Alfred Längler

Differences in Use of Complementary and Alternative Medicine Between Children and Adolescents With Cancer in Germany: A Population Based Survey

Use of complementary and alternative medicine (CAM) in children with cancer is common and probably increasing. However, data concerning differences between children and adolescents focusing on prevalence, reasons for use/non‐use, costs, adverse effects, and socio‐demographic factors are lacking.

Spiritual needs of mothers with sick new born or premature infants: A cross sectional survey among German mothers

BACKGROUNDnSpirituality is part of the basic needs of all humans, yet often undervalued by health professionals. Less is known about the spiritual needs of mothers of preterm or sick new born children.nnnAIMnIdentify unmet psychosocial and spiritual needs of these mothers, and to relate these needs to their perceived stress and impairments of life concerns.nnnMETHODSnAnonymous cross-sectional survey with standardized instruments (e.g., Spiritual Needs Questionnaire) among 125 mothers of two paediatric departments in Germany.nnnFINDINGSnMothers felt supported by their partner and hospital staff, and hospital staff assured 82% of them that they must not worry about their childs prognosis. They nevertheless did have specific unmet spiritual needs. Religious Needs and Existentialistic Needs scored lowest, while Giving/Generativity Needs were of moderate and Inner Peace Needs of strongest relevance. With respect to the expected diagnosis and prognosis of their child, there were no significant differences for their secular spiritual needs scores, but significant differences for Religious Needs which scored highest in mothers with children having an unclear prognosis (F=8.6; p=.004). Particularly Inner Peace Needs correlated with their stress perception (r=.34), impairments of life concerns (r=.25) and grief (r=.23).nnnDISCUSSIONnMothers of sick born/premature children felt supported by the hospital team and their partner, but nevertheless experienced stress and daily life impairments, and particularly have unmet Inner Peace Needs.nnnCONCLUSIONSnAddressing mothers specific needs may help support them in their struggle with their difficult situation avoiding fears and insecurity and thus facilitating positive bonding to their child.

The potential role of thyme in the treatment of pyodermia in newborn infants--a retrospective analysis.

Searches in the databases of Cochrane, EMBASE, NCCAM, NLM, DIMDI, CAMbase, and Medline and in the archives of Karger, Kluwer, Thieme, Springer, and the Merkurstab reveal only few specific data on skin infections in the neonatal period [1–3]. Knowledge about the treatment of these skin infections partly derives from the treatment of contagious impetigo of the older child [4–6]. The national and international research literature [7, 8] offers either only vague [9] or no recommendations at all [10]. A specific guideline for newborns does not exist [11]. On the other hand, there are numerous publications on the antimicrobial effect of thyme (Thymus vulgaris) [5, 12, 13], some of them representing popular medical opinions, others a long tradition of empirical use [14]. The disinfectant effect of thyme is supposed to be caused by essential oils, particularly thymol, carvacrol, and tannic acids. Based on traditional experience and the existing scientific literature, thyme has been used for many years as a concentrated tea for the treatment of superficial skin infections in the department of pediatrics, Gemeinschaftskrankenhaus Herdecke, [15, 16], usually supplementarily to systemic antibiotic therapy. The aim of this article is the systematic presentation of our therapeutic procedures for pyodermia in newborns. The focus lies on the documentation of desired and undesired effects as well as complications during the course of therapy. Methods

Integrative care for children with cancer. Project design for the development of an integrative care programme for use in paediatric oncology

PURPOSEnPurpose of this paper is to describe the project design for the development of a context-specific and patient-focused integrative care programme for an intensive care unit for paediatric oncology to ease the strain of the treatments for patients and their families. Integrative care interventions based on anthroposophical medicine such as wraps, compresses and rhythmic body oiling can be used to ease typical side effects such as nausea, pain and agitation.nnnMETHODSnConduct of a literature research on existing integrative care programmes in medical hospitals and biomedical settings and the identification of appropriate methods to achieve the research aim.nnnRESULTSnA project design was developed which can be used as a basis for developing, introducing and evaluating an integrative care programme for a paediatric oncological intensive care unit in a German university hospital. A qualitative study design was chosen to develop this programme. This included participant observations and interviews with all stakeholders at the respective oncology ward as well as in existing oncology wards that work with an integrative care programme. The primary emphasis was on the criteria appropriateness for the specific setting, sustainability and financial viability as well as on the development of an appropriate evaluation model.nnnCONCLUSIONSnWhen developing an integrative care programme for use in the specific setting of a paediatric oncology ward and selecting the appropriate interventions for inclusion in the programme, particular attention should be paid to the needs of the patients as well as to the practicability for the nursing staff, particularly with regard to resources such as time and personnel. Both the nursing team and nursing management should be actively involved in the project design from the outset. In the evaluation particular importance is attached to feasibility. The challenge for the economic evaluation is to create a robust database for negotiation of financing possibilities.

Safety of high-dose intravenous mistletoe therapy in pediatric cancer patients: A case series

BACKGROUNDnLong-term survival of children with cancer has reached rates of up to 80%. Nevertheless, continued research devoted to further improvement of survival rates especially for patients with high-risk illnesses is necessary. Recent studies have shown direct positive effects on tumor reduction through Viscum album (mistletoe) extracts in adults, mainly as a result of higher dosage treatment and intravenous or intratumoral application.nnnPATIENTS AND METHODnA retrospective analysis of data was carried out of all oncological, pediatric patients treated with intravenous high-dose mistletoe therapy for a period of two years (11/2013-11/2015).nnnRESULTSnA total of ten non-coherent cases were examined, all suffering from advanced and/or relapsed forms of cancer (leukemia, neuroblastoma, nephroblastoma, osteosarcoma, lymphoma, anaplastic astrocytoma, atypical teratoid rhabdoid tumor and soft tissue sarcoma). Patients were treated for an average period of 48u202fdays with a mean survival rate of 130u202fdays after beginning the mistletoe therapy. Partial remission was observed in four and a slowed disease progression was monitored in two patients. However, unrestricted progression of disease was documented in two other patients. Patients showed side effects including fever as well as fatigue and in some cases systemic inflammatory reactions with transient organ impairment occurred.nnnCONCLUSIONnOur study underpinned the safety and feasibility of high-dose mistletoe infusion in children with advanced stages of cancer and showed noteworthy antineoplastic effects, which should be verified in a prospective clinical phase II/III-study. Because of possible side effects, the treatment should be implemented only in an in-patient setting in experienced pediatric oncology centers.

Anthroposophic medicine in the treatment of pediatric pseudocroup: A systematic review

BACKGROUNDnIn Europe only few integrative pediatric wards exists and there are two German hospitals focusing on anthroposophic medicine as part of complementary and alternative medicine (CAM). Whilst the most common pediatric diseases are treated here, pseudocroup patients make up a large group in these hospitals, receiving conventional as well as anthroposophic therapies. However, effectiveness of these therapy concepts mostly based on physicians experiences but clinical studies are hitherto missing.nnnMETHODSnA systematic literature search identifying therapy approaches for pseudocroup in children was conducted in general electronic databases (Cochrane Library, PubMed, OVID) and in CAM-specific databases (CAMbase, CAM-QUEST®, Anthromedics). Search results were screened for anthroposophic therapy options. In addition, anthroposophic guidebooks were handsearched for relevant information.nnnRESULTSnAmong 157 articles fulfilling search criteria one retrospective study, and five experience reports describing anthroposophic treatments were identified. Several medications for the treatment of pseudocroup were mentioned such as Aconitum, Apis, Bryonia, Hepar sulfuris, Lavender, Pyrit, Sambucus and Spongia. During appropriate use no adverse effects were reported.nnnCONCLUSIONnAnthroposophic medicine harbors a broad spectrum of remedies for the treatment of pseudocroup in children. In particular, Aconitum, Bryonia and Spongia are frequently recommended; however, clinical trials investigating the effectiveness are sparse. Therefore, development and validation of therapy strategies are required.