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

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

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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

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Impact of transplant nephrectomy on peak PRA levels and outcome after kidney re-transplantation

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World Journal of Transplantation 2014年第2期4卷 141-147页

作者： dietlind Tittelbach-Helmrich Przemyslaw Pisarski Gerd Offermann Marcel Geyer Oliver Thomusch Ulrich Theodor Hopt Oliver Drognitz Department of General Surgery University of Freiburg79106 Freiburg i. Brsg.Germany Department of General Surgery University of Luebeck23538 LuebeckGermany Transplant Center Medical Department IVCampus Benjamin FranklinUniversity Charité of Berlin12200 BerlinGermany Department of Nephrology University of Freiburg79106 Freiburg i. Brsg.Germany

AIM: To determine the impact of transplant nephrectomy on peak panel reactive antibody(PRA) levels, patient and graft survival in kidney re-transplants. METHODS: From 1969 to 2006, a total of 609 kidney re-transplantations were performed at the University of Freiburg and the Campus Benjamin Franklin of the University of Berlin. Patients with PRA levels above(5%) before first kidney transplantation were excluded from further analysis(n = 304). Patients with graft nephrectomy(n = 245, NE+) were retrospectively compared to 60 kidney re-transplants without prior graft nephrectomy(NE-).RESUlTS: Peak PRA levels between the first and the second transplantation were higher in patients undergoing graft nephrectomy(P = 0.098), whereas the last PRA levels before the second kidney transplantation did not differ between the groups. Age adjusted survival for the second kidney graft, censored for death with functioning graft, were comparable in both groups. Waiting time between first and second transplantation did not influence the graft survival significantly in the group that underwent nephrectomy. In contrast, patients without nephrectomy experienced better graft survival rates when re-transplantation was performed within one year after graft loss(P = 0.033). Age adjusted patient survival rates at 1 and 5 years were 94.1% and 86.3% vs 83.1% and 75.4% group NE+ and NE-, respectively(P lUSION: Transplant nephrectomy leads to a temporary increase in PRA levels that normalize before kidney re-transplantation. In patients without nephrectomy of a non-viable kidney graft timing of re-transplantation significantly influences graft survival after a second transplantation. Most importantly, transplant nephrectomy is associated with a significantly longer patient survival.

关键词： Kidney re-transplantation Graft nephrectomy Panel reactive antibodies,Patient and graft survival

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