پاورپوینت کامل Integrative medicine and allergic disease 53 اسلاید در PowerPoint
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پاورپوینت کامل Integrative medicine and allergic disease 53 اسلاید در PowerPoint
اسلاید ۴: ObjectivesDefine CAMUnderstand the possible benefits and risks of CAMExamples of role/potential role of CAM in allergic rhinitis, atopic dermatitis, food allergy, and asthmaIdentify resources for CAM education
اسلاید ۵: DefinitionComplementary and alternative medicine (CAM) is very broad and constantly changing. “NCCAM defines CAM as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Complementary medicine“: alternative madicine together with conventional medicine, i.e. neti pot with nasal steroids for allergic rhinosinusitisAlternative medicine refers to use of alternative practices in place of conventional medicine.
اسلاید ۶: Integrative MedicineIntegrative medicine combines treatments from conventional medicine and CAM for which there is some high-quality evidence of safety and effectiveness. It is also called integrated medicine. ABIHM 2012 Mimi Guarini, MD “Integrative Medicine is the practice of medicinethat reaffirms the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.”
اسلاید ۷: Fig 3Source: Journal of Allergy and Clinical Immunology 20283-294.e10 (DOI:10.1016/j.jaci.2008.12.023 )Copyright © ۲۰can Academy of Allergy, Asthma & Immunology Terms and Conditions
اسلاید ۸: TraditionCAM has been developed over centuries in various cultures, based on teacher apprentice models, observations, and experiences i.e. TCM, ayurvedaWestern “allopathic” medicine is based on “scientific methods” and “evidence-based medicine”: Randomized controlled trials and meta-analyses/clinical reviews (Cochrane)
اسلاید ۹: Stats on CAM use from this paperCAM Cost and Spending, 2007 (NCCAM from the NHIS 2007)In 2007, Almost 4/10 adults had used CAM in the past 12 months with the most commonly used therapies being “nonvitamin, nonmineral, natural products” (۱۷.۷% i.e. fish oil, echinacea, glucosamine, flaxseed, ginseng)In 2007, approximately 1/9 children used CAM in past 12 months most commonly nonvitamin, nonmineral “natural” productsIn 2007, U.S. adults spent $33.9 billion out-of-pocket on visits to CAM practitioners and purchases of CAM products, classes, and materials.Barnes et. Al. Nat Health Stat Rep. 2008.
اسلاید ۱۰: National Health Information SurveyMost common used: nonvitamin, nonmineral natural products and deep breathing exercises (adult). Nonvitamin, nonmineral natural products and chiropractic or osteopathic manipulation (children)Allergists are more likely to use special diets, US population more likely to use prayer, herbal, chiropractic interventions*Source: Journal of Allergy and Clinical Immunology 20283-294.e10 (DOI:10.1016/j.jaci.2008.12.023 )
اسلاید ۱۱: Allergists are interested!Engler et. Al. The Journal of Allergy and Clinical Immunology Volume 123, Issue 2 , Pages 511-512, February 20p>
اسلاید ۱۲: Disadvantages to CAM“natural” does not equal safe, i.e. push for FDA regulation of “all natural” on food labelingNo FDA regulationRisk of contaminationAdverse effects and drug/supplement interactions, anaphylaxisLegal considerationsWe often do not use these options because the data is not there: there are no pharmaceutical co’s to fund vitamin and herb trials…role of NCCAM
اسلاید ۱۳: Biologically based systems“Natural” productsDietary supplements, herbal medicines (botanicals), probioticsEvidence found in mummified prehistoric “ice man”, Middle Ages use2007 NHIS (National Health Interview Survey)17.7% American adultsMost popular form of CAMFish oil/omega 3 (adults)Echinacea (children)
اسلاید ۱۴: How should we be using biologically based systemsDiagnosis: BronchitisTx: Take some “antibiotics”If we would not do this in the above example, why do we rationalize recommending some “probiotics”
اسلاید ۱۵: BotanicalsDietary Supplement and Health Education Act (DSHEA): 1994 dietary supplements marketed without prior approval of efficacy and safety by the FDA. “structure and function” claims (no claims made regarding prevention or treatment of a specific disease) Labels also must state that the FDA has not evaluated the product for any claim. German commission E (1994): scientific “expertise” for the approval of substances and products previously used in traditional, folk and herbal medicine, became known beyond Germany for compiling and publishing 380 monographs evaluating the safety and efficacy of herbs for licensed medical prescribing in Germany: political issues implicated in criticisms (JAMA 1999)ABIHM 2012 course curriculum study guide
اسلاید ۱۶: PitfallsActive part of plant: leaf versus root i.e. mullein: leaf for lung, flowers as ear drop in antimicrobialMost appropriate form: whole, fresh versus dried herb, tincture, tea, poultice, liquid extract/tincture, etc. It can be dried and placed into capsules. It can be sprayed onto inert powder or dried plant material, and then pressed into pill form. The liquid may be placed into capsules. Any of these processes can theoretically affect the bioavailability of the plant constituents. : ABHIM 2012 course curriculum study guide
اسلاید ۱۷: Mind and Body medicineMeditation, yoga, acupuncture*, deep breathing exercises, guided imagery, hypnotherapy, progressive relaxation, qi gong*, tai chiCrossover to energy medicine, manipulative practices, whole systems practice (TCM)Popular in top 10 CAM practices reported by adults in NHIS (deep-breathing, meditation, yoga)
اسلاید ۱۸: Other major categories of CAMManipulative and body based practices: Spinal manipulation, massage therapy: chiropractic, osteopathic physiciansMovement therapies: Feldenkrais method, Alexander technique, Pilates, Rolfing, TragerTraditional healers: Native AmericanEnergy medicines: magnet and light therapy, qi gong, Reiki, healing touch, halotherapyWhole medical systems: Ayurveda, traditional Chinese medicine, homeopathy, naturopathy
اسلاید ۱۹: How do I use CAMTools in the toolboxAdjunctive to allopathic toolsInterested patientsAdditions to refractory conditions
اسلاید ۲۰: J Allergy Clin Immunol Vol 123, 2, Feb 20al Reviews in Allergy and ImmunologyCAM: Herbs, phytochemicals and vitamins and their immunologic effects, Mainardi…Bielory et alEfficacy and mechanisms of action of traditional Chinese medicines for treating asthma
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