Barriers to implementing complimentary medicine into MD residency

Oct. 9, 2013 — Investigators at Boston University School of Medicine (BUSM) have identified that lack of time and a paucity of trained faculty are perceived as the most significant barriers to incorporating complementary and alternative medicine (CAM) and integrative medicine (IM) training into family medicine residency curricula and training programs.The study results, which are published online in Explore: The Journal of Science and Healing, were collected using data from an online survey completed by 212 national residency program directors. The study was led by Paula Gardiner, MD, MPH, assistant professor of family medicine at BUSM and assistant director of integrative medicine at Boston Medical Center, and colleagues from the department of Family Medicine.”This is a part of medicine that has significant impact on patient care,” said Gardiner. “We need to minimize barriers to implementing CAM/IM curricula in order to address these competencies and promote a larger focus on patient centered care.”According to the current study a majority of family medicine residency program directors felt that CAM and IM were an important part of resident training and, of those, a majority was aware of these recommended competencies. However, a majority of directors also did not have specific learning goals around CAM and IM in their residency programs. Of those directors aware of the competencies, a minority had an adequate evaluation of CAM or IM in their program.The survey respondents identified “strong” CAM/IM programs as those that incorporated at least one of the following modes of exposing residents to CAM or IM: didactics, clinical rotations or electives. “Weak” programs incorporated none of these modalities. Didactics were the most commonly employed techniques of the strong programs. There were significant differences between the strong and weak programs in perceived access to experts in CAM or IM and faculty training in these modalities.The study was conducted via an online survey and consisted of six questions on CAM and IM with a focus on awareness, competencies, attitudes toward curricula, barriers to implementation and management techniques.Given the use of CAM and IM modalities by patients and practicing physicians future directions should include raising awareness around the proposed competencies and identifying solutions to minimize the barriers to incorporating these competencies in residency training programs.

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New method rapidly identifies specific strains of illness

July 10, 2013 — Researchers from Boston University School of Medicine (BUSM) and George Washington University (GWU) have developed a method to rapidly identify pathogenic species and strains causing illnesses, such as pneumonia, that could help lead to earlier detection of disease outbreaks and pinpoint effective treatments more quickly.The findings are featured online in the journal Genome Research.Emerging sequencing technologies have revolutionized the collection of genomic data for bioforensics, biosurveillance and for use in clinical settings. However, new approaches are being developed to analyze these large volumes of genetic data. Principal investigator Evan Johnson, PhD, assistant professor of medicine at BUSM, and Keith Crandall, PhD, director of the Computational Biology Institute at GWU, have created a statistical framework called Pathoscope to identify pathogenic genetic sequences from infected tissue samples.This unique approach can accurately discriminate between closely related strains of the same species with little coverage of the pathogenic genome. The method also can determine the complete composition of known pathogenic and benign organisms in a biological sample. No other method can accurately identify multiple species or substrains in such a direct and automatic way. Current methods, such as the standard polymerase chain reaction detection or microscope observation, are often imperfect and time-consuming.”Pathoscope is like completing a complex jigsaw puzzle. Instead of manually assembling the puzzle, which can take days or weeks of tedious effort, we use a statistical algorithm that can determine how the picture should look without actually putting it together,” said Johnson. “Our method can characterize a biological sample faster, more accurately and in a more automated fashion than any other approach out there.”This work will be relevant in a broad range of scenarios. For example, in hospitals, this sequencing method will allow for rapid screening of thousands of infectious pathogens simultaneously, while being sensitive enough to monitor disease outbreaks caused by specific pathogenic strains. Veterinarians can even apply the method in their practices. …

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Banned fountain of youth drug may be making a comeback

July 3, 2013 — Despite it being more than 30 years since the “fountain of youth drug” Gerovital H3 was banned in the United States, it may be making a comeback. In an editorial published in this month’s Journal of the American Geriatrics Society BUSM researcher Thomas Perls, MD, points out that a few U.S.-based anti-aging and longevity clinics have begun to advertise Gerovital H3 in pill form and as intravenous infusions despite the fact that the U.S. Food and Drug Administration (FDA) banned it in 1982.Share This:Gerovital H3 is the dental anesthetic procaine hydrochloride (novocaine), yet in the 1950s, this drug was abused among Hollywood stars. According to Perls governmental bodies such as the FDA are relied upon to protect their citizens from drugs that do not do what they are claimed to do or are unsafe, yet in communist Romania, the opposite occurred with the state-sponsored marketing of Gerovital H3. In 1956, a paper titled “A new method for prophylaxis and treatment of aging with Novocain-eutrophic and rejuvenating effects” was published in the now discontinued journal Therapiewoche by Ana Aslan, director of the Geriatrics Institute of Bucharest. As a result the communist regime established an anti-aging resort and clinic for foreigners.Perls explains that by the 1970s, the National Institute on Aging commissioned a thorough evaluation of the studies and claims surrounding Gerovital H3. “The conclusion of that work was that, except for a possible mild monoamine oxidase (MAO) inhibitor effect that would potentially ameliorate depression, there was no scientifically credible evidence supporting the claims that procaine hydrochloride is beneficial in treating age-related diseases or syndromes,” said Perls, professor medicine at BUSM and director of the New England Centenarian and Supercentenarian Studies at Boston Medical Center. Perls points out that a plausible explanation for why some subjects might have experienced some improvements in health was that, in addition to receiving Gerovital H3, they were receiving other interventions such as exercise, stress reduction and healthy nutrition. “Thus, a glaring problem for the demonstration of any benefit associated with Gerovital H3 or similar compounds is the absence of any double-blind, placebo controlled trials demonstrating a significant improvement in the outcomes that anti-aging doctors and entrepreneurs claimed,” he added.Additional studies were later performed to further investigate a possible MAO inhibitory effect from procaine hydrochloride and any subsequent neurocognitive benefit but there was no evidence that procaine and its preparations could treat or preventing cognitive impairment or dementia.”Gerovital H3 appears to have experienced a recent rebound in marketing and sales in the United States, primarily because of Internet-based marketing. A search for “Gerovital H3” on Google or Yahoo! …

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