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BACKGROUND: Current literature suggests a positive influence of additive classical homeopathy on global health and well-being in cancer patients. Besides encouraging case reports, there is little if any research on long-term survival of patients who obtain homeopathic care during cancer treatment. DESIGN: Data from cancer patients who had undergone homeopathic treatment complementary to conventional anti-cancer treatment at the Outpatient Unit for Homeopathy in Malignant Diseases, Medical University Vienna, Department of Medicine I, Vienna, Austria, were collected, described and a retrospective subgroup-analysis with regard to survival time was performed. Patient inclusion criteria were at least three homeopathic consultations, fatal prognosis of disease, quantitative and qualitative description of patient characteristics, and survival time. RESULTS: In four years, a total of 538 patients were recorded to have visited the Outpatient Unit Homeopathy in Malignant Diseases, Medical University Vienna, Department of Medicine I, Vienna, Austria. 62.8% of them were women, and nearly 20% had breast cancer. From the 53.7% (n=287) who had undergone at least three homeopathic consultations within four years, 18.7% (n=54) fulfilled inclusion criteria for survival analysis. The surveyed neoplasms were glioblastoma, lung, cholangiocellular and pancreatic carcinomas, metastasized sarcoma, and renal cell carcinoma. Median overall survival was compared to expert expectations of survival outcomes by specific cancer type and was prolonged across observed cancer entities (p<0.001). CONCLUSION: Extended survival time in this sample of cancer patients with fatal prognosis but additive homeopathic treatment is interesting. However, findings are based on a small sample, and with only limited data available about patient and treatment characteristics. The relationship between homeopathic treatment and survival time requires prospective investigation in larger samples possibly using matched-pair control analysis or randomized trials.
Asunto(s)
Homeopatía , Neoplasias/epidemiología , Neoplasias/terapia , Pacientes Ambulatorios/estadística & datos numéricos , Adulto , Anciano , Austria/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Estudios Retrospectivos , Análisis de SupervivenciaRESUMEN
BACKGROUND: The interest in complementary and alternative medicine (CAM) has increased during the past decade and the attitude of the general public is mainly positive, but the debate about the clinical effectiveness of these therapies remains controversial among many medical professionals. METHODS: We conducted a systematic search of the existing literature utilizing different databases, including PubMed/Medline, PSYNDEX, and PsycLit, to research the use and acceptance of CAM among the general population and medical personnel. A special focus on CAM-referring literature was set by limiting the PubMed search to "Complementary Medicine" and adding two other search engines: CAMbase (www.cambase.de) and CAMRESEARCH (www.camresearch.net). These engines were used to reveal publications that at the time of the review were not indexed in PubMed. RESULTS: A total of 16 papers met the scope criteria. Prevalence rates of CAM in each of the included studies were between 5% and 74.8%. We found a higher utilization of homeopathy and acupuncture in German-speaking countries. Excluding any form of spiritual prayer, the data demonstrate that chiropractic manipulation, herbal medicine, massage, and homeopathy were the therapies most commonly used by the general population. We identified sex, age, and education as predictors of CAM utilization: More users were women, middle aged, and more educated. The ailments most often associated with CAM utilization included back pain or pathology, depression, insomnia, severe headache or migraine, and stomach or intestinal illnesses. Medical students were the most critical toward CAM. Compared to students of other professions (ie, nursing students: 44.7%, pharmacy students: 18.2%), medical students reported the least consultation with a CAM practitioner (10%). CONCLUSIONS: The present data demonstrate an increase of CAM usage from 1990 through 2006 in all countries investigated. We found geographical differences, as well as differences between the general population and medical personnel.
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STUDY OBJECTIVE: To evaluate the effectiveness, safety, ease of placement, and ventilatory parameters of a new alternate airway device, the EasyTube (EzT; Teleflex Ruesch, Research Triangle Park, NC), in comparison to the endotracheal tube (ETT). DESIGN: Prospective, randomized controlled trial. SETTING: University Hospital. SUBJECTS: 200 adult ASA physical status I and II patients scheduled for surgery. INTERVENTIONS: Patients were randomized to two groups, one to receive ventilation via the EzT (n = 100) or the ETT (n = 100). After preoxygenation and induction with fentanyl and propofol, patients received muscle relaxation. The respective airway device was then inserted and mechanical ventilation was instituted. MEASUREMENTS: Ease of insertion, number of insertion maneuvers, time until airtight seal of the airway was achieved, duration of surgery, leak pressure as well as arterial oxygen saturation (SpO(2)), and end-tidal carbon dioxide (ETCO(2)) data, were recorded. MAIN RESULTS: Mallampati airway class was higher in the EzT group (P < 0.029), while thyromental distance showed no difference between the two groups. Ease of insertion was noted in the EzT group (P < 0.043). Number of insertions was equal in both groups; insertion time was shorter with the EzT (15.5 +/- 3.6 sec vs. 19.3 +/- 4.6 sec; P < 0.0001). Leak pressure and SpO(2) were not significantly different, while ETCO(2) was lower with the ETT (P < 0.024). Adjustments had to be made for two EzT group patients. No difference in frequency of laryngo-pharyngeal discomfort was observed in either group. CONCLUSION: Insertion of an EzT appears to reduce time and facilitate placement of an airway device when compared with direct laryngoscopy and tracheal intubation.