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Incorporation of integrative medicine education into undergraduate medical education:a longitudinal study

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Journal of Integrative Medicine 2017年第6期15卷 442-449页

作者： saswati mahapatra anjali bhagra bisrat fekadu zhuo li brent a.bauer dietlind l.wahner-roedler division of general internal medicine mayo clinicRochesterMinnesota 55905USA mayo clinic school of medicine mayo clinic college of medicine and scienceRochesterMinnesota 55905USA biostatistics unit mayo clinicJacksonvilleFlorida 32224USA

OBJECTIVE： Integrative medicine （IM） combines complementary medical approaches into conventional medicine and considers the whole person. We implemented a longitudinal IM short-course curriculum into our medical school education. This study aimed to evaluate the feasibility and effectiveness of the curriculum via knowledge and attitude surveys regarding IM among students. METHODS： A mandatory short IM curriculum across all years of medical school was created and taught by IM professionals and physician faculty members with expertise in integrative therapies. Graduating classes of 2015 and 2016 completed the same survey in their first and third years of medical school. Paired data analysis was done, and only students who completed surveys at both time points were included in final analyses. RESULTS： Of 52 students in each class, 17 （33%） in the class of 2015 and 22 （42%） in the class of 2016 completed both surveys. After the IM curriculum, students＇ knowledge of and comfort with several IM therapies--biofeedback, mindfulness, and the use of St. John＇s wort--improved significantly. Students＇ personal health practices also improved, including better sleep, exercise, and stress management for the class of 2015. Students graduating in 2016 reported decreased alcohol use in their third year compared with their first year. CONCLUSION： It is feasible to incorporate IM education into undergraduate medical education, and this is associated with improvement in students＇ knowledge of IM and personal health practices.

关键词： course curriculum education integrative medicine medical students

Cutaneous myiasis with eosinophilic pleural effusion:A case report

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World Journal of Clinical Cases 2021年第18期9卷 4803-4809页

作者： Tao Fan Yu Zhang Yan Lv Jing Chang brent a bauer Juan Yang Cheng-Wei Wang Department of Integrated Traditional Chinese and Western Medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Respiratory and Critical Care Medicine Chengdu Integrated Traditi Department of General Internal Medicine Mayo ClinicRochesterMN 55905United States

BACKGROUND Cutaneous myiasis is frequently observed;however,eosinophilic pleural effusion induced by this condition is *** SUMMARY We report the case of a 65-year-old female Tibetan patient from Qinghai Province,who presented to West China Hospital of Sichuan University around mid-November 2011 with a chief complaint of recurrent cough,occasional hemoptysis,and right chest *** was no past medical and surgical history of note,except for occasional dietary habit of eating raw *** examination revealed a left lung collapse and diminished breathing sounds in her left lung,with moist rales heard in both *** X-rays demonstrated a left hydropneumothorax and a right lung *** computed tomography revealed a left hydropneumothorax with partial compressive atelectasis and patchy consolidation on the right *** data revealed peripheral blood eosinophilia of 37.2%,with a white blood cell count of 10.4×109/*** immunoglobulin E levels were elevated(1650 unit/mL).Serum parasite antibodies were negative except for cysticercosis immunoglobulin *** marrow aspirates were hypercellular,with a marked increase in the number of mature eosinophils and eosinophilic *** ultrasound-guided left-sided thoracentesis produced a yellow-cloudy exudative *** to respond to antibiotic treatment during hospitalization for her symptoms and persistent blood eosinophilia led the team to start oral albendazole(400 mg/d)for presumed parasitic infestation for three consecutive days after the ninth day of *** migratory stabbing pain and swelling sensation on both her upper arms and shoulders were reported;tender nodules and worm-like live organisms were observed in the responding sites 1 wk *** the removal of the live organisms,they were subsequently identified as first stage hypodermal larvae by the Sichuan Institute of *** patient’s symptoms were relieved soon *** follow

关键词： Cutaneous myiasis Eosinophilic pleural effusion Hypoderma larvae Albendazole Case report

Patient Feedback for Acupuncture Practice Improvement:A Survey from Mayo Clinic

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Chinese Journal of Integrative Medicine 2017年第11期23卷 816-821页

作者： Barbara S Thomley Saswati Mahapatra brent a bauer Molly J Mallory LI Guang-xi Alexander Do Tony Y Chon Division of Operations Mayo Clinic HospitalAZ(85054)United States Integrative Medicine and Health Division of General Internal MedicineMayo ClinicMN(55902)United States

Objective： To understand patient satisfaction with acupuncture appointment duration for the first and subsequent appointments in the plan of care, time spent with the acupuncture provider, willingness to pay for longer duration appointments, and lack of insurance coverage. Methods： Patients who were referred for an acupuncture consult to the Center for Integrative Medicine at Mayo Clinic were asked to participate in the survey in August 2014. Patients were given paper survey at time of appointment check-in and entered into Research Electronic Data Capture Survey database tool to reveal patient-reported outcomes. Results： In total, 104 of 329 patients receiving acupuncture treatment responded to the survey with a 32% response rate. Insight and recommended changes to the duration of the initial and subsequent appointments were obtained. Most patients reported that time spent with the provider（76 cases, 74%） and appointment length（74 cases, 68%） were ＂just right＂. Seventy cases（70%） of respondents indicated that they wanted longer treatment. Patients reported return appointments with duration of 30 min was not enough. Fifty-three patients（62%） were willing to pay for additional costs not covered by insurance. Conclusions： We used patient feedback to assess the acupuncture practice in a complementary and integrative medicine program. Most patients referred for the acupuncture consult appeared to be satisfied with the current level of practice. These findings were used to establish a quality improvement plan that may be implemented to improve patient satisfaction with the acupuncture practice.

关键词： care survey health integrative medicine acupuncture practice

Complementary and Alternative Medicine Therapies for Chronic Pain

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Chinese Journal of Integrative Medicine 2016年第6期22卷 403-411页

作者： brent A.bauer Jon C.Tilburt Amit Sood 李光熙王师菡 Division of Complementary and Integrative Medicine Mayo Clinic Division of Pulmonary and Critical Care Medicine Mayo Clinic Guang'anmen Hospital China Academy of Chinese Medical Sciences Division of Cardiovascular Diseases Mayo Clinic

ABSTRACT Pain afflicts over 50 million people in the US, with 30.7% US adults suffering with chronic pain. Despite advances in therapies, many patients will continue to deal with ongoing symptoms that are not fully addressed by the best conventional medicine has to offer them. The patients frequently turn to therapies outside the usual purview of conventional medicine （herbs, acupuncture, meditation, etc.） called complementary and alternative medicine （CAM）. Academic and governmental groups are also starting to incorporate CAM recommendations into chronic pain management strategies. Thus, for any physician who care for patients with chronic pain, having some familiarity with these therapies--including risks and benefits--will be key to helping guide patients in making evidence-based, well informed decisions about whether or not to use such therapies. On the other hand, if a CAM therapy has evidence of both safety and efficacy then not making it available to a patient who is suffering does not meet the need of the patient. We summarize the current evidence of a wide variety of CAM modalities that have potential for helping patients with chronic pain in this article. The triad of chronic pain symptoms, ready access to information on the internet, and growing patient empowerment suggest that CAM therapies will remain a consistent part of the healthcare of patients dealing with chronic pain.

关键词： complementary and alternative medicine therapy chronic pain safety and efficacy

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补充结合医学管理头痛

英国医学杂志中文版 2018年第5期21卷 264-274页

作者：廖星章轶立(译) 宋军校中国中医科学院中医临床基础医学研究所中国中医科学院医学实验中心

头痛是一种临床常见疾病，包括诸如偏头痛和紧张性头痛在内的原发性头痛。补充结合医学（CIM）以前被称为补充替代医学（CAM），采用循证的方式帮助患者恢复健康和治疗疾病。CIM通常包括营养剂使用、运动锻炼、手法治疗、传统中医和身... 详细信息

头痛是一种临床常见疾病，包括诸如偏头痛和紧张性头痛在内的原发性头痛。补充结合医学（CIM）以前被称为补充替代医学（CAM），采用循证的方式帮助患者恢复健康和治疗疾病。CIM通常包括营养剂使用、运动锻炼、手法治疗、传统中医和身心调整等多种方法。本文基于5篇meta分析、7篇系统性综述和34篇随机对照试验文献，回顾、总结了运用CIM治疗原发性头痛的进展和现状。CIM治疗头痛的证据质量总体偏低，偶有中等质量的证据。现有证据提示，包括针剌、按摩在内的中医治疗以及瑜伽、生物反馈和冥想都对偏头痛和紧张性头痛有积极作用。脊柱按摩、整脊治疗、某些营养剂、植物制剂、调整饮食和水疗也可能对偏头痛有益。CIM并未针对丛集性头痛开展研究或者对该病尚无疗效。未来需要进一步开展研究，以确定CIM在头痛患者治疗中最有效的作用。

关键词：医学头痛

Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study

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Journal of Integrative Medicine 2015年第5期13卷 306-313页

作者： Deborah J.Engen Samantha J.Mc Allister Mary O.Whipple Stephen S.Cha Liza J.Dion Ann Vincent brent A.bauer Dietlind L.Wahner-Roedler Department of Physical Medicine and Rehabilitation Mayo Clinic Division of General Internal Medicine Mayo Clinic Division of Biomedical Statistics and Informatics Mayo Clinic

BACKGROUND： Fibromyalgia is a syndrome characterized by chronic pain, fatigue, depression, and sleep disturbances. Its primary cause is unclear. Several studies have reported decreased intracellular magnesium levels in patients with fibromyalgia and have found negative correlation between magnesium levels and fibromyalgia symptoms.OBJECTIVE： To gather preliminary data on whether transdermal magnesium can improve quality of life for women who have fibromyalgia. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This is a patient questionnaires and survey in a fibremyalgia clinic at a tertiary medical center. Forty female patients with the diagnosis of fibremyalgia were enrolled. Each participant was provided a spray bottle containing a transdermal magnesium chloride solution and asked to apply 4 sprays per limb twice daily for 4 weeks. Participants were asked to complete the Revised Fibromyalgia Impact Questionnaire, SF-36v2 Health Survey, and a quality-of-life analog scale at baseline, week 2, and week 4. MAIN OUTCOME MEASURE： Questionnaire and survey scores, evaluated through intent-to-treat and per-protocol analyses. RESULTS： Twenty-four patients completed the study （mean [SD] age, 57.2 [7.6] years; white, 95%; mean body mass index, 31.3 kg/m2）. With intention-to-treat analysis, Revised Fibromyalgia Impact Questionnaire subscale and total scores were significantly improved at week 2 and week 4 （total score, P = 0.001）. Per-protocol analysis results were similar： all subscales of the Revised Fibremyalgia Impact Questionnaire were significantly improved at week 2 and week 4 （total score, P = 0.001）. CONCLUSION： This pilot study suggests that transdermal magnesium chloride applied on upper and lower limbs may be beneficial to patients with fibromyalgia.

关键词： fibromyalgia magnesium chloride Revised Fibromyalgia Impact Questionnaire clinical trial