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Arias-Vázquez PI, Ramírez-Wakamatzu MA, Legorreta-Ramírez BG. Biopuncture, A Multitarget Therapy in the Treatment of Individuals with Knee Osteoarthritis: state of the art. J Pharmacopuncture 2024; 27:190-198. [PMID: 39350927 PMCID: PMC11439516 DOI: 10.3831/kpi.2024.27.3.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 06/05/2024] [Accepted: 07/24/2024] [Indexed: 10/04/2024] Open
Abstract
Objectives The objective of this manuscript was to carry out a comprehensive review of the published information on the use of Biopuncture in patients with knee osteoarthritis. Methods A scientific search was performed using online databases following the terms (Biopuncture) and (Knee Osteoarthritis) to identify scientific manuscripts that were related to the use of Biopuncture in the treatment of individuals with knee osteoarthritis. Results With the information found, a theoretical framework was integrated that describes the components of Biopuncture, its mechanism of action and practical topics for the application of the technique. Conclusion Biopuncture appears to be a potential, simple and low-risk therapeutic strategy in the treatment of knee osteoarthritis, which is applied through periarticular subcutaneous injections, with multitarget mechanisms of action at various physiopathological levels such as the modulation of the inflammatory process, decreased peripheral sensitization, and stimulation of antidegenerative and trophic mechanisms. Perhaps it can be part of the integrative treatments for knee osteoarthritis.
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Affiliation(s)
- Pedro Iván Arias-Vázquez
- Rehabilitation Medicine, Sports Medicine, Department of Rehabilitation, Multidisciplinary Academic Division of Comalcalco, Autonomous Juarez University of Tabasco, Comalcalco Tabasco, México
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Dünkel J, Scheider TO, Tamborrini G. [Muscle injuries: the importance of high-resolution dynamic sonography in diagnostics, treatment and monitoring]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:404-414. [PMID: 38739271 PMCID: PMC11142968 DOI: 10.1007/s00132-024-04505-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Muscle injuries are common in football. Imaging diagnostics have a major role in establishing a diagnosis. The main diagnostic procedures are MRI and ultrasound. Both diagnostics have advantages and disadvantages, which should be balanced against each other. NEW ULTRASONIC TECHNIQUES The role of MRI as the gold standard is increasingly being replaced by high-resolution ultrasound techniques, and MRI imaging is not always useful. To detect complications in the early stages it is advised to perform regular ultrasound-imaging check-ups. The healing process can be monitored, and it offers additional options for ultrasound-guided interventions such as hematoma punctures and targeted infiltrations. ADVANTAGES AND DISADVANTAGES However, ultrasound imaging is highly user dependent. Experienced operators can eliminate this disadvantage, which makes ultrasound a superior imaging system in many areas, especially for dynamic examinations. Nevertheless, MRI imaging remains a necessary imaging method in certain areas.
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Affiliation(s)
- Jörg Dünkel
- Sportklinik Bern, Bümplizstrasse 83, 3018, Bern, Schweiz.
| | | | - Giorgio Tamborrini
- UZR - Schweizer Ultraschallzentrum und Institut für Rheumatologie, Basel, Schweiz
- Klinik für Rheumatologie, Universitätsspital Basel, Basel, Schweiz
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Halabchi F, Tavana MM, Seifi V, Mahmoudi Zarandi M. Medial Gastrocnemius Strain: Clinical Aspects and Algorithmic Approach. Med J Islam Repub Iran 2024; 38:55. [PMID: 39399607 PMCID: PMC11469716 DOI: 10.47176/mjiri.38.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Indexed: 10/15/2024] Open
Abstract
Medial gastrocnemius strain (MGS), is the most common cause of mid-calf pain in athletes due to the stretch of the gastrocnemius muscle when the knee is in extension and the ankle is in dorsiflexion. Chronological age and previous calf injury are the most substantial risk factors for MGS, including high body mass index, previous lower limb injuries, L5 radiculopathy, and inadequate warm-up. The dominant presentation of MGS is a pain that can be diverse from acute to latent, which is felt in the posteromedial aspect of the calf and is often preceded by a feeling of a pop. The signs of MGS include antalgic gait, ecchymosis, swelling, local tenderness, and sometimes a palpable gap felt along the muscle. Passive dorsiflexion of the ankle or resistive ankle plantarflexion with knee extension can indicate a more severe injury, while functional tests can illicit milder injuries of calf muscles-including gastrocnemius. The diagnosis of MGS is usually made by clinical evaluation. However, imaging modalities-including magnetic resonance imaging and ultrasound-can be helpful in case of suspicion. In most cases of MGS, the cornerstone of treatment is nonoperative rehabilitation, which can be performed as a 4-phase program and should be tailored individually. Some instances of MGS are referred for early or later surgical treatment if indicated. In this article, we review the literature about various aspects of MGS, from diagnosis to treatment and rehabilitation, and propose a structured approach to this injury.
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Affiliation(s)
- Farzin Halabchi
- Department of Sports and Exercise Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdi Tavana
- Department of Sports and Exercise Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Seifi
- Department of Sports and Exercise Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Mahmoudi Zarandi
- Department of Sports and Exercise Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Thiele K, Unmann A, Geyer S, Siebenlist S, Scheibel M, Seemann R, Lerchbaumer M, Schoch C, Mader K. Evaluation of the efficiency of an ultrasound-supported infiltration technique in patients with tennis elbow applying the ITEC medical device: a multicenter study. JSES Int 2024; 8:361-370. [PMID: 38464435 PMCID: PMC10920118 DOI: 10.1016/j.jseint.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
Background The treatment of lateral epicondylitis remains unsatisfactory in certain cases. The aim of this study is to investigate the efficiency of an ultrasound-guided infiltration combined with fenestration of the extensor tendon postulating a 50% reduction in pain on exertion within 6 months. Methods In a prospective, nonrandomized, multicenter study design, 68 patients with chronic lateral epicondylitis and symptoms lasted for at least 6 weeks were included. Each hospital has been assigned for Traumeel (A), autologous whole blood (B), or dextrose (C) in advance. Preinterventional, 6 weeks, 12 weeks, 6 and 12 months after infiltration, patient-related outcome parameter, and dorsal wrist extension strength were documented. Preinterventional (obligate) and after 6 months (optional) radiological evaluation (magnetic resonance imaging) was performed. Results The Visual Analog Scale showed a significant reduction after 6 months in all groups (A. 4.8-2.5, B. 6.2-2.3, C. 5.8-2.4). Similar results could be observed with Subjective elbow value, Disabilities of Arm, Shoulder, and Hand Score, Mayo Elbow Performance Score, and Patient Rated Tennis Elbow Evaluation. The loss of strength could be completely compensated after about 6 months. Magnetic resonance imaging did not fully reflect clinical convalescence. Re-infiltrations were sometimes necessary for final reduction of symptoms (A = 11, B = 8, C = 4). Switching to surgical intervention was most frequently observed in group C (A = 2, B = 1, C = 5). In 14.5% of the cases, no improvement of the symptoms could be achieved with this method. Conclusion The primary hypothesis of a significant long-term pain reduction of at least 50% could be achieved regardless of the medication chosen.
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Affiliation(s)
- Kathi Thiele
- Center for Musculoskeletal Surgery, Charité–University of Berlin, Berlin, Germany
| | - Annemarie Unmann
- Center for Musculoskeletal Surgery, Charité–University of Berlin, Berlin, Germany
- Trauma Department, LKH Feldbach, Feldbach, Austria
| | - Stephanie Geyer
- Department of Shoulder and Elbow Surgery, St. Vinzenz Klinik Pfronten, Pfronten, Germany
- Sektion Sportorthopädie, Klinikum rechts der Isar, München, Germany
| | | | - Markus Scheibel
- Center for Musculoskeletal Surgery, Charité–University of Berlin, Berlin, Germany
- Department of Shoulder and Elbow Surgery, Schulthess Klinik, Zürich, Switzerland
| | - Ricarda Seemann
- Center for Musculoskeletal Surgery, Charité–University of Berlin, Berlin, Germany
- Zentrum für Orthopädie&Unfallchirurgie Tettnang, Tettnang, Germany
| | | | - Christian Schoch
- Sektion Sportorthopädie, Klinikum rechts der Isar, München, Germany
| | - Konrad Mader
- Zentrum für Orthopädie&Unfallchirurgie Tettnang, Tettnang, Germany
- Division Hand, Forearm and Elbow Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Gerdesmeyer L, Vester J, Schneider C, Wildemann B, Frank C, Schultz M, Seilheimer B, Smit A, Kerkhoffs G. Topical Treatment Is Effective and Safe for Acute Ankle Sprains: The Multi-Center Double-Blind Randomized Placebo-Controlled TRAUMED Trial. J Clin Med 2024; 13:841. [PMID: 38337536 PMCID: PMC10856131 DOI: 10.3390/jcm13030841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Topical NSAIDs are widely used to treat ankle sprains. Traumed (Tr14) gel is a multicomponent formulation, demonstrating inflammation-resolution properties. METHODS This multicenter, double-blind trial investigated the efficacy and safety of Tr14 gel versus placebo gel and non-inferiority versus 1% diclofenac gel, applied 3×/day for 7 days after acute lateral ankle sprain (EudraCT Number: 2016-004792-50). The primary outcome was AUC for pain on passive movement, assessed by VAS from baseline to Days 4 and 7. RESULTS The trial population included 625 patients aged 18 to 78 years. The AUC scores were 187.88 and 200.75 on Day 4 (p = 0.02) and 294.14 and 353.42 on Day 7 (p < 0.001) for Tr14 and placebo, respectively. For Tr14 compared to diclofenac, the AUC scores were 187.50 and 197.19 on Day 4 (p = 0.3804) and 293.85 and 327.93 on Day 7 (p = 0.0017), respectively. On the FAAM-ADL subscale, Tr14 was superior to placebo and non-inferior to diclofenac at all time points. Time to 50% pain improvement was lowest for Tr14 (6.0 days), compared to placebo (7.1 days) and diclofenac (7.0 days). Adverse events were uncommon and minor. CONCLUSIONS Tr14 gel is effective and safe in acute ankle sprains, compared to placebo gel and diclofenac gel, and has faster pain resolution. TRIAL REGISTRATION The trial was registered in clinicaltrialsregister.eu, EudraCT number 2016-004792-50 on 07.06.2017.
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Affiliation(s)
- Ludger Gerdesmeyer
- Orthopedics and Trauma Surgery, Kiel Municipal Hospital, 24116 Kiel, Germany
| | | | | | - Britt Wildemann
- Experimental Trauma Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany
| | | | | | | | - Alta Smit
- Heel GmbH, 76532 Baden-Baden, Germany
| | - Gino Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Thiele K, Unmann A, Akgün D, Schoch C, Geyer S, Thiele H, Mader K, Siebenlist S. [Infiltration therapies for lateral epicondylopathy]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:379-386. [PMID: 37074369 DOI: 10.1007/s00132-023-04371-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/20/2023]
Abstract
The therapy of the lateral epicondylopathy (tennis elbow) includes drug injection into the extensor tendon insertion in chronic cases. The choice of medication and the type of injection is decisive for the success of therapy. Furthermore, accurate application is indispensable for therapy success (e.g. peppering injection technique, ultrasound-supported injection technique). Corticosteroid injection is often associated with short-term success, so that other options have found their way into everyday practice. Objectification of treatment success is usually defined by Patient-Reported Outcome Measurements (PROM). With the introduction of Minimal Clinically Important Differences (MCID), statistically significant results are put into perspective in terms of clinical significance. Therapy for lateral epicondylopathy was considered effective if the mean difference in score results between baseline and follow-up exceeded 1.5 points for the Visual Analogue Scale (VAS), 16 points for Disabilities of Arm, Shoulder and Hand Score (DASH), 11 points for Patient-Rated Tennis Elbow Evaluation (PRTEE), and 15 points for Mayo Elbow Performance Score (MEPS). However, the effectiveness must still be critically questioned according to meta-analytical evaluations, in which healing within 12 months was found in 90% of the cases of untreated chronic tennis elbow in the placebo groups. The use of substances, such as Traumeel (Biologische Heilmittel Heel GmbH, Baden-Baden, Germany), hyaluronic acid, botulinum toxin, platelet rich plasma (PRP), autologous blood or polidocanol, are based on various mechanisms. In particular, the use of PRP or autologous blood for the treatment of musculotendinous and degenerative articular pathologies has become popular, although the studies regarding effectiveness are inconsistent. PRP can be divided into leukocyte-rich (LR-PRP) and leukocyte-poor plasma (LP-PRP) according to its preparation. In contrast to LP-PRP, LR-PRP incorporates the middle and intermediate layers, but there is no standardized preparation described in the literature. Conclusive data regarding effective efficacy are still pending.
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Affiliation(s)
- Kathi Thiele
- Centrum für Muskuloskeletale Chirurgie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
- Auguste Viktoria Krankenhaus, Klinik für Schulterchirurgie, Rubensstrasse 125, Berlin, Deutschland.
| | - Annemarie Unmann
- Centrum für Muskuloskeletale Chirurgie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
- LKH Feldbach, Feldbach, Österreich
| | - Doruk Akgün
- Centrum für Muskuloskeletale Chirurgie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | | | - Stephanie Geyer
- St. Vinzenz Klinik Pfronten, Pfronten, Deutschland
- Klinikum rechts der Isar, München, Deutschland
| | | | - Konrad Mader
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Shahane K, Kshirsagar M, Tambe S, Jain D, Rout S, Ferreira MKM, Mali S, Amin P, Srivastav PP, Cruz J, Lima RR. An Updated Review on the Multifaceted Therapeutic Potential of Calendula officinalis L. Pharmaceuticals (Basel) 2023; 16:ph16040611. [PMID: 37111369 PMCID: PMC10142266 DOI: 10.3390/ph16040611] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
Calendula officinalis Linn. (CO) is a popular medicinal plant from the plant kingdom's Asteraceae family that has been used for millennia. This plant contains flavonoids, triterpenoids, glycosides, saponins, carotenoids, volatile oil, amino acids, steroids, sterols, and quinines. These chemical constituents confer multifaceted biological effects such as anti-inflammatory, anti-cancer, antihelminthic, antidiabetes, wound healing, hepatoprotective, and antioxidant activities. Additionally, it is employed in cases of certain burns and gastrointestinal, gynecological, ocular, and skin conditions. In this review, we have discussed recent research from the last five years on the therapeutic applications of CO and emphasized its myriad capabilities as a traditional medicine. We have also elucidated CO's molecular mechanisms and recent clinical studies. Overall, this review intends to summarize, fill in the gaps in the existing research, and provide a wealth of possibilities for researchers working to validate traditional claims and advance the safe and effective use of CO in treating various ailments.
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Affiliation(s)
- Kiran Shahane
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India
| | - Madhuri Kshirsagar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India
| | - Srushti Tambe
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India
| | - Divya Jain
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India
| | - Srutee Rout
- Department of Agricultural and Food Engineering, Indian Institute of Technology, Kharagpur 721302, India
| | - Maria Karolina Martins Ferreira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, Brazil
| | - Suraj Mali
- Department of Pharmaceutical Sciences & Technology, Birla Institute of Technology, Mesra 835215, India
| | - Purnima Amin
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India
| | - Prem Prakash Srivastav
- Department of Agricultural and Food Engineering, Indian Institute of Technology, Kharagpur 721302, India
| | - Jorddy Cruz
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, Brazil
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Wolfarth B, Speed C, Raymuev K, Vanden Bossche L, Migliore A. Managing pain and inflammation associated with musculoskeletal disease: time for a change? Curr Med Res Opin 2022; 38:1695-1701. [PMID: 35916625 DOI: 10.1080/03007995.2022.2108618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Bernd Wolfarth
- Department of Sports Medicine, Charité University Hospital and Professor, Humboldt University, Berlin, Germany
| | - Cathy Speed
- Department of Rheumatology, Sport & Exercise Medicine, Spire Cambridge Lea Hospital, Cambridge, UK
| | - Kirill Raymuev
- Department of Rheumatology, North-Western State Medical University I.I. Mechnikov, St Petersburg, Russia
| | - Luc Vanden Bossche
- Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| | - Alberto Migliore
- Department of Medicine, St Peter Fatebenefratelli Hospital, Rome, Italy
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Kalekhan F, Kudva AK, Raghu SV, Rao S, Hegde SK, Simon P, Baliga MS. Traditionally Used Natural Products in Preventing Ionizing Radiation-Induced Dermatitis: First Review on the Clinical Studies. Anticancer Agents Med Chem 2021; 22:64-82. [PMID: 33820524 DOI: 10.2174/1871520621666210405093236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/16/2020] [Accepted: 01/15/2021] [Indexed: 11/22/2022]
Abstract
In the treatment of cancer, the use of ionizing radiation is an important modality. However, on the downside, radiation, when used for curative purposes, causes acute dermatitis or radiodermatitis at the site of radiation in most individuals. From a clinical viewpoint, severe dermatitis causes a burning and itching sensation is very painful, and severely affects the quality of life of the individual undergoing treatment. In worse situations, acute radiation dermatitis can cause gaps or breaks in the planned treatment and this can adversely affect the treatment objective and outcome. BACKGROUND In various traditional and folk systems of medicine, plants and plant products have been used since time immemorial for treating various skin ailments. Further, many cosmeceutical creams formulated based on knowledge from ethnomedicinal use are marketed and used to treat various ailments. In the current review, an attempt is made at summarizing the beneficial effects of some plants and plant products in mitigating acute radiation dermatitis in humans undergoing curative radiotherapy. Additionally, the emphasis is also placed on the mechanism/s responsible for the beneficial effects. OBJECTIVE The objective of this review is to summarize the clinical observations on the prevention of radiodermatitis by plant products. In this review, the protective effects of Adlay (Coix lachryma-jobi L.) bran extract, Aloe vera, Calendula officinalis, Cucumis sativus, green tea constituent the epigallocatechin-3-gallate, honey, Achillea millefolium, Matricaria chamomilla, olive oil and some polyherbal creams are addressed by also addressing on the mechanism of action for the beneficial effects. METHODS Two authors' data mined for information in Google Scholar, PubMed, Embase and the Cochrane Library for publications in the field from 1901 up to July 2020. The focus was on acute radiation dermatitis, ionizing radiation, curative radiotherapy, human cancer. The articles were collected and analyzed. RESULTS For the first time, this review addresses the usefulness of natural products like adlay bran, Aloe vera, Calendula officinalis, Cucumis sativus, green tea constituent the epigallocatechin-3-gallate, honey, Achillea millefolium, Matricaria chamomilla, olive oil and some experimentally constituted and commercially available polyherbal creams as skincare agents against the deleterious effects of ionizing radiation on the skin. The protective effects are possibly due to the free radical scavenging, antioxidant, anti-inflammatory, wound healing and skin protective effects. CONCLUSION The authors suggest that these plants have been used since antiquity as medicinal agents and require in-depth investigation with both clinical and preclinical validated models of study. The results of these studies will be extremely useful to cancer patients requiring curative radiotherapy, the dermatology fraternity, agro-based and pharmaceutical sectors at large.
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Affiliation(s)
- Faizan Kalekhan
- Research Unit, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka. India
| | - Avinash K Kudva
- Department of Biochemistry, Mangalore University, Mangalagangotri, Karnataka. India
| | - Shamprasad V Raghu
- Neurogenetics Laboratory, Department of Applied Zoology, Mangalore University, Mangalagangotri, Karnataka. India
| | - Suresh Rao
- Radiation Oncology, Mangalore Institute of Oncology, Mangalore, Karnataka. India
| | - Sanath K Hegde
- Radiation Oncology, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka. India
| | - Paul Simon
- Research Unit, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka. India
| | - Manjeshwar S Baliga
- Research Unit, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka. India
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Patel A, Blackmore K, Carruthers R. The Integrated Treatment for Chronic Pain and Anxiety in a Patient with Breast Implant Illness Symptoms: A Case Report. Integr Med (Encinitas) 2020; 19:28-33. [PMID: 33132782 PMCID: PMC7572138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Women with breast implants may experience breast implant illness (BII). BII is comprised of a collection of systemic symptoms, such as fatigue and pain, that are postulated to be related to having breast implants. CASE PRESENTATION This case report documents the naturopathic treatment of a 35-year-old female patient diagnosed with fibromyalgia, tension headaches, and chronic anxiety, perceived to be linked to and exacerbated by her textured cohesive gel implants. The patient sought naturopathic treatment for support during the explant process of her breast implants.Naturopathic treatment was provided over a 3-month period in conjunction with prescribed medication for her anxiety and tension headaches. CONCLUSION At 3 months post-naturopathic treatment, the patient experienced a reduction in anxiety, fatigue, and self-reported pain. The integration of alternative therapies with prescribed pharmaceutical treatment appeared to positively impact the health of this patient.
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Affiliation(s)
- Asmita Patel
- South Pacific College of Natural Medicine, Auckland New Zealand; School of Clinical Sciences, Faculty Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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11
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Intramuscular Injection of Combined Calf Blood Compound (CFC) and Homeopathic Drug Tr14 Accelerates Muscle Regeneration In Vivo. Int J Mol Sci 2020; 21:ijms21062112. [PMID: 32204424 PMCID: PMC7139694 DOI: 10.3390/ijms21062112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/12/2022] Open
Abstract
Skeletal muscle injuries in competitive sports cause lengthy absences of athletes from tournaments. This is of tremendous competitive and economic relevance for both the athletes and their respective clubs. Therapy for structural muscle lesions aims to promote regeneration and fast-track return-to-play. A common clinical treatment strategy for muscle injuries is the intramuscular injection of calf blood compound and the homeopathic drug, Tr14. Although the combination of these two agents was reported to reduce recovery time, the regulatory mechanism whereby this occurs remains unknown. In this in vivo study, we selected a rat model of mechanical muscle injury to investigate the effect of this combination therapy on muscle regeneration. Gene expression analysis and histological images revealed that this combined intramuscular injection for muscle lesions can enhance the expression of pro-myogenic genes and proteins and accelerate muscle regeneration. These findings are novel and depict the positive effects of calf blood compound and the homeopathic drug, Tr14, which are utilized in the field of Sports medicine.
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Hui J, Seko K, Shrikhande G, Ahmed T, Hill C, Reutter C, Shrikhande A. A novel, nonopiod‐based treatment approach to men with urologic chronic pelvic pain syndrome using ultrasound‐guided nerve hydrodissection and pelvic floor musculature trigger point injections. Neurourol Urodyn 2019; 39:658-664. [DOI: 10.1002/nau.24242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/04/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Jordan Hui
- Department of Physical Medicine and Rehabilitation, NYU Langone Medical Center Rusk Institute New York New York
| | - Kyle Seko
- Department of Physical Medicine and Rehabilitation, NYU Langone Medical Center Rusk Institute New York New York
| | - Gautam Shrikhande
- Department of Physical Medicine and Rehabilitation Pelvic Rehabilitation Medicine New York New York
- Department of Physical Medicine and Rehabilitation Lenox Hill Hospital New York New York
- Department of Physical Medicine and Rehabilitation, Northwell Health Feinstein Institute for Medical Research Manhasset New York
| | - Tayyaba Ahmed
- Department of Physical Medicine and Rehabilitation Pelvic Rehabilitation Medicine New York New York
- Department of Physical Medicine and Rehabilitation Lenox Hill Hospital New York New York
- Department of Physical Medicine and Rehabilitation, Northwell Health Feinstein Institute for Medical Research Manhasset New York
| | - Charity Hill
- Department of Physical Medicine and Rehabilitation Pelvic Rehabilitation Medicine New York New York
- Department of Physical Medicine and Rehabilitation Lenox Hill Hospital New York New York
- Department of Physical Medicine and Rehabilitation, Northwell Health Feinstein Institute for Medical Research Manhasset New York
| | - Christian Reutter
- Department of Physical Medicine and Rehabilitation Pelvic Rehabilitation Medicine New York New York
- Department of Physical Medicine and Rehabilitation Lenox Hill Hospital New York New York
- Department of Physical Medicine and Rehabilitation, Northwell Health Feinstein Institute for Medical Research Manhasset New York
| | - Allyson Shrikhande
- Department of Physical Medicine and Rehabilitation Pelvic Rehabilitation Medicine New York New York
- Department of Physical Medicine and Rehabilitation Lenox Hill Hospital New York New York
- Department of Physical Medicine and Rehabilitation, Northwell Health Feinstein Institute for Medical Research Manhasset New York
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Plavnik K, Tenaglia A, Hill C, Ahmed T, Shrikhande A. A Novel, Non‐opioid Treatment for Chronic Pelvic Pain in Women with Previously Treated Endometriosis Utilizing Pelvic‐Floor Musculature Trigger‐Point Injections and Peripheral Nerve Hydrodissection. PM R 2019; 12:655-662. [DOI: 10.1002/pmrj.12258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 09/18/2019] [Indexed: 11/05/2022]
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14
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Das R, Deshmukh J, Asif K, Sindhura H, Devarathanamma MV, Jyothi L. Comparative evaluation of analgesic and anti-inflammatory efficacy of ibuprofen and traumeel after periodontal flap surgery: A randomized triple-blind clinical trial. J Indian Soc Periodontol 2019; 23:549-553. [PMID: 31849401 PMCID: PMC6906911 DOI: 10.4103/jisp.jisp_85_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Pain management after performing flap surgery is of paramount importance. Taking into consideration the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs), and the advantages of homeopathic medication, the analgesic and anti-inflammatory properties of ibuprofen (NSAID) and traumeel (homeopathic AID) following flap surgery were evaluated. Materials and Methods: A randomized, triple-blinded, split-mouth clinical trial, with a sample size of 20 (age range of 20–60 years) was planned. Subjects included patients diagnosed with moderate chronic generalized periodontitis. Two quadrants for each subject were operated on, with an interval of 3 weeks. Random assignment of the operated quadrants to the following medication protocols was carried out by a third person: Ibuprofen, 600 mg and traumeel, 600 mg (up to three tablets) every 8 h for first 24 h and SOS (Si Opus Sit/if needed) thereafter for a period of 1 week as pain medication, respectively. After 1 week, sutures were removed. Primary outcomes were mean postoperative pain (modified visual analog scale) and number of tablets consumed in 1 week. The secondary outcome was postoperative tissue response. Any adverse effects were recorded. Results: Number of tablets consumed and pain perception was lower in traumeel compared to ibuprofen Group (P < 0.001). A better tissue response was shown by the group treated with traumeel as compared to the ibuprofen receiving group (P < 0.05). Three patients reported adverse drug reactions after consumption of ibuprofen. Conclusion: The present study suggested that while managing pain following flap surgery, traumeel was superior as compared to ibuprofen, with minimal or no side effects.
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Affiliation(s)
- Revu Das
- Department of Periodontology, Navodaya Dental College and Hospital, Raichur, Karnataka, India
| | - Jeevanand Deshmukh
- Department of Periodontology, Navodaya Dental College and Hospital, Raichur, Karnataka, India
| | - Kardkal Asif
- Department of Periodontology, Navodaya Dental College and Hospital, Raichur, Karnataka, India
| | - Harsha Sindhura
- Department of Periodontology, Navodaya Dental College and Hospital, Raichur, Karnataka, India
| | | | - Lakshminarayana Jyothi
- Department of Periodontology, Navodaya Dental College and Hospital, Raichur, Karnataka, India
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15
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Image guided injection therapies in athletes-Do they work and what should we be using? Eur J Radiol 2018; 110:193-202. [PMID: 30599860 DOI: 10.1016/j.ejrad.2018.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 12/01/2018] [Indexed: 12/18/2022]
Abstract
In the modern management of the injured elite athlete, the goals of guided injection therapies have extended beyond simple reduction of pain to enhancement of tissue healing and accelerated return to competition, faster than natural healing can allow. This article will review the injection therapies which are frequently used in elite sports injury management and describe other less commonly used injection therapies that are available to the treating clinician and athlete. The evidence base, where available, for each treatment option will be summarised.
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16
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Karmali A. Conservative management of MRI-confirmed knee osteoarthritis with instrument-assisted soft-tissue mobilization, joint manipulation, and platelet-rich plasma. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2017; 61:253-260. [PMID: 29430055 PMCID: PMC5799834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To describe the successful conservative management of a patient with chronic degenerative knee pain. CLINICAL FEATURES An active 47 year-old female office-worker with intermittent right knee pain inferolateral to the right patella for eight months described difficulty ascending stairs, sitting on a chair for one hour, and squatting. A physical exam led to the diagnosis of a suspected chronic degenerative tear of the posterior horn of the right medial meniscus and chronic right subpatellar chondrosis, in addition to extensive cartilaginous degeneration revealed by an MRI study conducted prior to initial presentation. INTERVENTION AND OUTCOME A conservative chiropractic treatment plan was implemented in addition to two successive intra-articular and subpatellar platelet-rich plasma injections. The patient reported no pain after sixteen weeks and 93.75% functionality six months after the second injection.
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Affiliation(s)
- Arif Karmali
- Private practice, Calgary, Alberta
- Resident of the Royal College of Chiropractic Sports Sciences (Canada)
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17
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Tieppo Francio V, Dima RS, Towery C, Davani S. Prolotherapy and Low Level Laser Therapy: A Synergistic Approach to Pain Management in Chronic Osteoarthritis. Anesth Pain Med 2017; 7:e14470. [PMID: 29696113 PMCID: PMC5903214 DOI: 10.5812/aapm.14470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 06/02/2017] [Accepted: 10/09/2017] [Indexed: 12/14/2022] Open
Abstract
Regenerative injection therapy and low level laser therapy are alternative remedies known for their success in the treatment and symptomatic management of chronic musculoskeletal conditions. In response to the growing demand for alternative therapies in the face of the opioid epidemic, the authors conduct a literature review to investigate the potential for prolotherapy and LLLT to be used adjunctively to manage chronic osteoarthritis (OA). OA is a degenerative chronic musculoskeletal condition on the rise in North America, and is frequently treated with opioid medications. The regenerative action of prolotherapy and pain-modulating effects of LLLT may make these two therapies well-suited to synergistically provide improved outcomes for osteoarthritis patients without the side effects associated with opioid use. A narrative descriptive review through multiple medical databases (Google Scholar, PubMed, and MedLine) is conducted, restricted by the use of medical subject headings. 71 articles were selected for reading in full, and 40 articles were selected for use in the study after reading in full. A review of the literature revealed good clinical results in the use of prolotherapy and LLLT separately to manage chronic musculoskeletal pain due to osteoarthritis and other chronic conditions. It is also recognized in the literature that prolotherapy works most effectively when used adjunctively with other treatments. Downsides to the use of prolotherapy include mild side effects of pain, stiffness and bruising and potential adverse events as a result of injection. This study is limited by the lack of clinical trials available involving both LLLT and prolotherapy injections used adjunctively, and by the low number of high impact literature concerning the treatment of (specifically) osteoarthritis by alternative methods. The authors suggest that practicing health care providers consider utilizing LLLT and prolotherapy together as a supplementary method in the management of chronic pain due to osteoarthritis, to minimize the long-term prescription of opioids and emphasize a less invasive treatment for this debilitating condition.
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Affiliation(s)
- Vinicius Tieppo Francio
- University of Science, Arts and Technology - USAT College of Medicine, Olveston, Montserrat, BWI
- Essential Integrative Health - Spine, Orthopaedics and Pain Management, Oklahoma City, OK, USA
- Variety Care - Community Health Center, Oklahoma City, OK, USA
- Corresponding author: Vinicius Tieppo Francio, University of Science, Arts and Technology - USAT College of Medicine - Olveston, Montserrat, BWI. E-mail:
| | - Robert S Dima
- School of Interdisciplinary Sciences - McMaster University, Hamilton, ON, Canada
| | - Chris Towery
- University of Science, Arts and Technology - USAT College of Medicine, Olveston, Montserrat, BWI
| | - Saeid Davani
- University of Science, Arts and Technology - USAT College of Medicine, Olveston, Montserrat, BWI
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18
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St Laurent G, Seilheimer B, Tackett M, Zhou J, Shtokalo D, Vyatkin Y, Ri M, Toma I, Jones D, McCaffrey TA. Deep Sequencing Transcriptome Analysis of Murine Wound Healing: Effects of a Multicomponent, Multitarget Natural Product Therapy-Tr14. Front Mol Biosci 2017; 4:57. [PMID: 28879183 PMCID: PMC5572416 DOI: 10.3389/fmolb.2017.00057] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023] Open
Abstract
Wound healing involves an orchestrated response that engages multiple processes, such as hemostasis, cellular migration, extracellular matrix synthesis, and in particular, inflammation. Using a murine model of cutaneous wound repair, the transcriptome was mapped from 12 h to 8 days post-injury, and in response to a multicomponent, multi-target natural product, Tr14. Using single-molecule RNA sequencing (RNA-seq), there were clear temporal changes in known transcripts related to wound healing pathways, and additional novel transcripts of both coding and non-coding genes. Tr14 treatment modulated >100 transcripts related to key wound repair pathways, such as response to wounding, wound contraction, and cytokine response. The results provide the most precise and comprehensive characterization to date of the transcriptome's response to skin damage, repair, and multicomponent natural product therapy. By understanding the wound repair process, and the effects of natural products, it should be possible to intervene more effectively in diseases involving aberrant repair.
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Affiliation(s)
- Georges St Laurent
- St. Laurent InstituteVancouver, WA, United States.,SeqLL, Inc.Woburn, MA, United States
| | | | | | - Jianhua Zhou
- St. Laurent InstituteVancouver, WA, United States.,Nantong UniversityNantong, China
| | - Dmitry Shtokalo
- St. Laurent InstituteVancouver, WA, United States.,A.P.Ershov Institute of Informatics SystemsNovosibirsk, Russia.,AcademGene LLCNovosibirsk, Russia
| | - Yuri Vyatkin
- St. Laurent InstituteVancouver, WA, United States.,AcademGene LLCNovosibirsk, Russia
| | - Maxim Ri
- St. Laurent InstituteVancouver, WA, United States.,AcademGene LLCNovosibirsk, Russia
| | - Ian Toma
- Nantong UniversityNantong, China
| | - Dan Jones
- Biologische Heilmittel Heel GmbHBaden-Baden, Germany
| | - Timothy A McCaffrey
- Division of Genomic Medicine, The George Washington UniversityWashington, DC, United States
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Lozada CJ, del Rio E, Reitberg DP, Smith RA, Kahn CB, Moskowitz RW. A double-blind, randomized, saline-controlled study of the efficacy and safety of co-administered intra-articular injections of Tr14 and Ze14 for treatment of painful osteoarthritis of the knee: The MOZArT trial. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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20
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Muders K, Pilat C, Deuster V, Frech T, Krüger K, Pons-Kühnemann J, Mooren FC. Effects of Traumeel (Tr14) on recovery and inflammatory immune response after repeated bouts of exercise: a double-blind RCT. Eur J Appl Physiol 2017; 117:591-605. [PMID: 28224232 DOI: 10.1007/s00421-017-3554-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/21/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE The purpose of this double-blind, randomized, placebo-controlled clinical trial was to investigate the effects of the natural combination medicine Traumeel (Tr14) consisting of 14 diluted biological and mineral components on the inflammatory immune response and recovery up to 72 h after repetitive bouts of bicycle tests. METHODS Antigen-stimulated IL-1ra and IL-6 were defined as primary outcome measures. Moreover, various immunological and serum muscle damage markers were investigated. The evaluation was performed using the score of the area under the curve with respect to increase (AUCi) for 24 and 72 h after the second exercise test (EX2). RESULTS The Tr14 group indicated a lower decrease of lymphocytes by tendency (p = 0.06) and a lower activation of lymphocyte activation markers (CD62L absolute: p = 0.04; CD69: p = 0.01 and CD69 absolute: p = 0.05) in the period 24 h after EX2. In addition, the Tr14 group indicated a higher expression of antigen-stimulated CCL3 (p = 0.01), CCL4 (p = 0.07) and serum CCL2 (p = 0.05) in the period 24 h after EX2. There was a tendentially lower decrease of monocytes (p = 0.09) and a lower expression of antigen-stimulated MMP-3 (p = 0.01) in the Tr14 group in the period 72 h after EX2. However, antigen-stimulated IL-1ra and IL-6 showed no group differences. CONCLUSION In line with the previous results, it was shown that Tr14 attenuates the adaptive immune response partially. Furthermore, the results indicate that Tr14 is able to stimulate the innate immune system via an increased production of pro-inflammatory chemokines. It is speculated that the higher expression of chemokines might play a role in the regeneration and recovery after exercise.
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Affiliation(s)
- Kerstin Muders
- Department of Sports Medicine, Justus-Liebig-University, Kugelberg 62, 35394, Giessen, Germany.
| | - Christian Pilat
- Department of Sports Medicine, Justus-Liebig-University, Kugelberg 62, 35394, Giessen, Germany
| | - Vanessa Deuster
- Department of Sports Medicine, Justus-Liebig-University, Kugelberg 62, 35394, Giessen, Germany
| | - Torsten Frech
- Department of Sports Medicine, Justus-Liebig-University, Kugelberg 62, 35394, Giessen, Germany
| | - Karsten Krüger
- Department of Sports Medicine, Justus-Liebig-University, Kugelberg 62, 35394, Giessen, Germany
| | | | - Frank-Christoph Mooren
- Department of Sports Medicine, Justus-Liebig-University, Kugelberg 62, 35394, Giessen, Germany
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21
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Effects of Traumeel (Tr14) on Exercise-Induced Muscle Damage Response in Healthy Subjects: A Double-Blind RCT. Mediators Inflamm 2016; 2016:1693918. [PMID: 27478305 PMCID: PMC4949332 DOI: 10.1155/2016/1693918] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 06/02/2016] [Accepted: 06/05/2016] [Indexed: 12/20/2022] Open
Abstract
The present double-blind, randomized, placebo-controlled clinical trial intended to test whether ingestion of a natural combination medicine (Tr14 tablets) affects serum muscle damage and inflammatory immune response after downhill running. 96 male subjects received Tr14 tablets, which consist of 14 diluted biological and mineral components, or a placebo for 72 h after the exercise test, respectively. Changes in postexercise levels of various serum muscle damage and immunological markers were investigated. The area under the curve with respect to the increase (AUCi) of perceived pain score and creatine kinase (CK) were defined as primary outcome measures. While for CK the p value of the difference between the two groups is borderline, the pain score and muscle strength were not statistically significant. However, a trend towards lower levels of muscle damage (CK, p = 0.05; LDH, p = 0.06) in the Tr14 group was shown. Less pronounced lymphopenia (p = 0.02), a trend towards a lower expression of CD69 count (p = 0.07), and antigen-stimulated ICAM-1 (p = 0.01) were found in the verum group. The Tr14 group showed a tendentially lower increase of neutrophils (p = 0.10), BDNF (p = 0.03), stem cell factor (p = 0.09), and GM-CSF (p = 0.09) to higher levels. The results of the current study indicate that Tr14 seems to limit exercise-induced muscle damage most likely via attenuation of both innate and adaptive immune responses. This study was registered with ClinicalTrials.gov (NCT01912469).
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22
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Pilat C, Frech T, Wagner A, Krüger K, Hillebrecht A, Pons-Kühnemann J, Scheibelhut C, Bödeker RH, Mooren FC. Exploring effects of a natural combination medicine on exercise-induced inflammatory immune response: A double-blind RCT. Scand J Med Sci Sports 2014; 25:534-42. [DOI: 10.1111/sms.12265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2014] [Indexed: 12/26/2022]
Affiliation(s)
- C. Pilat
- Department of Sports Medicine; Justus Liebig University; Giessen Germany
| | - T. Frech
- Department of Sports Medicine; Justus Liebig University; Giessen Germany
| | - A. Wagner
- Department of Sports Medicine; Justus Liebig University; Giessen Germany
| | - K. Krüger
- Department of Sports Medicine; Justus Liebig University; Giessen Germany
| | - A. Hillebrecht
- Department of Sports Medicine; Justus Liebig University; Giessen Germany
| | | | - C. Scheibelhut
- Medical Statistics; Justus Liebig University; Giessen Germany
| | - R.-H. Bödeker
- Medical Statistics; Justus Liebig University; Giessen Germany
| | - F.-C. Mooren
- Department of Sports Medicine; Justus Liebig University; Giessen Germany
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Speed C, Wolfarth B. Challenges of pain masking in the management of soft tissue disorders: optimizing patient outcomes with a multi-targeted approach. Curr Med Res Opin 2014; 30:953-9. [PMID: 24730542 DOI: 10.1185/03007995.2014.913412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Current approaches to managing soft tissue injuries often rely upon the use of non-steroidal anti-inflammatory drugs (NSAIDs). The use of NSAIDs in this manner is contentious, and some believe that the risks of using NSAIDs can outweigh any potential benefit. In this article the issues of toxicity, pain masking and return to full activity are reviewed, and an alternative strategy for the management of inflammation in soft tissue injuries is proposed. We consider that a multi-targeted approach has the potential to improve healing, reduce additional injury from premature return to full activity as a consequence of pain masking, and improve prognosis for many patients with soft tissue injuries.
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Affiliation(s)
- Cathy Speed
- Rheumatology, Sport & Exercise Medicine, Cambridge Centre for Health and Performance , Cambridge , UK
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González de Vega C, Speed C, Wolfarth B, González J. Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: a multicentre, randomised, blinded, controlled and non-inferiority trial. Int J Clin Pract 2013; 67:979-89. [PMID: 23889885 PMCID: PMC4231442 DOI: 10.1111/ijcp.12219] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 05/22/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Acute ankle sprains are common and activity limiting injuries, and topical diclofenac gel has proven efficacy in alleviating pain and restoring function. This trial aimed to compare a topical natural agent, Traumeel with topical diclofenac gel (1%) in the management of acute ankle sprain. METHODS This prospective, multicentre, randomised, blinded, active-control and non-inferiority study involved 449 physically active adults sustaining unilateral grade 1 or 2 ankle sprain within the past 24 h. Participants were randomised to receive 2 g of Traumeel ointment (T-O) (n = 152) or Traumeel gel (T-G) (n = 150) or diclofenac gel (D-G) (n = 147), administered topically to the ankle three times a day for 14 days, with 6-weeks follow up. RESULTS Day 7 median percentage reductions in Visual Analogue Scale pain score were 60.6%, 71.1% and 68.9% for the T-O, T-G and D-G groups, respectively. Total pain relief was reported by 12 (8.5%), 7 (5.0%) and 8 (5.9%) participants in each group, respectively. Median improvements in Foot and Ankle Ability Measure Activities of Daily Living subscale score were 26.2, 26.2 and 25.0 points for T-O, T-G and D-G groups, respectively. Mann-Whitney effect sizes and lower bound confidence intervals demonstrated non-inferiority of Traumeel vs. diclofenac for reducing pain and functional improvement. At 6 weeks, participants reported total pain relief and normal functioning. Adverse events (n = 43) were reported by 31/447 participants (6.9%). Treatments were equally well tolerated. CONCLUSIONS T-O and T-G decreased pain and improved joint function to the same extent as D-G in acute ankle sprain, and were well tolerated.
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25
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Arora D, Rani A, Sharma A. A review on phytochemistry and ethnopharmacological aspects of genus Calendula. Pharmacogn Rev 2013; 7:179-87. [PMID: 24347926 PMCID: PMC3841996 DOI: 10.4103/0973-7847.120520] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 05/10/2013] [Accepted: 10/25/2013] [Indexed: 11/04/2022] Open
Abstract
This review includes 84 references on the genus Calendula (Asteraceae) and comprises ethnopharmacology, morphology and microscopy, phytoconstituents, pharmacological reports, clinical studies and toxicology of the prominent species of Calendula. Triterpene alcohols, triterpene saponins, flavonoids, carotenoids and polysaccharides constitute major classes of phytoconstituents of the genus. A few species of this genus have medicinal value, among these Calendula officinalis Linn., has been traditionally used in the treatment of various skin tumors, dermatological lesions, ulcers, swellings and nervous disorders as well as almost 200 cosmetic formulations, i.e., creams, lotions, shampoos. Despite a long tradition of use of some species, the genus has not been explored properly. In the concluding part, the future scope of Calendula species has been emphasized with a view to establish their multifarious biological activities and mode of action.
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Affiliation(s)
- Disha Arora
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Anita Rani
- L. R. Institute of Pharmacy, Solan, Himachal Pradesh, India
| | - Anupam Sharma
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
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Barkey E, Kaszkin-Bettag M. A Homeopathic Arnica Patch for the Relief of Cellulitis-derived Pain and Numbness in the Hand. Glob Adv Health Med 2012; 1:18-20. [PMID: 24278813 PMCID: PMC3833497 DOI: 10.7453/gahmj.2012.1.2.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: Arnica montana, belonging to the Compositae family, is a plant with a longstanding tradition of relieving pain and/or inflammation in muscles and joints and may thus represent an alternative to nonsteroidal antiinflammatory drugs, which are often ineffective or lead to a number of adverse effects. A homeopathic arnica patch (3X dilution according to the Homeopathic Pharmacopoeia of the United States) was developed to alleviate pain symptoms in the back and neck muscles and joints. Case Presentation: The present case report describes the treatment outcome after administration of the arnica patch in a 55-year-old female patient with pain in the right hand and numbness in the fourth finger after cellulitis in the palmar area. The cellulitis was treated with antibiotics, but pain symptoms remained at 7 points on a 0-to-10–point visual analog scale (VAS) for pain despite intake of oral ibuprofen and oral and topical application of an arnica-containing complex homeopathic ointment. Ten arnica patches were dispensed to the patient. She cut the patch into strips to cover all painful areas of the hand and applied them at night. After 3 days, she reported a substantial decrease in pain symptoms (VAS = 1) and a marked decrease in numbness and in the size of a tender nodule on the third metacarpal area. Moreover, the patient was able to sleep through the night without being awakened by the pain. The symptoms declined further during the next 2 days. Conclusion: This case demonstrates that after a relatively short period of time, the administration of the arnica patch on the hand provided a marked reduction of pain and recovery of functionality of the hand.
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Affiliation(s)
- Elisabeth Barkey
- Internal medicine and practices in her private office in Santa Fe, New Mexico
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