ICIM Blog

A showcase for the research of medical students, residents, and newer practitioners in integrative and holistic medicine

sponsored by the
American Holistic Medical Association and
International College of Integrative Medicine

in cooperation with their joint conference, March 19-21, 2010
“Healthy Brain, Healthy Body: Mental Wellness in the 21st Century”

PURPOSE
The purpose of the student/new practitioner poster competition is to allow medical students, residents, and newer practitioners to synthesize their research and showcase their work on a topic in the field of integrative and holistic medicine.

AWARDS & RECOGNITION

Students/residents/practitioners will share their ideas with members and guests of the AHMA and ICIM at their first-ever joint conference on March 19-21 in Nashville, Tennessee.

• The winner will receive a cash prize of $200. Judging will be conducted by a panel of multi-disciplinary academic leaders in integrative medicine.
• All poster authors will be recognized on the conference website, in the conference catalog, and in one or more organizational newsletter(s). A press release will be sent to the media in the winner’s hometown.
• Abstracts from selected high-quality submissions will be published in Alternative Therapies in Health and Medicine – the leading peer-reviewed journal in integrative medicine.

ELIGIBILITY
The competition is open to all students, residents and practitioners who are no more than 4 years past graduation.
• You need not be an AHMA or ICIM member to submit an abstract.
• All abstracts must be original work. Encore presentations are acceptable as long as the work has not been previously published.
• All co-authors must be given appropriate credit.
• If your abstract is selected by the Review Committee, you must be available to present your poster at the official event on the morning of Sunday, March 21, 2010, at the Marriott Nashville Airport Hotel. Convention registration fees apply for presenters and any co-authors who attend.

ABSTRACT SUBMISSIONS
Appropriate abstract areas include:
• Basic Research
• Clinical Research
• Integrative program design and implementation
• Integrative Education

Your abstract should include a concise introduction describing the purpose of the poster, as well as a brief description of the methods, subjects, procedures, results and conclusions. If appropriate, results can be presented in tabular form. Your abstract should not include graphs, diagrams or photographs.

Abstracts submitted should be no longer than 250 words when using 12-point, Calibri font, single-spaced. Make sure to review your abstract in its entirety prior to submitting. If your abstract is selected, content may be published and provided to all event attendees.

Abstracts will be reviewed and accepted/declined on a rolling basis, with an absolute deadline for submission of March 1, 2010. Abstracts must be emailed to nas28@case.edu to be eligible. Only electronic submissions will be accepted. Submit now online.

All submissions received before the stated deadline will receive an e-mail from the ICIM/AHMA conference committee within one week of submission as to the status of the abstract.

JUDGING CRITERIA
Your poster should be prepared so that it can be easily understood in your absence, since neither you nor your representative will be present during the judging.
Abstracts will be judged by a Review Committee composed of medical and educational professionals on the following criteria:
• Innovation and originality of project or research
• Relevance to the field of holistic/integrative medicine
• Clarity of the written abstract
• Organization of the information
• Scientific merit and/or clinical significance (for basic research and clinical research submissions)
• Impact on students, school or education (for integrative education submissions)
Judging criteria are based solely on the content of the front of the poster.
Note: With regard to research using human subjects, AHMA and ICIM endorse the protections embodied in the Basic Principles of the Declaration of Helsinki and its explanation in the regulations governing research supported by the U.S. Government (45 CFR Part 46:56 FR 28003). Research must be conducted in accordance with these regulations or it will not be accepted. Research involving humans must be approved by institutional IRBs. Investigations involving animals reported in abstracts must have been conducted with IACUC approval and in accordance with the principles set out in the NIH Guide for the Care and Use of Laboratory Animals.

GUIDELINES FOR POSTER SESSION PRESENTERS
The content of the poster must fit with a 3 x 5 foot space. Poster board and push pins will be provided by the conference. All other materials are the responsibility of the presenters.
Noted below are a few websites that show sample templates and tips for poster presentations. You can find numerous others on the Internet as well.
- http://www.posterpresentations.com/html/free_poster_templates.html?gclid=CP-Ay4Hk2J4CFRXxDAodUyo6yQ
- http://www.swarthmore.edu/NatSci/cpurrin1/posteradvice.htm
- http://www.ncsu.edu/project/posters/NewSite/
- http://www.postersession.com/?gclid=CJyDgrPn2J4CFRHyDAodjD5I8A

SCHOLARSHIPS

Participants who are full-time students in an accredited MD or DO program who are planning to attend the 2-1/2 day conference, may apply for all, or a portion of their registration fees, through the William D. Mitchell Scholarship Fund. To apply:
1. Register for the conference at www.integrativemedicineconference.org. When you fill in the registration form, just write "student" in the pay box.
2. Send a brief paragraph to nas28@case.edu describing why you would like to attend the conference, what you expect to bring to the experience, and/or what you would like to take away.
Scholarships will be distributed on a rolling basis, and early application is greatly encouraged.

Submitted by ICIM President Robban Sica MD
"If you haven't seen this, you really must watch it!"

Ask Your Doctor! A music video by Neil Fox
http://www.youtube.com/watch?v=eaF6ZD0TweA
(5 minutes)

Topic: Antidepressants

By Andrew Stern, submitted by board member Jim Smith DO
CHICAGO (Reuters) - Mild to severe depression might be better treated with alternatives to antidepressant drugs, which do not help patients much more than an inactive placebo, researchers said Tuesday.
Combining data from six studies that examined the effectiveness of two commonly prescribed antidepressants -- paroxetine and imipramine -- found the drugs produced benefits only slightly greater than a placebo in patients with mild to severe depression.
"They would have done just as well or just about as well with a placebo," said Robert DeRubeis, a psychologist at the University of Pennsylvania, Philadelphia, who with colleagues performed the meta-analysis.
Paroxetine is one of a popular class of drugs, selective serotonin reuptake inhibitors, and is sold under the brand name Paxil by GlaxoSmithKline. Imipramine is an older tricyclic antidepressant drug developed in the 1950s.
The so-called placebo effect is powerful in treating depression, where people believe they are helped even though they are taking an inactive sugar pill, DeRubeis said.
CONSIDER ALTERNATIVES?
In the report published in the Journal of the American Medical Association involving nearly 800 patients, the drugs' impact was noticeably stronger than a placebo in people diagnosed with very severe cases of depression.
Using a scoring system for depression where a diagnosis of 24 or above indicates a very severe case, the researchers said patients treated with drugs saw their scores drop by 13 points, compared to a drop of 9 points for those given a placebo.
But for those with initial depression scores of 23 or below the drop averaged 8 points for those given antidepressants and 7 points for those given a placebo. Roughly half of those prescribed antidepressants fit into the mild to severe categories.
"Our data should give some pause" to doctors and patients weighing antidepressants, DeRubeis said in a telephone interview. "They should give some consideration to other alternatives."
Exercise has been shown to be helpful to stem depression, as does psychotherapy, and even "self-treatment" with the aid of the plethora of self-help literature, he said.
A spokeswoman for GlaxoSmithKline said the report "contributes to the extensive research" into antidepressants, noting that Paxil received U.S. government approval in 1992 and has helped "millions of people battling mental illness.
"The studies used for the analysis in the JAMA paper differ methodologically from studies used to support the approval of paroxetine for major depressive disorder, so it is difficult to make direct comparisons between the results," spokeswoman Sarah Alspach said.
At least 27 million Americans take antidepressants, nearly double the number that did in the mid-1990s, according to a study by Columbia University and University of Pennsylvania researchers reported in the Archives of General Psychiatry.
More than 164 million prescriptions for antidepressants were written in 2008, totaling nearly $10 billion in U.S. sales, according to IMS Health. Global sales were twice that.
(Editing by Eric Walsh)

http://www.sciencedaily.com/releases/2009/12/091230152424.htm

ScienceDaily (Dec. 31, 2009) — Vitamin-fortified foods and dietary health supplements can ease health worries. But what kinds of vitamins are right for you? And how much of them should you take, and how often?
A research group from Tel Aviv University has done the most comprehensive and accurate study of clinical data on Vitamin E use and heart disease to date, and it warns that indiscriminate use of high-dose Vitamin E supplementation does more harm than good. Their results were recently reported in ATVB, a leading journal of cardiology, and discussed in the journal BioFactors.
"There were so many conflicting reports about Vitamin E and its effect on various diseases, particularly heart disease, that we wanted to set the record straight, says Prof. Dov Lichtenberg of TAU's Sackler School of Medicine.
"Our new study shows that some people may be harmed by the treatment, whereas others may benefit from it. Now we're trying to identify groups of people that are most likely to benefit from the effects of Vitamin E," adds study co-researcher Dr. Ilya Pinchuk. The TAU research team also included decision analyst Dr. Moshe Leshno of the Sackler Faculty of Medicine and the Leon Recanati Faculty of Management and Dr. Yedidya (Didi) Dotan, whose PhD thesis is the basis for this analysis.
A longer life without it?
Applying a very different approach than any previous study, the team of researchers put their heads together to draw definitive conclusions about Vitamin E. In their publication in ATVB the Tel Aviv University researchers evaluated the results of the prominent studies measuring the health benefits of Vitamin E but reached varying conclusions. There have been many previous publications on the subject. Analysis of the results of all these past publications together revealed that subjects who did not take a Vitamin E supplement enjoyed more quality-adjusted-life-years (QALY), a standard parameter used in medicine to assess the effect of medical interventions.
"To explain the meaning of this parameter," says Dr. Pinchuk, "consider a participant who was healthy during the first 10 out of 20 years of the study, but then suffered a stroke and became dependent on others throughout the following 10 years. The QALY during the first 10 years of healthy life is 10, but after the stroke the quality of life is only half of what this person had before. Therefore, the second decade is considered the equivalent of merely 5 years of healthy life and in sum a person's QALY is 15.
The researchers examined data from more than 300,000 subjects in the US, Europe and Israel. "Our major finding," says Dr. Pinchuk, "was that the average quality-adjusted life years (QALY) of Vitamin E-supplemented individuals was 0.30 less than that of untreated people. This, of course, does not mean that everybody consuming Vitamin E shortens their life by almost 4 months. But on average, the quality-adjusted longevity is lower for vitamin-treated people. This says something significant."
Overturning earlier studies
In the BioFactors article, the TAU researchers defined "the real challenge as being able to identify who is likely to benefit taking Vitamin E." They also explored the first hypothesis of the oxidative theory of atherosclerosis published more than 20 years ago, which was the basis for the widespread use of antioxidants today. At first, this hypothesis raised great enthusiasm that anti-oxidants like Vitamins E and C and flavonoids could be used to prevent disease or its progression. In this respect, the new findings are very disappointing.
"We've now concluded that going to the grocery or to a health food store to buy Vitamin E supplements, for the most part, won't do you good. In some cases it can do harm," says Dr. Pinchuk. "A doctor wouldn't prescribe anti-hypertension drugs to the whole population, only to those with low blood pressure. It seems this is true for antioxidants, too. When you give them to everybody, you may be doing more harm than good. Some people may benefit from it, but more may be harmed."
The researchers are now building sets of criteria that detail under what conditions Vitamin E supplements should be taken. They are also investigating the chemical mechanisms of antioxidants in general to better understand how they work.
American Friends of Tel Aviv University (2009, December 31). Putting limits on vitamin E. ScienceDaily.

http://www.sciencedaily.com/releases/2008/12/081204133604.htm

ScienceDaily (Dec. 4, 2008) — With up to half of a person’s body mass consisting of skeletal muscle, chronic inflammation of those muscles – which include those found in the limbs – can result in significant physical impairment.According to University of Illinois kinesiology and community health professor Kimberly Huey, past research has demonstrated that the antioxidant properties of Vitamin E may be associated with reduced expression of certain pro-inflammatory cytokines, in vitro, in various types of cells. Cytokines are regulatory proteins that function as intercellular communicators that assist the immune system in generating a response.
To consider whether the administration of Vitamin E, in vivo, might have similar effects on skeletal and cardiac muscle, Huey and a team of Illinois researchers put Vitamin E to the test in mice. The team included study designer Rodney Johnson, a U. of I. professor of animal sciences, whose previous work has suggested a possible link, in mice, between short-term Vitamin E supplementation and reduced inflammation in the brain.
The study represents the first time researchers have looked at in vivo effects of Vitamin E administration on local inflammatory responses in skeletal and cardiac muscle. In this study, the researchers investigated the effects of prior administration of Vitamin E in mice that were then injected with a low dose of E. coli lipopolysaccharide (LPS) to induce acute systemic inflammation. The effects were compared with those found in placebo control groups. The research team examined the impact the Vitamin E or placebo treatment had on the mRNA and protein levels of three cytokines – interleukin (IL-6), tumor necrosis factor-alpha (TNF-alpha) and IL- 1beta. “The mice were administered Vitamin E for three days prior to giving them what amounts to a minor systemic bacterial infection,” Huey said. “One thing we did – in addition to (looking at) the cytokines – was to look, in the muscle, at the amount of oxidized proteins.
“Oxidation can be detrimental, and in muscle has been associated with reduced muscle strength,” Huey said.
Among the team’s major findings, in terms of function, Huey said, was that “there was a significant reduction in the amount of LPS-induced oxidized proteins with Vitamin E compared to placebo.” “So that’s a good thing,” she said. “Potentially, if you reduce the oxidized proteins, that may correlate to increased muscle strength.”
Additionally, the researchers’ experiments yielded a significant decrease in two cytokines – IL-6 and IL- 1beta – with Vitamin E, compared with the placebo. That finding translates to somewhat mixed reviews. “It’s hard to say functionally what those cytokine changes might mean,” Huey said. “IL-1beta is primarily a pro-inflammatory cytokine, so that could be a good thing – especially in terms of cardiac function.” However, she said, “IL-6 can have both pro- or anti-inflammatory actions.” She said that the literature has yielded some evidence pointing to the detrimental effects of chronic increases in IL-6. But the effects of acute increases in IL-6 in skeletal muscles – which occur during exercise – may be another story. “Whether there’s a difference between exercise-induced increases versus inflammation-induced
increases in IL-6 is still highly debatable,” she said. Nonetheless, Huey said, the larger take-home message of the study, published in the December issue of the journal Experimental Physiology, is that Vitamin E “may be beneficial in individuals with chronic inflammation, such as the elderly or patients with type II diabetes or chronic heart failure.”
While the Illinois research team’s work provides a foundation for future investigations that could
ultimately have positive outcomes for people afflicted with chronic skeletal or cardiac muscle
inflammation, Huey cautioned that it is still far too soon to speculate on results in humans.
“This is clearly an animal model so whether it would translate to humans still requires a lot more
research,” she said. “Vitamin E is a supplement that is already approved, and these results may suggest an additional benefit of taking Vitamin E beyond what’s already been shown.”
In addition to Huey and Johnson, other members of the research team included undergraduate student Gabriel Fiscus, graduate student Ben Meador and former graduate student Amy Richwine.
University of Illinois at Urbana-Champaign (2008, December 4). Vitamin E Shows Possible Promise In
Easing Chronic Inflammation. ScienceDaily. Retrieved December 6, 2008, from