While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM’s applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients’ perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
There is a growing body of research exploring Complementary and Alternative Medicine (CAM) for the overall population; however, few studies have examined the effectiveness and applications of CAM practices in the paediatric population. According to the World Health Organization (WHO), parent's prevalence using CAM in their dependents is estimated to be as high as 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM applications and effectiveness caused mainly by variances in sociodemographic factors and national healthcare systems differences. Additionally, a lack of consensus and polarised positions among mainstream professionals regarding the CAM mechanism of action, applications, and effectiveness were identified. This narrative review shows debatable results for most CAM therapies and their applications. However, some evidence suggests that acupuncture, Yoga, Tai Chi, and massage might benefit users' physical and mental health. Additionally, meditation's available evidence indicates that it might be only helpful in the enhancement of mental health, whereas Reiki only displays an effect on patients' perceptions of comfort. Lastly, herbal medicine was observed to have non-specific evidence to support its claim, given the diverse nature and complexity of herbal compounds and procedures. This comprehensive narrative review might offer health professionals a reference to guide their health practices towards a personalised approach, taking into account the patient's values and beliefs, both important aspects of integrated, evidence-based practice, aiming to improve the quality of the offered health services and patients' satisfaction.
Osteoarthritis (OA) has emerged as a significant public health crisis in Latin America, with prevalence rates in Mexico doubling over the last two decades. Despite this growing burden, current management in underrepresented populations —defined here as groups facing structural barriers to care, including rural or remote communities, uninsured individuals, and socioeconomically disadvantaged groups —is hindered by a critical mismatch between international guidelines and regional healthcare realities. This narrative review, synthesized under the SANRA framework, evaluates the last 20 years of evidence to address the structural and clinical barriers that sustain a 50% diagnostic gap at the primary care level and high rates of inadequate pain relief. Using Mexico as a primary case study, we move beyond conventional symptomatic treatment to explore the complex interplay of central sensitization, neuroinflammation, and metabolic phenotypes, factors often overlooked in standardized protocols. By identifying the limitations of current pharmacological reliance and the underutilization of non-pharmacological interventions, this work proposes a strategic shift toward a multidisciplinary, patient-centered model. We outline a translational roadmap that integrates multi-omic research with personalized therapeutic strategies, emphasizing the need for evidence-based clinical practice guidelines tailored to the socioeconomic and genetic contexts of Latin American patients. Ultimately, this review serves as a call to action to bridge the healthcare disparity gap, offering a framework for innovative, integrative care to transform long-term clinical outcomes in developing healthcare systems.
31 March 2025 in Journal of Neurosurgery: Case Lessons
BACKGROUND: Leiomyosarcoma (LMS), a smooth muscle–derived tumor, is associated with a poor prognosis and a high potential for metastasis to local and distal sites. Skull metastases are exceptionally rare, with few cases documented in the literature. Diagnosing and treating these lesions is challenging due to their nonspecific clinical presentation and imaging similarities to other tumors. OBSERVATIONS: The authors report the case of a 46-year-old female with a 4-month history of a right parietal tumor, accompanied by headaches and left hemiparesis. MRI revealed a heterogeneous, intra- and extra-axial lesion with irregular margins in the right parietal region. Resection of the tumor was performed, and histopathological findings confirmed a diagnosis of metastatic LMS involving the bone and dura. Postoperative radiotherapy was administered, and the patient showed no evidence of recurrence 1 year after initial treatment. A review of the past 30 years of existing case reports of uterine LMS (uLMS) with cranial and intracranial metastases is also provided. LESSONS: This report highlights the diagnostic and therapeutic complexity of metastatic LMS to the skull. Adjuvant radiotherapy might prove advantageous in improving the prognosis of patients with uLMS, underscoring the significance of integrating clinical, radiological, histopathological, and immunohistochemical findings for accurate diagnosis and management. https://thejns.org/doi/10.3171/CASE24769