Embargoed materials for Complementary & Integrative Medicine Conference

NOTE: The HMS public affairs office is extending the media materials below on behalf of the North American Research Conference on Complementary & Alternative Medicine, which is sponsored by the Consortium of Academic Health Centers for Integrative Medicine. The chair of the consortium's scientific review committee is HMS faculty member David Eisenberg, MD.

BELOW PLEASE FIND MEDIA MATERIALS ASSOCIATED WITH THIS WEEK'S PRESENTATIONS AT THE NORTH AMERICAN RESEARCH CONFERENCE ON COMPLIMENTARY & ALTERNATIVE MEDICINE

With the Exception of Item Four, All Materials Below Are Embargoed until May 25, 2006 at 9AM EST

ORAL PRESENTATION HEADLINES (FULL RELEASES BELOW)

1.) Massage Therapy May be Effective for the Treatment of Osteoarthritis of the Knee

2.) Effect of Mindfulness-Based Stress Reduction on Psychological and Physical Symptoms of Rheumatoid Arthritis

3.) A Randomized Sham-controlled Clinical Trial of Acupuncture for Hot Flashes Shows No Effect

4.) Sham Acupuncture Has Greater Effects than Placebo Pill for the Treatment of Arm Pain

5.) Addition of Acupuncture to Routine Care for Patients with Osteoarthritis Is More Effective than Routine Care Alone

6.) Survey Reveals Pharmacists' Concerns About Natural Health Products

7.) Integrative Care Combining Conventional and Complementary/Alternative Medicine Offers Benefits to Patients with Low Back Pain

8.) Research Finds Relatively Low Rate of Potential Drug-Herb Interactions

9.) Quality Assurance and Lactobacillus-Containing Dietary Supplements Commercially Available in Washington State

10.) Conventional and Complementary/Alternative Medicine Inter-institutional Programs Are Mixed

11.) Green Tea Component May Have Potential for Treating HIV Infection

ORAL PRESENTATION 242
May 26, 2006 11:15 AM
Salon 8

Presenting Author: Adam Perlman, MD, MPH
University of Medicine and Dentistry of New Jersey
Newark, NJ

Massage Therapy May be Effective for the Treatment of Osteoarthritis of the Knee

In a randomized, controlled trial of adults with osteoarthritis of the knee, patients receiving massage therapy experienced significant pain relief and improvements in physical function compared with those not receiving massage therapy. The results, which are to be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006, suggest that such therapy might offer an alternative or adjunct to drug treatments for osteoarthritis.

In this study, 68 adults over age 35 years with a diagnosis of osteoarthritis of the knee who experienced pain levels between 4 and 9 on a pain scale (0=no pain, 10=worst pain ever) were enrolled. Patients were excluded if they had rheumatoid arthritis, fibromyalgia, pseudo-gout, cancer, or other serious medical conditions or if they had a recent history of steroids or oral corticosteroids use or recent arthroscopy or injury of the knee.

Patients received either 8 weeks of Swedish full-body therapeutic massage or 8 weeks of usual care. In the massage group, massages were given twice weekly for the first 4 weeks, and then once weekly for the remainder of the trial. The two groups were comparable in demographic and baseline clinical characteristics. Specifically, most participants were Caucasian, female, elderly, and generally overweight.

When investigators measured pain in the patients following the 8 week trial, they found that the massage therapy group demonstrated significant decreases in pain sensation and stiffness as well as improvements in physical function and the time to walk 50 feet. At 16 weeks, improvements seen in the massage therapy group generally persisted.

"Massage therapy appears to be efficacious and well tolerated in the treatment of osteoarthritis of the knee," the investigators concluded. "Further study of this modality is clearly warranted," they added.

Osteoarthritis of the knee is the most common form of osteoarthritis, or gradual breakdown of cartilage, affecting the lower limbs. More than 10 million Americans have osteoarthritis of the knee. The most common type of medication currently used to treat osteoarthritis is nonsteroidal anti-inflammatory drugs. Cortisone shots can also help decrease inflammation, and surgery is an option for those with severely damaged joints.

Abstract 242 Massage Therapy for Osteoarthritis of the Knee: Results of Randomized Controlled Trial
Perlman, Adam; Mojica, Elena; Williams, Anna-Leila; Njike, Valentine; Katz, David L.

ORAL PRESENTATION 248
May 26, 2006 11:45 AM
Salon 8

Presenting Author: Elizabeth Kimbrough Pradhan, PhD
Center for Integrative Medicine, University of Maryland School of Medicine
Baltimore, MD

Effect of Mindfulness-Based Stress Reduction on Psychological and Physical Symptoms of Rheumatoid Arthritis

In a randomized, controlled study, a mindfulness meditation program reduced psychological distress, decreased disease activity, and decreased nonspecific inflammation in patients with rheumatoid arthritis. The study's results will be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006.

In the study, 63 patients were randomized to 8 weeks of usual care or meditation, in which individuals were asked to practice a meditation program at home 6 hours a week. All patients were under the regular care of their rheumatologist and remained on prescribed medications.

Assessments were made at the start of the trial and then at 2 months and 6 months later. Two patients dropped out after baseline, 3 after 2 months. Analyses indicated that at 2 months, psychological distress was reduced by 30% in the meditation group and 10% in the control group. From baseline to 6 months, psychological distress was reduced by 33% in the meditation group and 2% in controls.

Rheumatoid arthritis disease activity (which includes joint tenderness, patient assessment, and other measures) was not affected at 2 months, but at 6 months, the meditation group had an 11% mean decrease in disease activity with 0% change among controls.

At 2 months, the meditation group had a 25% mean decrease in nonspecific inflammation, compared with an 8% increase in controls. And at 6 months, this inflammation dropped 35% in the meditation group, compared with an 11% increase in controls, suggesting a 46% improvement associated with treatment.

"The Mindfulness-Based Stress Reduction program may be beneficial in reducing psychological distress and disease activity among rheumatoid arthritis patients," the authors concluded.

Rheumatoid arthritis, a chronic disease that causes inflammation of the joints and surrounding tissues, often requires lifelong treatment, including medications, physical therapy, exercise, and sometimes surgery. While the cause of rheumatoid arthritis is not known and there is no cure, aggressive treatment for the condition can delay joint destruction. Ongoing research is looking at the potential genetic, environmental, and hormonal causes of the condition.

Abstract 248 Effect of Mindfulness-Based Stress Reduction on Psychological and Physical Symptoms of Rheumatoid Arthritis
Pradhan, Elizabeth K. Berman, Brian Gilpin, Adele K. Hochberg, Marc Handwerger, Barry

ORAL PRESENTATION 251
May 26, 2006 at 9:45 AM
Salon 8

Presenting Author: Ann Vincent, MD
Mayo Clinic
Rochester, MN

A Randomized Sham-controlled Clinical Trial of Acupuncture for Hot Flashes Shows No Effect

Suffering from hot flashes and other negative symptoms, many women going though menopause seek relief through over-the-counter remedies, including alternative therapies. Several pilot studies have suggested that acupuncture may have potential for decreasing the incidences of hot flashes, but this randomized, controlled clinical trial of acupuncture for hot flashes reveals that medical acupuncture is no more effective than sham, or mock, acupuncture. The data will be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006.

This prospective, randomized, single-blinded, sham-controlled clinical trial in peri-menopausal and postmenopausal women experiencing hot flashes included 103 women with = 5 hot flashes a day who were randomized to medical or sham acupuncture. Participants received bi-weekly acupuncture for a period of 5 weeks after a baseline assessment week. They were then followed for an additional 7 weeks to see what treatment effects if any persisted.

Results were obtained through daily hot flash questionnaires completed by the study participants. At week 6, data for 46 participants each in the medical and sham acupuncture groups were analyzed. Residual hot flashes were experienced by 61% of the women in the sham group and 62% of the women in the medical acupuncture group.

At week 12 data were available for 45 participants in the sham group and 46 participants in the medical acupuncture group. At this time, residual hot flashes were experienced by 60% of the women in the sham group and 71% of the women in the medical acupuncture group. Participants reported no adverse effects related to the treatments.

"The results of this study failed to suggest that the utilized medical acupuncture was any more effective than the chosen sham acupuncture for reducing hot flashes," the authors concluded.

While hormonal and neurologic factors are thought to play a role in the occurrence of hot flashes, more work remains to understand the causes and mechanisms involved before effective therapies can be designed. Hormone replacement therapy may relieve hot flashes and other symptoms of menopause, but many adverse effects can accompany these treatments.

Abstract 251 A Randomized Sham-controlled Clinical Trial of Acupuncture for Hot Flashes
Vincent, A; Barton, D; Mandrekar, J; Cha, S; Zias T; Wahner-Roedler, D; Keppler, M; Kreitzer, MJ; Loprinzi, C.

ORAL PRESENTATION 256
May 26, 2006 at 10AM
Salon 8

Author: Ted Kaptchuk, OMD
Harvard Medical School
Boston, MA

Sham Acupuncture Has Greater Effects than Placebo Pill for the Treatment of Arm Pain

Which works better, an inert pill or an ineffective needle? According to a study to be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006, it's the latter: sham acupuncture was more effective than a placebo pill at relieving aches in patients with persistent arm pain due to repetitive use.

The single blind randomized controlled trial involved 270 adults with pain lasting for at least 3 months despite treatment and who scored 3 or higher on a 10-point pain scale. In the trial, patients first underwent a 2 week 'run-in' phase in which they were in the placebo arms of two clinical trials comparing acupuncture and the drug amitriptyline with their respective placebo controls. The participants then went on to receive either sham acupuncture twice weekly for 6 weeks or a placebo pill once daily for 8 weeks. At the end of these sessions, the investigators assessed arm pain, arm function, and arm strength.

During the 2 week run-in period, pain decreased to a similar extent in both the sham acupuncture and placebo pill groups. Symptom severity and grip strength were similar in both groups as well, but arm function improved more in the placebo pill group than in the sham acupuncture group.

Throughout the treatment period that followed the run-in period, greater decreases in both the 10-point arm pain scale and in symptom severity occurred each week in the sham acupuncture group compared with those in the placebo pill group. Differences were not statistically significant, however, in terms of arm function or grip strength.

"The sham device had greater effects than the placebo pill on self-reported arm pain and arm symptom severity over the entire course of treatment, but not during a two-week placebo run-in," concluded the authors. They added that placebo effects are malleable and depend on the behaviors embedded in medical rituals.

Placebo, from the Latin for "I will please," was defined in Hooper's medical dictionary of 1811 as "an epithet given to any medicine adapted more to please than benefit the patient." It is thought that the positive or negative effects experienced by patients on placebos are psychological in nature or due to unrelated factors. Much mystery remains as to why and how placebo effects occur in individuals. "A better understanding of the psychological and physical basis of placebo effects may lead to new ways to treat chronic pain," said Ted Kaptchuk, OMD.

Abstract 256 Sham Device vs. Inert Pill: A RCT Comparison of Two Placebo Treatments for Arm Pain due to Repetitive Use
Kaptchuk TJ, Stason,WB, Davis RD, Legedza ATR,. SchnyerRN, . Kerr CE, Ph.D. Stone DA, Nam,BY, Kirsch I, Goldman RH.

ORAL PRESENTATION 302
May 26, 2006
Salon 8

Presenting Author: Claudia Witt, MD
University Medical Center Charité, Berlin

Addition of Acupuncture to Routine Care for Patients with Osteoarthritis Is More Effective than Routine Care Alone

While a recent randomized controlled trial of acupuncture for osteoarthritis of the knee showed that the treatment provided significant benefits for patients compared with sham acupuncture (Witt et. al. Lancet 2005;366:136-143), the effectiveness and cost-effectiveness of the procedure remains unclear.

In a study presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006, 632 patients aged e40 years with chronic arthritis of the hip and the knee were randomly assigned to receive up to 15 acupuncture sessions over 3 months or to receive no acupuncture. All study participants were allowed to receive additional usual medical care covered by health insurance companies.

The investigators used questionnaires to assess symptoms of osteoarthritis and health related quality of life at the start of the trial, and then after 3 and 6 months. Data for direct costs and sick leave (number of days absent from work) were provided by the health insurance companies.

After 3 months of treatment, symptoms of osteoarthritis decreased in patients in the acupuncture group but not in those receiving routine care alone, an effect which persisted for up to 6 months. In addition, quality of life improved significantly more in the acupuncture group.

While the acupuncture treatment was associated with higher overall costs, there were more quality adjusted life years gained in the acupuncture group compared with the group receiving routine care alone. Therefore, acupuncture for patients with osteoarthritis can be regarded as cost-effective, the authors concluded.

Acupuncture originated in China more than 2,000 years ago, making it one of the oldest medical procedures in the world. According to The Arthritis Foundation, acupuncture therapy has been tried by an estimated 15 million Americans, and it is offered in many chronic pain clinics and is covered by some insurers and managed heath organizations. The World Health Organization recommends it for more than 40 conditions from asthma to chronic pain. Costs vary, but generally a first visit costs from $75 to $150, and follow-up visits are $35 to $75.

Abstract 302 Effectiveness and Costs of Acupuncture in Patients with Osteoarthritis - the Acupuncture in Routine Care Study (ARC)
Witt C, Reinhold T, Jena S, Brinkhaus B, Liecker B, Willich SN

ORAL PRESENTATION 326
May 26, 2006 at 11:45AM
Salon 9

Presenting Author: Theresa L. Charrois, BScPharm, MSc
University of Alberta
Edmonton, Canada

Survey Reveals Pharmacists' Concerns About Natural Health Products

As natural health products are not scrutinized or standardized to the same extent as pharmaceutical drugs, questions exist about the safety of these products, particularly with respect to potential interactions with various over-the-counter and prescription medications.

A recent survey of community pharmacists shows that many share concerns about the quality of natural health products and the potential adverse events and/or drug interactions associated with these products. The results will be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006.

In the survey, 132 pharmacists in Alberta and British Columbia responded, for a response rate of 41%. A total of 19% of the respondents had previously reported an adverse event to Health Canada. When asked specifically about natural health product-drug interactions or adverse events, 47% of pharmacists stated they had seen a potential interaction, however, only 2 of these respondents reported it to Health Canada. About half of these pharmacists discussed the interaction with the patient.

The majority (89%) of pharmacists reported being moderately to extremely concerned about natural health product-drug interactions and adverse events. Over 82% reported being moderately to extremely concerned regarding the quality of natural health products, with 91% of respondents indicating that their concern was due to lack of standardization.

This survey suggests that pharmacists are encountering reportable adverse events in patients using natural health products, but many are not reporting these events.

The investigators conclude that the current system of passive surveillance is likely not adequate. "Whether this lack of reporting is an issue with regards to knowledge about the reporting system or due to other constraints, is unknown," the authors wrote. The majority (92%) of pharmacists surveyed felt that more education on natural health products was needed on this subject.

According to the National Center for Complementary and Alternative Medicine, a part of the National Institutes of Health, just because an herbal supplement is labeled "natural" does not mean it is without any harmful effects. For example, the herbs kava and comfrey have been linked to serious liver damage. In addition, some herbal supplements are known to interact with medications in ways that cause health problems.

Abstract 326 Survey of community pharmacists reporting of adverse drug reactions associated with natural health products
Charrois TL, Hill R, Vu D, Foster B, Boon H, Cramer K, Vohra S

ORAL PRESENTATION 366
May 15, 2006 at 9:45AM
Salon 9

Author: David Eisenberg, MD
Harvard Medical School
Boston, MA

Integrative Care Combining Conventional and Complementary/Alternative Medicine Offers Benefits to Patients with Low Back Pain

While Western medicine and complementary/alternative medicine often seem to be at odds, a multidisciplinary care approach which combines the two may be effective. Researchers set out to evaluate the potential of such integrative care that combines conventional and complementary/alternative medicine for the treatment of sub-acute low back pain in a hospital setting. The results of their study will be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006.

The investigators randomized adults with sub-acute low back pain in a 1:2 ratio to usual care or usual care plus treatment by the integrative care team at the Brigham and Women's Hospital, a teaching hospital affiliated with Harvard Medical School. In the study, a multidisciplinary team consisted of individuals with expertise in acupuncture, chiropractic, internal medicine, massage therapy, neurology, nursing, nutritional counseling, occupational therapy, orthopedics, psychiatry/mind-body, physical therapy and rheumatology.

Initial patient evaluations were done by two members of the team, one physician and one complementary/alternative medicine clinician, and individualized treatment plans were developed. Treatment was provided for up to 12 weeks and was modified based on progress and input by the team. The investigators assessed differences in pain scores (on a 0-10 scale) and functional status (on a 0-23 scale) at the start of the trial and at 2, 5, and 12 weeks after randomization

To date, 19 patients have been randomized, 13 to integrative care and 6 to usual care. Over the 12 weeks, participants in the integrative care group had an average of 12.2 visits and experienced significantly greater reduction in pain scores (0.37 per week compared with 0.14 per week for those in the usual care group) and functional status (1.11 per week compared with 0.49 per week for those in the usual care group).

"It was feasible for a multidisciplinary integrative care team to deliver a coordinated, integrative care intervention to patients with sub-acute low back pain," the authors concluded. They added that initial results show a promising trend for benefit of treating patients with persistent low back pain and should be further evaluated.

The integrative model in this study could have benefits for companies in reducing disability setbacks. "You can imagine if you could get more people back to work who would otherwise not go back to work, it would pay for the entire investment in the team and the maintenance of the team, just through reductions in disability costs, replacement costs, and worker productivity costs," said lead author David Eisenberg, MD, of Harvard Medical School. "If the model could be shown to be effective, reproducible, and then tested in a larger study, companies would want these to be available. This would then result in having third party reimbursement for these kinds of integrative models available for the first time regardless of socio-economic background," he added.

Abstract 366 Testing a Model of Integrative Care in an Academic Health Center: Results of a Pilot Study
Eisenberg DM, Post DE, Hrbek AL, Connelly MT, Levy D, O'Connor B, Cunningham M, Davis RB, Cohen MH, Cherkin DC, Buring JE

ORAL PRESENTATION 373
May 26, 2006 at 11:15AM
Salon 9

Presenting Author: Shelly Vik
University of Calgary
Calgary, Alberta, Canada

Research Finds Relatively Low Rate of Potential Drug-Herb Interactions

As more and more individuals are taking complementary and alternative medicines in addition to prescription and over-the-counter drugs without consulting their physicians, there is an increasing concern about potential drug-herb interactions in patients. To assess the situation in patients with osteoporosis, researchers conducted a study on the prevalence of potential drug-herb interactions among participants in the Canadian Multicentre Osteoporosis Study, a prospective cohort study evaluating prevalence, incidence, and determinants of osteoporosis. Their data will be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006.

Participants aged >25 years were recruited to the study in 1995, and the data for this analysis were collected between 2001-2002, during 5-year follow-up interviews. Potentially dangerous drug-herb interactions were analyzed for individuals taking cardiovascular agents including digoxin, furosemide and warfarin, and neuroleptic agents including alprazolam, levodopa, lithium, phenelzine and selective serotonin reuptake inhibitors. The concomitant use of St. John's Wort with cyclosporin, spironolactone, or venlafaxine was also examined.

At the 5-year follow-up, 81 % of the original participants were remaining, the average age was 70 years (range 31-99), and 70% were female. Of the 7652 participants remaining, 1069 (14%) were taking at least one of the prescription medications for which drug-herb interactions were assessed. Only 14 (1.3%) of these 1069 participants were using at least one contraindicated drug-herb combination.

Of the 514 subjects on one of the cardiovascular medications, 13 (2.5%) were concomitantly using a contraindicated herb. Only one of the 514 subjects taking a neuroleptic agent was identified as at-risk for a potential drug-herb interaction (lithium and psyllium). No subjects were concomitantly using the potentially dangerous combination of St. John's Wort with cyclosporin, spironolactone, or venlafaxine.

"In this randomly selected, population-based sample we found a relatively low rate of potential drug-herb interactions, most of which were among subjects using specific cardiovascular medications," the authors concluded.

The National Center for Complementary and Alternative Medicine advises that individuals to consult their health care providers before taking any herbal supplement, especially if it is being taken in addition to another medication.

Abstract 373 A Preliminary Assessment of Potential Drug-Herb Interactions in a Canadian Population-based Study
Vik SA, Hanley DA, Patten SB, Verhoef M, Brasher P, Hopman W, Anastassiades T, Tanveer T.

ORAL PRESENTATION 383
May 26, 2006 at 11:30 AM
Salon 9

Presenting Author: Petra Elena Eichelsdoerfer, ND, MS, RPh
Bastyr University
Kenmore, WA

Quality Assurance and Lactobacillus-Containing Dietary Supplements Commercially Available in Washington State

While bacteria and other microorganisms are often given a bad rap because some can cause potentially dangerous diseases, some microorganisms are essential to healthy living-for example, bacteria living in the gut and intestines are important for digestion and illness or antibiotic treatment that disturbs them can cause diarrhea.

Probiotic supplements, which contain helpful bacteria such as those in the genus Lactobacillus, inhibit pathogenic bacteria, prevent antibiotic-caused diarrhea, and may help in the treatment of irritable bowel syndrome. But because these supplements contain live microorganisms, they're susceptible to contamination and loss of viability during manufacturing, shipping, and storage.

Therefore, researchers evaluated probiotic supplements labeled to contain Lactobacillus and sold across Washington State for viability, contamination, label accuracy, storage recommendations, and price at the point of purchase by the consumer. Their data will be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006.

Lactobacillus dietary supplements are available to the public through many sources including pharmacies and health food stores. In their analysis of 94 samples, the investigators found that 83 (88%) samples proved viable, and of these, lab results matched manufacturer labeling exactly for seven (8%) products, while 42 (51%) products contained at least one organism that matched labeling at both genus and species level. Seventy-three (88%) products contained organisms matching labeling at the genus level. Finally, 67 (71%) of products contained at least one organism not listed on the label, and eight (10%) had more than one potentially pathogenic organism.

The investigators concluded that most commercially available Lactobacillus supplement products available in Washington State were viable, but a large discrepancy existed between labeling and actual contents. The most commonly identified labeling discrepancy was at the species level rather than the genus level.

"Many products contained organisms not listed on the label," the authors noted. "Some of these could act as human pathogens, posing risk if used by susceptible consumers," they added. It is not clear where quality was compromised in the chain of events from manufacturer to consumer.

Additional research is needed to identify the brands of Lactobacillus dietary supplements that are safe and viable. If supplements contain nonviable microorganisms, the products will fail to produce the desired benefit, and if they contain potential pathogens, they could be harmful to patients.

Abstract 383 Quality Assurance and Lactobacillus-Containing Dietary Supplements Commercially Available in Washington State
Berman, S, Eichelsdoerfer, PE, Spicer, D, McGann, M

ORAL PRESENTATION 520
May 26, 2006 at 11:00AM
Salon 4

Presenting Author: John Weeks
National Education Dialogue to Advance Integrated Health Care: Creating Common Ground (Integrated Healthcare Policy Consortium)
Seattle, WA

Conventional and Complementary/Alternative Medicine Inter-institutional Programs Are Mixed

For complementary/alternative medicine to play an important and beneficial role in today's health care, it must establish a relationship with conventional medicine. A number of federally-recognized complementary/alternative medicine schools and conventional academic health centers have launched inter-institutional partnerships in recent years, and now investigators have revealed the extent and nature of their relationships, and the data will be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006.

The study included 130 complementary/alternative medicine schools accredited by a federally-recognized accrediting agency in one or more of five disciplines: chiropractic, acupuncture and Oriental medicine, massage therapy, naturopathic medicine and direct-entry midwifery. Also included were 28 conventional academic medical schools that are part of the Consortium of Academic Health Centers for Integrative Medicine.

Survey responses were received from 93% of conventional medical school programs and 61% of complementary/alternative medicine programs. Overall, 34% of complementary/alternative medicine schools noted formal relationships with conventional medical programs.

The results indicated that more than 50% of the relationships between the two disciplines were based on informal contacts, while 15% to 30% were formal relationships. Specifically, conventional programs were more likely to have formal relationships with schools of acupuncture (32%) and massage (20%) and less likely with chiropractic (12%) and naturopathic medicine (8%).

Approximately 85% of respondents from both medical and complementary/alternative medicine schools agreed that "creating a fully integrated healthcare system will require that institutions/programs like ours develop stronger, multi-dimensional, inter-institutional relationships" with programs of the other disciplines.

The respondents noted that strengthening and deepening these relationships may be achieved by strategies that incorporate materials on best practices, including the sharing of sample agreements created by other institutions, and focused meetings on the topic. These were viewed as top strategies for enhancing inter-institutional relationships.

"Conventional and complementary/alternative educational programs presently have a significant web of relationships that is yet marked by an informality which does not reflect the importance such relationships are viewed as having in fostering fully-integrated healthcare," the authors concluded.

Abstract 520 Survey of Educators at Conventional Integrative Medicine Programs and Accredited CAM Schools on the Status of Inter-Institutional Relationships
Weeks J, Kligler B, Qiao Y, Snider P, Haramati A, O'Bryon D, Perlman A, Lawson K, Goldstein M

Poster Session: A-34
May 26, 2006 at 5:45pm

Presenting Author: Christina Nance, PhD
Texas Children's Hospital and Baylor College of Medicine
Houston, TX

Green Tea Component May Have Potential for Treating HIV Infection

While green tea has been touted as having many potential benefits for maintaining general health, new research to be presented at The North American Research Conference on Complementary and Integrative Medicine held in Edmonton, Alberta, Canada, May 24th-27th, 2006, reveals that it may have particular promise for treating a serious condition, HIV infection and subsequent impaired immunity.

The green tea component epigallocatechin gallate (EGCG) has been proposed to have medicinal properties against cancer, heart disease, and the effects of HIV infection. Research has shown that HIV-1 infection causes impaired immune function by binding to the CD4 molecule on immune cells, and now this study demonstrates that EGCG binds to CD4 and inhibits HIV from attaching to host cells.

The investigators assessed whether EGCG is capable of inhibiting the binding of HIV proteins called gp120 that are essential for the virus to attach to CD4 molecules and gain entry into host cells. Specifically, they analyzed the binding ability of gp120 to EGCG-treated and untreated immune cells expressing CD4. EGCG markedly inhibited the binding of HIV gp120 proteins to these immune cells in a dose-dependent manner. In addition, molecular modeling studies suggested that EGCG and gp120 both bind to the same spot on CD4 molecules.

"We have demonstrated clear evidence of high affinity binding of EGCG to the CD4 molecule. EGCG at concentrations equivalent to those obtainable by the consumption of green tea is able to significantly reduce the attachment of gp120 to CD4," the authors concluded. They added that the competitive binding properties of EGCG for the CD4 binding sites by gp120 may help researchers design new therapies to treat and prevent HIV infection. While EGCG may be effective against HIV in laboratory cells, much more research is needed to determine if it has potential in infected humans.

Abstract A-34 Epigallocatechin Gallate, Green Tea Catechin, Binds to T Cell Receptor, CD4
Nance, Christina; Williamson, Mike; Paulson, Susan; McCormick, Theron; Shearer, William

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About the Consortium of Academic Health Centers for Integrative Medicine
The Consortium of Academic Health Centers for Integrative Medicine was established in 2002 and is comprised of 30 schools of medicine in the U.S. and Canada. Its mission is to help transform medicine and healthcare through rigorous scientific studies, new models of clinical care, and innovative educational programs that integrate biomedicine, the complexity of human beings, the intrinsic nature of healing and the rich diversity of therapeutic systems. The Consortium's goal is to make a qualitative difference in people's health by advocating an integrative model of healthcare, incorporating mind, body and spirit. For more information and a list of members please visit the website: www.imconsortium.org


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