Evaluation of healing by gentle touch

OBJECTIVES: To evaluate the effectiveness and safety of healing by gentle touch in clients attending The Centre for Complementary Care (CCC) in Eskdale, Cumbria. STUDY DESIGN: An evaluation of data collected by questionnaire over 6 years. METHODS: All clients attending the CCC between 1995 and 2001 were invited to participate in this study, and data were collected from 300 subjects with a wide range of ailments who received four treatment sessions within 6 weeks. Exclusion criteria were: recent treatment at the CCC; failure to complete four treatment sessions; and age under 16 years. Outcome measures included comparison of pre- and post-treatment levels of physical (pain, disability, immobility, sleep disturbances, reliance upon medication, daily activities) and psychological (stress, panic, fear, anger, relaxation, coping, depression/anxiety) functioning; these were assessed using a questionnaire with visual analogue scales for subjective rating of symptoms and the EuroQoL (EQ-5D), a generic state-of-health measure. RESULTS: Wilcoxon signed ranks tests showed statistically significant improvements in both psychological and physical functioning, particularly in stress reduction (median stress levels fell by four points), pain relief (median pain ratings fell by two points), increased ability to cope (median improvement of three points) and increased general health ratings (median improvement of 20 points) between study entry and end of treatment (P < 0.0004 for all these symptoms). The most substantial improvements were seen in those with the most severe symptoms at study entry. No adverse effects of treatment were documented. CONCLUSIONS: This audit of treatment outcomes provides evidence consistent with the hypothesis that healing, as provided at the CCC, was associated with improved psychological and physical functioning in the majority of subjects, and is worthy of further evaluation.     

Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial

BACKGROUND & AIMS: Nutrients putatively implicated in pressure ulcer healing were evaluated in a clinical setting. METHODS: Sixteen inpatients with a stage 2, 3 or 4 pressure ulcer randomised to receive daily a standard hospital diet; a standard diet plus two high-protein/energy supplements; or a standard diet plus two high-protein/energy supplements containing additional arginine (9 g), vitamin C (500 mg) and zinc (30 mg). Nutritional status measurements (dietary, anthropometric and biochemical) and pressure ulcer size and severity (by PUSH tool; Pressure Ulcer Scale for Healing; 0=completely healed, 17=greatest severity) were measured weekly for 3 weeks. RESULTS: Patients' age and BMI ranges were 37-92 years and 16.4-28.1 k g/m2) respectively. Baseline PUSH scores were similar between groups (8.7+/-0.5). Only patients receiving additional arginine, vitamin C and zinc demonstrated a clinically significant improvement in pressure ulcer healing (9.4+/-1.2 vs. 2.6+/-0.6; baseline and week 3, respectively; P<0.01). All patient groups presented with low serum albumin and zinc and elevated C-reactive protein. There were no significant changes in biochemical markers, oral dietary intake or weight in any group. CONCLUSIONS: In this small set of patients, supplementary arginine, vitamin C and zinc significantly improved the rate of pressure ulcer healing. The results need to be confirmed in a larger study.     

Changes in Gelatinase Activity in the Gastrointestinal Tract After Anastomotic Construction in the Ileum or Colon

PURPOSE The strength of the uninjured and anastomosed intestinal wall is determined by its submucosal connective tissue. Matrix degradation by matrix metalloproteinases may result in loss of strength. It is known that anastomotic construction leads to up-regulation of matrix metalloproteinase activity in the wound area, but no quantitative data are available as to the extent of this effect throughout the intestinal wall. This study was designed to quantitate changes in gelatinolytic activity in the intestine after anastomotic construction in the ileum or colon. METHODS An anastomosis was constructed in the distal ileum or distal colon of rats, and animals were killed after one or three days. Tissue samples (5 mm) were collected containing the suture line, its adjacent segments (2- × 5-mm in both directions) and at nine other, more distant, sites throughout the gastrointestinal tract. Similar samples were collected from nonoperated control rats. All samples were analyzed by quantitative gelatin zymography. RESULTS In control rats, the most prominent gelatinolytic activities were found at 80 kDa, thought to represent a nonspecific proteolytic activity, 60 kDa and 50 kDa, representing the proform and active form of matrix metalloproteinase-2, respectively. Activities were higher in the small bowel than in the large bowel. Anastomotic construction led to massive up-regulation of an activity at 105 kDa, and its dimer, believed to represent promatrix metalloproteinase-9. Matrix metalloproteinase-2 remained unaffected, whereas the activity of the 80 kDa protein was significantly (P < 0.05) reduced. Significantly increased matrix metalloproteinase-9 activity was found in the actual anastomotic segments and in the immediately adjacent tissue. Matrix metalloproteinase-9 activities in the anastomotic segments were highest at Day 1 in the ileum and at Day 3 in the colon. Anastomotic construction in the ileum or colon did not lead to any significant changes of any gelatinolytic activity at the more distant sites in the bowel wall. CONCLUSIONS Up-regulation of gelatinase activity after anastomotic construction in the intestine is caused by matrix metalloproteinase-9. Because the effect is local and not systemic, unwanted matrix degradation at distant sites seems unlikely. Supported by the Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Reprints are not available.     

Does a form of 'entanglement' between people explain healing? An examination of hypotheses and methodology

Quantum entanglement is a phenomenon in which entangled systems exhibit correlations that cannot be explained by classical physics. It has recently been suggested that a similar process occurs between people and explains anomalous phenomena such as healing. This paper explores the hypothesis that the therapeutic interaction involves some kind of 'entanglement' between people. There are several different versions of the theory that entanglement is possible between people: the versions differ in the way entanglement between people is derived, and the way it has a therapeutic effect. The two main versions are generalised, specific entanglement, and global, emergent entanglement-specific entanglement. Two research ideas are presented for testing the hypothesis of entanglement between people, both of which are based on predicting variation in outcome in naturally occurring contexts (the naturalistic observational study).     

The Effect of Calcium and Vitamin D<Subscript>3</Subscript> Supplementation on the Healing of the Proximal Humerus Fracture: A Randomized Placebo-Controlled Study

The purpose of this study was to (1) quantify the healing process of the human osteoporotic proximal humerus fracture (PHF) expressed in terms of callus formation over the fracture region using BMD scanning, and (2) quantify the impact of medical intervention with vitamin D₃ and calcium on the healing process of the human osteoporotic fracture. The conservatively treated PHF was chosen in order to follow the genuine fracture healing without influence of osteosynthetic materials or casts. Thirty women (mean age = 78 years; range = 58–88) with a PHF, osteoporosis or osteopenia (based on a hip scan, WHO criteria), and not taking any drugs related to bone formation, including calcium or vitamin D supplementation, were randomly assigned to either oral 800 IU vitamin D₃ plus 1 g calcium or placebo, in a double-blind prospective study. We measured biochemical, radiographic, and bone mineral density effect parameters to evaluate the impact on the healing process. Scanning procedures of the fractured shoulder included use of a fixation device to obtain the highest possible precision. Double scans of the fractured shoulder revealed a coefficient of variation (CV) on BMD measurements that improved from 2.8% immediately after fracture occurrence to 1.7% at 12 weeks (P = 0.003) approaching the 1.2% levels observed over the healthy shoulder. BMD was similar in the two groups at baseline (active 0.534 g/cm² vs. placebo 0.518 g/cm²), and both increased over the 12-week observation period, with peak levels in week 6. By week 6 BMD levels were higher in the active group (0.623 g/cm²) compared with the placebo group (0.570 g/cm², P = 0.006). Thirty seven percent of the patients presented with vitamin D levels below 30 nmol/l, indicative of mild vitamin D insufficiency. In conclusion, we have demonstrated that it is possible to quantify callus formation of the PHF with sufficiently high precision to demonstrate the positive influence of vitamin D₃ and calcium over the first 6 weeks after fracture. Whether this results in more stable fractures, extends to other fracture types, or applies to other osteogenic bone agents such as bisphosphonates remains to be examined.     

Relationship Between Fibril Length and Tissue Ingrowth in the Healing of Expanded Polytetrafluoroethylene Grafts

Purpose To determine whether fibril length is correlated with graft healing as well as cellular and capillary ingrowth in a canine carotid implantation model.Methods Expanded polytetrafluoroethylene (ePTFE) vascular grafts with three different fibril lengths (30, 60, and 90µm) were implanted into the carotid artery in dogs. They were retrieved 4 weeks later, and subjected to histomorphometric analysis.Results Endothelial healing was best in the 60-µm grafts. Not only cellular ingrowth but also capillary ingrowth was most evident in the 60-µm grafts, followed by the 90-µm grafts and then the 30-µm grafts.Conclusion Better endothelial healing of ePTFE vascular grafts is correlated with more cellular and capillary ingrowth, but more cellular and capillary ingrowth is not correlated with longer fibril length or higher air porosity.     

Intestinal Anastomoses from Diabetic Rats Contain Supranormal Levels of Gelatinase Activity

PURPOSE: Early postoperative strength in intestinal anastomoses is reduced in diabetic rats, whereas collagen deposition is essentially unchanged, suggesting that increased matrix degradation may be the cause of diminished wound strength. The aim of this study was to investigate whether (gelatin-degrading) matrix metalloproteinase activity is enhanced in intestinal anastomoses from diabetic rats. METHODS: Sixty male young adult Wistar rats underwent resection and anastomosis of both ileum and colon. In half the animals diabetes was induced seven days before operation by streptozotocin injection (50 mg/kg intravenously). Gelatinase activities in extracts from uninjured intestine and anastomoses at one, three, or seven days after surgery were measured by quantitative gelatin zymography. RESULTS: After surgery, profound changes were observed with time for gelatinase activities with molecular weights of 50 and 60 kDa, thought to represent matrix metalloproteinase-2, and of 66, 80, 105, 140, 220, and 260 kDa, thought to represent various forms of matrix metalloproteinase-9. In many cases, specific activities were significantly (P < 0.05) higher in the anastomotic extracts from diabetic rats. Total anastomotic activities present at Day 7 were strongly elevated for most matrix metalloproteinase forms in ileum and colon from diabetic animals. CONCLUSION: Experimental diabetes leads to a sustained and elevated presence of gelatinase activity in intestinal anastomoses. Increased local matrix degradation may contribute significantly to impaired anastomotic strength in the intestine observed under this condition.     

脑血管病患者的康复护理

脑血管病是一组突然起病的脑血液循环障碍性疾病，具有发病率、致残率、病死率高的特点，存活患者中大约3／4有肢体及语言功能障碍，严重影响患者的生存质量，给家庭和社会带来巨大负担。我科对2006年1月至2007年12月收治的262例脑血管病患者在进行积极治疗预防并发症的同时，及早进行康复护理，对减少致残、最大限度地发挥患者的残存功能、提高生存质量方面收到了较好效果，现报告如下。     

生理湿润环境对急慢性损伤愈合的临床观察

目的:探讨生理湿润环境对急慢性损伤愈合作用的临床效果.方法:采用多中心协作研究的方法,对59例住院或门诊急慢性损伤患者的创面采用美宝创面速愈贴创造生理湿润环境的方法处理,观察其减轻疼痛、预防控制感染、促进创面愈合和减少瘢痕的作用.结果:进入本次研究的病例59例,其中急性损伤28例,创面愈合时间5d~21d;慢性损伤31例,创面愈合时间7d～45d.收到了较好的止血、止痛、控制感染、促进愈合和减少瘢痕的效果,治愈率100%.结论:生理湿润环境不仅能够促进各种急慢性损伤的愈合,同时具有良好的止痛、止血、预防控制感染和减少搬痕的作用,值得临床推广应用.     

Hancornia speciosa: indications of gastroprotective, healing and anti-Helicobacter pylori actions

Ethnopharmacological relevance

Mangaba (Hancornia speciosa Gomez) is a medicinal plant frequently cited in ethnopharmacological inventories of the central region of Brazil against gastrointestinal disorders such as diarrhoea, ulcer, gastritis and stomachache.

Aim of the study

The hydroalcoholic extract (HE) and infusion (BI) of Hancornia speciosa bark were investigated for their ability to prevent and heal rodent gastric ulcer.

Materials and methods

The preventive and healing action of both preparations of Hancornia speciosa were evaluated in experimental models in rodents that simulated this disease in human gastric mucosa.

Results

BI did not exert gastroprotective effect, in contrast to HE (500 mg/kg, p.o.) that decreased (p < 0.05) the severity of gastric damage induced by HCl/ethanol (52%), indomethacin/bethanechol (51%), stress (52%) or pylorus ligature experiments (54%). HE increased (p < 0.05) the pH and decreased acid output of gastric juice. This extract promoted increase of mucus amount (3.62 mg/wt. tissue vs. 5.81 mg/wt. tissue), healing action (67%) and displayed anti-Helicobacter pylori effect.

Conclusions

The antiulcer action of Hancornia speciosa resulted in increase of gastric mucus formation and antioxidant properties of polymeric proanthocyanidins present in the bark composition of this medicinal plant.