Current Issue:  Volume 5, Issue 1 (2014)

Topics in Integrative Health Care: an International Journal (TIHC) is a peer-reviewed, open-access online journal. It is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care. It presents themed issues on topics of current relevance to health care providers interested in integrative, conservative care, health promotion and disease prevention. It includes international, interdisciplinary Grand Rounds in order to facilitate communication and patient comanagement among various health professions, for the good of patients everywhere.

Topics in Integrative Health Care (TIHC) is published by Healthindex, Inc. (ChiroACCESS).


Topics in Integrative Health Care

Cheryl Hawk, DC, PhD, CHES    

Topics in Integrative Health Care 2014, Vol. 5(1)     ID: 5.1001   

Topics in Integrative Health Care welcomes unsolicited manuscripts with original research, Grand Rounds, clinical briefs and “fast facts” collections. All submissions are peer-reviewed.


Preliminary Comparison of Gatorade G2® to Red Bull® on Maximal Cycle Ergometer Performance

John Ward, DC, MA, MS

William Amonette, Ph.D.

Jesse Coats, D.C., B.S., D.A.A.P.M.

Cami Stastny, B.S.

Sally Oguzhan, B.S.

Topics in Integrative Health Care 2014, Vol. 5(1)     ID: 5.1002   

Background: Gatorade G2® (G2) and Red Bull® (RB) are two common sport and energy drinks athletes consume. The difference between the two beverages on performance is not known.

Purpose: The purpose of this study was to compare G2 to RB on a maximal cycle ergometer (bike) test.

Methods: Thirty healthy college students were randomly divided into three comparative groups that engaged in an Åstrand maximal cycle ergometer test twice, with one week of rest in between test sessions. Participants in each group consumed a designated beverage and then engaged in the cycle ergometer test 30 minutes later. Group 1 consumed G2 during week one and RB during week two. Group 2 consumed RB during week one and G2 during week two. Group 3 consumed water during both weeks. Data from this group were used as a control to measure test-retest variability. Electrocardiogram measurements and Rating of Perceived Exertion (RPE) were recorded at baseline and after each stage of the exercise test. Cycle time to exhaustion and blood lactate were recorded at the conclusion of the exercise test. A between-within analysis of variance (ANOVA) was used to analyze electrocardiogram and RPE data. A one-way ANOVA was utilized to analyze blood lactate and cycle time to exhaustion.

Results: No statistically significant differences were noted between RB and G2. However, participants in the G2 group were able to cycle 17 seconds longer to exhaustion and reported less abdominal discomfort.

Conclusions: Preliminarily, this research suggests that consumption of RB or G2 prior to sustained aerobic exercise result in similar performance.

Ayurvedic Therapy for Hepatic Encephalopathy: A Case Report

Mahesh Sabade, M.D. (Ayurveda)

Topics in Integrative Health Care 2014, Vol. 5(1)     ID: 5.1003   

Ayurveda is an Indian system of medicine which has been in practice for thousands of years. Ayurvedic medications have been shown to be effective in the treatment of several disorders of the liver including liver cirrhosis, hepatitis and fatty liver. This case report describes an unusual intervention utilizing Ayurvedic treatment for hepatic encephalopathy. A patient with miliary tuberculosis undergoing anti-tubercular treatment developed hepatic encephalopathy presenting with coma, severely increased liver function tests (LFTs) and other abnormalities. Treatment based on Ayurvedic diagnosis and medication was deployed. It resulted in improvement in liver function, with normalization of LFTs and restoration of consciousness within a short period of time. This case report indicates a possible role for Ayurveda in hepatic encephalopathy and warrants further investigation.

Case Report: A Patient with Low Back Pain and Somatic Referred Pain Concomitant with Intermittent Claudication in a Chiropractic Practice

Kathryn Hoiriis, D.C.

Brent S. Russell, M.S., D.C.

Topics in Integrative Health Care 2014, Vol. 5(1)     ID: 5.1004   

Introduction: Approximately 12% of older patients in the general population have atherosclerotic disease of the aorta and lower extremity arteries, i.e., peripheral artery disease (PAD). Intermittent claudication is the most common symptom. When a patient with low back pain complains of lower extremity pain that is worsened with mild exercise (e.g. walking), the etiology is often not clear.

Case Presentation: A 56 year-old male presented with low back pain, left hip and buttock discomfort, numbness in thigh and calf, and left knee weakness while walking.

Intervention and Outcome: Chiropractic care was provided and the low back pain improved. The patient developed leg weakness. Radiographic evaluation showed calcification of abdominal aorta and common iliac arteries. The patient was referred for medical evaluation and diagnostic ultrasound findings of arterial occlusion lead to surgical referral. The surgeon reported a “significant amount” of blockage of the left external iliac artery. Leg weakness resolved following placement of surgical stents.

Discussion: Claudication may go undiagnosed because many people consider the pain a consequence of aging, and may therefore just reduce their activity level to avoid the pain. Early diagnosis of PAD/intermittent claudication is important since PAD is a major risk factor for adverse cardiovascular events.

Conclusion: Patient management in the chiropractic clinical setting required appropriate medical referral in this case. Surgical implantation of stents in the left external iliac artery resolved the complaint of leg weakness. It is imperative for health care professionals to have awareness of the high occurrence of PAD in the general population.

Fast Facts

Fast Facts

THIC Staff    

Topics in Integrative Health Care 2014, Vol. 5(1)     ID: 5.1005   

Readers are welcome to contribute to Fast Facts. Please include the original abstract (with citation) that is the source of your contribution. Contributors’ names will be included along with the item.

The following is an excerpt:

The purpose of this study was to develop evidence-based treatment recommendations for the treatment of nonspecific (mechanical) neck pain in adults. Interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain. Increased benefit has been shown in several instances where a multimodal approach to neck pain has been used. Free full text available at:

Bryans R, Decina P, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg RP, Shaw L, Watkin R, White E: Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014, 37:42-63.