Pushing the envelope of nutrition support: complementary therapies

Use of alternative medicines by patients with OA that adversely interact with commonly prescribed medications

Owing to the increasing prevalence, patient interest, and high risk of adverse effects associated with use of complementary and alternative medicine (CAM), investigation of this issue in an orthopaedic population is warranted. The objectives of this study were to (1) identify the prevalence of CAM use, (2) assess the level of communication between patients and physicians regarding CAMs, (3) uncover reasons for nondisclosure, and (4) identify potentially harmful interactions between CAMs and conventional therapy. We conducted a cross-sectional observational study among patients being treated in orthopaedic surgical clinics for osteoarthritis (OA). Of the 373 participants, 42.9% reported taking one or more CAMs, and 40.6% admitted their surgeons were unaware of their alternative therapy use. Reasons for nondisclosure included, the patient thought: (1) it was not important (29.7%); (2) the surgeon would not be interested (13.5%); and (3) their surgeon would not know about CAMs (8.2%). Twenty-two of 281 patients (7.8%) were taking alternative medicines that could interact with their blood pressure medication, 28.6% were taking anticoagulant/antiplatelet medication and also taking a CAM that could interact, and 5.9% were taking conventional pain medications along with a CAM that potentially could interact. Orthopaedic surgeons should make it part of their consultation to inquire about CAM use.

LEVEL OF EVIDENCE

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Herbs or Natural Products That Protect Against Cancer Growth: Part Three of a Four-Part Series

PURPOSE/OBJECTIVES

To provide evidence-based research information about 47 herbs and natural products that have the potential to protect against the development of cancer.

DATA SOURCES

Natural Medicines Comprehensive Database and Lawrence Review of Natural Products-Monograph System. Information about these herbs has been found in evidence-based studies cited in the references.

DATA SYNTHESIS

Early research shows that some herbs and natural products appear to have the potential to prevent cancer growth.

CONCLUSIONS

This preliminary evidence may be useful to healthcare professionals or patients who are concerned about cancer.

IMPLICATIONS FOR NURSING

Oncology nurses who receive this information can become resources for patients or other healthcare professionals.

Possible contraindications and adverse reactions associated with the use of ocular nutritional supplements

The role of oxidation in the development of age-related eye disease has prompted interest in the use of nutritional supplementation for prevention of onset and progression. Our aim is to highlight possible contraindications and adverse reactions of isolated or high dose ocular nutritional supplements. Web of Science and PubMed database searches were carried out, followed by a manual search of the bibliographies of retrieved articles. Vitamin A should be avoided in women who may become pregnant, in those with liver disease, and in people who drink heavily. Relationships have been found between vitamin A and reduced bone mineral density, and beta-carotene and increased risk of lung cancer in smoking males. Vitamin E and Ginkgo biloba have anticoagulant and anti-platelet effects respectively, and high doses are contraindicated in those being treated for vascular disorders. Those patients with contraindications or who are considered at risk of adverse reactions should be advised to seek specialist dietary advice via their medical practitioner.