Hintergrund/Einleitung: Etwa 50% der Patienten mit chronisch entzündlichen Darmerkrankungen (CED) wenden komplementärmedizinische Therapiemethoden (engl. „complementary and alternative medicine“, CAM) an. Dies belegen Studien aus Kanada, den USA, Irland, Schweden und Deutschland. Nur wenige Daten gibt es zu den Determinanten und Hintergründen dieses Phänomens.

Focus on Alternative and Complementary TherapiesVolume 10, Issue s1 p. 20-21 Introducing a computer-assisted, digital tongue-imaging device to standardise and evaluate traditional Chinese tongue diagnosis IK Gareus, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorL Tan, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorR Lüdtke, Karl and Veronica Carstens-Foundation, Am Deimelsberg 36, 45276 Essen, GermanySearch for more papers by this authorC Niggemeier, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorFM Li, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorM Bäcker, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorC Lehmann, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorP Klose, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorG Spahn, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this author IK Gareus, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorL Tan, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorR Lüdtke, Karl and Veronica Carstens-Foundation, Am Deimelsberg 36, 45276 Essen, GermanySearch for more papers by this authorC Niggemeier, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorFM Li, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorM Bäcker, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorC Lehmann, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorP Klose, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorG Spahn, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Chair for Complementary and Integrative Medicine, University Duisburg-Essen, GermanySearch for more papers by this author First published: 14 June 2010 https://doi.org/10.1111/j.2042-7166.2005.tb00478.xCitations: 1Read the full textAbout ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume10, Issues1March 2005Pages 20-21 RelatedInformation

Focus on Alternative and Complementary TherapiesVolume 8, Issue 4 p. 520-520 Thermal hydrotherapy according to Kneipp improves quality of life and haemodynamic function in patients with chronic heart failure A Michalsen, A Michalsen Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorR Lüdtke, R Lüdtke Karl and Veronica Carstens Foundation, Essen, GermanySearch for more papers by this authorM Bühring, M Bühring Department for Natural Medicine, Free University of Berlin, Klinikum Benjamin Franklin, Immanuel Hospital, Berlin, GermanySearch for more papers by this authorG Spahn, G Spahn Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorJ Langhorst, J Langhorst Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, GJ Dobos Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this author A Michalsen, A Michalsen Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorR Lüdtke, R Lüdtke Karl and Veronica Carstens Foundation, Essen, GermanySearch for more papers by this authorM Bühring, M Bühring Department for Natural Medicine, Free University of Berlin, Klinikum Benjamin Franklin, Immanuel Hospital, Berlin, GermanySearch for more papers by this authorG Spahn, G Spahn Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorJ Langhorst, J Langhorst Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, GJ Dobos Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this author First published: 14 June 2010 https://doi.org/10.1111/j.2042-7166.2003.tb04040.xRead the full textAbout ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume8, Issue4December 2003Pages 520-520 RelatedInformation

Focus on Alternative and Complementary TherapiesVolume 8, Issue 4 p. 540-541 Characteristics of German cancer patients using CAM: a survey in 441 cancer patients G Spahn, G Spahn Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorA Hartmaring, A Hartmaring Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorR Lüdtke, R Lüdtke Karl and Veronica Carstens Foundation, Essen, GermanySearch for more papers by this authorM Fuchs, M Fuchs Department of Haematology/Oncology, Kliniken Essen-Mitte, GermanySearch for more papers by this authorJ Langhorst, J Langhorst Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorA Michalsen, A Michalsen Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, GJ Dobos Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this author G Spahn, G Spahn Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorA Hartmaring, A Hartmaring Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorR Lüdtke, R Lüdtke Karl and Veronica Carstens Foundation, Essen, GermanySearch for more papers by this authorM Fuchs, M Fuchs Department of Haematology/Oncology, Kliniken Essen-Mitte, GermanySearch for more papers by this authorJ Langhorst, J Langhorst Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorA Michalsen, A Michalsen Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, GJ Dobos Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this author First published: 14 June 2010 https://doi.org/10.1111/j.2042-7166.2003.tb04073.xCitations: 3Read the full textAbout ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume8, Issue4December 2003Pages 540-541 RelatedInformation

Focus on Alternative and Complementary TherapiesVolume 8, Issue 4 p. 521-521 Impact of mindfulness-based stress reduction in supporting smoking cessation: results of a non-randomised, controlled trial A Michalsen, A Michalsen Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorN Altner, N Altner Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorB Richarz, B Richarz Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorH Reichardt, H Reichardt Department of Pneumology, Kliniken Essen-Mitte, GermanySearch for more papers by this authorN Konietzko, N Konietzko Ruhrland-Hospital; Pneumology, University Hospital, Essen, GermanySearch for more papers by this authorG Spahn, G Spahn Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, GJ Dobos Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this author A Michalsen, A Michalsen Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorN Altner, N Altner Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorB Richarz, B Richarz Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorH Reichardt, H Reichardt Department of Pneumology, Kliniken Essen-Mitte, GermanySearch for more papers by this authorN Konietzko, N Konietzko Ruhrland-Hospital; Pneumology, University Hospital, Essen, GermanySearch for more papers by this authorG Spahn, G Spahn Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, GJ Dobos Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this author First published: 14 June 2010 https://doi.org/10.1111/j.2042-7166.2003.tb04042.xCitations: 1Read the full textAbout ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume8, Issue4December 2003Pages 521-521 RelatedInformation

Children with cancer still experience chemotherapy-induced nausea and vomiting despite the use of modern antiemetic therapy, such as 5-hydroxytryptamine-3 (5-HT3) antagonists. In adult cancer patients, additional Pericardium 6 (P6) stimulation by acupressure or acupuncture has been shown to reduce these symptoms. We conducted a randomised, placebo-controlled, crossover pilot study to evaluate bilateral P6-point acupressure (with elastic bands) and manual acupuncture during three cycles of high emetogenic chemotherapy. Each supplemental therapy was tested on a cohort of 18 children with cancer. All patients received standard antiemetic medication with a 5-HT3 antagonist. Verum (P6-point), sham (placebo) acupressure/acupuncture or no (control) acupressure/acupuncture was applied on each day during one chemotherapy cycle in the same patient. Acute nausea (4-point scale), acute emesis (metric scale), application of concomitant pharmacological antiemetics and outcome of a newly developed emesis score and failure of treatment score were the criteria analysed. All criteria were assessed for each eligible chemotherapy cycle for the patient cohorts, which included 42/54 and 48/54 for acupressure and acupuncture, respectively. Nausea occurred in 67% and 69% of chemotherapy cycles in patients treated with acupressure or acupuncture, respectively. Emesis occurred in 26% and 31% of chemotherapy cycles and additional antiemetics were required in 43% and 54% of chemotherapy cycles in patients treated with acupressure or acupuncture, respectively. The emesis score was positive in 81% of the chemotherapy cycles in either treatment group, and the failure of treatment scores were positive in 71% and 79% for acupressure or acupuncture, respectively. No significant benefit was detected for children receiving verum acupressure or acupuncture in this pilot study; however, a trend was detected for a benefit to patients treated with verum acupuncture. A study of a larger number of patients is required to confirm whether verum acupuncture could truly benefit pediatric cancer patients.

We report the final results of a randomised controlled trial in 55 breast cancer patients (90% ER/PR positive) without signs of active cancer who showed high fatigue scores at least 3 months after completion of multimodal tumour treatment (surgery, chemotherapy and radiotherapy). Twenty-five patients were allocated to a home-based pulse-controlled walking group under the supervision of a sports instructor (duration 10 weeks, minimal 3×30 min of moderate walking exercise per week), 30 patients took part in a 10-week outpatients mind–body programme including moderate walking exercise, relaxation, nutrition, hydrotherapy, cognitive restructuring and an introduction to mindfulness-based stress reduction. Fatigue, anxiety and depression, life quality and functional well-being were assessed with standard questionnaires for oncology patients (MFI-20, FAQ subscales, EORTC-QLQ C30, Menopausal rating scale, HADS) at entry (T1), end of study (T2) and 3 months (T3) after completion. Fatigue in a homogeneous study population of breast cancer patients suffering of long-term tumour-associated fatigue was markedly reduced in both the control group (exercise only) and the multimodal intervention group without significant differences between the groups. Marked improvement was also seen in parameters of life quality and general functional well-being. Fatigue patients who suffered of pain or anxiety showed a better outcome after the multimodal intervention with significant reduced scores in these symptoms compared to the control group.

In a variety of cancers chronic inflammation is the starting point for the development of invasive and aggressive tumours and lymphomas. Clinical examples include gastric lymphoma, pancreatic cancer, colorectal cancer, hepatocellular carcinoma, cervical cancer, head and neck cancers and lung cancer. Phytochemicals have long been used in traditional medicine for the treatment of chronic diseases in which chronic inflammation is involved. Plants with a high potential of anti-inflammatory, cytotoxic and antiangiogenetic properties include Boswellia serrata, Artemisia annua, Curcuma longa, Zingiber officinalis and Panax ginseng. In a number of preclinical studies the molecular mechanisms of action of most of these plants have been elucidated and include inhibition of cyclooxygenase pathways, 5-lipoxygenase pathways, NF-Kappa-B-inhibition and involvement of Toll-like receptors. B. serrata and C. longa are amongst the most promising plant extracts with anti-inflammatory, apoptotic and antiangiogenetic properties for the integrative treatment of cancer to be used in the future.

The diagnosis of cancer puts an individual in a crisis, moreover, if the course of the disease is chronic or palliative. Physical, psychosocial and spiritual issues have to be dealt with: decisions have to be made not only concerning treatment pathways, but also to define the way of palliation, resolution or acceptance of cancer, further to find one's own understanding of life quality during a period of changing functional status. Spirituality holds a salutogenetic quality which may influence the various changes cancer induces on the level of body image, emotions and social functioning. Spiritual experiences either in a religious or a nonreligious context can increase the feeling of confidence and are essential components of the meaningfulness a human being strives for in a life-changing situation. In the area of cancer care, the therapist–patient relation is characterized by the need for a reliable and confidential relationship in order to decrease anxieties, insecurities and all the pain this disease may cause. The enhancement of a feeling of confidence and meaningfulness within the given situation may therefore be a goal for therapists working with cancer patients. Consequently, we should ask the question whether cancer care teams should provide a space for spiritual experiences? How should they look like? Mindfulness as a basic tool in the care of patients, but also as a formal exercise for patients and therapists alike may provide a possibility to open the space for spiritual experiences shared by patients, doctors and nurses and other health care providers. Education in the concept of salutogenesis and in techniques such as mindfulness mediation may greatly enhance the satisfaction of patients and therapists working in the field of cancer care.

Acupuncture is the most popular component of traditional Chinese medicine in western countries, which has been widely used in the treatment of numerous medical conditions, e.g., pain, emesis or asthma. However, the effects of acupuncture on neuroendocrine and immune functions in humans remain unclear. Therefore, the present study was performed to analyse whether acupuncture treatment affects leukocyte circulation as well as plasma levels of cortisol and norepinephrine in humans. Ten healthy young male subjects were enrolled in a randomized single-blind two-period crossover study. Each period contained three sessions of either acupuncture or sham acupuncture (placebo) treatment. After randomisation, the group 1 (n=5) received acupuncture treatment at acu-points ST36, LI11, SP10, and GV14, while sham acupuncture was performed for group 2 (n=5). Two weeks later, each group received the alternative treatment. Blood samples were taken before needling, 10min after, and 30min after removing the needles in the first and the third session. In addition, blood pressure and heart rate were determined simultaneously. Although acupuncture treatment did not affect leukocyte circulation in peripheral blood after the first session, we observed a significant decrease in leukocyte and lymphocyte values after the third session. In contrast, cortisol and norepinephrine plasma levels remained unchanged by acupuncture. These data indicate that repeated acupuncture treatment can affect leukocyte circulation in healthy humans by still unknown mechanisms.

Einleitung : Während die medikamentöse Therapie der Colitis ulcerosa in den letzten Jahren eine weitere Optimierung erfahren hat, wird die Bedeutung von psychologischer Variablen und Faktoren des Lebensstils für den Krankheitsverlauf weiterhin kontrovers diskutiert und nicht strukturiert in die Therapie integriert. Methodik: In einer randomisierten, kontrollierten Studie mit Wartegruppendesign erhielten 15 der insgesamt 30 Patienten ein 60-stündiges Übungsprogramm über 10 Wochen mit den Elementen Stress-Erkennung und Reduktion, Bewegungstherapie, Ernährungstherapie, spezielle behaviorale Techniken und naturheilkundliche Selbsthilfestrategien. Die Untersuchung der Lebensqualität und psychometrischer Variablen erfolgte mit standardisierten Meßinstrumenten (IBDQ, SF–36, SCL–90, HADS). Zur Baseline und nach Abschluss der Intervention erfolgte die Bestimmung neuroendokriner and zellulärer Immunparameter sowie Entzündungsmarker im Stuhl. Ergebnisse : In der Interventionsgruppe verbesserte sich der IBDQ-Gesamtscore von 160 auf 179,2 zum Therapieende und auf 176 drei Monate nach Ende der Therapie. Im Vergleich zur Kontrollgruppe ergab sich für die Belastung durch Darmsymptome eine signifikante Verbesserung (p=0.0091). Der SF–36 zeigte signifikante Verbesserungen für den psychischen Summenscore (p=0.028) sowie für die Subskalen Vitalität (p=0.008), emotionale Rollenfunktion (p=0.06) und körperliche Rollenfunktion (p=0.08). Im Vergleich zu einer gesunden Kontrollgruppe zeigten beide Patientengruppen eine signifikant verminderte basale TNF-alpha Produktion. Plasma Cortisol, Catecholamine im Urin, die Verteilung zirkulierender Leukozyten- und Lymphozytensubpopulationen zeigten keine signifikanten Veränderungen nach Therapieende. Bei weitgehend unveränderter Kontrollgruppe bildete sich der Stuhlentzündungsparameter PNM-Elastase in der Therapiegruppe bei 5 von 11 Patienten mit initial pathologischen Werten in den Normbereich zurück. Schlussfolgerungen: Eine intensivierte Lebensstilmodifikation verbessert die Lebensqualität von Patienten mit Colitis ulcerosa. Veränderungen des Stuhlentzündungsparameters weisen auf eine Beeinflussung der Krankheitsaktivität hin.

Between 1993 and 1996, several groups involved in natural medicine and connected to European universities started a series of meetings and ended in founding a new society -the European Society for Classical Natural Medicine.Different concepts as well as administrative conditions in participating countries were to be respected.After an intensive process, the society confined its activites to the 'classical' approach in natural medicine: hydrotherapy and spa therapy; diet, nutrition and fasting; massage and exercise; phytomedicine; mental health.Present Status: ESCNM consists of natural persons, sections of participating countries as well as national and international medical societies.Communication is arranged by the bilangual (German/English) journal «Forschende Komplementärmedizin und Klassische Naturheilkunde».Annual conferences have been held in Spain and Germany.Perspectives: Scientific goals are additional conferences on methods and diseases, multicenter studies, and creation of scientific expertise.The society also wants to enlarge its na-tional activities to more countries, esp. in Eastern Europe.As the European Union is levelling conditions of medical practice, research and regulatory measures, e.g.drug administration, ESC-NM should also keep its members informed and express their interests through statements, hearings, and counselling of national and European authorities.

Background: In 1999 the Clinic for Internal Medicine and Integrative Medicine was founded in Essen as a regular part of the German inpatient health care system. Integrative medicine ( standard internal medicine, evidence-based complementary and alternative medicine combined with intensified lifestyle modification) aims to help patients with chronic illness to cope with their condition more effectively and to achieve a health-promoting lifestyle. Techniques include cognitive restructuring, the elicitation of the relaxation response, and lifestyle education. The goal is to increase health-related quality of life (QoL) as well as control beliefs and to reduce morbidity in later life. Aim: To demonstrate changes in quality of life, lifestyle, and control beliefs after a two-week hospital stay. Methods: Uncontrolled prospective observational study with 557 consecutive hospital patients. Outcome parameters were quality of life (SF36), control beliefs (GKU), and daily health-related behavior ( nutrition, physical activity, relaxation) on admission, at discharge, as well as 3 and 6 months after discharge. Results: Weekly physical activity increases by 29%, consumption of not recommendable foods decreases by 18%. The majority of patients (57%) engage in relaxation exercises 6 months after discharge ( on admission 23%). The physical sum scale ( SF36) increases from 33.9 (95% KI 32.5-35.3) on admission to 37.3 (35.8-38.9) 6 months after discharge, the mental sum scale from 41.2 (39.5-42.9) to 45.1 (43.5-46.7). The ratio internal/external control belief rises from 1.17 (95% KI 1.11-1.24) to 1.32 (1.24-1.40). Pretherapeutic ratio internal/external control belief and its increase are associated with rises in QoL. Conclusions: After integrative medicine treatment a lasting increase in QoL and lifestyle changes can be achieved. Reinforcement of internal control beliefs and own competence is possible and enhances outcomes in chronically ill patients.

Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study

BACKGROUND:Leech therapy was commonly used in traditional medicine for treating localized pain. Clinically significant pain relief after leech therapy for osteoarthritis of the knee has been demonstrated by preliminary data.OBJECTIVE:To evaluate the effectiveness of leech therapy for symptomatic relief of osteoarthritis of the knee.DESIGN:Randomized, controlled trial.SETTING:Outpatient department for integrative medicine of an academic teaching hospital.PATIENTS:51 patients with osteoarthritis of the knee (leech therapy: 24 patients, mean age [+/-SD], 62.5 +/- 10.2 years; topical diclofenac therapy: 27 patients, mean age [+/-SD], 65.5 +/- 6.7 years).INTERVENTION:A single treatment with 4 to 6 locally applied leeches (leech therapy group) or a 28-day topical diclofenac regimen (control group).MEASUREMENTS:Mean of the pain, function, and stiffness subscores of the Western Ontario and McMaster Universities Osteoarthritis Index and physical sum score of the Medical Outcomes Study 36-Item Short-Form Health Survey with group comparisons at days 3, 7, 28, and 91.RESULTS:The primary end point, pain at day 7, was reduced from a mean (+/-SD) of 53.5 +/- 13.7 to 19.3 +/- 12.2 after leech therapy compared with 51.5 +/- 16.8 to 42.4 +/- 19.7 with topical diclofenac (estimated group difference, -23.9 [95% CI, -32.8 to -15.1]; P < 0.001). Although the difference between group pain scores was no longer significant after day 7, differences for function, stiffness, and total symptoms remained significant in favor of leech therapy until the end of study and for quality of life until day 28. Results were not affected by outcome expectation.CONCLUSIONS:Leech therapy helps relieve symptoms in patients with osteoarthritis of the knee. The potential of leech therapy for treating osteoarthritis and the pharmacologic properties of leech saliva remain to be clarified.

Focus on Alternative and Complementary TherapiesVolume 8, Issue 4 p. 540-540 Improvement of fatigue and role function of cancer patients after an outpatient integrative mind/body intervention G Spahn, G Spahn Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorN Lehmann, N Lehmann Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, GermanySearch for more papers by this authorU Franken, U Franken Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorA Paul, A Paul Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorJ Langhorst, J Langhorst Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorA Michalsen, A Michalsen Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, GJ Dobos Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this author G Spahn, G Spahn Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorN Lehmann, N Lehmann Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, GermanySearch for more papers by this authorU Franken, U Franken Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorA Paul, A Paul Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorJ Langhorst, J Langhorst Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorA Michalsen, A Michalsen Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this authorGJ Dobos, GJ Dobos Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, GermanySearch for more papers by this author First published: 14 June 2010 https://doi.org/10.1111/j.2042-7166.2003.tb04072.xCitations: 3Read the full textAbout ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume8, Issue4December 2003Pages 540-540 RelatedInformation

Background Chronic heart failure is characterized by increased peripheral vascular resistance and reduced peripheral perfusion due to adrenergic and renin angiotensin activation and impaired endothelial function. Recent studies have shown that non pharmacological peripheral vasodilation with thermal therapy by means of warm-water baths and sauna has beneficial effects in chronic heart failure. European hydrotherapy (according to Kneipp) additionally uses short cold water stimuli, which lead to prolonged vasodilation and adaptive responses. Studies on the efficacy of hydrotherapy in chronic-heart failure are lacking.Methods We studied 15 patients (5 men, 10 women, mean (+/-SD) age 64.3 +/- 1.8 years) with mild chronic heart failure (NYHA functional class II to III, ejection fraction 30%-40%). Patients were randomly assigned to 6 weeks of intensive home-based hydrotherapy or 6 weeks restriction in a crossover intervention trial. Quality of life and heart-failure-related symptoms were assessed by means of a validated questionnaire (PLC). Graded bicycle exercise test with incremental workloads (0, 50, 75, 100 watts) was performed at the end of each treatment period. The hydrotherapeutic program consisted of a structured combination of daily home-based external warm- and cold-water applications.Results Baseline characteristics were balanced between the groups. With hydrotherapy, a significant (Pless than or equal to.05) improvement in 3 of 6 dimensions of quality of life (mood, physical capacity, enjoyment) and a significant reduction in heart-failure-related symptoms was found. Heart rates at rest and at 50-Watt workload were significantly reduced by hydrotherapy; blood pressure decreased nonsignificantly at rest and during exercise. The hydrotherapeutic treatment was well accepted and no relevant adverse effects were observed.Conclusions A home-based hydrotherapeutic thermal treatment program improves quality of life, heart-failure-related symptoms and heart rate response to exercise in patients with mild chronic heart failure. The results of this investigation suggest a beneficial adaptive response to repeated brief cold stimuli in addition to enhanced peripheral perfusion due to thermal hydrotherapy in patients with chronic heart failure.