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Fennel, intestinal spasms, and infantile colic new
#23206 - 10/12/03 04:48 PM

Altern Ther Health Med. 2003 Jul-Aug;9(4):58-61.

The effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study.

Alexandrovich I, Rakovitskaya O, Kolmo E, Sidorova T, Shushunov S.

Department of Pediatrics, St. Petersburg Medical Academy of Postdoctoral Education, St. Petersburg, Kirochnaya, Russia.

CONTEXT: Despite its benign, natural course, colic is a significant problem in infants and imparts a psychological, emotional, and physical burden to parents. Dicyclomine hydrochloride is the only pharmacological treatment for infantile colic that has been consistently effective. Unfortunately, 5% of infants treated with dicyclomine hydrochloride develop serious side effects, including death. Fennel seed oil has been shown to reduce intestinal spasms and increase motility of the small intestine. However, there have not been any clinical studies of its effectiveness. OBJECTIVES: To determine the effectiveness of fennel seed oil emulsion in infantile colic. DESIGN: Randomized placebo-controlled trial. SETTINGS: Two large multi-specialty clinics. SUBJECTS: 125 infants, 2 to 12 weeks of age, who met definition of colic. INTERVENTION: Fennel seed oil emulsion compared with placebo. OUTCOME MEASURE: Relief of colic symptoms, which was defined as decrease of cumulative crying to less than 9 hours per week. RESULTS: The use of fennel oil emulsion eliminated colic, according to the Wessel criteria, in 65% (40/62) of infants in the treatment group, which was significantly better than 23.7% (14/59) of infants in the control group (P < 0.01). There was a significant improvement of colic in the treatment group compared with the control group [Absolute Risk Reduction (ARR) = 41% (95% CI 25 to 57), Number Needed to Treat (NNT) = 2 (95% CI 2 to 4)]. Side effects were not reported for infants in either group during the trial. CONCLUSION: Our study suggests that fennel seed oil emulsion is superior to placebo in decreasing intensity of infantile colic.

Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial

PMID: 12868253 [PubMed - indexed for MEDLINE]

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Fennel for the treatment of primary dysmenorrhea new
#23207 - 10/12/03 04:51 PM

Int J Gynaecol Obstet. 2003 Feb;80(2):153-7.

Comparison of fennel and mefenamic acid for the treatment of primary dysmenorrhea.

Namavar Jahromi B, Tartifizadeh A, Khabnadideh S.

Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.

OBJECTIVES: To compare the effect of Foeniculum vulgare variety dulce (Sweet Fennel) vs. mefenamic acid for the treatment of primary dysmenorrhea. METHODS: A cohort of seventy women, 15-24 years old from a local university and high-school, who complained of dysmenorrhea were enrolled in this study. Ten cases were excluded due to evidence of secondary dysmenorrhea. The remaining 60 patients were graded mild, moderate and severe on the basis of a verbal multidimensional scoring system. Thirty patients with mild dysmenorrhea were also excluded from the study. Each of the 30 cases with moderate to severe dysmenorrhea was evaluated for three cycles. In the first cycle no medication was given (control cycle), in the second cycle the cases were treated by mefenamic acid (250 mg q6h orally) and in the third cycle, essence of Fennel's fruit with 2% concentration (25 drops q4h orally), was prescribed at the beginning of the cycle. These cycles were compared day by day for the effect, potency, time of initiation of action and also complications associated with each treatment modality, by using a self-scoring system. Intensity of pain was reported by using a 10-point linear analog technique. Statistical analyses were performed by the independent sample t-test, paired t-test and repeated measurement analysis method. RESULTS: In the study group the mean age of menarche was 12.5+/-1.3 years, the mean duration of menstruation was 6.6+/-1.4 days with the mean cycle days of 27+/-3. The findings observed during menses were as follows: headache in 26.7%, nausea in 63.3%, vomiting in 23.3%, diarrhea in 33.3%, fatigue in 93.3% and leaving the daily tasks undone was reported in 86.9% of the cases. Both of the drugs effectively relieved menstrual pain as compared with the control cycles (P<0.001). The mean duration of initiation of action was 67.5+/-46.06 min for mefenamic acid and 75+/-48.9 min for fennel. The difference was not statistically significant (P=0.57). Mefenamic acid had a more potent effect than fennel on the second and third menstrual days (P<0.05), however, the difference on the other days was not significant. No complication was reported in mefenamic acid treated cycles, but one case (3.11%) reported a mild increase in the amount of her menstrual flow. CONCLUSIONS: The essence of fennel can be used as a safe and effective herbal drug for primary dysmenorrhea, however, it may have a lower potency than mefenamic acid in the dosages used for this study.

PMID: 12566188 [PubMed - indexed for MEDLINE]

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Hepatoprotective effect of Fennel essential oil new
#23208 - 10/12/03 04:53 PM

Fitoterapia. 2003 Apr;74(3):317-9.

Hepatoprotective effect of Foeniculum vulgare (Fennel) essential oil.

Ozbek H, Ugras S, Dulger H, Bayram I, Tuncer I, Ozturk G, Ozturk A.

Yuzuncu Yil University, Faculty of Medicine, Department of Pharmacology, Van 65300, Turkey. hanefiozbek@homail.com

Hepatoprotective activity of Foeniculum vulgare (fennel) essential oil (FEO) was studied using carbon tetrachloride (CCl(4)) induced liver injury model in rats. The hepatotoxicity produced by acute CCl(4) administration was found to be inhibited by FEO with evidence of decreased levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and bilirubin. The results of this study indicate that FEO has a potent hepatoprotective action against CCl(4)-induced hepatic damage in rats.

PMID: 12727504 [PubMed - indexed for MEDLINE]

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Possible Drug Interactions with: Ginger new
#23260 - 10/13/03 01:19 PM

Possible Interactions with: Ginger

If you are currently being treated with any of the following medications, you should not use ginger without first talking to your healthcare provider.

Blood-thinning medications
Although ginger may interfere with blood clotting, there have been no scientific or case reports of interactions between ginger and blood-thinning medications. However, people taking these medications with ginger should be monitored closely by a healthcare practitioner for risk of bleeding.

Cyclophosphamide
Ginger may reduce the toxic side effects of cyclophosphamide (a medication used to treat a variety of cancers). More research is needed in this area.

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HeatherAdministrator

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Aloe plant's IBS healing powers tested new
#27741 - 11/18/03 03:42 PM

Plant's IBS healing powers tested

Millions of people could benefit from pioneering research at three south west Wales hospitals which are investigating the medicinal properties of a desert plant.

Neath, Morriston and Singleton hospitals are the first to trial aloe vera as a treatment for irritable bowel syndrome (IBS), which affects around 20% of the UK population.

Aloe vera is a native plant of southern Africa.

More than 250 IBS sufferers in the region are taking part in the two-year study, which will cost 50,000.

One of the volunteers Glyn Stevens, from Swansea, said the condition, which ranges from acute diarrhoea to constipation, has had a profound affect on his life.

"The pain is really bad and affects me on a daily basis," he said.

"It makes me cough so much it almost chokes me."

Sufferers often desperately need to go to the toilet with little warning, which severely limits their lifestyle.

There is a lot of anecdotal evidence of the beneficial properties of aloe vera but this has never been proven

Claire Hopkins, 26, from Penclawdd, said: "I have terrible stomach problems which have really affected my life.

"A cure would be marvellous."

So far clinical research has failed to identify the causes of IBS or a remedy for the condition.

However, experts working on the aloe vera trials are hopeful they can exploit the plant's healing properties.

Professor John Williams, consultant gastroenterologist, said: "IBS is very debilitating, causing troublesome symptoms which interfere with the social and working life of the individual.

"This is a study to look for an alternative treatment.

"There is a lot of anecdotal evidence of the beneficial properties of aloe vera but this has never been proven."

Aloe vera is not a drug but is derived from a plant which is part of the lily family.

It has been used as a complementary treatment since the 18th Century.

Each aloe vera plant takes about five years to mature and has a life span of about 12 years.

The leaves are harvested between three and four years of age which is used to make the liquid, which will be the basis of the research.

The study is being funded by the Foundation for Integrated Medicine.


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Probiotic improves gastrointestinal symptoms in patients with chronic constipation new
#29624 - 12/01/03 06:00 PM

Canandian Journal of Gastroenterology
November 2003, Volume 17, Number 11:655-659

Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation

C Koebnick, I Wagner, P Leitzmann, U Stern, HJF Zunft

BACKGROUND: The aim of the present study was to investigate the effect of a probiotic beverage on gastrointestinal symptoms in patients with chronic constipation.

METHODS: A double-blind, placebo-controlled, randomized study was conducted over a four-week period in patients with symptoms of chronic constipation (n=70). To all patients, 65 mL/day of a probiotic beverage containing Lactobacillus casei Shirota (LcS) or a sensorially identical placebo was administered. Patients completed a questionnaire on gastrointestinal symptoms, well-being and stool habits and underwent a medical examination weekly. Severity of constipation, flatulence and bloating was summarized into four categories (severe, moderately severe, mild and no symptoms).

RESULTS: The consumption of LcS resulted in a significant improvement in self-reported severity of constipation and stool consistency, starting in the second week of the intervention phase (P<0.0001). Severe and moderately severe constipation was observed less in the LcS group. The occurrence and degree of flatulence or bloating sensation did not change. In the final examination, 89% of the LcS group and 56% of the placebo group showed a positive effect of their beverage on constipation (P=0.003). No adverse reactions were reported.

CONCLUSIONS: The results indicate a beneficial effect on gastrointestinal symptoms of patients with chronic constipation. The administration of probiotic foodstuffs may be recommended as an adjunctive therapy of chronic constipation.


http://www.pulsus.com/Gastro/17_11/koeb_ed.htm

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Lactobacillus Reduces Irritable Bowel Bloating new
#29625 - 12/01/03 06:06 PM

Lactobacillus Plantarum 299v Reduces Irritable Bowel Bloating

American Journal of Clinical Nutrition

03/12/2001
By Elda Hauschildt


Lactobacillus plantarum 299v decreases abdominal bloating in patients with irritable bowel syndrome.

Swedish researchers from Lund University in Lund note that lactic acid fermentation is the simplest and safest way to preserve food. They suggest that people have likely always used it in food preservation.

Various species, such as L plantarum, L rhamnosus, L paracasei, L acidophilus and L salivarius, occur in human mucosa from the mouth to the rectum.

Investigators point out that L plantarum is found in foods that are fermented from plants, while L paracasei and L rhamnosus are associated with dairy products.

They explain that L plantarum 299v is a strain originating from the human intestinal mucosa. Animal research has shown that it decreases translocation and improves mucosal and liver status. It also improves the immunological status of mucosa and reduces mucosal inflammation.

In people, L plantarum 299v increases the concentration of carboxylic acids in feces and decreases abdominal bloating in patients with IBS. It can also decrease fibrinogen concentrations in the blood.

Investigators note that a probiotic food product that contains no milk constituent was launched in Sweden in 1994. This product -- a lactic acid-fermented oatmeal gruel mixed with a fruit drink -- contains approximately 5 x 10(10) colony-forming units of L plantarum 299v.

"Should probiotics be administered through foods," the researchers point out, "the probiotic organism must remain vigorous in the food until consumption, and the food must remain palatable."

They add that L plantarum 299v affects both the bacterial flora of the intestinal mucosa and regulates the host's immunologic defence.
American Journal of Clinical Nutrition, 2001; 73: 380S-385S

http://www.docguide.com/news/content.nsf/news/8525697700573E1885256A0C006D6D93

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HeatherAdministrator

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Bacteria Basics - Probiotics for IBS and IBD new
#56178 - 03/30/04 01:56 PM

Bacteria Basics

by Dr. Hilary Marshall


Battling my way around the supermarket aisles, bamboozled by the array of new products on the shelves, I am suddenly aware of an invasive life form taking hold of the chiller cabinet. Having turned yoghurts into drinks, the marketing men have decided to woo us with science, by plastering the word "probiotic" on the pots.

The blurb tells us that they are good for us; that they aid digestive health; and that they give our guts that most elusive elixir of 21st century life - balance.

But if you dont have time to peruse the fine print on those little bottles of Yakult, Danone Actimel et al, you may have walked on by to the check-out simply because you dont know what a probiotic is.

Even if you do, you may well be wondering how much scientific evidence exists to back the manufacturers claims that they are good for your health.

Probiotics - which means "for life" - are so-called "friendly bacteria" which are believed to be beneficial in maintaining a healthy digestive system.

The human gut is home to around 400 different species of bugs, some good, and some bad. The Lactobacillus and Bifidobacterium lurking there are probiotic species of bugs which aid digestion by breaking down tough fibres, enzymes and other proteins in our food. Probiotics also produce important nutrients such as vitamin K, and ferment organic acids which are absorbed into the bloodstream for energy.

However, these good guys have to share their habitat with bad bugs such as E.Coli, Salmonella and Clostridium - bugs which are responsible for most bouts of diarrhoea, and which can prove fatal.

The balance between the good and bad bacteria is key to maintaining good digestive health, and when all is well our digestive systems are a relatively stable "microflora".

So if probiotics are already part of the bodys natural make-up, why pay to throw even more of them down our throats? The answer to that lies in the daily assaults our digestive system receives from what we consume, and the way we live.

Stress, illness and prescription medicines can all play havoc with the bacterial balance. Antibiotics pose particular problems, because as well as killing off the bad bacteria for which they were prescribed, they kill off the good guys too.

It is in a bid to restore balance - or guard against imbalance - that most people turn to probiotic products.

Probiotics certainly have an army of fans, with the worldwide markets for products such as Yakult, Danone, Actimel and the like estimated to stand at 3.3 billion a year.

Over the past century or so probiotics have been credited with alleviating symptoms in a range of illnesses, from constipation and irritable bowel syndrome, to more serious gut complaints such as ulcerative colitis and Crohns disease. They have also been applied in the treatment of vaginal, urinary tract, dental, ear and wound infections. In addition, they have been shown to reduce the length of illness in some of the 100,000 cases of food poisoning seen in the UK annually due to pathogen - or disease causing - bacteria.

But how big is the body of scientific evidence that probiotics actually work?

Probiotics have had almost a century to prove themselves. The concept first emerged in 1907, when Elie Metchnikoff, the Nobel Prize winning scientist, attributed the longevity of a Bulgarian peasant village to its inhabitants consumption of live yoghurt. Metchnikoffs work influenced a Japanese doctor, Minoru Shirota, who in 1935 developed a fermented milk drink containing the unique probiotic, Lactobacillus casei shirota. Shirota claimed this bacteria was beneficial, and named it Yakult - the Esperanto word for yoghurt. The probiotic drink was born.

Since then a number of well designed clinical trials have shown beneficial effects of probiotics in the treatment of travellers diarrhoea, acute diarrhoea in children and antibiotic associated diarrhoea. Other trials have also shown that lactobacilli taken as live yoghurt or vaginal tablets can successfully treat vaginal bacterial and Candida infections. One Canadian research team has had some success in using intravaginal probiotics to treat recurrent urinary tract infections. Trials also suggest that such bacteria can have a beneficial effect on the immune system.

One Finnish study found that giving a daily dose of the probiotic Lactobacillus rhamnosus bacteria to pregnant women and their babies during the first six months of life reduced the incidence of eczema, when compared with a control group which did not receive the bacteria.

The Bifidobacteria which are present in breast milk, are also known to rapidly colonise the guts of breast-fed babies, who suffer fewer gastrointestinal infections as a result. Scientists are now wondering if probiotics could play a part in the immunisation of babies, and if it would be beneficial to add probiotic substances to infant milk formulas.

A similar approach is already being used by the United States Agricultural Research Service to reduce levels of disease-causing bacteria such as Salmonella and Campylobacter in poultry. Newly hatched birds are fed probiotic bacteria to prevent their guts being colonised with bacteria, which have the potential to cause food-borne illness in humans.

Professor Tom MacDonald, a gut immunologist at Southampton University, is currently looking at various aspects of immune function in healthy individuals taking the probiotic drink Actimel.

He says that the scientific community is very interested in the use of probiotics in treating inflammatory bowel diseases such as ulcerative colitis and crohns, but says there is a paucity of good clinical trials in this area.

Professor George MacFarlane, a bacteriologist at the Medical Research Council Microbiology and Gut Biology Unit at Ninewells Hospital in Dundee, may have found a way to make the "probiotic hit" more effective. Researchers recently completed a pilot study in ulcerative colitis of a "synbiotic" - a prebiotic given in combination with a probiotic - which he says gives the probiotic a better opportunity to establish itself in the bowel.

"We found that there were differences in the populations of Bifidobacteria in the gut lining of healthy people compared with ulcerative colitis patients. We then selected a Bifidobacterium from a healthy mucosa [gut lining] and looked to see whether it had probiotic qualities and whether it grew well on the probiotic," he says. Colitis patients were given the synbiotic for a month in a double-blind placebo-controlled trial. The results are yet to be published, but Prof MacFarlane says it found marked improvements in clinical appearance and reduced inflammation.

Considering the apparent benefits of probiotics, they were slow to arrive in the UK. Yakult launched in Japan in 1955, but it only started manufacturing in Europe in 1994 and did not reach the UK until 1996. Danone launched its probiotic drink Actimel in Belgium in 1994, and it now sells in 26 countries, with an estimated 6 million bottles being consumed daily. Danone claims its patented probiotic, Lactobacillus.casei.immunitass, "helps support your bodys natural defences". Muller introduced their probiotic, Provitality, range in 2000. Probiotic products seem to be proliferating faster than a bacterial culture.

But if research has been lacking in some areas, that seems about to change. Although technically rivals, Danone and Yakult recently announced that they are to collaborate more closely on the development of probiotic products. The EU recently invested more than 15 million on research in this area, and a forthcoming directive on food labelling may allow probiotic products to carry wider claims about their health benefits.

But what does all this mean when you are doing your supermarket shop? Should you go probiotic? And if so, how much should you consume, and how often? Scientists point out that the intestinal microflora is carefully balanced, and therefore it is difficult for invading bacteria to gain a foothold - and that goes for probiotic strains too. For that reason, it is generally recommended that probiotics are taken on a daily basis.

Professor Colette Shortt, director of science at Yakult, says: "We carried out a study of healthy individuals in the Netherlands, and that showed that there were increased levels of the actual probiotic strain. However, after seven days or so the levels of bacteria fall. So there is only a transient colonisation. The probiotics have to be ingested regularly to maintain levels." Results which are sure to maintain sales.

If probiotics attract you, but those pale liquids dont, check out health food shops for capsule forms - or try prebiotic tablets which aim to selectively stimulate the growth of good bacteria.

The Food Standards Agency in England is due to publish the results of two surveys shortly, one on the persistence of probiotics in the lower bowel, the other on the labelling of probiotic foodstuffs and supplements. The results should pave the way for tighter regulation of health claims on all foodstuffs - including probiotics - and so make it easier for consumers to make informed choices.

Meanwhile, the gut feeling among experts seems to be that consumption of probiotics may have health benefits for us all. Professor MacDonald says: "They certainly dont do any harm. And compared with other things we put in our mouths, probiotics are not so bad."

http://news.scotsman.com/features.cfm?id=362982004

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HeatherAdministrator

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Loc: Seattle, WA
Yogurt Prevents Antibiotic-Associated Diarrhea new
#60843 - 04/13/04 02:50 PM

Yogurt Prevents Antibiotic-Associated Diarrhea

Clinical Question: Is yogurt effective in the prevention of antibiotic-associated diarrhea?

Setting: Inpatient (any location) with outpatient follow-up

Study Design: Randomized controlled trial (nonblinded)

Synopsis: Probiotic agents are effective in preventing antibiotic-associated diarrhea. Controversy exists about whether commercially available yogurt products are similarly effective. A total of 202 hospitalized patients receiving oral or intravenous antibiotics were randomized (concealed allocation assignment) to receive vanilla-flavored yogurt (8 oz twice daily for eight days) or usual care without yogurt supplementation.

The authors do not specify the brand or type of yogurt, but note that manufacturer-supplied nutritional data indicated that the product contained active cultures of Lactobacillus acidophilus, Lactobacillus bulgaricus, and Streptococcus thermophilus. The mean age of the study participants was 70 years. All of the patients were followed for a total of eight days. Persons assessing outcomes were not blinded to treatment group assignment. Antibiotic-associated diarrhea was defined as the new onset of more than two less-than-formed bowel movements per day representing a change in previous bowel patterns.

Using intention-to-treat analysis, the authors found that patients receiving yogurt reported less frequent diarrhea (12 versus 24 percent in the usual care group; P = .04; number needed to treat = 12). In addition, patients ingesting yogurt daily reported significantly fewer days with diarrhea (23 versus 60 days). No side effects were reported other than boredom: yogurt-fed patients yearned for fruit-flavored yogurt to break the monotony.

Bottom Line: Vanilla-flavored yogurt containing active bacterial cultures effectively decreases the incidence and duration of antibiotic-associated diarrhea. Patients should be told to consume yogurt that contains active cultures. If they cannot find it, physicians should consider prescribing probiotic agents. (Level of Evidence: 2b)

david slawson, m.d.

study reference: Beniwal RS, et al. A randomized trial of yogurt for prevention of antibiotic-associated diarrhea. Dig Dis Sci October 2003;48:2077-82.

From Slawson D. Yogurt prevents antibiotic-associated diarrhea. Accessed January 6, 2004, at: http://www.InfoPOEMs.com.


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Heather is the Administrator of the IBS Message Boards. Shes the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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Probiotics and Prebiotics in Gastrointestinal Disorders new
#65453 - 04/27/04 08:53 PM

Probiotics and Prebiotics in Gastrointestinal Disorders

Posted 04/09/2004

Richard N. Fedorak, Karen L. Madsen

Abstract and Introduction

Abstract

Purpose of review: This review summarizes the clinical efficacy of probiotics and prebiotics in gastrointestinal disorders and examines the mechanisms of action related to their therapeutic effect.

Recent findings: The demonstration that immune and epithelial cells can discriminate between different microbial species has extended the known mechanism(s) of action of probiotics beyond simple barrier and antimicrobial effects. It has also confirmed that probiotic bacteria modulate mucosal and systemic immune activity and epithelial function. The progressive unraveling of these mechanisms of action has led to new credence for the use of probiotics and prebiotics in clinical medicine. Level I evidence now exists for the therapeutic use of probiotics in infectious diarrhea in children, recurrent Clostridium difficile-induced infections and postoperative pouchitis. Level II evidence is emerging for the use of probiotics in other gastrointestinal infections, prevention of postoperative bacterial translocation, irritable bowel syndrome, and in both ulcerative colitis and Crohn disease. Nevertheless, one consistent feature has emerged over the past year: Not all probiotic bacteria have similar therapeutic effects. Future clinical trials will need to incorporate this fact into trial planning and design.

Summary: The use of probiotics and prebiotics as therapeutic agents for gastrointestinal disorders is rapidly moving into the mainstream. Mechanisms of action explain the therapeutic effects and randomized; controlled trials provide the necessary evidence for their incorporation into the therapeutic armamentarium.

http://www.medscape.com/viewarticle/470571?src=mp

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