Lectures 2016

Thomas Burgoon, MD, President of AAMA ((USA)
Presomatic Syndrome – disease in formatiion
Recent advances in research on acupuncture mechanisms of action confirm some fundamental principles of traditional Chinese acupuncture, Since the 1960s modern scientific research has sought to understand how acupuncture is able to achieve its beneficial effects. While the initial research focused on mechanisms of pain reduction, more recent research on acupuncture’s action has expanded to include some details of effects on inflammation, gastroenterology, and cardiovascular physiology. These studies make an outstanding contribution and enrich our modern understanding of acupuncture. Rather than disproving traditional principles of acupuncture, these studies confirm some of the most important and profound principles of traditional acupuncture theory and practice. These studies provide an important foundation of communication with our non-acupuncture medical colleagues about the practice and benefits of acupuncture.
 
 
 
Fransisco Lazano, Professor of TCM, MD, PhD, President of MEXFAS & FILASMA (Mexico)
The Role of Traditional Chinese Acupuncture on the “PRE” Stage-An Integral Treatment for Prevention & Maintenance-
In Chinese medicine it is essential to consider the individual in an integral manner, perform a detailed evaluation of the patient and establish a complete diagnosis, to also offer an integral treatment, that allows the regulation or balance of the whole body in its physical, mental and emotional aspects, as well as for health maintenance and disease prevention. In western medicine practice, there is a tendency to evaluate the patient in a fractionate manner, focusing only in isolated systems or affected regions, establishing fixed partial diagnosis and commonly offering just a symptomatic treatment or directed exclusively to the patient’s main pathologic condition, and little or no attention is given to prevention. Besides, the healthy individual or the “asymptomatic patient” usually does not look for medical assessment for prevention and physicians commonly does not give enough attention too. Moreover, even though it is recognized, that there are many diseases for which inheritance is a determining risk factor, and that actions could be taken to prevent them or reduce risks, in general, not enough resources are given or are frequently ignored by both patients and physicians. Unfortunately, this also happens frequently in the practice of acupuncture. We are aware that there is no single medical system that on its own can guarantee complete cure or prevention, and that it is required a complementary and multidisciplinary participation, as well as the active intervention of the individuals. At this point, especially on prevention, we are convinced that traditional Chinese medicine and acupuncture, with its’ diagnostic and therapeutic resources can contribute in various ways that deserve attention and recognition. In the practice of acupuncture and Chinese medicine the patient’s integral evaluation enables us to provide preventive benefits at different levels: prevent the condition from worsening or complications development; that other coexisting diseases progresses unfavorably; prevent or reduce the risk for other imbalances, etc. In addition, there is the possibility to assess the status of “health” of a “healthy” or “asymptomatic” individual and still offer various prevention options. Furthermore, with acupuncture and traditional Chinese medicine it is possible to strengthen the “essence” and potentially prevent the expression of the inherited disease factors and thereby achieve some degree of prevention, either by avoiding the occurrence of the disease, delaying its onset, diminishing the intensity with which it emerges and reducing or preventing complications. The “PRE” stage is that status in which the individual is at increased risk or vulnerability to become sick, of developing a specific disease, or to worsen and develop complications of an existing illness. In the practice of Chinese medicine, even the healthier patient can be identified as being in a “PRE” stage and determine the type of imbalance or pattern of disharmony, design strategies to treat it, and potentially prevent progression to a disease stage. Integral evaluation, regular medical assessment and “PRE” stage recognition to opportunely treat with Chinese medicine and acupuncture are vital for health maintenance and prevention. I will discuss some examples of diseases and conditions that usually go through the “PRE” stage and provide various preventive strategies with Acupuncture. “The inferior doctor treats actual sickness; the mediocre doctor attends to impending sickness; the superior doctor prevents sickness” (Chinese Proverb).

luxenburger-(1)Hedi Luxenburger, MD, Anaesthesiologist, Pain specialist (Germany)

Chronic allergic rhinitis, a randomized study, Charité University, Berlin
There is an  increasing number of patients, suffering from allergic rhinitis during the last years. Within Europe there are spent  1-1,5 Billion Euros for the treatment and there are further indirect costs of 1-2 Billion Euros/ Year. Depending on different staudies 17-19 % of the patients use acupuncture treatment. Different pilote studies had shown positive effects. On this background Benno Brinkhaus et al. from Charité in Berlin run a big randimized study on this problem. Presentation of ACUSAR, a study by Benno Brinkhaus et alii, Charité Berlin, Effectiveness of acupuncture in chronic allergic rhinitis possible preventive effects
 
 
 
 
 
Konstantina Theodoratou, MD, Med. Psyc., MSc in Acupuncture, President of Icmart, President of Samag, Athens (Greece)
a)Acupuncture preventing chronic pain – Review of updated research As medical science progresses with gigantic leaps over the past years, so is our need for better understanding of traditional medical techniques, that withstand more than 2000 years and still prove clinically effective. Integrative medical modalities, like acupuncture are being investigated thoroughly over the last 40 years. Continuous advancement in technology, instrumentation, test models and so on create an unstoppable path of discoveries with vast and endless scientific data of its mechanisms of action upon living organisms. Research still has a long way to reach full comprehension, but so far we established well documented evidence of how acupuncture affects and alters the transmission of pain signals from peripheral to central nervous system. It is not a coincidence that more than 30% of the planets population still resort to acupuncture treatment to relieve painful pathologic conditions. Persistent, protracted or recurrent pain incur a heavy toll on overall health of individuals. All these forms of chronic pain affect primarily personal life quality, productivity, effectiveness and even economy in a wider sense. A systematic review was conducted, utilizing approximately 6.855 relevant publications, from 1970 till 2015 retrieved from research data bases, journals, conference material etc, about the effect of acupuncture on chronic pain using lab animal models trials. The research was focused on the existence of solid and incontrovertible evidence whether acupuncture provides an effective treatment of chronic pain, or not.   
b)WorkShop: Acupuncture clinical protocols for prevention: addictions, obesity, chronic pain. Application of acupuncture on acute physical or psychological disease states is widely accepted. However during the chronic states like in the case of chronic pain,obesity or addictions (chronic psychological dysfunctions), acupuncture can be applied during the exacerbated stages, as well as on recession of the condition,providing a preventive and prophylactic effect. According to modern science, acupuncture’s effects on central action causes changes on the mode of operation of different brain regions resulting on a balanced function, avoidance of challenging chronic conditions and thus resulting on prevention. This workshop will provide a thorough analysis of the treatment protocols that can provide prevention to chronic conditions, reduce the severity of the symptoms and in some cases even to reverse the process of the condition. All relevant questions will be dealing with repetition and duration of treatments required and types of acupuncture used on each case.
 
Georgios J. Bellos, MD, PhD, MR CGP, MEPMA, Athens (Greece)
Medical Acupuncture’s contribution in coping with/preventing pathogenic insulin resistance as the main pathophysiological component of metabolic diseases 
Insulin resistance (IR) is a physiologic phenomenon and may be an appropriate response to nutrient excess. Recent data especially from the field of OMICS science support the hypothesis that IR protects the heart from consequences of fuel overload in the dysregulated metabolic state of obesity and diabetes. It is a cellular antioxidant defense mechanism which by the time is deteriorating initially locally and later systemic in a pathogenic way. The transition and many times simultaneously are from the obesity associated chronic low-grade inflammation which is responsible for the decrease of insulin sensitivity. This state of IR is caused again by over nutrition, lack of physical exercise, psychological toxic stress and is initiating from the altered brain-e.n.s-local and enteric microbiota with immune system crosstalk. Therefore both the fluctuation of communicating cytokines and the status of relevant signaling pathways is considered when analyzing inflammation-related insulin resistance. In this presentation we discuss how these factors from BCAA amino-acids and other metabolites with fatty acids and cytokines both in the circulation and locally in the hypothalamus eventually leads to central IR. Electro acupuncture has been shown to be effective as an adjunct therapy in improving insulin sensitivity and lowering blood glucose in diabetic humans and rodents although by few studies. Interestingly laser acupuncture treatment of streptozotocin-induced diabetic rats also decreases blood glucose levels relative to untreated diabetic controls and may have role in the treatment of diabetes. Modern technology has proven that acupuncture is regulating the neuro-endocrine-immuno-microbiota network to homeostasis and through these actions to eliminate or even helping stop disease mechanisms as IR and metabolic disorders.

Michael Tarabe, MD, PhD, Dipl. BSBRM, FEBOPRAS, Plastic Surgeon, Athens (Greece)
a) Curcumin as an adjunct  treatment modality in  stress management 
Newly published data about curcumincontinues to astonish scientists, physicians, and the lay public.Modern science has discovered that this ancient compound can drastically impact neurodegenerative diseases and cancer. Animal experiments show that curcumin can help protect against these factors in the aging brain. For example, studies demonstrate curcumin’s ability to improve the management of cellular energy and to enhance cellular free radical protection systems. The result is reduced fat oxidation and decreased accumulation of toxic molecules that contribute to premature brain cell death. Stress is an unavoidable life experience that can disturb emotional and cognitive processes, and neuroplasticity. This study was designed  to observed  aspects of probable curcumin effects  on  reducing stress levels  by measuring HRV  changes after administering  a stat dose of  turmeric tablets (group A)and in combination with acupuncture treatment on DU 20 (group B). We present in detail our clinical early results  analyzing statistically our findings and review of the relevant  bibliography
β)Integrative Acupuncture in Prevention of the Aging Process
The integrative application of acupuncture and adjunctive techniques promotes the healing process and increases the effectiveness of medical treatments in controling the aging process especially that of connective tissues . Techniques such as a) “wet” acupuncture with homotoxicological substances b) crystal light therapy c) electroacupuncture d) Acupoint stimulation with compatible threads , are used in combination. This therapeutic approach augments the wholistic biological antiaging process from within to improve the
outer part of the body by improving digestion , sleeping patterns , level of anxiety and metabolic balance.
 
George Lazarou, MD, MSc, PhD, Orthopaedic Surgeon, Athens (Greece)
Prevention of Musculoskeletal incidents using Acupuncture  
Primary prevention aims to prevent incidents before they occur, while secondary prevention aims to reduce the impact of incidents that have already occurred. There is also tertiary prevention, which aims to prevent the long-term consequences of incidents.Acupuncture may be of assistance in any level of prevention, although secondary prevention is most common in the setting of a team physician in most sports. Especially for musculoskeletal incidents the most basic form of acupuncture is usually sufficient, in the form of sensitive/painful points, trigger points, +/- master points for the injured tissue and alternative points for equivalent joints. Several specific examples are given for the commonest injuries that may or may not be sport specific and the main treatment guidelines are being discussed.
 
 
 
 
 
Evdokia Tsalkama, DVM Equine practitioner, Thessaloniki (Greece)
Application of acupuncture on lab animal studies researching pain prevention
While reviewing the effect of acupuncture on pain caused by different aetiologies on lab animal experiments in the last 30 or more years, we can clearly identify that diagnostic pathways, mapped routes of investigation and trends, are constantly changing every decade or so. However, the vast majority of the studies investigated the consequences of lessening the effects of an already present painful stimulus, either acute or constant-chronic in nature. Visceral pain, migraine, neuropathic pain and other forms of pain were all treated with acupuncture with an acceptable rate of success and some cases even better when combined with pharmaceutical substances indicated for the condition accordingly. We wouldn’t overemphasize the fact that science shows a predilected preference for acupuncture point ST-36, almost to the point of obsession, which proved efficient and delivered every time its desired effects. What we can conclude from studying the researches is that acupuncture can definitely provide prevention of pain in all stages, that is before painful disease ensues, during and even in chronic painful pathologies. Like any other tool in our arsenal has the ability to prevent and remedy pain and science has provided evidence beyond any doubt.
 
 
Vasilis Giannakopoulos, Psychiatrist. 
The importance of mental health for the prevention of diseases; What is the most simple and effective route to mental health 
The mental state of man is now known in the medical world that plays a huge role in the prevention and treatment of all diseases. To mention some few examples from a huge list, people who have anxiety are more prone to coronary heart disease and peptic ulcers. People who have a lot of guilt often suffer autoimmune diseases. Chronic suppression of anger is believed to be a factor that promotes cancer. Any kind of mental distress lowers the performance of the immune system and makes people more prone to infections. A chronic upset or mental distress, which may be unconscious or not fully conscious, can disrupt the physical health in the following ways: One is to cause or aggravate damages and malfunctions in various organs and systems such as those mentioned above. The other is to lead to harmful habits (smoking, alcohol abuse, drug abuse, overeating, eating unhealthy food, non-compliance in various hygiene rules, etc.) which in turn create physical ailments. The reality is that if we do not address these behaviors at their roots, i.e. if we do not restore a significant degree of mental health, every effort we make to eliminate usually either fails or succeeds only temporarily. And of course not to mention here a variety of physical symptoms that do not conceal some undiagnosed general medical condition and are clearly due to psychological factors. However let’s note that such symptoms may account for even 50% of visits to doctors of various specialties of physical medicine. The role therefore of the mental health for the prevention of various diseases is essential, ultimately one with the greatest importance and greater leverage. For the protection of mental health, the most important factor is the growing of self-acceptance. This is because if we look into as much detail as we can, we would conclude that any kind of mental agitation or distress, regardless of the obvious reason, is due to a conscious or subconscious belief that something we have not done well, we haven’t done the best we could and therefore we are not fine as we are. Nevertheless, this belief is false because if we think carefully, we see that we people always do the best we can based on our assets and obstacles (psychological and objective) encountered. 
 
Natalia Tzima, Physician Physician and Homeopath, MSc Pharmacology, PhD in Nutrition and Dietetics
Homeopathy, informative medicine and prevention
Generally in medicine but especially in traditional and complementary (T&C) medicine -which includes Homeopathy too- great emphasis is given to the prevention and early restoration of organism’ s imbalances, even before organic problems and diseases being established. The energetic and informative nature of T&C medicine will be analyzed and the related scientific evidences will be presented. The concept of the ‘bio-field’ and the consideration of the living organism as an open complex system are necessary for building a holistic health model and for a deeper understanding of the significance of prevention.
 
 
 
Antonio Carlos Sant’Ana, MD, Bauru Estadual Hospital, (Brazil)
TCM and the art of motorcycle maintenance, How can our patients understand the importance of prevention
In order to cooperate with a treatment, a good understanding of the worth of prevention in health matters is of paramount importance for patients either during their follow-up with a doctor or under some kind of medical care. But this understanding is frequently brought down by the barriers of communication, mainly in those domains where specific medical terms are to be used. Therefore, in order to favour their comprehension, sometimes the doctor may profit of a more day to day language, adapted to conditions and systems more close and familiar to the patient’s environment. A few tips in this direction are dealt with in this speech. 
 
Efthymios Angelakis, Neuropsychologist PhD
Motor function’s improvement, in patients with movement disorders/difficulties, with transcranial electrical stimulation
Attention Deficit / Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders, presenting difficulties in sustained focused attention and/or hyperactive-impulsive behavior. Approximately 70% of children with ADHD fulfill the diagnostic criteria during adolescence, and 66% fulfill the diagnostic criteria in adulthood. In addition to its core symptoms mentioned above, ADHD causes secondary dysfunctions in several areas, such as behavior at home and at school, academic/work performance, interpersonal relations, and self-esteem. Moreover, individuals with ADHD are more prone to comorbid disorders such as oppositional/defiant or conduct disorder, specific learning difficulties, anxiety or mood disorders, or addictions. College students with ADHD report higher symptoms of depression and academic uncertainty, and get lower grades, and these problems are not reduced with medication for ADHD. Electroencephalographic (EEG) recordings show electrical brainwaves at different wave frequencies, that are correlated with different brain functions/states. Studies have shown that most individuals with ADHD have increased slow brainwaves (theta rhythms at 4-8 Hz) and reduced fast brainwaves (beta rhythms at 13-18 Hz) at central of frontal areas of the scalp. This observation has been used to train people with ADHD self-regulate their brainwaves with EEG biofeedback (neurofeedback), a technique that shows one’s filtered brainwaves in real time. Trainees use this feedback to learn how to control – and eventually normalize – their own brainwaves. The effectiveness of neurofeedback in reducing symptoms and secondary effects of ADHD has been shown in multiple studies, including randomized controlled double blinded studies, and results are shown to last for prolonged time periods after completion of training. The American Academy of Pediatrics rates neurofeedback as level 1 – best supported evidence-based intervention for ADHD.
 
Clipboard01kljk Nikolaos Roussos, MD
Prolotherapy as therapeutic and preventive agent.
The idea of prolotherapy is that some forms of chronic pain is the result of weak ligaments and tendons. Prolotherapy aims to strengthen ligaments and to reduce pain.By the method of prolotherapy we inject a moderate irritant solution directly to the ligament activating thereby an inflammatory reaction. In the injected area increases the concentration of fibroblasts, which activate fibroblasts deposition enhancing thus the ligaments in order to avoid the hyperextension  and cause pain.The injections are made every 4-6 weeks. Most patients require 4-6 sessions to have the desired analgesia. Often analgesia obtained with the first session, and few patients have no progress after 4-6 sessions. Like any injection procedure is necessary to take all precautions during injection. The improvement of the pain in 50% of patients fell by 50%. In many patients there will be improvements that can reach up to 100%. In the majority of the injected patients, the improvement of functionality is sufficient to prevent the surgical repair of the joint.