E Ernst

..It is concluded that adulteration of CHMs with synthetic drugs is a potentially serious problem which needs to be addressed by adequate regulatory measures...

..There is a need for further research involving randomized controlled trials into the efficacy of complementary and alternative therapies in the treatment of depression...

..Many of these apparent responses could have been due to other factors including the use of herbal (non-diluted) Arnica, placebo response and natural course of disease...

..The majority of rigorous trial data available to date suggest that ASU is effective for the symptomatic treatment of OA and more research seems warranted. However, the only real long-term trial yielded a largely negative result...

..The efficacy of homeopathic remedies has remained controversial. The homeopathic remedy most frequently studied in placebo-controlled clinical trials is Arnica montana...

..Complementary medicine has become an important aspect of palliative cancer care. This overview is primarily aimed at providing guidance to clinicians regarding some commonly used complementary therapies...

..To evaluate the effectiveness of chiropractic and massage therapy for the reduction of any type of pain...

..In conclusion, the effectiveness of acupuncture as a treatment of depression remains unproven and the authors' findings are consistent with acupuncture effects in depression being indistinguishable from placebo effects...

..This paper provides a systematic review of adverse drug reactions (ADRs) associated with the use of extracts of the herb St. John's wort (Hypericum perfbratum L.) for the treatment of mild to moderate depression...

..69; 95% confidence interval, 3.54-15.83). These data imply that kava extract is superior to placebo as a symptomatic treatment for anxiety. Therefore, kava extract is an herbal treatment option for anxiety that is worthy of consideration...

..It is concluded that the expectations of CAM users are currently not rigorously investigated. Future studies should have a clear focus on specific aspects of this broad question...

..Yet CAM can play an important role in oncology, and that is in supportive and palliative care. Several treatments can decrease the side-effects of cancer drugs or improve quality of life in other ways...

..On the basis of these findings, a rigorous investigation of the effectiveness, safety and costs of CM in rheumatology seems desirable...

..The research required to fill the gaps in present knowledge should have a high priority...

..Generally speaking, complementary and alternative medicine is grossly underresearched. Because of the popularity of complementary and alternative medicine, adequately defining risk-benefit relationships is an urgent matter...

..CAM journals, and most likely CAM itself, are associated with a lack of clinical trials and a bias in favour of positive conclusions...

..Results also show that patient blinding was successful. In conclusion, this study does not provide evidence that this form of acupuncture is effective in the prevention of episodic tension-type headache...

..Acupuncture has been suggested as a treatment for stroke rehabilitation, but the question whether it is effective has not been answered satisfactorily...

..On the basis of current evidence, no complementary/alternative therapy can be recommended as a treatment for premenstrual syndrome...

..The clinical evidence appears promising, however, and more research into this area seems warranted...

..The aims of this systematic review are to update the evidence from rigorous clinical trials for or against the efficacy of feverfew for migraine prevention and to provide a safety profile of this herbal remedy...

..Our knowledge regarding the potential benefit and harm of CAM is insufficient...

..The evidence for this approach is still preliminary but, generally speaking, promising. The challenge for the future is to obtain reliable evidence and to identify those approaches that do more good than harm...

..However, the intake of E. sinica and ephedrine is associated with an increased risk of adverse events. Interventions suggesting positive effects in single RCTs require independent replication...

..Large proportions of patients use herbal medicinal products, and encouraging data in terms of effectiveness exist for some of these. One aspect, however, which is still largely under-investigated is the question of potential harm...

..The objective of this systematic review and meta-analysis was to assess the evidence for or against the effectiveness of spa therapy and balneotherapy for treating low back pain...

..The clinical relevance of the effect is debatable and the lack of robustness means that the result has to be interpreted with caution...

..It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice...

..Herbal medicinal products are often used for the relief of dyspeptic symptoms...

..The aim of this study was to investigate Internet advice offered by "medical herbalists" to a pregnant woman regarding herbal treatment of morning sickness...

..Acupuncture is commonly used to treat back pain. A meta-analysis of clinical trials of acupuncture for this condition came to a positive conclusion whilst a qualitative review was negative...

..These findings should alert us to the possibility of heavy metal content in traditional Indian remedies and motivate us to consider means of protecting consumers from such risks...

..The aim of this study was to investigate whether this representation can be used as a valid method of diagnosis...

..The true prevalence of use of complementary/alternative medicine in the general population remains uncertain...

..It is concluded that regular exercise for women of practically all ages is well advised...

..Sauerbruch are briefly discussed as examples of medical resistance...

..In Germany, for instance, 80% of the Heilpraktiker (nonmedically qualified health practitioners) practice iridology. Ophthalmologists may therefore ask what is iridology and how valuable is it?..

..38; 95% CI, 0.14-1.02). These data demonstrate the equality of artemether and quinine for severe malaria and indicate a trend toward greater effectiveness of artemether in regions where there is recognized quinine resistance...

..Nonetheless the results of these trials collectively imply that massage therapy could be a promising treatment for chronic constipation. Future, more rigorous trials should evaluate its true value...

..The German and Austrian medical profession may have forfeited the chance to learn an important lesson relating to its own past...

..Asian HMPs are most often implicated. It is concluded that HMPs are not free of risk. More research and more information are required in order to maximize consumers' safety...

..It would be foolish not to learn from experiences of the past. Nazi medicine can therefore never be an irrelevant subject of the days gone by...

..Chelation therapy is popular in the United States. The question of whether it does more good than harm remains controversial...

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..One possible reason for this is that the optimal acupuncture technique was not applied or that the technique was not repeated sufficiently often...

..However, several uncertainties remain and, at present, prevent unreserved recommendations...

..It is concluded that recent clinical trials strengthen the case for hypericum as an antidepressant, but more work needs to be done to answer the remaining questions...

..This article is an attempt to systematically review the evidence from randomised clinical trials for or against effectiveness of external TTO in dermatological conditions...

..An important argument against spa treatment has been the supposed lack of evidence for its efficacy. This analysis was undertaken to gather firm data bearing on this problem...

..To summarize the data from randomized controlled trials of acupuncture for temporomandibular joint dysfunction...

..With this high level of prevalence, research into the potential risks and benefits of CM is urgently needed. Dermatologists should consider discussing CM openly with their patients...

..Thus location of trials in terms of journal type and impact factor should be taken into account when the literature on complementary therapies is being examined...

..Research in this area is scarce and with numerous therapies we cannot be sure about efficacy or safety. It follows that our current knowledge gaps urgently needs to be filled...

..The concept that alternative therapies can eliminate toxins and toxicants from the body, i.e. 'alternative detox' (AD) is popular...

..In general, the money spent on CM was modest. It is concluded that CM is frequently used for asthma. Therefore, this area of healthcare would seem to warrant more rigorous investigation...

..Acupuncture is commonly used to treat back pain, but there is no published meta-analysis of trials of its effectiveness for this condition...

..In certain instances they may, however, require some adaptation to fit the special needs of CM. It is concluded that key questions in CM remain unanswered and research efforts to find these answers should be increased...

..A speedy solution to the obvious problems is therefore not in sight. On the basis of these facts, there are hardly any good reasons for introducing the "Heilpraktiker" in Austria...

..Iridologists claim to be able to diagnose medical conditions through abnormalities of pigmentation in the iris. This technique is popular in many countries. Therefore it is relevant to ask whether it is valid...

..Under certain conditions, the clinical use of placebos might therefore be a realistic option. In the final analysis, however, our knowledge for a conclusive risk-benefit evaluation of placebo is incomplete...

..Serious adverse effects continue to be reported. Numerous reviews have produced little convincing evidence that acupuncture is effective in reducing pain. Serious adverse events, including deaths, continue to be reported...

..This study was undertaken to determine if there is any evidence for the clinical efficacy of herbal preparations for the treatment of asthma symptoms...

..Tinnitus is a prevalent condition for which patients may seek treatment with acupuncture since no conventional treatment has been shown to be effective...

..In particular, we should determine the efficacy, safety and expense of these treatments through rigorous, unbiased investigations...

..It is concluded that phyto-anti-inflammatories have considerable, albeit under-researched, potential in the symptomatic treatment of rheumatic disorders...

..This trial was aimed at assessing the efficacy of one form of distant healing on common skin warts...

..To determine the effectiveness of acupuncture for smoking cessation and to examine whether any individual aspect of trials is associated with an effect...

..The aim of this systematic review was to critically evaluate the evidence regarding the adverse effects (AEs) of homeopathy...

..The objective of this systematic review was to assess the effectiveness of spinal manipulations as a treatment for migraine headaches...

..It is concluded that the best clinical evidence does not demonstrate convincingly reflexology to be an effective treatment for any medical condition...

..To review systematically all reports of economic analysis of complementary and alternative medicine...

..In many countries, recent data on the use of complementary and alternative medicine (CAM) are available. However, in England, there is a paucity of such data. We sought to determine the prevalence and predictors of CAM use in England...

..It is concluded that good evidence in this area is scarce. Vis-à-vis the high prevalence of unconventional cancer treatments, rigorous investigations are mandatory, not least for increasing the safety of future patients...

..It is concluded that adverse effects of herbal medicines are an important albeit neglected subject in dermatology, which deserves further systematic investigation...

..Numerous pre-clinical and clinical investigations seem to suggest that Ukrain is pharmacologically active and clinically effective. We wanted therefore to critically evaluate the clinical trial data in the form of a systematic review...

..Exceptions are Garcinia cambogia and yerba mate, which merit further investigation...

..K., CAM has become a respectable area of scientific investigation only during the last decade. In this article, we review the 10 years of CAM research in Britain...

..Only for kava were independent replications available. It was concluded that there is a lack of rigorous studies in this area and that only kava has been shown beyond reasonable doubt to have anxiolytic effects in humans...

..However, the literature indicates that T. wilfordii is associated with serious adverse events which make the risk-benefit analysis for this herb unfavourable. Therefore, we cannot recommend its use...

..Considering the popularity of herbal medicine among chronic obstructive pulmonary disease patients, rigorously designed studies seem warranted...

..Considering its favourable safety profile acupuncture seems an option worthy of consideration particularly for knee OA. Further studies are required particularly for manual or electro-acupuncture in hip OA...

..Acupuncture is often used and frequently advocated for the symptomatic treatment of fibromyalgia. A systematic review has previously demonstrated encouraging findings. As it is now outdated, we wanted to update it...

..Anthroposophic medicine (AM) is popular in Europe. This review is an attempt to critically evaluate the effectiveness and safety of AM. The aim is to contribute to a critical discussion of this subject...

..Nonserious adverse effects occur in 7-11% of all patients. In conclusion, acupuncture remains steeped in controversy. Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response...

..The revised argument should be 'if it helps my patient, I want research undertaken to find out whether more people could benefit from it'...

..The purpose of this study was to conduct a systematic review to examine the evidence for the use of herbal medicines for RA based on randomized clinical trials (RCTs)...

..Clearly, rigorous testing of complementary treatments is possible, and considering their popularity, should be encouraged...

..The results of this trial do not suggest that homeopathic arnica has an advantage over placebo in reducing postoperative pain, bruising and swelling in patients undergoing elective hand surgery...

..The direction of the evidence, however, remained unchanged for all but one therapy. We conclude that the value of complementary therapies in the management of back pain remains encouraging but not fully convincing...