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BMC Nephrology Jun 2013Complementary and Alternative Medicines (CAMs) are increasingly practiced in the general population; it is estimated that over 30% of patients with chronic diseases use... (Review)
Review
Reiki and related therapies in the dialysis ward: an evidence-based and ethical discussion to debate if these complementary and alternative medicines are welcomed or banned.
BACKGROUND
Complementary and Alternative Medicines (CAMs) are increasingly practiced in the general population; it is estimated that over 30% of patients with chronic diseases use CAMs on a regular basis. CAMs are also used in hospital settings, suggesting a growing interest in individualized therapies. One potential field of interest is pain, frequently reported by dialysis patients, and seldom sufficiently relieved by mainstream therapies. Gentle-touch therapies and Reiki (an energy based touch therapy) are widely used in the western population as pain relievers.By integrating evidence based approaches and providing ethical discussion, this debate discusses the pros and cons of CAMs in the dialysis ward, and whether such approaches should be welcomed or banned.
DISCUSSION
In spite of the wide use of CAMs in the general population, few studies deal with the pros and cons of an integration of mainstream medicine and CAMs in dialysis patients; one paper only regarded the use of Reiki and related practices. Widening the search to chronic pain, Reiki and related practices, 419 articles were found on Medline and 6 were selected (1 Cochrane review and 5 RCTs updating the Cochrane review). According to the EBM approach, Reiki allows a statistically significant but very low-grade pain reduction without specific side effects. Gentle-touch therapy and Reiki are thus good examples of approaches in which controversial efficacy has to be balanced against no known side effect, frequent free availability (volunteer non-profit associations) and easy integration with any other pharmacological or non pharmacological therapy. While a classical evidence-based approach, showing low-grade efficacy, is likely to lead to a negative attitude towards the use of Reiki in the dialysis ward, the ethical discussion, analyzing beneficium (efficacy) together with non maleficium (side effects), justice (cost, availability and integration with mainstream therapies) and autonomy (patients' choice) is likely to lead to a permissive-positive attitude.
SUMMARY
This paper debates the current evidence on Reiki and related techniques as pain-relievers in an ethical framework, and suggests that physicians may wish to consider efficacy but also side effects, contextualization (availability and costs) and patient's requests, according also to the suggestions of the Society for Integrative Oncology (tolerate, control efficacy and side effects).
Topics: Complementary Therapies; Evidence-Based Medicine; Humans; Renal Dialysis; Therapeutic Touch; Treatment Outcome
PubMed: 23799960
DOI: 10.1186/1471-2369-14-129 -
Acta Dermato-venereologica Jan 2020Basic mechanisms and pathways of itch signaling are reviewed, with an emphasis on the progress to date as well as remaining challenges in translating current knowledge... (Review)
Review
Basic mechanisms and pathways of itch signaling are reviewed, with an emphasis on the progress to date as well as remaining challenges in translating current knowledge to the clinical treatment of chronic itch. Recent studies reveal 3 subsets of pruriceptive sensory neurons highly expressing itch-related genes. Their fibers project into the spinal cord to activate neurons expressing gastrin releasing peptide (GRP) and its receptor (GRPR), which connect to neurons that express the substance P (NK-1) receptor and project to the parabrachial nucleus and thalamus. Spinal inhibitory interneurons release GABA, glycine and dynorphin to modulate segmental itch transmission. However, near-ly all pruriceptive neurons also respond to algogens such as capsaicin. Alternative theories of itch-pain discrimination, such as intensity or spatial contrast, are based on the observation that focal stimulation of nociceptive nerve endings elicits itch while more wide-spread stimulation elicits pain. These findings cloud the issue of a labeled line for itch- a long-debated but currently unresolved challenge. In higher primates there is a dichotomy of histaminergic and non-histaminergic itch-signaling pathways which is less demarcated in rodents, suggesting species differences. A cardinal symptom of chronic itch is alloknesis, i.e., mechanical or touch-evoked itch. Recent evidence indicates that low-threshold mechanosensory afferents can access the spinal itch pathway, but are normally kept in check by inhibitory interneurons expressing neuropeptide Y (NPY). In chronic itch, NPY-mediated inhibition is reduced, allowing touch to excite itch-signaling pathways. These recent advances provide novel targets for development of therapeutic strategies to relieve chronic itch.
Topics: Animals; Antipruritics; Biomedical Research; Humans; Pruritus; Signal Transduction; Skin
PubMed: 31940043
DOI: 10.2340/00015555-3343 -
Integrative Cancer Therapies Jan 2014This mixed methods study sought to evaluate the outcomes of an integrative Reiki volunteer program in an academic medical oncology center setting.
OBJECTIVE
This mixed methods study sought to evaluate the outcomes of an integrative Reiki volunteer program in an academic medical oncology center setting.
METHOD
We used de-identified program evaluation data to perform both quantitative and qualitative analyses of participants' experiences of Reiki sessions. The quantitative data were collected pre- and postsession using a modified version of the distress thermometer. The pre- and postsession data from the distress assessment were analyzed using a paired Student's : test. The qualitative data were derived from written responses to open-ended questions asked after each Reiki session and were analyzed for key words and recurring themes.
RESULTS
Of the 213 pre-post surveys of first-time sessions in the evaluation period, we observed a more than 50% decrease in self-reported distress (from 3.80 to 1.55), anxiety (from 4.05 to 1.44), depression (from 2.54 to 1.10), pain (from 2.58 to 1.21), and fatigue (from 4.80 to 2.30) with P < .001 for all. Using conservative estimates that treat missing data as not endorsing Reiki, we found 176 (82.6%) of participants liked the Reiki session, 176 (82.6%) found the Reiki session helpful, 157 (73.7%) plan to continue using Reiki, and 175 (82.2%) would recommend Reiki to others. Qualitative analyses found that individuals reported that Reiki induced relaxation and enhanced spiritual well-being.
CONCLUSIONS
An integrative Reiki volunteer program shows promise as a component of supportive care for cancer patients. More research is needed to evaluate and understand the impact that Reiki may have for patients, caregivers, and staff whose lives have been affected by cancer.
Topics: Data Collection; Female; Humans; Integrative Medicine; Male; Neoplasms; Program Evaluation; Surveys and Questionnaires; Therapeutic Touch
PubMed: 24105356
DOI: 10.1177/1534735413503547 -
Revista Latino-americana de Enfermagem Nov 2016to evaluate the effectiveness of massage and reiki in the reduction of stress and anxiety in clients at the Institute for Integrated and Oriental Therapy in Sao Paulo... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
to evaluate the effectiveness of massage and reiki in the reduction of stress and anxiety in clients at the Institute for Integrated and Oriental Therapy in Sao Paulo (Brazil).
METHOD
clinical tests randomly done in parallel with an initial sample of 122 people divided into three groups: Massage + Rest (G1), Massage + Reiki (G2) and a Control group without intervention (G3). The Stress Systems list and the Trace State Anxiety Inventory were used to evaluate the groups at the start and after 8 sessions (1 month), during 2015.
RESULTS
there were statistical differences (p = 0.000) according to the ANOVA (Analysis of Variance) for the stress amongst the groups 2 and 3 (p = 0.014) with a 33% reductions and a Cohen of 0.78. In relation to anxiety-state, there was a reduction in the intervention groups compared with the control group (p < 0.01) with a 21% reduction in group 2 (Cohen of 1.18) and a 16% reduction for group 1 (Cohen of 1.14).
CONCLUSION
Massage + Reiki produced better results amongst the groups and the conclusion is for further studies to be done with the use of a placebo group to evaluate the impact of the technique separate from other techniques. RBR-42c8wp.
Topics: Adult; Anxiety; Female; Humans; Male; Massage; Stress, Psychological; Therapeutic Touch
PubMed: 27901219
DOI: 10.1590/1518-8345.1614.2834 -
Journal of Evidence-based Complementary... Oct 2017This study reviews the available clinical studies of Reiki to determine whether there is evidence for Reiki providing more than just a placebo effect. The available... (Review)
Review
This study reviews the available clinical studies of Reiki to determine whether there is evidence for Reiki providing more than just a placebo effect. The available English-language literature of Reiki was reviewed, specifically for peer-reviewed clinical studies with more than 20 participants in the Reiki treatment arm, controlling for a placebo effect. Of the 13 suitable studies, 8 demonstrated Reiki being more effective than placebo, 4 found no difference but had questionable statistical resolving power, and only one provided clear evidence for not providing benefit. Viewed collectively, these studies provide reasonably strong support for Reiki being more effective than placebo. From the information currently available, Reiki is a safe and gentle "complementary" therapy that activates the parasympathetic nervous system to heal body and mind. It has potential for broader use in management of chronic health conditions, and possibly in postoperative recovery. Research is needed to optimize the delivery of Reiki.
Topics: Heart Rate; Humans; Therapeutic Touch; Vagus Nerve
PubMed: 28874060
DOI: 10.1177/2156587217728644 -
Revista Brasileira de Enfermagem 2021to understand the meanings of Reiki therapy in the Unified Health System, based on the experiences of users and therapists.
OBJECTIVES
to understand the meanings of Reiki therapy in the Unified Health System, based on the experiences of users and therapists.
METHODS
thematic oral history study, conducted with 12 users and 11 Reiki therapists, in three public health services, in the city of São Paulo, SP, in 2018. The interviews were transcribed and categorized, through thematic content analysis, with the help of the Atlas.ti software.
RESULTS
for the interviewees, Reiki activates a universal energy, offering benefits to the body, mind, and spirit. The engagement of therapists in such practice was motivated by the desire to carry out voluntary work. Users claim to seek this therapy to overcome a state of suffering and use natural practices.
FINAL CONSIDERATIONS
the meanings and experiences with Reiki therapy are many, but they converge in the understanding of this practice as a producer of health, well-being, and quality of life, through care centered on the integral human being.
Topics: Brazil; Delivery of Health Care; Health Facilities; Humans; Quality of Life; Therapeutic Touch
PubMed: 33787777
DOI: 10.1590/0034-7167-2019-0816 -
American Journal of Physiology.... Mar 2021The extensive investigation of the human microbiome and the accumulating evidence regarding its critical relationship to human health and disease has advanced... (Review)
Review
The extensive investigation of the human microbiome and the accumulating evidence regarding its critical relationship to human health and disease has advanced recognition of its potential as the next frontier of drug development. The rapid development of technologies, directed at understanding the compositional and functional dynamics of the human microbiome, and the ability to mine for novel therapeutic targets and biomarkers are leading innovative efforts to develop microbe-derived drugs that can prevent and treat autoimmune, metabolic, and infectious diseases. Increasingly, academics, biotechs, investors, and large pharmaceutical companies are partnering to collectively advance various therapeutic modalities ranging from live bacteria to small molecules. We review the leading platforms in current development focusing on live microbial consortia, engineered microbes, and microbial-derived metabolites. We will also touch on how the field is addressing and challenging the traditional definitions of pharmacokinetics and pharmacodynamics, dosing, toxicity, and safety to advance the development of these novel and cutting-edge therapeutics into the clinic.
Topics: Animals; Anti-Bacterial Agents; Bacteria; Biological Therapy; Drug Design; Gastrointestinal Agents; Gastrointestinal Microbiome; Humans
PubMed: 33264062
DOI: 10.1152/ajpgi.00381.2019 -
Missouri Medicine 2023A number of chronic skin diseases, such as vitiligo and alopecia areata, are historically resistant to or respond poorly to treatment. Additionally, disorders such as... (Review)
Review
A number of chronic skin diseases, such as vitiligo and alopecia areata, are historically resistant to or respond poorly to treatment. Additionally, disorders such as atopic dermatitis and psoriasis have subtypes that are inadequately treated by current medications. Lastly, in the field of dermatology there are a number of conditions, some genetic (such as Darier's disease and Hailey-Hailey disease) and others caused by aberrant inflammatory responses (macrophage-driven conditions such as sarcoidosis and autoimmune conditions such as localized scleroderma) where effective treatments have been limited to date. A new class of anti-inflammatory medications that inhibit the Janus Kinase-Signal transducer and activator of transcription pathway (JAK-STAT) show great promise in providing new and effective treatment of these formerly recalcitrant conditions. This brief review will cover inhibitors of the JAK-STAT pathway (JAK inhibitors) currently approved for use in treating dermatologic diseases including several very recently approved medications. It will also touch on additional conditions under study or where early reports of efficacy are promising.
Topics: Humans; Janus Kinase Inhibitors; Janus Kinases; STAT Transcription Factors; Signal Transduction; Skin Care
PubMed: 36860609
DOI: No ID Found -
Cureus Mar 2022Enhanced recovery after surgery (ERAS) protocols are the current standard of care when it comes to improving post-surgical outcomes in breast cancer patients. Compliance... (Review)
Review
Enhanced recovery after surgery (ERAS) protocols are the current standard of care when it comes to improving post-surgical outcomes in breast cancer patients. Compliance with all protocol items is required in order for patients to experience significant benefits. Given that the ERAS protocols involve numerous medications which each have unique side effect profiles and medication interactions, this is often difficult to accomplish. Additionally, breast cancer patients are often left with a large psychological burden, which ERAS protocols fail to address. This review aims to determine the role that alternative therapies can play in improving both the emotional and physical strains patients experience during the post-operative stage of recovery. A PubMed search was conducted using the following search terms ("alternative medicine" or "complementary medicine" or "integrative medicine" or "holistic medicine" or "natural medicine" or "mediation" or "aromatherapy" or "music" or "art" or "reiki" or "massage") and ("surgery") and ("pain"). Studies selected for this review include articles published or translated in English that addressed alternative medical interventions affecting pre-, peri-, or post-operative outcomes in breast biopsies, surgeries, or breast-related procedures. Eighteen articles fit the inclusion criteria, with seven addressing music, five addressing meditation, yoga, and guided imagery, five addressing massage, one addressing myofascial release, four addressing aromatherapy, two addressing acupuncture, and three addressing hypnosis. Most forms of alternative therapies offered some benefit to patients following breast-related procedures, many resulting in improvements in post-operative outcomes including pain, fatigue, energy, stress, anxiety, mood, and depression. The reviewed studies demonstrated numerous benefits to integrating alternative medicine into standardized therapy to improve postoperative outcomes. Most studies analyzed did not include placebo controls as including proper placebos was often not feasible. Future studies with larger sample sizes are needed to better quantify the benefits patients receive from these noninvasive, low-risk complementary therapies.
PubMed: 35481320
DOI: 10.7759/cureus.23443 -
Frontiers in Rehabilitation Sciences 2022How, and how much, physiotherapists should touch in practice is once again being debated by the profession. COVID-19 and people's enforced social isolation, combined...
How, and how much, physiotherapists should touch in practice is once again being debated by the profession. COVID-19 and people's enforced social isolation, combined with the growth of virtual technologies, and the profession's own turn away from so-called "passive" therapies, has placed therapeutic touch once again in an uncertain position. The situation is more ambiguous and uncertain because, despite its historical importance to the profession, physiotherapists have never articulated a comprehensive philosophy of touch, taking-for-granted its seeming obviousness as either a bio-physical or inter-subjective phenomenon. But both of these approaches are limited, with one failing to account for the existential and socio-cultural significance of touch, and the other rejecting the reality of the physical body altogether. And both are narrowly humanistic. Since touch occurs between all entities throughout the cosmos, and human touch makes up only an infinitesimally small part of this, physiotherapy's approach to touch seems paradoxically to be at the same time both highly reductive ontologically vague. Given physiotherapists' much vaunted claim to be experts in therapeutic touch, it would seem timely to theorize how touch operates and when touch becomes therapeutic. In this paper I draw on Gilles Deleuze's machine ontology as a new way to think about touch. Critiquing existing approaches, I argue that machine ontology provides a more robust and inclusive philosophy of touch, pointing to some radical new possibilities for the physical therapies.
PubMed: 36189047
DOI: 10.3389/fresc.2022.934698