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Medicina
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The Future of Medicine: Frontiers in Integrative Health and Medicine
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The Future of Medicine: Frontiers in Integrative Health and Medicine

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 96848

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Dr. Robert H. Schneider

E-Mail Website
Guest Editor
College of Integrative Medicine; Institute for Natural Medicine and Prevention, Maharishi International University, Institute for Prevention Research, Fairfield, IA, USA
Interests: prevention; integrative medicine; mind-body medicine; traditional systems of medicine; evidence-based medicine
Dr. Mahadevan Seetharaman

E-Mail
Co-Guest Editor
Duke Integrative Healthcare Leader; School Director, AYU Academy; Adjunct Professor for School of Health Sciences, Transdisciplinary University (TDU)
Interests: ayurveda; yoga; integrative healthcare; clinical research; health policy; wellness

Special Issue Information

Dear Colleagues,

Despite advances in modern medicine, contemporary society has experienced epidemics and pandemics of both non-communicable-chronic diseases and communicable-infectious diseases. These public health epidemics and pandemics are related, at least in part, to behavior and lifestyle.

Emerging scientific evidence suggests that the integration of conventional medicine with traditional, complementary, and alternative medicine (TCAM) may be useful for the prevention and treatment of chronic and infectious diseases related to behavior and lifestyle. The aim of this issue is to explore the scientific evidence for these approaches of evidence-based integrative health, which hold promise for the future of medicine.

Traditional, complementary, and alternative medicine (TCAM) is a group of diverse medical and health care approaches that are not presently considered part of conventional, modern medicine. TCAM includes a range of systems and modalities, such as Ayurveda, Yoga, traditional Chinese medicine, other traditional systems of medicine, meditation, herbal medicines and nutritional supplements, movement therapies, and other mind-body practices.

There has been a surge in the public interest and the use of TCAM globally. Nearly 50% of the population in developed nations (United States, 42%; Australia, 48%; France, 49%; Canada, 70%), and similar or greater numbers in developing countries (India, 70%; China, 40%; Chile, 71%; Colombia, 40%; up to 80% in Africa) use some form of TCAM. The World Health Organization and governments of several countries have established agencies to support research and practical utilization of TCAM and integrative health care, also called TCIM (for traditional, complementary, and integrative medicine).

At present, the growing use of integrative health and medicine has stimulated the scientific community to investigate the clinical utility, mechanisms, cost effectiveness and policy implications of these therapies. However, with notable exceptions, much of the research effort has been on quality, safety, and efficacy of TCAM products. This could be due to the potential for exploitation in drug discovery and commercial development. For other TCAM approaches, there is often a dearth of scientific studies or the research that has been conducted is of questionable quality and may lack modern scientific methodology. For ensuring the safe and effective practice of integrative care, there is a critical need to collect more evidence through well-designed scientific studies, to evaluate the available evidence, and to disseminate information—so that policy recommendations for safe and effective use in clinical practice and reimbursement may be made.

Besides the focus on efficacy, mechanisms, safety, clinical and cost effectiveness of integrative medicine, there is a need to educate modern health care practitioners, educators, researchers, policy makers and students on the basic science and theoretical models of TCAM that form the foundation of the practice of integrative medicine.

The goal of this issue of Medicina is to address these gaps in collective understanding and to promote the integration of TCAM into contemporary medicine and public health. This collection of articles will stimulate further research and support healthcare professionals, consumers, and policy makers to make informed decisions about the utilization of evidence-based integrative medicine for the future of healthcare.

Types of manuscripts we are interested in:

  • Original clinical research
    • Experimental studies (controlled clinical trials)
    • Observational studies
  • Reviews of the literature
    • Narrative reviews
    • Systematic reviews
    • Meta-analyses
  • Perspective, opinion, commentary, and theoretical foundations
Dr. Robert H. Schneider
Dr. Mahadevan Seetharaman
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • integrative medicine and health
  • traditional systems of medicine
  • mind-body medicine
  • ayurveda; yoga and meditation
  • communicable and noncommunicable diseases
  • aging
  • prevention
  • health promotion
  • systems medicine
  • evidence-based medicine

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Published Papers (14 papers)

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Editorial

Jump to: Research, Review, Other

7 pages, 419 KiB  
Editorial
The Future of Medicine: Frontiers in Integrative Health and Medicine
by Mahadevan Seetharaman, Geetha Krishnan and Robert H. Schneider
Medicina 2021, 57(12), 1303; https://doi.org/10.3390/medicina57121303 - 28 Nov 2021
Cited by 16 | Viewed by 6054
Abstract
Despite advances in modern medicine, contemporary society has experienced a series of epidemics and pandemics of noncommunicable, chronic diseases and communicable, infectious diseases [...] Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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Research

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18 pages, 2539 KiB  
Article
Transcriptomics of Long-Term Meditation Practice: Evidence for Prevention or Reversal of Stress Effects Harmful to Health
by Supaya Wenuganen, Kenneth G. Walton, Shilpa Katta, Clifton L. Dalgard, Gauthaman Sukumar, Joshua Starr, Frederick T. Travis, Robert Keith Wallace, Paul Morehead, Nancy K. Lonsdorf, Meera Srivastava and John Fagan
Medicina 2021, 57(3), 218; https://doi.org/10.3390/medicina57030218 - 1 Mar 2021
Cited by 6 | Viewed by 5291
Abstract
Background and Objectives: Stress can overload adaptive mechanisms, leading to epigenetic effects harmful to health. Research on the reversal of these effects is in its infancy. Early results suggest some meditation techniques have health benefits that grow with repeated practice. This study [...] Read more.
Background and Objectives: Stress can overload adaptive mechanisms, leading to epigenetic effects harmful to health. Research on the reversal of these effects is in its infancy. Early results suggest some meditation techniques have health benefits that grow with repeated practice. This study focused on possible transcriptomic effects of 38 years of twice-daily Transcendental Meditation® (TM®) practice. Materials and Methods: First, using Illumina® BeadChip microarray technology, differences in global gene expression in peripheral blood mononuclear cells (PBMCs) were sought between healthy practitioners and tightly matched controls (n = 12, age 65). Second, these microarray results were verified on a subset of genes using quantitative polymerase chain reaction (qPCR) and were validated using qPCR in larger TM and control groups (n = 45, age 63). Bioinformatics investigation employed Ingenuity® Pathway Analysis (IPA®), DAVID, Genomatix, and R packages. Results: The 200 genes and loci found to meet strict criteria for differential expression in the microarray experiment showed contrasting patterns of expression that distinguished the two groups. Differential expression relating to immune function and energy efficiency were most apparent. In the TM group, relative to the control, all 49 genes associated with inflammation were downregulated, while genes associated with antiviral and antibody components of the defense response were upregulated. The largest expression differences were shown by six genes related to erythrocyte function that appeared to reflect a condition of lower energy efficiency in the control group. Results supporting these gene expression differences were obtained with qPCR-measured expression both in the well-matched microarray groups and in the larger, less well-matched groups. Conclusions: These findings are consistent with predictions based on results from earlier randomized trials of meditation and may provide evidence for stress-related molecular mechanisms underlying reductions in anxiety, post-traumatic stress disorder (PTSD), cardiovascular disease (CVD), and other chronic disorders and diseases. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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Review

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12 pages, 342 KiB  
Review
Antiviral and Immunomodulation Effects of Artemisia
by Suhas G. Kshirsagar and Rammohan V. Rao
Medicina 2021, 57(3), 217; https://doi.org/10.3390/medicina57030217 - 27 Feb 2021
Cited by 38 | Viewed by 7610
Abstract
Background and Objectives: Artemisia is one of the most widely distributed genera of the family Astraceae with more than 500 diverse species growing mainly in the temperate zones of Europe, Asia and North America. The plant is used in Chinese and Ayurvedic systems [...] Read more.
Background and Objectives: Artemisia is one of the most widely distributed genera of the family Astraceae with more than 500 diverse species growing mainly in the temperate zones of Europe, Asia and North America. The plant is used in Chinese and Ayurvedic systems of medicine for its antiviral, antifungal, antimicrobial, insecticidal, hepatoprotective and neuroprotective properties. Research based studies point to Artemisia’s role in addressing an entire gamut of physiological imbalances through a unique combination of pharmacological actions. Terpenoids, flavonoids, coumarins, caffeoylquinic acids, sterols and acetylenes are some of the major phytochemicals of the genus. Notable among the phytochemicals is artemisinin and its derivatives (ARTs) that represent a new class of recommended drugs due to the emergence of bacteria and parasites that are resistant to quinoline drugs. This manuscript aims to systematically review recent studies that have investigated artemisinin and its derivatives not only for their potent antiviral actions but also their utility against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Materials and Methods: PubMed Central, Scopus and Google scholar databases of published articles were collected and abstracts were reviewed for relevance to the subject matter. Conclusions: The unprecedented impact that artemisinin had on public health and drug discovery research led the Nobel Committee to award the Nobel Prize in Physiology or Medicine in 2015 to the discoverers of artemisinin. Thus, it is clear that Artemisia’s importance in indigenous medicinal systems and drug discovery systems holds great potential for further investigation into its biological activities, especially its role in viral infection and inflammation. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
12 pages, 350 KiB  
Review
Natural Products and Nutrients against Different Viral Diseases: Prospects in Prevention and Treatment of SARS-CoV-2
by Syed Ghazanfar Ali, Mohammad Azam Ansari, Mohammad A. Alzohairy, Ahmad Almatroudi, Mohammad N. Alomary, Saad Alghamdi, Suriya Rehman and Haris M. Khan
Medicina 2021, 57(2), 169; https://doi.org/10.3390/medicina57020169 - 14 Feb 2021
Cited by 11 | Viewed by 3922
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused a global pandemic and is posing a serious challenge to mankind. As per the current scenario, there is an urgent need for antiviral that could act as a protective and therapeutic against SARS-CoV-2. Previous studies [...] Read more.
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused a global pandemic and is posing a serious challenge to mankind. As per the current scenario, there is an urgent need for antiviral that could act as a protective and therapeutic against SARS-CoV-2. Previous studies have shown that SARS-CoV-2 is much similar to the SARS-CoV bat that occurred in 2002-03. Since it is a zoonotic virus, the exact source is still unknown, but it is believed bats may be the primary reservoir of SARS-CoV-2 through which it has been transferred to humans. In this review, we have tried to summarize some of the approaches that could be effective against SARS-CoV-2. Firstly, plants or plant-based products have been effective against different viral diseases, and secondly, plants or plant-based natural products have the minimum adverse effect. We have also highlighted a few vitamins and minerals that could be beneficial against SARS-CoV-2. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
16 pages, 1206 KiB  
Review
On the Neurobiology of Meditation: Comparison of Three Organizing Strategies to Investigate Brain Patterns during Meditation Practice
by Frederick Travis
Medicina 2020, 56(12), 712; https://doi.org/10.3390/medicina56120712 - 18 Dec 2020
Cited by 10 | Viewed by 5982
Abstract
Three broad organizing strategies have been used to study meditation practices: (1) consider meditation practices as using similar processes and so combine neural images across a wide range of practices to identify the common underlying brain patterns of meditation practice, (2) consider meditation [...] Read more.
Three broad organizing strategies have been used to study meditation practices: (1) consider meditation practices as using similar processes and so combine neural images across a wide range of practices to identify the common underlying brain patterns of meditation practice, (2) consider meditation practices as unique and so investigate individual practices, or (3) consider meditation practices as fitting into larger categories and explore brain patterns within and between categories. The first organizing strategy combines meditation practices defined as deep concentration, attention to external and internal stimuli, and letting go of thoughts. Brain patterns of different procedures would all contribute to the final averages, which may not be representative of any practice. The second organizing strategy generates a multitude of brain patterns as each practice is studied individually. The rich detail of individual differences within each practice makes it difficult to identify reliable patterns between practices. The third organizing principle has been applied in three ways: (1) grouping meditations by their origin—Indian or Buddhist practices, (2) grouping meditations by the procedures of each practice, or (3) grouping meditations by brain wave frequencies reported during each practice. Grouping meditations by their origin mixes practices whose procedures include concentration, mindfulness, or effortless awareness, again resulting in a confounded pattern. Grouping meditations by their described procedures yields defining neural imaging patterns within each category, and clear differences between categories. Grouping meditations by the EEG frequencies associated with their procedures yields an objective system to group meditations and allows practices to “move” into different categories as subjects’ meditation experiences change over time, which would be associated with different brain patterns. Exploring meditations within theoretically meaningful categories appears to yield the most reliable picture of meditation practices. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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8 pages, 500 KiB  
Review
Ayurveda and Epigenetics
by Hari Sharma and Robert Keith Wallace
Medicina 2020, 56(12), 687; https://doi.org/10.3390/medicina56120687 - 11 Dec 2020
Cited by 14 | Viewed by 11080
Abstract
Ayurveda is a comprehensive, natural health care system that originated in the ancient Vedic times of India. Epigenetics refers to the external modification of DNA that turns genes on and off, affecting gene expression. This occurs without changes in the basic structure of [...] Read more.
Ayurveda is a comprehensive, natural health care system that originated in the ancient Vedic times of India. Epigenetics refers to the external modification of DNA that turns genes on and off, affecting gene expression. This occurs without changes in the basic structure of the DNA. This gene expression can have transgenerational effects. The major factors that cause epigenetic changes are lifestyle and behavior, diet and digestion, stress, and environmental factors. Ayurveda addresses these factors, thereby affecting the Deha (body) Prakriti (psychophysiological constitution), which corresponds to the phenotype, and indirectly the Janma (birth) Prakriti, which corresponds to the genotype. Thus, it is proposed that epigenetics is an important mechanism of Ayurveda. This correlation and understanding will lead to better communication and understanding with the current medical system, and lead to better integration of both sciences in the management of optimal health. In addition, research on Ayurvedic modalities affecting gene expression will further increase correlation and understanding between the current medical system and Ayurveda. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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7 pages, 433 KiB  
Review
Ayurgenomics and Modern Medicine
by Robert Keith Wallace
Medicina 2020, 56(12), 661; https://doi.org/10.3390/medicina56120661 - 30 Nov 2020
Cited by 13 | Viewed by 8235
Abstract
Within the disciplines of modern medicine, P4 medicine is emerging as a new field which focuses on the whole patient. The development of Ayurgenomics could greatly enrich P4 medicine by providing a clear theoretical understanding of the whole patient and a practical application [...] Read more.
Within the disciplines of modern medicine, P4 medicine is emerging as a new field which focuses on the whole patient. The development of Ayurgenomics could greatly enrich P4 medicine by providing a clear theoretical understanding of the whole patient and a practical application of ancient and modern preventative and therapeutic practices to improve mental and physical health. One of the most difficult challenges today is understanding the ancient concepts of Ayurveda in terms of modern science. To date, a number of researchers have attempted this task, of which one of the most successful outcomes is the creation of the new field of Ayurgenomics. Ayurgenomics integrates concepts in Ayurveda, such as Prakriti, with modern genetics research. It correlates the combination of three doshas, Vata, Pitta and Kapha, with the expression of specific genes and physiological characteristics. It also helps to interpret Ayurveda as an ancient science of epigenetics which assesses the current state of the doshas, and uses specific personalized diet and lifestyle recommendations to improve a patient’s health. This review provides a current update of this emerging field. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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12 pages, 545 KiB  
Review
The Microbiome in Health and Disease from the Perspective of Modern Medicine and Ayurveda
by Robert Keith Wallace
Medicina 2020, 56(9), 462; https://doi.org/10.3390/medicina56090462 - 11 Sep 2020
Cited by 18 | Viewed by 12127
Abstract
The role of the microbiome in health and disease helps to provide a scientific understanding of key concepts in Ayurveda. We now recognize that virtually every aspect of our physiology and health is influenced by the collection of microorganisms that live in various [...] Read more.
The role of the microbiome in health and disease helps to provide a scientific understanding of key concepts in Ayurveda. We now recognize that virtually every aspect of our physiology and health is influenced by the collection of microorganisms that live in various parts of our body, especially the gut microbiome. There are many external factors which influence the composition of the gut microbiome but one of the most important is diet and digestion. Ayurveda and other systems of traditional health have for thousands of years focused on diet and digestion. Recent research has helped us understand the connection between the microbiome and the many different prevention and therapeutic treatment approaches of Ayurveda. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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Graphical abstract

19 pages, 1173 KiB  
Review
Asthma: New Integrative Treatment Strategies for the Next Decades
by Diego A. Arteaga-Badillo, Jacqueline Portillo-Reyes, Nancy Vargas-Mendoza, José A. Morales-González, Jeannett A. Izquierdo-Vega, Manuel Sánchez-Gutiérrez, Isela Álvarez-González, Ángel Morales-González, Eduardo Madrigal-Bujaidar and Eduardo Madrigal-Santillán
Medicina 2020, 56(9), 438; https://doi.org/10.3390/medicina56090438 - 28 Aug 2020
Cited by 13 | Viewed by 6033
Abstract
Asthma is a chronic disease whose main anatomical–functional alterations are grouped into obstruction, nonspecific bronchial hyperreactivity, inflammation and airway remodeling. Currently, the Global Initiative of Asthma 2020 (GINA 2020) suggests classifying it into intermittent cases, slightly persistent, moderately persistent and severely persistent, thus [...] Read more.
Asthma is a chronic disease whose main anatomical–functional alterations are grouped into obstruction, nonspecific bronchial hyperreactivity, inflammation and airway remodeling. Currently, the Global Initiative of Asthma 2020 (GINA 2020) suggests classifying it into intermittent cases, slightly persistent, moderately persistent and severely persistent, thus determining the correct guidelines for its therapy. In general, the drugs used for its management are divided into two groups, those with a potential bronchodilator and the controlling agents of inflammation. However, asthmatic treatments continue to evolve, and notable advances have been made possible in biological therapy with monoclonal antibodies and in the relationship between this disease and oxidative stress. This opens a new path to dietary and herbal strategies and the use of antioxidants as a possible therapy that supports conventional pharmacological treatments and reduces their doses and/or adverse effects. This review compiles information from different published research on risk factors, pathophysiology, classification, diagnosis and the main treatments; likewise, it synthesizes the current evidence of herbal medicine for its control. Studies on integrative medicine (IM) therapies for asthmatic control are critically reviewed. An integrative approach to the prevention and management of asthma warrants consideration in clinical practice. The intention is to encourage health professionals and scientists to expand the horizons of basic and clinical research (preclinical, clinical and integrative medicine) on asthma control. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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Graphical abstract

Other

5 pages, 728 KiB  
Perspective
Vegetarian Diets, Ayurveda, and the Case for an Integrative Nutrition Science
by Archana Purushotham and Alex Hankey
Medicina 2021, 57(9), 858; https://doi.org/10.3390/medicina57090858 - 24 Aug 2021
Cited by 2 | Viewed by 3801
Abstract
Two recent studies of the health effects of vegetarian diets reported conflicting results: the EPIC-Oxford study reported a significant increase in strokes among vegetarians compared to meat-eaters among a predominantly Caucasian cohort, while another, performed on Taiwanese Buddhists, reported significantly lower incidence of [...] Read more.
Two recent studies of the health effects of vegetarian diets reported conflicting results: the EPIC-Oxford study reported a significant increase in strokes among vegetarians compared to meat-eaters among a predominantly Caucasian cohort, while another, performed on Taiwanese Buddhists, reported significantly lower incidence of strokes among vegetarians. This was doubly puzzling given the pronounced decrease in cardiovascular events among the EPIC-Oxford group. In this article, we make a detailed comparison of the actual dietary intake of various food groups by the cohorts in these studies. We then use the nutritional principles of Ayurveda—traditional Indian medicine—to show how these apparently contradictory results may be explained. Systems of traditional medicine such as Ayurveda possess profound knowledge of the effects of food on physiology. Ayurveda takes into account not just the type of food, but also multiple other factors such as taste, temperature, and time of consumption. Traditional cuisines have evolved hand in hand with such systems of medicine to optimize nutrition in the context of local climate and food availability. Harnessing the experiential wisdom of these traditional systems to create an integrative nutrition science would help fight the ongoing epidemic of chronic lifestyle diseases, and improve health and wellness. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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12 pages, 2707 KiB  
Perspective
The Case for Whole-Person Integrative Care
by Wayne B. Jonas and Elena Rosenbaum
Medicina 2021, 57(7), 677; https://doi.org/10.3390/medicina57070677 - 30 Jun 2021
Cited by 27 | Viewed by 8472
Abstract
Rationale: There is a need for medicine to deliver more whole-person care. This is a narrative review of several models of whole-person care and studies that illustrate the business case for whole-person models in primary care. Objectives: To provide an overview of what [...] Read more.
Rationale: There is a need for medicine to deliver more whole-person care. This is a narrative review of several models of whole-person care and studies that illustrate the business case for whole-person models in primary care. Objectives: To provide an overview of what whole-person care models exist and explore evidence to support these models. Study Selection: Representative whole-person care models widely used in the United States are summarized and evaluated. Selected studies focused on outpatient primary care with examples from programs that integrate the delivery of conventional medical care, complementary and alternative medicine, and self-care within the context of social and cultural environments. Methods: Pubmed search conducted December 2020–February 2021. Two iterative searches using terms for “Whole Health Veterans Administration”, “integrative medicine”, “integrative health”, “complementary and alternative medicine”, and, as they related to the outcomes, of “health outcomes”, “cost-effectiveness”, “cost reduction”, “patient satisfaction”, and “physician satisfaction”. Additional studies were identified from an initial search and the authors’ experience of over 50 years. We looked for studies of whole-person care used in general primary care, those not using a single modality and only from United States practices. Results: A total of 125 (out of 1746) studies were found and met our inclusion criteria. We found that whole-person models of primary care exist, are quite heterogeneous in their approaches, and routinely report substantial benefits for improving the patient experience, clinical outcomes and in reducing costs. Conclusions: Evidence for the benefit of whole-person care models exist but definitions are quite heterogenous and unfocused. There is a need for more standardization of whole-person models and more research using whole systems approaches rather than reductionistic attempts using isolated components. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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24 pages, 4321 KiB  
Systematic Review
A Systematic Review and Meta-Analysis of Ayurvedic Herbal Preparations for Hypercholesterolemia
by Dinesh Gyawali, Rini Vohra, David Orme-Johnson, Sridharan Ramaratnam and Robert H. Schneider
Medicina 2021, 57(6), 546; https://doi.org/10.3390/medicina57060546 - 28 May 2021
Cited by 20 | Viewed by 10763
Abstract
Background and Objectives: Cardiovascular disease (CVD) is the leading cause of death globally and hypercholesterolemia is one of the major risk factors associated with CVD. Due to a growing body of research on side effects and long-term impacts of conventional CVD treatments, focus [...] Read more.
Background and Objectives: Cardiovascular disease (CVD) is the leading cause of death globally and hypercholesterolemia is one of the major risk factors associated with CVD. Due to a growing body of research on side effects and long-term impacts of conventional CVD treatments, focus is shifting towards exploring alternative treatment approaches such as Ayurveda. However, because of a lack of strong scientific evidence, the safety and efficacy profiles of such interventions have not been well established. The current study aims to conduct a systematic review and meta-analyses to explore the strength of evidence on efficacy and safety of Ayurvedic herbs for hypercholesterolemia. Methods: Literature searches were conducted using databases including Medline, Cochrane Database, AMED, Embase, AYUSH research portal, and many others. All randomized controlled trials on individuals with hypercholesterolemia using Ayurvedic herbs (alone or in combination) with an exposure period of ≥ 3 weeks were included, with primary outcomes being total cholesterol levels, adverse events, and other cardiovascular events. The search strategy was determined with the help of the Cochrane Metabolic and Endocrine Disorders Group. Two researchers assessed the risk of each study individually and discrepancies were resolved by consensus or consultation with a third researcher. Meta-analysis was conducted using the inverse variance method and results are presented as forest plots and data summary tables using Revman v5.3. Results: A systematic review of 32 studies with 1386 participants found randomized controlled trials of three Ayurvedic herbs, Allium sativum (garlic), Commiphora mukul (guggulu), and Nigella sativa (black cumin) on hypercholesterolemia that met inclusion criteria. The average duration of intervention was 12 weeks. Meta-analysis of the trials showed that guggulu reduced total cholesterol and low-density lipoprotein levels by 16.78 mg/dL (95% C.I. 13.96 to 2.61; p-value = 0.02) and 18.78 mg/dL (95% C.I. 34.07 to 3.48; p = 0.02), respectively. Garlic reduced LDL-C by 10.37 mg/dL (95% C.I. −17.58 to −3.16; p-value = 0.005). Black cumin lowered total cholesterol by 9.28 mg/dL (95% C.I. −17.36, to −1.19, p-value = 0.02). Reported adverse side effects were minimal. Conclusion: There is moderate to high level of evidence from randomized controlled trials that the Ayurvedic herbs guggulu, garlic, and black cumin are moderately effective for reducing hypercholesterolemia. In addition, minimal evidence was found for any side effects associated with these herbs, positioning them as safe adjuvants to conventional treatments. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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5 pages, 221 KiB  
Perspective
The Future of Women and Heart Disease in a Pandemic Era: Let’s Learn from the Past
by Suzanne Steinbaum
Medicina 2021, 57(5), 467; https://doi.org/10.3390/medicina57050467 - 11 May 2021
Cited by 1 | Viewed by 2656
Abstract
When the pandemic started in February, about 5 million women were running businesses. Just 2 months later, 25% of those businesses closed. Approximately 2.5 million women have lost their jobs or dropped out of the workforce since the pandemic, but that is just [...] Read more.
When the pandemic started in February, about 5 million women were running businesses. Just 2 months later, 25% of those businesses closed. Approximately 2.5 million women have lost their jobs or dropped out of the workforce since the pandemic, but that is just the start of the impact on women. Women have been disproportionately affected by the pandemic, as the brunt of homelife has fallen on them, and the psychosocial impact will inevitably have a physical impact. The pandemic has revealed the gender inequality that exists from the socioeconomic perspective, but soon we will see the impact from the medical perspective. Predictably, we know that the impact of stress and lack of self-care that women have had to endure heightens heart disease, already the number one killer of all women. Heart disease is 80% preventable based on the major risk factors: high cholesterol, high blood pressure, elevated sugar, obesity, smoking, sedentary lifestyle, and poor diet. But the psychological risk factors drive up biomarkers and the root causes of manifesting disease. Historically, women have been less diagnosed and treated, and less likely to receive lifesaving care in a timely fashion. The pandemic is sure to amplify these issues. Without mitigation and prevention, women’s hearts will suffer. We need to be aware of this now to prepare for the future potential of a significant increase in the incidence of women and heart disease. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
7 pages, 280 KiB  
Hypothesis
Integrative Medicine and Plastic Surgery: A Synergy—Not an Antonym
by Ioannis-Fivos Megas, Dascha Sophie Tolzmann, Jacqueline Bastiaanse, Paul Christian Fuchs, Bong-Sung Kim, Matthias Kröz, Friedemann Schad, Harald Matthes and Gerrit Grieb
Medicina 2021, 57(4), 326; https://doi.org/10.3390/medicina57040326 - 1 Apr 2021
Cited by 1 | Viewed by 2398
Abstract
Background: Integrative medicine focuses on the human being as a whole—on the body, mind, and spirit—to achieve optimal health and healing. As a synthesis of conventional and complementary treatment options, integrative medicine combines the pathological with the salutogenetic approach of therapy. The aim [...] Read more.
Background: Integrative medicine focuses on the human being as a whole—on the body, mind, and spirit—to achieve optimal health and healing. As a synthesis of conventional and complementary treatment options, integrative medicine combines the pathological with the salutogenetic approach of therapy. The aim is to create a holistic system of medicine for the individual. So far, little is known about its role in plastic surgery. Hypothesis: We hypothesize that integrative medicine based on a conventional therapy with additional anthroposophic therapies is very potent and beneficial for plastic surgery patients. Evaluation and consequence of the hypothesis: Additional anthroposophic pharmacological and non-pharmacological treatments are promising for all areas of plastic surgery. We are convinced that our specific approach will induce further clinical trials to underline its therapeutic potential. Full article
(This article belongs to the Special Issue The Future of Medicine: Frontiers in Integrative Health and Medicine)
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