Jala neti in the management of acute and chronic rhinosinusitis

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Conclusion: EYT in paediatric cerebral tumour survivors iseasible and patients may profit from this new approach.

ttp://dx.doi.org/10.1016/j.eujim.2012.07.642

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an a dog’s presence reduce pain and distress in childrenuring venipuncture? A pilot study

agnoli Laura, Caprilli Simona, Zagni Silvia, Mugnairancesca, Messeri Andrea

Azienda Ospedaliero Universitaria Meyer, Florence, Italy

Aim: The aim is to investigate the effectiveness of animal-ssisted intervention (AAI) as a distraction for reducinghildren’s pain and distress before, during and after standardlood collection procedure.

Methods: A total of 50 children (4–11 years), undergo-ng venipuncture, were randomly assigned to the experimentalroup (EG), where the presence of the dog was included inhe procedure (n = 25), or to the control group (CG) wherehe venipuncture was carried out without dog and the childreneceived routine medical care (n = 25). In both cases, parentsccompanied the child to the procedure room. Distress experi-nced by the child was measured with the Amended Observationcale of Behavioral Distress (OSBD-A), while perceived painas measured with the visual analogue scale (VAS) or Wongaker Scale (Faces Scale); levels of cortisol in blood were ana-

ysed as well. Parents’ anxiety during the blood test of their childas measured with State Trait Anxiety Inventory (STAI Y-1).Results: Children assigned to the EG group react with less

istress than those of the CG group. Furthermore, we found thatevels of cortisol were lower in the EG group compared to the CGroup. Conclusion: It appears that the presence of dogs duringlood tests reduces distress in children.

ttp://dx.doi.org/10.1016/j.eujim.2012.07.643

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ala neti in the management of acute and chronic rhinosi-usitis

hiantaretto Alberto, Gargano Stefano

Acute rhinosinusitis (ARS < 4 weeks with two or more majorymptoms) and chronic rhinosinusitis (CRS > 8–12 weeks withwo or more major symptoms) are a common problem with con-iderable morbidity and a significant impact on patient’s qualityf life. In USA, prescriptions for CRS increased from 5.8 mil-ion in 1985 to 13 million in 1992. In 1994, the number ofRS cases in USA was estimated at 35 million for a preva-

ence of 134 per 1000 patients. In modern times, nasal irrigations becoming accepted as a remedy for treating ARS and CRS.urrently, there are several ways of nasal irrigation: by posi-

ive pressure supplied by manually squeezing a reservoir bottle

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tegrative Medicine 4S (2012) 9–123 73

rature from many years, there is growing scientific evidencen the indication of nasal irrigation with saline solution iso-onic (0.9%) or hypertonic (3%) for these affections: reviewsnd metanalysis assert that nasal irrigation is more effective asherapy and prevention for CRS than other support therapies,ess expensive, easy to do by the patient at home and withoutide effects. The reasons for the efficacy of the nasal irrigationnclude that it decreases the inflammatory mediators, removinghe mucus and improving mucociliary clearance. Jala neti (San-krit: jala = water neti = cleaning) is a method of nasal cleansingriginating in the Hata Yoga tradition and in Ayurvedic medicines dinacarya (daily rules) with the aim to clear the sinus anderebral structures (through nasal lamina cribrosa), dripping aaline solution from a pot (Sanskrit lota). Isotonic solution = 1easpoon of salt in 1 l of lukewarm water; hypertonic solution = 2easpoon of salt. Olson shows by TC that the best diffusion ofaline in the sinus is from irrigation by gravity as in jala netind the worst by nebulisation. The clinical indications of jalaeti refer to management of ARS and upper respiratory tractnfection (URTI). (Kassel J, King,D. Saline nasal irrigation forcute upper respiratory tract infections, Cochrane Acute Respi-atory Infections Group, published on line 17 MAR 2010, andf CRS (Harvey R.,Hannan S., Nasal saline irrigation for theymptoms of chronic rhinosinusitis The Cochrane Data Base ofyst Revues 2007,3)

ttp://dx.doi.org/10.1016/j.eujim.2012.07.644

P-150

lassical homeopathy helps hyperactive children–a 10-yearollow-up of homeopathic and integrated medical treatmentn children suffering from attention deficit disorder with andithout hyperactivity

on Ammon Klaus 1, Sauter Ursula 1, Frei Heiner 2, Kretschmarabine 1, Thurneysen André 1, Frei-Erb Martin 1

Institute of Complementary Medicine KIKOM, University ofern, BernSpezialarzt FMH für Kinder und Jugendliche, Laupen,witzerland

Aim: To investigate long-term clinical and cost effectivenessf individualised homeopathic and medical treatment of childrenith attention deficit hyperactivity disorder (ADHD).Methods: An open pilot study had revealed sufficient data

o develop a randomised, double-blind, placebo-controlled trialRCT), embedded in a prospective observational study ofhildren with ADHD diagnosis, according to established neu-opsychiatric criteria (Diagnostic and Statistical Manual of

ental Disorders, 4th Edition (DSM-IV)). After a screeningun-in phase of homeopathic treatment, the crossover RCTas followed by open-label long-term follow-up. At diagno-

is, beginning of, and after each crossover period, and five timesn long-term follow-up, parents reported Conners’ Global Index