Category Archives: Alternative Medicine

Shuai Xia,1 Liyan Ma,2 Guoxing Wang,1 Jie Yang,1 Meiying Zhang,3 Xuechen Wang,1 Jianrong Su,2 Miaorong Xie1

1Department of Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, Peoples Republic of China; 2Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, Peoples Republic of China; 3Department of Emergency Center, Peking University First Hospital, Peking University, Beijing, 100050, Peoples Republic of China

Correspondence: Miaorong Xie, Department of Emergency and Critical Care, Center, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, Peoples Republic of China, Email [emailprotected]

View the original paper by Mr Xia and colleagues

This is in response to the Letter to the Editor

Thanks to Dr. Savita V Jadhav and the medical stuff for their interest in our article.1 We would like to make it clear about the specific comments.

Firstly, the concern regarding the CLSI guidelines in methodology with reference number 19 may be the result of a misunderstanding. In the context, what we mentioned was that the MIC determination method was recommended by CLSI guideline rather than why RIF and CLI were selected to be tested. Secondly, the comments about RIF prescription should be avoided in diseases other than Mycobacterial diseases are very constructive. Currently, our research remains at the laboratory stage; it is necessary to put into practice in vivo to evaluate the clinical effects because the RIF alone is rarely used to treat MRSA. However, no papers or guidelines show that the RIF cannot treat MRSA infection. According to the updated MRSA treatment guidelines from UK,2 RIF is recommended in combination with other agents to treat MRSA infections. Our study found that berberine in combination with RIF has an excellent synergistic effect which is not in conflict with clinical application. Furthermore, the synergistic activities in vivo are on-going and it is our pleasure to improve the clinical practices expanding RIF indication if the experimental results are satisfactory. Lastly, regarding your advice for us to further evaluate other synergistic effects with oxacillin, azithromycin and levofloxacin as well as additive effects with ampicillin and cefazolin, these have already been reported in previous studies.3,4 We consider it a meaningful proposal and will perform the experiments in vivo in the near future.

The authors report no conflicts of interest in this communication.

1. Xia S, Ma L, Wang G, et al. In vitro antimicrobial activity and the mechanism of berberine against methicillin-resistant staphylococcus aureus isolated from bloodstream infection patients. Infect Drug Resist. 2022;15:19331944. doi:10.2147/IDR.S357077

2. Brown NM, Goodman AL, Horner C, Jenkins A, Brown EM. Treatment of methicillin-resistant Staphylococcus aureus (MRSA): updated guidelines from the UK. JAC Antimicrob Resist. 2021;3(1):dlaa114. doi:10.1093/jacamr/dlaa114

3. Yu HH, Kim KJ, Cha JD, et al. Antimicrobial activity of berberine alone and in combination with ampicillin or oxacillin against methicillin-resistant Staphylococcus aureus. J Med Food. 2005;8(4):454461. doi:10.1089/jmf.2005.8.454

4. Zuo GY, Li Y, Han J, Wang GC, Zhang YL, Bian ZQ. Antibacterial and synergy of berberines with antibacterial agents against clinical multi-drug resistant isolates of methicillin-resistant Staphylococcus aureus (MRSA). Molecules. 2012;17(9):1032210330. doi:10.3390/molecules170910322

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Response to Letter in regards to Berberine: Best Alternative Medicine | IDR - Dove Medical Press

June 22, 2022 | Using ultrasound to stimulate neurometabolic pathways in the body to prevent or reverse type 2 diabetes is a centerpiece of research and development efforts at the General Electric (GE) Research Center in Niskayuna, NY. It has been known for many years now that electrical activity within peripheral nerves modulates end-organ function, including those involved in sensing food intake and glucose levels. But there have been limited means to noninvasively control those signals to fight disease, according to Chris Puleo, a senior biomedical engineer at GE Research.

Ultrasound neuromodulation could become a new option in the therapeutic arsenal for treating the predominant form of diabetes worldwide, he says, alongside drugs designed to lower insulin and glucose levels. The potential of peripheral focused ultrasound stimulation (pFUS) has already been demonstrated in small and large animal species, as recently reported in Nature Biomedical Engineering (DOI: 10.1038/s41551-022-00870-w), by activating neurons through ion channels that are sensitive to mechanical forces.

That study concluded several years ago and, since then, multiple clinical trials have launched and some of those are reaching completion, says Puleo.

Over the past five years, GE Research has published a handful of papers that notably includes a 2019 article in Nature Communications (DOI: 10.1038/s41467-019-08750-9) where ultrasound was directed at certain points within the spleen or liver to deliver results on par with implant-based vagus nerve stimulation. Importantly, the ultrasound technique more precisely affected the targeted organ to either reduce cytokine inflammation levels or modulate blood glucose levels, notes Victoria Cotero, co-lead on both the Nature Communications and Nature Biomedical Engineering studies.

Progress to date has been a team effort with industry, academic institutions, and government agencies. The use of ultrasound as a potential non-invasive alternative to current therapies is a major research program at the GE Research Center with both internal funding and external financial support, says Puleo.

Partners for the most recently published study included several scientists and engineers at the Niskayuna site (including co-lead Jeff Ashe), scientists at Albany Medical College who showed that metabolic effects from the ultrasound stimulation changed the nerve firing rate, and others at the University of California, Los Angeles (UCLA), who demonstrated that ultrasound treatments influence cultured neurons that are also dependent on mechanically-sensitive ion channels.

Additionally, team members at the Feinstein Institutes for Medical Research (FIMR) replicated results in diabetic mice and swine. Researchers at Yale School of Medicine used additional techniques such as glucose clamps to further characterize the therapeutic effect in rodents. The tests in swine were performed in a way that gave researchers a real time, before-and-after view of glucose changes when pFUS was turned on, Puleo says.

Ultrasound neuromodulation is part of the broader world of bioelectronic medicinea term coined by FIMR research scientist and former neurosurgeon Kevin J. Tracey, M.D., and his colleagues to describe the diagnosis and treatment of diseases with devices that regulate electrical signaling within the nervous system. Work in the field began decades ago and notably introduced cardiac pacemakers and computerized implantable devices for treating inflammatory conditions.

Tracey, one of the co-authors on the Nature Biomedical Engineering paper, and his team is behind the discovery of a unique neuroimmune pathway that could be leveraged to tamp down cytokine output. Specifically, Tracey helped identify how tumor necrosis factor (TNF) promotes inflammation when the body suffers injury or shock, and he was the first to apply electrical stimulation to the vagus nerve to stop production of TNF in the body as if it were a dose of a monoclonal anti-TNF inhibitor.

Of course, vagus nerve stimulation involves an implantable device with all the challenges associated with having a surgical procedure.

In the latest report on preclinical experiments led by GE Research with its research partners, multiple diabetic animal models received daily, three-minute ultrasound stimulation of the liverbrain neural pathway that resulted in long-term maintenance of normal blood glucose levels.

The study team has more recently tried stimulating many different spots in the metabolic system with ultrasound to arrive at an optimum dose, says Puleo, and those results are expected to be published soon.

It is not better or worse [than drugs], its a new option, stresses Puleo. But one day, pFUS tools might become suitable for at-home use given the availability of low-cost wireless ultrasound systems, wearable ultrasound probes, and intelligent image recognition software in lieu of skilled ultrasonographers.

From the physician perspective, one of the biggest potential payoffs of ultrasound treatment of diabetic patients is to improve insulin sensitivity as few currently available drugs can do that. If the promise of pFUS seen in animal studies is confirmed in clinical trials, bioelectronic medicine could offer a convenient and hassle-free way to simultaneously improve both glucose tolerance and insulin resistance.

More here:

Ultrasound May Become Alternative To Antidiabetic Drugs - Bio-IT World

For millions of people in the United States, staying healthy includes a daily regimen of vitamins and/or supplements.

According to the U.S. Centers for Disease Control and Prevention, more than half of surveyed U.S. adults used at least one dietary supplement in 2018.

Most people interviewed by Healthline for this story said they believe that vitamins and/or supplements can keep diseases at bay.

However, the U.S. Preventive Services Task Force (USPSTF), an independent panel of national experts in disease prevention and evidence-based medicine, concluded in a report published today that the evidence is insufficient to determine the balance of benefits and harms of supplementation with multivitamins for the prevention of cancer and cardiovascular disease.

In an editorial running today in the Journal of the American Medical Association, scientists at Northwestern Medicine said they support the USPSTFs findings.

For non-pregnant, otherwise healthy Americans, vitamins and supplements are a waste of money for those who think they can help prevent cardiovascular disease or cancer, the Northwestern scientists wrote.

Beyond wasted money, the focus on supplements might be viewed as a potentially harmful distraction. Rather than focusing money, time, and attention on supplements, it would be better to emphasize lower-risk, higher-benefit activities, the scientists added.

Dr. Jenny Jia, a co-author of Northwesterns editorial, told Healthline that if people really want to focus on preventing chronic diseases such as cancer and heart disease, they need to focus on evidence-based lifestyle behaviors, including eating a balanced diet and exercising regularly every week.

Dr. Jeffrey A. Linder, the chief of general internal medicine in the department of medicine at Northwestern University Feinberg School of Medicine in Illinois, said in a press statement, Patients ask all the time, What supplements should I be taking? Theyre wasting money and focus thinking there has to be a magic set of pills that will keep them healthy when we should all be following the evidence-based practices of eating healthy and exercising.

The task force is not saying dont take multivitamins, but theres this idea that if these were really good for you, wed know by now, he added.

Despite these conclusions, there is still support among some patients and physicians that vitamins and supplements can have a positive effect on disease.

Gordon Saxe, PhD, MPH, is an oncologist and the director of the UC San Diego Center for Integrative Nutrition and chair of the Krupp Endowment for research on the benefits of natural complementary and alternative medicine.

Hes conducted research on the epidemiology of diet and gene expression as well as prostate, breast, and pancreas cancer.

Conservative bodies like USPSTF dismiss supplements because of the lack of evidence, but many of these supplements have simply not been adequately studied, Dr. Saxe told Healthline.

We should be more open and curious and not fear these things or be dismissive, he said. Its one thing to say that there have simply not been enough studies of these supplements, but its another to dismiss them as if the lack of evidence implies that they dont work.

Saxe said that evidence from ecological epidemiological studies suggests that vitamin D might in fact be protective against a number of common cancers, including breast cancer and colon cancer.

But the data is not perfect and it needs to undergo rigorous trials before we can conclude that it is for sure preventive or therapeutic, he said.

Vitamin D needs to be studied more, and I am not asserting that it will prevent cancer. But it may. And the harm is minimal, so why not? Saxe added.

Patients interviewed for this story say they take vitamins and/or supplements and believe they can help with cancer, cardiovascular disease, and other health issues.

All of my doctors recommend vitamin D, said Mia Dansky Blitstein, a non-Hodgkins lymphoma survivor.

My doctors recommended vitamin D3 for stage 2 lung cancer, added Jean Walcher.

Katherine Page had stage 2 breast cancer when she was 36. It has not returned.

I try to eat a lot of omega-3 fatty acids by taking a pill and eating a lot of power seeds like flax, pumpkin, and almond, she told Healthline.

I also drink only water or green tea. Lots of green tea. I take turmeric and vitamin D. I do not eat red meat and every morning I have antioxidants in the form of berries either with the seeds and yogurt or oatmeal or a smoothie, she added.

Nonetheless, some people interviewed by Healthline agree with the new guidelines:

My mom did the holistic route with breast cancer, said Bill Ray, a professional musician. She got cancer, took about a week of chemo, then began doing the whole cannabis/vitamins route.

Ray said his mom delved deep into things he had never heard of such as Rh-negativity and more.

It took her about two years to go overall. It wasnt pretty, he said. Those Ive known who went the holistic route, the outcome was much sadder. This is something that concerns me, as both my grandparents and my mother succumbed to cancer, and its probably what will take me out.

Read more here:

Vitamins and Cancer, Heart Disease Risk - Healthline

Cannabis has been proven to help benefit veterans struggling with pain and insomnia, as well as ... [+] symptoms of depression, anxiety and PTSD.

Recently, the VA launched of a new grants program on suicide prevention services for military veterans that specifically states that it wont support any treatments involving the use of cannabis. We know that cannabis has been proven to help benefit veterans struggling with pain and insomnia, as well as symptoms of depression, anxiety and PTSD, but unfortunately only 50% of veterans that return from service seek help.

One thing Im always on the lookout for is ways to support veterans with cannabis medicine. When I co-founded and operated Harborside, we were one of the first dispensaries to offer a veterans discount (15%), and we hosted free support groups to educate and help veterans with their physical ailments and PTSD. We also tried to show that our community cared for veterans with free alternative health services like yoga and reiki, and our free care package program for vets with low incomes. I recently met Tim Tofaute, the Director of Security & Operations with Operational Security Solutions (OSS).

Tofaute is a US Navy SEAL veteran and no stranger to the long-term damaging effects of PTSD and chronic pain. Hes been working on these issues for some time, and owns a company that provides cash handling and banking services to the cannabis industry. Hes passionate about shining a light on medical cannabis reform for US veterans utilizing VA ressources. OSS supports dozens of financial institutions and more than 100 cannabis-related businesses; the team consists of former law enforcement, military and federal professionals to directly support the security and banking needs of the legal cannabis industry.

This is what he had to say.

Tim Tofaute, the Director of Security & Operations with Operational Security Solutions (OSS).

What does war and/or service do to the soldier and why can cannabis help?

Tim Tofaute: This is a very involved question. War-time service and peace-time service are two different things. Im not saying one is more valuable than the other, just that they're different. However, all service can make a soldier feel like they were a part of something larger than themselves and part of a meaningful cause. That can really help someone with their sense of confidence and sense of belonging. It helps the servicemember feel like their efforts are important and making a difference regardless of military occupation specialty (MOS) or job position.

War takes things to whole different magnitudes. This can be a profoundly different distinction because it's also deeply personal. The experiences of war are often very hard to speak about as most people just wouldnt get it. Also, it can take a long time to process these experiences and many vets dont want to relive it, so its just easier not to talk about it. Not to mention, the carnage often makes you develop a pretty macabre sense of humor that most civilians cant relate to. Humor in times of duress often helps everyone keep it together. War changes you, and changes your perspective on things, also how you manage stress.

You can usually tell somebody who has had to live through extremely traumatic circumstances. I have several colleagues that I work with that use cannabis as a treatment for PTSD and pain, and have had some success with that. That is not a doctor-prescribed treatment, but they used it as an alternative treatment, and they saw benefit from using cannabis. There are some war vets that swear by it and others won't touch it.

Cannabis, if administered in the right amounts can help reduce anxiety and calm the mind, and help vets process their feelings easier. In order to accurately speak to the effectiveness, we need more research to be done; and without support from the federal government that's going to be difficult, we need more research and clinical trials.

Do you feel that cannabis should be made available to active duty soldiers and vets?

TT: I think that might be an option, but only after there is through study and case studies done on the veterans side, where we can really review whether or not the treatment works or if there are any side effects, before looking at that as an option for an active duty soldier to be performing their duties possibly impaired.

What has been your personal experience as a veteran and soldier, and how has cannabis helped you?

TT: I personally haven't used cannabis with great success for pain, but I work with and I have several fellow ex-veterans that are friends that have used cannabis with great success and swear by it.

What is your vision for medical cannabis reform at the VA?

TT: Assuming that there have already been enough studies that show that cannabis would be a plausible alternative treatment, then it's really up to the caregiver and the patient to determine their treatment route. Over time, and as more research is conducted, I think the VA should support this model as well.

Tell me about your company OSS and what role it plays in the cannabis industry?

TT: OSS is a cash logistics management firm that provides secure cash-in transit, security and risk management and onsite security services to cannabis companies that are forced to operate as cash-only as the federal government continues to keep marijuana on a list of Schedule 1 controlled substances. We are acting on behalf of financial institutions that have legal banking programs.

Anything else you would like me to know?

TT: As an armed courier service supporting the cannabis industry with financial solutions, we are extremely excited to be expanding our service footprint on the East Coast in areas including Pennsylvania, New Jersey and Maryland where we have programs open right now. New Jersey's recreational program is moving forward very rapidly and the state may be announcing new details of their program very soon.

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Vets And Medical Cannabis: It's The Least We Can Do - Forbes

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Ganglion Cysts treatment Market Analysis, Growth, Statistics, By Application, Production, Revenue & Forecast to 2028 Designer Women - Designer...

1Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Peoples Republic of China; 2Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, Peoples Republic of China

Correspondence: Yongxuan Hu, Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, 183 West Zhongshan Road, Guangzhou, Peoples Republic of China, Tel + 86 20 62784560, Email [emailprotected]

Abstract: Cutaneous fungal infections are common in humans and are associated with significant physical and psychological distress to patients. Although conventional topical and/or oral anti-fungal medications are commonly recommended treatments, drug resistance has emerged as a significant concern in this patient population, and safer, more efficacious, and cost-effective alternatives are warranted. Recent studies have reported effectiveness of photodynamic therapy (PDT) against fungal infections without severe adverse effects. In this review, we briefly discuss the mechanisms underlying PDT, current progress, adverse effects, and limitations of this treatment in the management of superficial and deep fungal infections.

Cutaneous fungal infections are categorized as superficial and deep infections and are associated with significant physical and psychological distress to patients. Conventional therapy may be ineffective, particularly for deep fungal infections. Furthermore, antifungal agents may cause severe adverse effects, such as liver toxicity, drug interactions, and drug resistance.1 Some superficial fungal infections, such as tinea pedis and cruris are recommended treatment continued for two weeks, post clinical cure for topical agents, and recalcitrant cases usually need continued systemic therapy to eliminate pathogens,2 which is known to reduce patient compliance and remains therapeutically challenging in clinical practice.

Reportedly, photodynamic therapy (PDT) is effective against fungal infections and serves as an alternative treatment strategy. PDT was originally discovered in 1900 and was used for its anti-microbial action; however, this treatment is gradually being accepted as an anti-fungal treatment option since the 1980s.3

The rapid onset of action, mild adverse effects, combinations with other therapies, and applicability in patients with contraindications to other drugs or in those with unresponsiveness to oral antifungal agents serve as advantages of PDT. Little to no risk of development of resistance and its repeatability are other advantages of this treatment. Currently, PDT is widely used to treat many cutaneous fungal infections, such as onychomycosis, tinea capitis, pityriasis versicolor (PV), oral candidiasis, vulvovaginal candidiasis (VVC), chromoblastomycosis (CBM) and cutaneous sporotrichosis, among others, of which onychomycosis is the focus of most research. PDT is a potentially promising therapeutic alternative for treatment of cutaneous fungal infections.

In this review, we discuss the published mechanisms underlying PDT, in addition to representative research on PDT in superficial and deep skin mycoses, and summarize the reported efficacy and limitations of this therapy for the management of fungal infections.

PDT involves the use of the following three elements: a photosensitizer (PS), a light source, and molecular oxygen.1 The PS frequently used in clinical practice include 5-aminolevulinic acid (5-ALA), methylamino levulinate (MAL), and methylene blue (MB). Light sources include red, green, and blue light, and lasers, among others. The mechanism underlying PDT effects is as follows: the PS absorbs energy under the action of light, changes its energy state, and reacts with oxygen molecules to generate reactive oxygen species (ROS), which selectively injure the infected or proliferative tissue.

PS produce their effects via the following mechanisms: A Type I reaction involves an interaction between the PS and the substrate, which generates free radicals, including hydroxyl radicals, hydrogen peroxide, and a superoxide anion that reacts with oxygen molecules to generate ROS, which cause fungal apoptosis.4 A Type II reaction involves direct transfer of energy from the PS to oxygen to form singlet oxygen (1O2), a potent ROS,5 which initiates cell injury (Figure 1).6

Figure 1 Mechanisms of action of photodynamic therapy. Following light absorption, excited state 3PS* reacts with O2 to produce ROS and 1O2 (type I and II reactions). Type III PSs combine properties leading to the generation of 1O2 and reduction of native free radicals in target cells. Type IV mechanism involves a structural change from excited state 1PS* by photoisomerization to enable molecular target binding of the activated PS* to its cellular target site. (* represents the excited state).

Abbreviations: PS, photosensitizer; 1PS, singlet photosensitizer; 3PS, triplet photosensitizer; ROS, reactive oxygen species; 1O2, singlet oxygen; O2, oxygen.

Type III and IV reactions have also been described in the literature.7,8 These reactions are cytotoxic to intracellular structures in the absence of oxygen. Type III PSs are usually classified as antioxidant carrier sensitizers (ACS), which result in the generation of efficient 1O2 and reduce the concentration of native free radicals in target cells. A Type IV reaction involves binding of a PS to its cellular target site after the activation of light excitation. Among the aforementioned mechanisms underlying PDT effects, Type I and II are indirect reactions, whereas Type III and IV reactions lead to direct activation of the PS molecule, which produces secondary reactions independent of interactions with oxygen (Figure 1).

ROS are key participants in phototoxic reactions. Some in vitro experiments have shown the possible mechanisms contributing to the growth-inhibiting effect of PDT, including destruction of biofilm formation and fungal cell wall structure secondary to enhanced ROS production.5,9,10 PDT produces oxidative damage to cellular structures and DNA, causes structural modifications in the plasma membrane, and inhibits enzymatic systems.11 Studies have reported that PDT-mediated therapy directly destroys microorganisms and also promotes neutrophil and lymphocyte infiltration at the affected sites to augment its fungicidal effect.12,13

Onychomycosis is one of the most common superficial fungal infections encountered in clinical practice, with a relapse rate of 25%30%.14 It is caused by dermatophytes, yeasts, and non-dermatophyte molds (NDMs).15 The most common etiological pathogen is Trichophyton rubrum, one of the dermatophytes.16 Many topical and oral agents cannot penetrate the nail plate and are not absorbed owing to the insufficient blood supply to the nail plate, which is invariably thickened in a diseased state.14 Currently, PDT is a promising strategy to enhance nail penetration. A systemic review showed that PDT led to negative results on microscopy and/or culture studies in 67% of patients (N = 58) who received this treatment.17 PDT combined with other physical therapies, such as lasers results in good penetration of the nail plate. A clinical trial (n=7) in which PDT with combined with carbon dioxide (CO2) laser to treat recurrent onychomycosis reported a mycological cure rate of 100%.18 Some in vitro experiments and mouse models have shown that PDT could disrupt bacterial and fungal biofilms,1922 such as Pseudomonas aeruginosa, Staphylococcus aureus, and Candida strains biofilms, which refers to a freely suspended microbial community that provides protection against host defenses.17 Theoretically, the anti-biofilm action of PDT can prevent recurrent onychomycosis.

Various PSs are used for PDT; however, these may show different levels of antifungal effects. Reportedly, nail penetration of MB is better than that of ALA, and MB is therefore associated with higher complete cure rates.1,23,24 MB usually does not require pre-treatment except in patients with nail hyperkeratosis measuring at least 2 mm, who require nail microabrasion.25 In contrast, ALA requires pre-treatment and prolonged exposure because the ALA molecule is required to undergo enzymatic conversion into a protoporphyrin for pre-use activation.25 Furthermore, high water solubility and absorption bands in the red spectrum are important features that determine selection of PS for the treatment of onychomycosis.26

New-generation PSs wrapped in nanoemulsions are shown to have good effectiveness and a high safety profile.27 A clinical trial using aluminum-phthalocyanine chloride with nanoparticles reported photoactivation for treatment of deeper nail layers.28 Two other studies have shown that light-induced gold nanoparticles could inhibit spore germination and achieve high complete cure rates.29,30 Nanoemulsions may serve as an excellent delivery system for PS and enhance penetration of aqueous tunnels created by pre-treatment using urea solution.28 Newer PS may possess intrinsically good nail penetration capacity, which may reduce incubation time, obviate the need for pre-treatment, and also be effective under low-oxygen conditions.31

Evidence from many in vitro studies supports the role of PDT as a potential therapeutic alternative for Trichophyton rubrum infection. Rose Bengal and Citrus aurantifolia essential oil (Citrus EO) PS activated by light are shown to reduce the growth of T. rubrum.32,33 Citrus EO is activated by sunlight, and no special light source is required. Sylsens B was shown to be an effective PS to prevent T. rubrum microconidia germination.26 Although these in vitro studies have shown promising results, no clinical trials have corroborated these findings. Further in vivo studies are required to verify the fungicidal effects of these agents (Table 1).

Tinea pedis is a common fungal skin infection; topical antifungal medications remain the mainstay of treatment, and oral antifungal drugs are considered in cases of infection that remain refractory to local therapy.34 Tinea pedis is a chronic and contagious condition with reservoir effect; therefore, long-term treatment (over >4 weeks) is recommended in recalcitrant cases.2 PDT was attempted for the management of tinea pedis to overcome the limitations of long-term drug therapy. However, this approach was not more effective than conventional therapies. Two clinical studies investigated ALA-PDT for the treatment of interdigital tinea pedis, the most common type of mycotic infection of the feet.35,36 In the two studies, complete cure rates were obtained at 30% and 22% at follow-up. ALA-PDT treatment of interdigital tinea pedis showed lower response rates than conventional topical allylamines (naftifine and terbinafine) therapy with mycological cure rates of 62%100% and clinical cure rates of 66%86%.37 It may be attributable to the fact that PDT treatment administered to irregular surfaces may result in light-blind areas, which may serve as a source of re-infection (Table 1).

Tinea cruris is a fungal infection of the groin, buttocks, and perineal and perianal skin. Reportedly, cure rates range from 80% to 90% following accurate diagnosis and optimal therapy.38 However, an alarming trend of recalcitrant tinea cruris is being observed, with reduced treatment compliance in patients.39 PDT has been attempted to overcome this concern; however, long-term outcomes were not favorable.

In a clinical trial that included 10 patients with tinea cruris caused by Trichophyton, the author administered 20% 5-ALA-PDT (570670 nm wavelengths) at a light dose of 50 J/cm2 for 4 hours/ session. Direct microscopy performed after 12 sessions showed negative results in 8 patients (80%). However, only 4 patients (40%) showed sustained healing at 8-week follow-up.40 Recurrence rates were as high as 50% in this study, which suggests that PDT may not be adequately effective for the eradication of fungi. The unsatisfactory therapeutic response to PDT may be attributed to high humidity and temperature in the groin, which affect the cellular uptake of ALA (Table 1).

Tinea capitis is one of the most common fungal infections observed in pre-pubertal children.41 Oral antifungal medications are considered standard therapy for tinea capitis; however, the increasing prevalence of resistant strains and adverse events limit the use of conventional antifungal treatment. Lu et al42 reported a case of relapsed suppurative tinea capitis in a child who showed mycological and clinical cure after ALA-PDT plus itraconazole treatment administered over three sessions. Treatment included topical application of 20% 5-ALA and an occlusive dressing for 3 hours, followed by irradiation using a light-emitting diode (LED) light (630 nm, 80 J/cm2) for 20 min/session. The authors observed that PDT destroyed metabolically active cells in addition to resistant forms such as conidia. PDT may serve as a useful adjunct for the treatment of refractory tinea capitis (Table 1).

Pityriasis versicolor (PV) is a chronic recurrent fungal infection of the stratum corneum. Although guidelines recommend systemic therapy for PV, this chronic condition is characterized by refractoriness to treatment. MB and MAL are common PSs used for the treatment of PV because the hydrophilicity of MB limits it to the stratum corneum, and the lipophilicity of MAL, restrains lipophilic Malassezia.1,43 Alberdi et al43 used MB-PDT (2% MB and a red LED lamp [= 6305 nm, 37 J/cm2]) to treat 5 women with disseminated PV on the back. MB-PDT administered over six sessions with a 2-week interval between sessions led to complete cure and good cosmetic outcomes without recurrence at the 6-month follow-up. The authors also recommended MB-PDT as a potential prophylactic treatment owing to its cost-effective and highly selective features (Table 1).

Oral candidiasis is a common opportunistic fungal infection typically observed in immunocompromised patients. Infection control is extremely important in these patients to avoid serious and often fatal outcomes. Candida albicans is the most common pathogen that causes oral candidiasis. Compared with its planktonic form, the biofilm-forming species is more pathogenic and necessitates a higher concentration of PS and a longer incubation period.4446 A study performed by Freire et al, which included biofilm growth in vitro and in a mouse model showed the efficacy of new methylene blue (NMB)-mediated PDT against C. albicans.47 Both the survival fraction analysis (log reduction of colony forming units (CFU/mL)) of C. albicans and histopathological examination showed eradication of fungi. The authors also observed that potassium iodide (KI) potentiated MB-PDT, which may be secondary to the fact that KI provides a greater number of electrons to MB to initiate a Type I photochemical reaction.

A case report and an in vivo experiment in the Galleria mellonella model have described that MB-PDT could rapidly heal oral lesions caused by drug-resistant C. albicans strains and reduce the fungal burden by 0.2 log in the animal model.48,49 However, the role of PDT in the prevention of drug resistance remains unclear.

In addition to oral lesions, C. albicans causes esophageal candidiasis (EC), particularly in immunocompromised hosts such as in patients with cancer, AIDS, diabetes, or a glucocorticoid-dependent state.50 Qiu et al51 successfully treated EC and controlled the progression of esophageal cancer using photocarcinorin-mediated PDT. Photocarcinorin (PSD-007), a mixed porphyrin preparation, is used as a PS; however, the mechanism of photo-oxidative injury remains unknown (Table 1).

Vulvovaginal candidiasis (VVC) affects approximately 75% of women of child-bearing age; C. albicans is the main pathogen associated with this infection.52 The azole family of drugs is widely used against Candida infection; however, these drugs block the activity of some essential enzymes and lead to adverse effects.53 The etiological agents implicated in VVC, including C. albicans and C. glabrata may be resistant to antifungal agents, including fluconazole.54 PDT represents a novel therapeutic adjuvant without deleterious effects.

A study performed by de Santi et al reported the use of MB- and protoporphyrin IX (PpNetNI)-mediated PDT to treat VVC in a mouse model.55 The authors observed reductions of one order of magnitude in the CFUs of C. albicans after 7-day treatment without any adverse effects on the vaginal mucosa at the ultrastructural level. In addition to its fungicidal effect, PDT reduced edema and abscess formation, which provided adequate time for the host immune system to eradicate the fungi.55

Machado-de-Sena et al observed reduction in the fungal burden and inflammation in a murine model of VVC within 24 hours of completion of MB-PDT (Table 1).56 However, fungal recolonization occurred 96 hours after PDT because this organism is a commensal that colonizes the healthy human mucosa. The authors speculated that MB-PDT may inhibit the formation of germ tubes, which contribute significantly the virulence of C. albicans. Additionally, PDT minimizes the harmful effects of toxins on the vaginal mucosa and is therefore a safe therapeutic choice.56

Chromoblastomycosis (CBM), a chronic granulomatous subcutaneous fungal infection caused by dematiaceous fungi is associated with low cure and high relapse rates.9 Fonsecaea monophora, Fonsecaea pedrosoi, and Cladophialophora carrionii are the most common fungal species associated with CBM. Notably, fibrosis is a major obstacle to successful oral antifungal management. Owing to diverse clinical manifestations and etiological agents, the optimal therapy for CBM remains uncertain. PDT has emerged as a promising physical approach to treating CBM, particularly in the early stages of the disease.57

Two in vitro experiments have shown that ALA-PDT and MB-PDT significantly decreased fungal CFUs in CBM by 24 and 4 orders of magnitude, respectively.58,59 Clinical trials have reported that muriform cells pose a therapeutic challenge; following tissue invasion, fungi are transformed into muriform cells, which aid with immune system evasion and antifungal drug resistance. PDT may directly destroy muriform cells or stimulate the host immune response. An in vivo experiment in the Galleria mellonella model confirmed the antimicrobial effect of ALA-PDT via immunomodulation of innate immunity secondary to increased hemocyte density, cell morphological transformation, and pathogen sensitivity.60

Combination therapy including PDT and systemic antifungal drugs is preferred in clinical practice, because most patients present for evaluation with moderate or severe disease. There are some successful clinical practices for PDT in patients with complex CBM using ALA-PDT associated with itraconazole or terbinafine.9,58,61 A sequential PDT protocol after failed drug therapy showed fungicidal effects similar to those observed with combination therapy.62 In patients with CBM post PDT treatments, most lesions showed clear improvement, and mycological examination results were negative after the last therapy session, with a few pigmentary changes but no new lesions on long-term follow-up.9

In addition to the combination of two methods, comprehensive treatment using several methods may be beneficial. Lan et al63 reported that PDT combined with oral antifungal agents, isotretinoin, and CO2 laser showed antifungal activity against clinical CBM (Table 1). The CO2 laser slightly injures the skin surface and thereby promotes penetration of the PS; such comprehensive management produces synergistic inhibitory effects.

Moreover, in vitro susceptibility tests may not accurately predict clinical response. A study has reported that several isolates of pathogenic strains from patients were sensitive to oral antifungal drugs but showed resistance in vivo.9 The overall patient status, phenotypic changes, differential gene regulation, and biofilm formation by dermatophytes may affect treatment efficacy.64 Therefore, clinical trials that determine the response rate of specific fungi to PDT are urgently needed.

Sporotrichosis, a fungal infection caused by the Sporothrix schenckii complex, a thermally dimorphic species, is often restricted to cutaneous, subcutaneous tissue, and lymphatic vessels.65 Oral itraconazole is commonly used for treatment of sporotrichosis; however, drug-induced hepatotoxicity remains a serious concern. PDT is an effective alternative for localized fungal infections without severe adverse effects.

Gilaberte et al66 reported complete microbiological and clinical cures in a patient with recalcitrant cutaneous sporotrichosis, who received intralesional 1% MB-PDT combined with intermittent low-dose itraconazole. The authors also performed an in vitro photoinactivation test on the fungus isolated from the patient and observed that three phenothiazinium PSs (MB, NMB, and 1.9-dimethyl methylene blue) produced a 6 log10 fungicidal effect, whereas MAL did not inhibit fungal growth, even at high concentrations (6 M). This result was consistent with the clinical outcomes observed in the patient (Table 1). Reportedly, the S. schenckii complex produces melanoid pigments that absorb light and scavenge ROS to limit the efficacy of PDT.67 The fungicidal efficacy of MB-PDT specifically against S. schenckii complex may be attributed to the method of administration, low optical interference, and high ROS production.66

Phaeohyphomycosis is a fungal infection that includes a wide spectrum of infections of the epidermis and subcutaneous tissues in addition to systemic involvement. It is caused by melanized fungi, and no standard antifungal therapy is currently available for this infection. Liu et al68 reported the use of ALA-PDT as adjuvant therapy combined with oral itraconazole and terbinafine to treat an elderly immunocompromised woman with phaeohyphomycosis caused by Exophiala spinifera. The authors used 20% 5-ALA red light (633 nm) at an intensity of 120 mW/cm2 administered over three sessions. Mycological evaluation showed negative results with significantly improved lesions and no notable adverse effects (Table 1).

Majocchis granuloma (MG) is a deep suppurative granulomatous perifolliculitis primarily caused by T. rubrum. Shi et al12 reported a case of refractory MG that was successfully treated after three-cycles of ALA-PDT. The lesions were treated using a plum-blossom needle before incubation with 10% ALA, followed by irradiation using red LED light (635 nm) at a power density of 100 mW/cm2 for 120 J/cm2. The authors simultaneously used the clinical strain isolated of the patient for in vitro and in vivo experiments in a guinea pig model. Both in vitro and in vivo experiments demonstrated that ALA-PDT directly destroys the structural framework of the fungal cells and thereby inhibits T. tonsurans and also recruits CD4+ T lymphocytes (Table 1).

Mucormycosis, most commonly caused by Rhizopus oryzae is an aggressive and invariably fatal opportunistic fungal infection that originates in the nasal tissues and spreads into the paranasal sinuses and deep organs with a rapid angioinvasive course. Mucorales are resistant to most triazoles, and surgical debridement is associated with specific limitations.11 Liu et al11 observed that MB-PDT inhibited the growth of R. oryzae and enhanced its susceptibility to azoles and amphotericin B in vitro, which explains the synergistic effects of antifungal agents combined with PDT, which was observed in the clinic to some extent (Table 1).

Usually, most adverse effects of PDT, including local erythema, edema, pain, burning and stinging sensations, and itching, which occur within the first PDT session are mild and tolerable.69,70 Slight blistering and minimal exudation may occur in a few patients. Hyper- or hypopigmentation or scars may persist over a long period of time, particularly in patients with deep fungal infections using ALA-PDT.71 However, most adverse effects are temporary and usually disappear within 2 weeks after PDT.72

Although significant research has focused on the role of PDT against fungal infections in recent years, most studies have provided proof-of-concept evidence in case reports in contrast to clinical data obtained through large-scale randomized controlled trials to confirm the long-term efficacy and safety of PDT, to optimize PDT protocols, and definitively establish PS for optimal benefit in specific fungal infections.

Comparison between articles is difficult owing to heterogeneity across studies, which results in a lack of high-quality meta-analyses. Notably, with regard to PDT, the type and concentration of PS, incubation time, light source, wavelengths used, energy, density, duration of exposure to irradiation, frequency of treatment, and growth of microorganisms, among such variables differed across studies, and in view of the diverse treatment settings, results too tend to vary widely, which may interfere with the accuracy of results, with regard to the efficacy of PDT.

Most studies have focused on only a few fungal diseases such as onychomycosis, oral candidiasis, and CBM that are commonly observed in clinical practice or are refractory to standard therapy.15,31,48,57,63 Further studies are needed to gain deeper insight into the exact mechanisms underlying cell death and enhanced susceptibility of fungi to antifungal medications.9,11,60

Few clinical studies in the literature have investigated the specific fungal response to PDT. Some studies have reported inconsistent and even contradictory results between in vitro and in vivo experiments.9 Therefore, in vitro experiments may not accurately predict the clinical response to PDT, and systematic clinical evaluation of specific fungal susceptibility to PDT is essential.

PDT may serve as a potential therapeutic alternative to address increasing drug-resistance encountered in patients with cutaneous fungal infections. PDT is effective against onychomycosis, tinea capitis, PV, oral candidiasis, and VVC in patients with superficial fungal infections. However, PDT did not offer any advantages over conazoles for the treatment of tinea pedis and tinea cruris.73 With regard to deep fungal infections, PDT combined with antifungal drugs was shown to improve treatment efficacy in patients with CBM, sporotrichosis, phaeohyphomycosis, MG, and mucormycosis.

To summarize, PDT is safe and effective and is occasionally useful as a prophylactic and cosmetic tool. Most adverse effects of PDT are limited, temporary, and tolerable. PDT monotherapy or PDT combined with oral antifungal medications may be a promising therapeutic strategy for the management of recurrent or severe cutaneous fungal infections.

This work was supported by grants from the Scientific Research Project of the Traditional Chinese Medicine Bureau of Guangdong Province (Grant no-20212147).

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

The authors report no conflicts of interest in this work.

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The clinics treatments have minimal disruption of patients lives as they barely have any downtime once the healing begins. The experienced staff and technologies improve accuracy in diagnosis and treatment, resulting in better patient outcomes. The therapies offer an alternative to patients who do not want to experience the high costs and long recovery periods commonly associated with invasive providers like surgery.

QC Kinetix (Grand Junction) offers other services like free consultations. During the first visit, the patients treatment eligibility is determined, and the staff recommends the best treatments for their pain or injury.

For consultation and booking, contact their staff by calling (970) 747-5868. The clinic is located at 2646 Patterson Rd, Suite B Grand Junction, CO, 81506, US. Visit the company website for more information on their Grand Junction office and their natural regenerative medicine treatments.

Media Contact

Company NameQC Kinetix (Grand Junction)Contact NameScott HootsPhone(970) 747-5868Address2646 Patterson Rd, Suite BCityGrand JunctionStateCOPostal Code81506CountryUnited StatesWebsitehttps://qckinetix.com/grand-junction/

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QC Kinetix (Grand Junction) is Improving the Quality of Life for Patients Suffering Pain and Injuries Through Regenerative Medicine - Digital Journal

Green Bay, WI QC Kinetix (Ashwaubenon) has recorded many patient testimonials from Green Bay residents who have chosen to explore alternative treatments to combat joint pain and related problems. The pain control clinic leverages its regenerative medicine treatment approach to address common pain complaints affecting the joints while improving patients quality of life.

Describing their treatment program, the Pain control clinics spokesperson noted that they use natural treatment therapies in conjunction with regenerative medicine to address common symptoms complained by patients suffering from joint pain. According to the clinics spokesperson, their treatment approach is free from the use of heavy medications or other conventional treatment approaches, instead, they focus on encouraging the bodys natural healing abilities using natural and minimally invasive treatment strategies.

Green Bay residents who have been told to seek surgical intervention can also prevent the risks and complications associated with such invasive procedures by scheduling an appointment with QC Kinetix (Ashwaubenon).

Describing their surgery alternative, one of the treatment providers at the clinic said: Many residents in Ashwaubenon have received a surgery recommendation as the only option to relieve their chronic pain. However, regenerative medicine offers countless alternatives to surgery that could help you heal. Why not seek a second opinion from the orthopedic treatment providers at QC Kinetix or schedule a free initial consultation at our Ashwaubenon regenerative clinic to learn more? Our team offers an extensive range of regenerative medical solutions. These treatments offer natural, non-surgical alternatives to treating the chronic pain and inflammation associated with various conditions, including degenerative diseases, inherited diseases, sports injuries, and trauma injuries.

Encouraging Green Bay residents to explore their Green Bay regenerative medicine services, another treatment provider at the clinic noted that their treatment approach not only addresses the symptoms but also goes deeper to address underlying conditions and problems. Patients at the clinic will enjoy many benefits, including the repair and restoration of damaged and injured tissues, strengthened existing healthy tissue, reduced pain and inflammation, and increased response to repairs in the body.

QC Kinetix (Ashwaubenon) offers personalized services to each patient. The treatment providers will learn more about their patients during the consultation, perform a comprehensive examination and physical assessment, and then provide tailored treatment plans to address diagnosed problems. The pain control clinic welcomes interested people to visit their website to check testimonials of patients who have experienced improvements after four treatment sessions.

QC Kinetix (Ashwaubenon) is open to victims of all kinds of joint-related problems, including knee pain, shoulder pain, elbow and wrist pain, finger, toe, and ankle pain, etc. The treatment providers can be reached at their clinic located at 1525 Park Place, Suite 200, Green Bay, WI, 54304, United States. Call (920) 944-8811 to schedule an appointment or visit their website to fill out a web form.

Media Contact

Company NameQC Kinetix (Ashwaubenon)Contact NameScott HootsPhone(920) 944-8811Address1525 Park Place, Suite 200CityGreen BayStateWIPostal Code54304CountryUnited StatesWebsitehttps://qckinetix.com/green-bay/ashwaubenon/

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QC Kinetix (Ashwaubenon) Reveals How Its Green Bay Regenerative Medicine Treatments Have Improved Patients' Lives - Digital Journal

Health minister Khairy Jamaluddin speaks during a press conference in Petaling Jaya June 21, 2022. Picture by Firdaus Latif

By Shahrin Aizat Noorshahrizam

Tuesday, 21 Jun 2022 1:46 PM MYT

KUALA LUMPUR, June 21 The Ministry of Health is currently monitoring the medicine shortage issue in the country and has conducted random surveys in local health facilities to ascertain the situation.

Health Minister Khairy Jamaluddin said through the survey that was conducted in seven hospitals and 10 private clinics, it was found that at least one medicine that is usually used to treat common ailments like cough and cold fever is facing a shortage.

Since June 16, 1,231 products have been sent to product registration holders to get active ingredient feedback ... we have received 50 percent of the feedback. There is a shortage of alternative products that have been reported by the medical association of hospitals and so on so that they can get alternative medicine.

Last week, the MoH agreed to lend medicines to private medical facilities that have enough of their medicines. We expect this situation to be stabilized within the next month or so, he said during a press conference today.

On June 9, Khairy said that the medicine shortage issue was not due to panic buying by members of the public.

He clarified that the shortage was due to the high demand for certain medications following the spread of the Omicron variant of Covid-19 and the rising cases of the hand, foot and mouth disease (HFMD) at the moment.

However, Khairy said the situation is not reported nationwide and only involved several locations. Earlier this month, Bandar Kuching MP Dr Kelvin Yii raised the issue and urged the government to come up with a clear policy to address the current shortage of medicines in the country.

He said this is on top of devising a "longer-term national medicine security strategy" to prevent future drug shortages in Malaysia, given the countrys current vulnerable position as a net importer of pharmaceutical products.

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Khairy: Medicine shortage will be resolved within next month | Malay Mail - Malay Mail

Get to know Chiropractor Dr. Anthony Hardnett, who serves patients throughout the State of Maryland.

(ProNewsReport Editorial):- New York City, New York Jun 21, 2022 (Issuewire.com)An established chiropractor, Dr. Hardnett places his emphasis on treating the patient as a whole and finding the cause of the problem, not just the symptoms. He owns and operates the premier state-of-the-art Effective Chiropractic Health & Wellness Center in Maryland, and has an overwhelmingly high success rate in helping patients with their health concerns. He feels that offering the latest treatment options, efficient care plans and patient education are all keys to the patients ultimate success. In 11 short years, he has made his practice the premier state-of-the-art chiropractic health and wellness facility in Maryland.

Effective Chiropractic Health & Wellness Center has grown from a small, 2-person office to a staff of 16 with expanded services and providers to meet their patients needs. It provides a variety of services that make them a one-stop-shop for healthcare. And in an effort to further expand services, the doctor has now added a Medical Doctor and Nurse Practitioner establishing Effective Integrative Healthcare, LLC to provide more integrative services for the community. He also added another office in Prince Georges County to further expand the practices ability to reach and help more patients.

In regards to his educational background, Dr. Hardnett graduated with his Doctor of Chiropractic degree from Life University in 2007. He is board-certified in Integrative Medicine (BCIM), which is the practice of using multiple treatment options within traditional medicine and alternative medicine to help patients. He also has extensive post-doctorate education relating to MRI interpretation and treatment of disc-related injuries.

With an unwavering commitment to his specialty, the doctor has been recognized as a Diplomate of the College of Manipulative and Body-Based Practices (DMBBP), which enhances his knowledge of how manipulation of the spine can assist the body to heal, as well as a Diplomate of the American Academy of Medical Legal Professionals (DAAMLP).

Chiropractic is a form of alternative medicine that mainly deals with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine. A chiropractor uses spinal adjustments, manipulation, and other techniques to manage patients health concerns, including neck pain, back pain, headaches, vertigo, and a long list of other ailments and conditions. They aim to improve patients functionality and quality of life by properly aligning the bodys musculoskeletal structure and enabling the body to heal itself naturally, without the use of medication or surgery.

Learn More about Dr. Anthony Hardnett:Through his findatopdoc profile, https://www.findatopdoc.com/doctor/2610078-Anthony-Hardnett-Chiropractor, or through Effective Chiropractic Health & Wellness Center, https://www.eihmd.com/about-us/

About FindaTopDoc.comFindaTopDoc is a digital health information company that helps connect patients with local physicians and specialists who accept your insurance. Our goal is to help guide you on your journey towards optimal health by providing you with the know-how to make informed decisions for you and your family.

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Anthony Hardnett, DC, BCIM, DMBBP, DAAMLP, a Chiropractor with Effective Chiropractic Health Wellness Center - Pro News Report