Phytochemicals as an Alternative or Integrative Option, in Conjunction with Conventional Treatments for Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most abundant form of liver cancer. It accounts for 75–85% of liver cancer cases and, though it ranks globally as the sixth most common cancer, it ranks second in cancer-related mortality. Deaths from HCC are usually due to metastatic spread of the cancer. Unfortunately, there are many challenges and limitations with the latest HCC therapies and medications, making it difficult for patients to receive life-prolonging care. As there is clearly a high demand for alternative therapy options for HCC, it is prudent to turn to plants for the solution, as their phytochemicals have long been used and revered for their many medicinal purposes. This review explores the promising phytochemical compounds identified from pre-clinical and clinical trials being used either independently or in conjunction with already existing cancer therapy treatments. The phytochemicals discussed in this review were classified into several categories: lipids, polyphenols, alkaloids, polysaccharides, whole extracts, and phytochemical combinations. Almost 80% of the compounds failed to progress into clinical studies due to lack of information regarding the toxicity to normal cells and bioavailability. Although large obstacles remain, phytochemicals can be used either as an alternative or integrative therapy in conjunction with existing HCC chemotherapies. In conclusion, phytochemicals have great potential as treatment options for hepatocellular carcinoma.

SENSORY-INTEGRATION THERAPY IN THE TREATMENT OF AGGRESSIVE BEHAVIOR IN CHILDREN WITH MULTIPLE DISABILITIES

In recent years, sensory-integration therapy has emerged as one of the most popular treatments for aggressive behavior in children with different disorders. This article is devoted to an experimental study aimed at determining the effects of sensory-integration therapy on the aggressive behavior of children with multiple disabilities. Eighteen children participated in the study. The registration of the children's behavioral responses for 24 consecutive school days allowed the collection of evidence in support of the thesis in the study. The individual child’s frequency of aggressive behaviors in four domains was recording on 12 days while undergoing sensory-integrative therapy and 12 days without a treatment with sensory-integrative techniques. The following methods were used in the analysis of the results: Paired samples t-tests to test the four null hypotheses, a Shaprio-Wilk test for the assumption of normality, Cohen's d to determine the effect size attributable to the therapy, and descriptive statistics for the dependent variables. The statistical results indicated a high level of significance for the three variables: aggression towards property, physical aggression, and aggression toward self. The obtained average values for the three modules are evidence for the positive effects of the sensory-based therapy in children with emotional and behavioral problems. The fourth variable, verbal aggression did not show a statistically significant difference between the mean values before and after the sensory-based intervention.

Integrative Therapy Combining Chinese Herbal Medicines With Conventional Treatment Reduces the Risk of Cardiovascular Disease Among Patients With Systemic Lupus Erythematosus: A Retrospective Population-Based Cohort Study

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that involves multiple systems and organs. Advanced conventional treatment does not appear to markedly reduce the risk of cardiovascular disease (CVD) among patients with SLE. Chinese medicine is a complementary and alternative medicine system, and some SLE patients in Taiwan also use Chinese herbal medicines (CHMs). Thus, we aimed to investigate whether integrative therapy combining CHMs with conventional therapy reduces the risk of CVD among patients with SLE. We performed a 12-years population-based retrospective cohort study using the “Systemic Lupus Erythematosus Health Database” of the National Health Insurance Research Database (NHIRD) in Taiwan. Patients newly diagnosed with SLE between 2004 and 2013 were divided into CHM and non-CHM groups and followed up until the end of 2015. We applied 1:1 individual matching by age, gender, and year of being newly diagnosed with SLE; accordingly, 2,751 patients were included in both CHM and non-CHM groups after matching. We applied the Cox proportional hazard regression model to determine the risk of CVD in relation to CHM use. During the follow-up period, 407 patients in the CHM group and 469 patients in the non-CHM group developed CVD, with incidence rates of 337 and 422 per 10,000 person-years, respectively. The Cox proportional hazards model demonstrated a significantly decreased risk of CVD among SLE patients using CHMs (adjusted HR: 0.83; 95% CI 0.73–0.95; p = 0.008). Further analyses of different types of CVDs also showed a significantly decreased risk of ischemic stroke in the CHM group (adjusted HR: 0.74; 95% CI 0.57–0.97; p = 0.032). Among the frequently used single herbs and polyherbal formulas, Shu-Jing-Huo-Xue-Tang was associated with a significantly decreased risk of CVD (adjusted HR: 0.76; 95% CI 0.58–0.99; p = 0.041). In conclusion, CHM use reduced the risk of CVD among patients with SLE in Taiwan. Further randomized studies may be needed to determine the definite causal relationship between CHM use and its protective effects against CVD among patients with SLE.

Exercise as Treatment for Neuropathy in the Setting of Diabetes and Pre-diabetic Metabolic Syndrome: a Review of Animal Models and Human Trials

Background: Peripheral neuropathy is among the most common complications of diabetes, but a phenotypically identical distal sensory predominant, painful axonopathy afflicts patients with prediabetic metabolic syndrome, exemplifying a spectrum of risk and continuity of pathogenesis. No pharmacological treatment convincingly improves neuropathy in the setting of metabolic syndrome, but evolving data suggests that exercise may be a promising alternative. Objective: To review in depth current literature regarding exercise treatment of metabolic syndrome neuropathy in humans and animal models, highlight the diverse mechanisms by which exercise exerts beneficial effects, and examine adherence limitations, safety aspects, modes and dose of exercise. Results: Rodent models that recapitulate the organismal milieu of prediabetic metabolic syndrome and the phenotype of its neuropathy provide a strong platform to dissect exercise effects on neuropathy pathogenesis. In these models, exercise reverses hyperglycemia and consequent oxidative and nitrosative stress, improves microvascular vasoreactivity, enhances axonal transport, ameliorates the lipotoxicity and inflammatory effects of hyperlipidemia and obesity, supports neuronal survival and regeneration following injury, and enhances mitochondrial bioenergetics at the distal axon. Prospective human studies are limited in scale, but suggest exercise improves cutaneous nerve regenerative capacity, neuropathic pain, and task-specific functional performance measures of gait and balance. Like other heath behavioral interventions, benefits of exercise are limited by patient adherence. Conclusion: Exercise is integrative therapy that potently reduces cellular inflammatory state and improves distal axonal oxidative metabolism to ameliorate features of neuropathy in metabolic syndrome. Intensity of exercise need not improve cardinal features of metabolic syndrome [e.g. weight, glucose control] to exert beneficial effects.

EFFECT OF SAVASANAAS AN ADJUNCT TO CONVENTIONAL SENSORY INTEGRATION THERAPY ON ANXIETY LEVEL OF CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER.

Attention Decit Hyperactivity Disorder (ADHD) is a neurobehavioral disorder characterized by either signicant difculties of inattention or/ and impulsiveness or a combination of two. This results in hyperactivity.The Children with ADHD often have problems with working memory, organization and time management that make it hard to follow daily routines, It is accompanied by heightened anxiety levels. Savasana has been found to be effective in reducing stress in cardiac conditions. The Savasana may help to reduce anxiety in children with ADHD.The study was conducted to study the effect of Savasana along with conventional sensory integration therapy on anxiety levels of Chidren with ADHD & compare the anxiety level in children with ADHD receiving conventional Sensory integrative therapy. Children meeting inclusion criterion were allocated in two groups and were evaluated on Revised Children`s Manifest Anxiety Scale (RCMAS) at the baseline,at 4 weeks & at 8th week. There was signicant difference in improvement at 8th week follow-up between the groups with p< 0.001. The Savasana being integral part of Yoga, Savasana can help in reducing the anxiety.The parents expressed satisfaction, as they noted reduction in hyperactivity of their child & improved attention during short term activities. They have also reported improvement in their behavior at school.The study on larger population is recommended.

MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study

Post-traumatic stress disorder (PTSD) presents a major public health problem for which currently available treatments are modestly effective. We report the findings of a randomized, double-blind, placebo-controlled, multi-site phase 3 clinical trial (NCT03537014) to test the efficacy and safety of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of patients with severe PTSD, including those with common comorbidities such as dissociation, depression, a history of alcohol and substance use disorders, and childhood trauma. After psychiatric medication washout, participants (n = 90) were randomized 1:1 to receive manualized therapy with MDMA or with placebo, combined with three preparatory and nine integrative therapy sessions. PTSD symptoms, measured with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5, the primary endpoint), and functional impairment, measured with the Sheehan Disability Scale (SDS, the secondary endpoint) were assessed at baseline and at 2 months after the last experimental session. Adverse events and suicidality were tracked throughout the study. MDMA was found to induce significant and robust attenuation in CAPS-5 score compared with placebo (P < 0.0001, d = 0.91) and to significantly decrease the SDS total score (P = 0.0116, d = 0.43). The mean change in CAPS-5 scores in participants completing treatment was −24.4 (s.d. 11.6) in the MDMA group and −13.9 (s.d. 11.5) in the placebo group. MDMA did not induce adverse events of abuse potential, suicidality or QT prolongation. These data indicate that, compared with manualized therapy with inactive placebo, MDMA-assisted therapy is highly efficacious in individuals with severe PTSD, and treatment is safe and well-tolerated, even in those with comorbidities. We conclude that MDMA-assisted therapy represents a potential breakthrough treatment that merits expedited clinical evaluation.

Integrative Treatment of Lung Cancer Patients: Observational Study of 57 Cases

Introduction A retrospective clinical study was performed to identify the characteristics of patients with lung cancer treated with integrative cancer treatment in addition to conventional medicine. Materials and Methods We reviewed medical records for lung cancer patients who visited a single integrative setting in Rome, Italy. A total of 57 patients were included, and the majority had advanced-stage cancer. All of them underwent integrative therapy with nutrition and phytotherapy indications. The diet was designed to reduce most of possible factors promoting cancer proliferation, inflammation, and obesity. Foods with anti-inflammatory, prebiotic, antioxidant, and anticancer properties had been chosen. Herbal supplements with known effects on lung cancer were prescribed. In particular, astragal, apigenine, fucosterol, polydatin, epigallocatechin gallate, cannabis, curcumin, and inositol were used. Furthermore, medical mushrooms and other substances were used to improve the immune system and to reduce chemotherapy side effects. Five key parameters have been evaluated for 2 years starting at the first surgery: nutritional status, immune status, discontinuation of therapy, quality of life, and prognosis of the disease. Results A relevant improvement in parameters relative to nutritional status, immune status, and quality of life has been observed after integrative therapy compared with the same parameters at the first medical visit before starting such approach. Conclusion The results suggest that integrative therapy may have benefits in patients with lung cancer. Even though there are limitations, the study suggests that integrative therapy could improve nutritional status and quality of life, with possible positive effect on overall survival.

CORTICAL INTEGRATIVE THERAPY EFFECTIVENESS IN THE TREATMENT OF POST-CONCUSSION SYNDROME AND MILD TRAUMATIC BRAIN INJURY

Post-Concussion Syndrome (PCS) is a relatively prevalent condition that emerges after sustaining a head injury. Individuals with PCS experience prolonged impairments and distress associated with the injury which can impact the individuals’ quality of life experiences. In this retrospective chart review of refractory adult patients diagnosed with PCS and mild Traumatic Brain Injury (mTBI), the effectiveness of Cortical Integrative Therapy (PedroCIT®) was investigated by comparing measures of postural stability, brain sequencing and timing, and self-reports of physical and psychosocial symptoms of PCS obtained before and after PedroCIT®. Multivariate and Repeated Measures General Linear Models showed improvements across the measures from before to after treatment in all subjects, highlighting the effectiveness of PedroCIT®. To further underscore the capacity of PedroCIT® to elicit improvements in patients who have been resistant to treatment prior to PedroCIT®, the duration of time that the subjects underwent PedroCIT® was compared to the duration of time since the injury to the subjects’ first PedroCIT® intervention session. The findings of this study showed significant improvements from pre- to post-treatment in postural stability, brain sequencing and timing, and self-reported symptoms for patients affected by PCS and mTBI, and treatment outcomes were largely not contingent upon the severity of the condition at the beginning of treatment. Altogether, this retrospective study suggests that refractory individuals affected by PCS and mTBI can benefit from undergoing PedroCIT® and their treatment outcomes may not be related to the degree of impairment presented at the beginning of treatment.

CORTICAL INTEGRATIVE THERAPY FOR THE TREATMENT OF MIGRAINES AND HEADACHES

Migraine is a common neurological disorder that is characterized by a host of symptoms including severe throbbing headaches. In this retrospective chart review, the effectiveness of Cortical Integrative Therapy (PedroCIT®) was examined in adults with migraines. Multivariate General Linear Model (M-GLM) was utilized to determine if the emotional, functional, and overall difficulties, as well as the intensity of pain experienced with headaches decreased from before to after PedroCIT® treatment in individuals with mild to complete disability resulting from headaches. Repeated Measures General Linear Model (RM-GLM) was also used to investigate if postural stability increased from pre- to post-treatment. The results of the M-GLM showed that PedroCIT® was effective in reducing emotional, functional, overall disability, and intensity of pain resulting from headaches. Furthermore, RM-GLM indicated that patients who underwent PedroCIT® improved their postural stability from pre- to post-treatment. Finally, the findings also showed that the duration of the treatment did not have any effect among patients with varied degrees of headache disability. This study illustrates the effectiveness of PedroCIT® in the treatment of headaches and postural instability in migraine patients.