolve to saving the earth's ecosystems through the intelligent application of sound agricultural and geoengineering principles," Gant says. "Without solving our carbon problem, our planet and humankind's health is not sustainable."

After completingresidency training in Family Practice and Psychiatry, Gant integrated his psychology, addiction medicine, meditation other healing methods into his practice. He pioneered the concept of "causal medicine."

For the last five decades, Gant has expanded eclectic healing approaches for the mind, body and spirit. He defines causal medicine as "an innovative approach to disease prevention and treatment that takes into account individual differences in biochemistry, immunology, endocrinology, toxicology and environmental stressors in order to optimize genetic expression and wellness."

Exploring the root causes and possible solutions for climate change was Gant's next logical subject to tackle head-on in "An Earthly Chance,"since the quality of our environment, our air, food and water, greatly impact such genetic expression and wellness.

"Sequestrating carbon into the topsoil through regenerative agriculture, and thus removing a trillion tons of carbon dioxide from our atmosphere, is a critical way to begin to markedly enhance the quality of food and reverse our epidemics of chronic disease, thus increasing our health, enhancing longevity, and averting ecological disaster," Gant says.

"Only by empowering consumers, can we take responsibility to reverse and solve climate change and bring all these positive benefits to humanity. This book explains precisely how we can do this!"

Available now in Kindle format through Amazon, "An Earthly Chance," will be published soon in both hard and soft copies https://www.amazon.com/Earthly-Chance-Charles-Gant-PhD-ebook/dp/B09TS6KXVS/ref=sr_1_4?qid=1647278565&refinements=p_27%3ACharles+Gant&s=books&sr=1-4

Getting to the root of a problem is inherent in Gant's DNA: "Climate change is primarily caused by excess carbon in the air. This occurs by burning fossil fuels and modern agricultural methods. Climate change can be solved, lifespans markedly improved and all life on our precious planet can be saved," he explained.

"We are expected to sacrifice the burning of carbon, which is the only inexpensive, plentiful, and indispensable fuel that provides for the feeding of our planet and brings us abundance and prosperity.

"Without solving our carbon problem our planet and humankind's health is not sustainable, but most countries will not jeopardize their militaries and their ability to grow, harvest and provide food because agriculture and military security totally depends on the energy derived from fossil fuels."

Gant remains optimistic that climate change is possible, "but we must recognize that restrictions in the burning of fossil fuels is a hoax. Instead we can solve Climate Change by taking excess carbon out of the atmosphere and sequestering it into our soils and plants to markedly improve health and longevity."

"It's not too late," the doctor, teacher and author says in the introduction to "An Earthly Chance." "The only sane climate change solution possible is science-based, economically responsible and depends on healing human beings and our environment."

About Dr. Charles GantDr. Charles Gant is the author of eight books, a teacher and a medical practitioner. He holds both a doctor of medicine (M.D.) and a doctorate (Ph.D.) degrees.

As a physician, Gant has practiced functional and integrative medicine and mindfulness-based cognitive psychotherapy for nearly five decades. He has incorporated Causal Medicine into his practice in the last decade. Precision medicine is an innovative approach to disease prevention and treatment that considers each individual's differences in genomics, environmental stressors, biochemistry, and lifestyles. https://www.nihadc.com/practitioners/dr-chas-gant-md-ph-d.html

He holds a B.S. in chemistry from Hampden-Sydney College in Virginia, an M.D. from the University of Virginia Medical School and postgraduate training in Family Practice, Psychiatry and Psychology(Ph.D.)

Media Contact: Dr. Charles GantPhone: (240) 800-4955

SOURCE Dr. Charles Gant, MD

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Noted Alternative Medical Guru Takes on Climate Change in his 8th Book - PR Newswire

If youve never heard of Frog pose, TikTokers think you should learn the classic yoga pose. Videos claiming its a cure all for everything from pain to digestion to mental health to better sex are going viral.

TikToker Olga Urbanovich (426.3K followers) posted a video in September 22, 2021, claiming that practicing a daily, one-minute Frog pose position could improve your sex life, strengthen the pelvic muscles, stimulate digestion, and promote better circulation. The video has since garnered 14 million views.

Other TikTokers have been raving about Frog pose and posting their own videos ever since: #frogpose now has 23.1 million views and #frogposechallenge has 289.9 thousand views. They claim the benefits go beyond Urbanovichs list.

TikToker Vanessa Hammond (36.9K followers) posted a video on March 15 with 1.5 thousand likes claiming the pose helps with opening up hips and overall flexibility.

Mariah McLean (5K followers) posted a videoon February 22 with 14.7 thousand views claiming the pose reduces stress and anxiety.

Victoria Sisco (223.9K followers) posted a video on February 10 with 2.9 thousand likes saying Frog pose aids in relieving lower back pain and knee pain and strengthens the back.

Does the pose actually deliver on any of these purported benefits? And should you try it?

Frog pose is primarily a stretching pose for the hips and inner thighs, explains Monisha Bhanote, MD, an integrative medicine physician in private practice in Jacksonville Beach, Florida, and a yoga teacher certified by Yoga Medicine. Frog pose is a yoga pose that targets the hips and inner thighs (adductor muscles). Mandukasana is the traditional Sanskrit name for the pose.

You get into the pose by:

Frog pose can provide certain health benefits, Dr. Bhanote says. But, the improvements youll experience depend largely on how much time you spend in Frog pose and your body state.

Frog pose can help with stretching the inner thighs and hips, as well as improving overall flexibility and range of motion particularly around the hips, as those are major areas at play in the posture, Bhanote explains. It also stretches the muscles of the back, so it can help relieve lower back tension, too.

While there arent many studies performed on Frog pose specifically, research says that in comparison to physical therapy, yoga provides equal pain improvement on patients with chronic lower back pain.

Bhanote adds that Frog pose can help strengthen the core and pelvic muscles. Astudy published in May 2017 in the International Journal of Yoga indeed concludes that the core muscles engage for yoga poses that require trunk and pelvic movements; Bhanote says Frog pose is one such movement.

And while studies havent (yet) specifically looked at whether Frog pose can help relieve stress better than other yoga poses, Bhanote says there is evidence that consistent yoga practice can help people manage stress; research shows that just 12 minutes of yogic meditation can reverse neural responses linked to stress.

And if youre doing yoga correctly, youre breathing slowly and deeply, which can also help with stress and anxiety, Bhanote adds. (Other research indeed concludes that breathwork in yoga improves mood and can reduce symptoms of anxiety and depression, according to a study published inThe Journal of Alternative and Complementary Medicinein March 2017.)

What about the claim that Frog pose can help with circulation? Again, theres little evidence that Bhanote says shes aware of thats specifically looked at Frog pose and circulation, but research does suggest that meditative practices, such as yoga, can help reduce blood pressure. One small study also indicated that practicing simple yoga poses at home may have an antihypertensive effect.

Bhanote cautions that Frog pose, however, will probably not help with knee pain and could actually make it worse. I have seen knee pain aggravated with this pose, she says.

And whether one minute a day is enough to make a difference, Bhanotes says generally the more time you devote to a yoga practice, the more its going to help with any of these things, she says. The more you practice, the more you will benefit.

Frog pose is generally a safe one for most people, Bhanote says. But know that it will yield a pretty intense stretch for the groin, inner thigh muscles, and hips. Start slowly and dont go deeper in the pose if you start to feel pain. Practicing it with consistency will improve flexibility and your ability to sit back farther in the posture, she says.

Additionally, if you feel pain or discomfort, stop and rest in childs pose, Bhanote says with hands and knees on floor in tabletop position, sit back onto your heels and lower forehead toward the ground.

And if you feel too much pressure in the knees, try folding a yoga mat or blanket under your knees and ankles for support or try using a yoga bolster (or pillow) to rest your chest or head on. If you have a previous knee injury or have knee pain, Bhanote suggests skipping the pose.

Pregnant women should be careful doing the pose, Bhanote adds. It may be safe if someone has previous yoga experience, but to know if its okay for you, check with your doctor, she says.

People with knee, ankle, hip, or lower back injuries should also avoid the pose or check with their doctor before trying it.

Frog pose can definitely offer a number of health benefits, namely flexibility and range of motion to the muscles and joints of the hips. But its an advanced position, and can be intense for beginners. If youre going to try it, do so slowly and gently. Avoid (or check with your doctor first) if you are pregnant or have lower body or lower back injuries.

While its possible that Frog pose can offer some of the benefits TikTokers mentioned, Bhanote adds a quick caveat to this generalization: Limited studies are done on individual yoga poses. So its tough to say with certainty if any one position can provide the same health benefits for everyone.

Link:
Frog Pose Can It Really Help With Pain, Digestion, and Better Sex? - Everyday Health

Newswise Baltimore, Md. March 23, 2022 Healthworx, the innovation and investment arm of CareFirst BlueCross BlueShield (CareFirst), and LifeBridge Health selected seven promising healthcare innovators to participate in the second cohort of 1501 Health, an incubator for healthcare startups. 1501 Health provides investment and resources to help early-stage companies develop and scale their healthcare solutions.

1501 Health will officially welcome the second cohort at an event on April 27, debuting its physical incubator space within CareFirsts Baltimore headquarters (1501 S. Clinton Street).

The seven companies, chosen from 112 international applicants, are:

Candoo of New York, NY, helps older adults stay safe, independent and connected by educating them on utilizing digital tools designed for daily use, such as Instacart and Uber. In addition, Candoo offers tech concierge services for troubleshooting, installation help and other digital needs.

Flowly of Los Angeles, CA, helps users manage pain and anxiety through virtual reality experiences as an alternative to medication. Backed by NIH clinical trial data, Flowly uses an integrative medicine approach to care using VR technology at home.

Frame Fertility of San Francisco, CA, serves as a prospective parents personalized fertility guide, offering an assessment to identify barriers to fertility, followed by personalized coaching and care navigation to reduce costly and unnecessary fertility treatments.

Health in Her Hue of New York, NY, empowers Black women and women of color along their healthcare journey by reducing racial disparities in the way care is delivered. Leveraging the power of technology, they connect women of color with culturally competent providers and supportive communities.

Lantern of New York, NY, guides users through death and loss at all stages. The platform can guide users in end-of-life pre-planning. Several supports they offer include establishing a legacy, providing clarity for family before the event, or assisting grieving family members in managing someones affairs with helpful checklists.

Ryse Health of Arlington, VA and Baltimore, MD, is an endocrinology practice using tech-enabled solutions and community-based supports to help patients manage type 2 diabetes. The care team utilizes digital applications to check in with patients frequently as a follow up on each patients custom care plan.

Xploro of Manchester, UK, delivers a platform thats designed for children with preexisting conditions and illnesses, and tested by an Advisory Board of 12 children aged 9-17. The digital engagement platform uses 3D models and gamification to increase health literacy for children.

Six of the seven cohort companies were founded by women.

There is such diversity in this cohort in terms of backgrounds, solutions and stages of development, Jordan Evans, 1501 Health Co-Manager and Innovation Project Manager at LifeBridge Health, said. All of them tackle some of the most pressing issues in healthcare today but from such varied backgrounds and solutions-oriented mindsets. We are excited to see what heights they can reach in this cohort.

Cohort members receive up to $100,000 in investment capital and have access to unique mentorship opportunities and support from payer and provider experts, along with networking and educational events with other startups, investors and stakeholders.

David Black, Co-Founder and CEO of Even Health said of his experience in the first cohort, 1501 Health has helped us and our cohort of companies navigate how our innovations can be successfully adopted into the larger network of solutions and opportunities in healthcare. Without 1501 Healths support, I suspect we would have spent a good deal of time pursuing an incorrect path for growth and adoption in our solution, and every startup knows that we have limited windows of opportunity to make the right decisions to reach new stages of growth.

"Our first cohort made meaningful and impactful progress in just 12 months, Emily Durfee, 1501 Health Co-Manager and Director of Healthworx Strategy and Portfolio Acceleration, said. They scaled digital solutions that have the potential to completely redefine how healthcare is delivered. They are creating access points for people in ways left untouched by traditional healthcare. We are excited to see how the new ideas this second cohort brings change healthcare.

1501 Health is a unique partnership between Healthworx and LifeBridge Health, representing expertise in both health insurance and financing (payers) and healthcare delivery and services (providers). The investment and incubation program empowers entrepreneurs to get their innovative solutions to market and expand their impact in healthcare quality, access and affordability. To learn more about 1501Health, visit http://www.1501Health.com.

About Healthworx

Healthworx operates at the intersection of healthcare and innovation by creating, co-creating and investing in companies that are improving healthcare quality, accessibility, affordabilityand equity. As the innovation and investment arm of CareFirst, Healthworx envisions a healthier future for all people by changing the way health works. To connect with Healthworx about partnering, media interviews or speaking opportunities, email[emailprotected].

About LifeBridge Health

LifeBridge Health is one of the largest, most comprehensive providers of health services in Maryland. LifeBridge Health includes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, Grace Medical Center and related affiliates. For more information, visit http://www.lifebridgehealth.org

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Seven Healthcare Startups Selected for 1501 Health Incubator Second Cohort - Newswise

Evolved for Thirty Years, The Health Coach Training Program Supports Wellness Seekers on Their Journey to Live a Life They Love

NEW YORK, March 23, 2022 /PRNewswire/ --The Institute for Integrative Nutrition(IIN), the world's leading health coaching and nutrition school, continues to innovate and set the standard for health coaching education with the relaunch of their evolved and reimagined online Health Coach Training Program.

With new expert faculty, expanded curriculum content, and a brand-new, state-of-the-art learning platform and mobile app that is accessible to more students than ever before, IIN is reinforcing its commitment to training the next generation of wellness seekers, entrepreneurs, and Integrative Nutrition Health Coaches. The success of our graduates, the largest community of Health Coaches in the world (155,000 graduates in 175 countries), is paramount to our mission.

An Integrated Approach Like No OtherIIN empowers individuals to tap into the innate wisdom of their bodies to nourish, heal, and thrive in all aspects of their lives. Students of IIN's Health Coach Training Program gain access to a wide range of perspectives and teachings from over 95 visiting faculty, leaders in functional medicine and nutrition, personal development, spirituality, coaching, and business such as Deepak Chopra, MD, Daniel Amen, MD, Gabby Bernstein, Will Cole, DC, IFMCP to name a few.

The program is hosted online in the IIN Learning Center, built by leading educators and instructional design experts to provide an innovative and intuitive health coaching education that is accessible on any device, from anywhere in the world. The Health Coach Training Program is dual licensed by the New York State Education Department and the Ohio State Board of Career Colleges and Schools. It is available in six- or twelve-month terms and is the only fully translated Health Coach curriculum in two languages: English and Spanish.

"The past years have emphasized the value of health and well-being. IIN is on a mission to create a ripple effect that transforms the world, starting by unleashing people's innate wisdom and potential to nourish, heal and thrive," said Lynda Cloud, IIN's CEO. "We're honored to play a crucial role in improving the health and happiness of others."

At The Forefront of the Coaching IndustryHoned for over thirty years, the IINtegrative Coaching Method is a life-changing foundation for personal and professional growth. Students learn best-practice coaching skills and cutting-edge techniques.

For more information about the evolved program, visit http://www.integrativenutrition.com.

About Institute for Integrative Nutrition (IIN)Institute for Integrative Nutrition(IIN) is the world's largest and longest-standing health coaching and nutrition school providing a holistic health education. For the past 30 years, IIN has pioneered the field of health coaching. With 155,000 students and graduates spanning 175 countries, IIN is actively changing the wellness of the world. The IINtegrative Coaching MethodTM is IIN's unique approach to coaching and sets a life-changing foundation for personal and professional growth.

SOURCE Institute for Integrative Nutrition

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Institute for Integrative Nutrition Launches the Next Generation of Health Coach Training to Transform the Wellness Industry - PR Newswire