Adolescents

David Brulé et al. (2024) · Journal of integrative and complementary medicine

This randomized trial of 146 treated children and adolescents with attention-deficit/hyperactivity disorder (ADHD) explored whether homeopathy helps manage the condition, and which part of the treatment might be responsible. ADHD is a neurodevelopmental condition marked by inattention, hyperactivity and impulsivity, and roughly 30% of diagnosed children do not respond to standard medication or behavioral treatment. Homeopathy uses highly diluted natural substances prescribed one patient at a time, and in practice it combines a long consultation with a chosen remedy. Earlier open-label results could not tell those two components apart, so this study separated them. Children aged 6 to 16 in Toronto, Canada were randomly assigned to one of three groups. One group (47 children) received homeopathic consultations plus an individualized remedy, a second (48 children) received the same consultations plus a look-alike placebo granule, and a third (51 children) continued usual care only. Consultations lasted up to two hours at intake and recurred about monthly for 28 weeks. Parents rated symptoms with the Conners 3 Global Index-Parent T-score, where lower scores mean fewer symptoms. Symptom scores fell by about 6.2 points in the remedy group and 6.4 points in the placebo group, compared with 2.2 points in usual care (complete-case analysis, 126 children). After adjustment, the remedy-plus-consultation group differed from usual care (p=0.037), while the placebo-plus-consultation group fell just short of the corrected significance threshold (p=0.026 against a cutoff of 0.025). The two consultation groups did not differ from each other (p=0.93). A clinically meaningful improvement (a drop of at least 7.36 Conners T-score points) occurred in 35.9%, 44.2% and 13.6% of the three groups respectively (p=0.006). Parents in both consultation groups also reported better coping (p=0.012 and p=0.003). Side effects were all mild (Grade 1), mainly increased hyperactivity, emotional outbursts and tics, and did not differ between groups. Because the remedy and placebo groups improved similarly, the authors attribute the benefit to the consultation rather than the remedy itself. Participants knew whether they were receiving consultations, parents scored the main outcome, and recruitment fell short of the planned 177 because the COVID-19 pandemic halted trials, so expectation effects and limited statistical power remain possible. The authors recommend further research into the mechanism and into whether other forms of consultation or psychological support produce comparable results.

María Magdalena Vaccarezza et al. (2026) · PloS one

This systematic review with meta-analysis pooled 17 randomized controlled trials of ketogenic diet therapies (KDTs) for drug-resistant epilepsy, meaning epilepsy that keeps causing seizures after two or three appropriately chosen antiseizure medications have failed. About 30% of people with epilepsy fall into this group. KDTs are high-fat, low-carbohydrate, adequate-protein diets that shift the body toward burning fat and producing ketone bodies, which are fat-derived fuel molecules that may calm brain activity and support neuron energy metabolism. Several forms exist: the classical ketogenic diet, the medium-chain triglyceride (MCT) diet, the modified Atkins diet with unrestricted protein, and the low glycemic index treatment. A 2020 Cochrane review left the evidence uncertain, and this update added newer trials. Eleven trials enrolled children and six enrolled adolescents and adults, with follow-up of up to 24 months. In nearly all trials, a ketogenic diet was compared with usual care, most often an added medication. The authors searched four databases in February 2024 and again in June 2025, screened 1,193 unique records in duplicate, and pooled results as relative risks (RR) using random-effects models. Study bias was rated with the Cochrane RoB 2 tool, and confidence in each result was graded from high to very low using GRADE. In children, a 50% or greater drop in seizures was far more likely with KDT (RR 4.06, meaning roughly four times the likelihood; 49.7% versus 12.2%, or 37 more children per 100). A 90% or greater drop was borderline (RR 1.74, 95% CI 1.00 to 3.03). Adverse events were similar to usual care (RR 1.03), and dropout was not significantly different (RR 1.64, 95% CI 0.88 to 3.07). In adolescents and adults, 50% or greater seizure reduction was also more likely (RR 7.73, which translates to 16 more per 100), with moderate certainty. Near-complete seizure control (RR 13.00, with a very wide interval of 0.74 to 226.98), side effects and dropout could not be judged because of very low certainty. Reported side effects were mainly gastrointestinal and resolved when the diet stopped. Quality of life findings were mixed: one infant trial found small differences favoring medication in temperament and peer relationships, while parents in another trial reported improved alertness and sleep. The authors interpret the findings as a clinically meaningful benefit for moderate seizure reduction, strongest in children. Certainty was limited by the impossibility of blinding a diet, small event counts and high heterogeneity for some outcomes. Most trials came from high-income countries, which may limit generalizability, and publication bias could not be excluded. No trial reported hospitalizations, status epilepticus or survival. The authors call for better evidence on safety, adherence, cognition and quality of life.

Yang Zhu et al. (2026) · PeerJ

This systematic review and meta-analysis pooled 22 randomized controlled trials with 375 mostly male participants to ask when, if at all, a single cold-water immersion (CWI) after exercise helps muscles recover. CWI means immersing the body, from navel depth up to the neck, in water of roughly 5 to 20 degrees C for about 6 to 20 minutes. Exercise-induced muscle damage (EIMD) is the loss of force, soreness and raised creatine kinase (CK, a blood marker leaking from stressed muscle cells) that follows hard or unaccustomed exercise, often with delayed onset muscle soreness (DOMS). Earlier reviews mixed time points, so this one separated results at 0, 24, 48 and 72 hours. The included trials enrolled healthy non-athletes and athletes aged about 16 to 49, who exercised with intervals, simulated matches, distance running or heavy eccentric lifting. After exercise, one group sat in cold water and the comparison group rested seated for a similar time. Researchers measured maximal voluntary isometric contraction (MVIC, the hardest possible static muscle squeeze), countermovement jump (CMJ, jump height as a gauge of explosive power), CK, and soreness on a visual analog scale (VAS, a line marked from no pain to worst pain). Maximal strength was unchanged by CWI (g = 0.08, 95% CI -0.11 to 0.26, p = 0.42; a negligible effect) at every time point. Jump performance was worse immediately afterward (g = -0.68, p = 0.01; a medium-sized drop) and showed no difference by 24 to 48 hours (g = 0.38 at 24 h, p = 0.06; g = 0.06 at 48 h, p = 0.68). CK looked lower after CWI (g = -0.43, p < 0.001; a small effect), but the result shrank to non-significance after correcting for likely missing small studies (g = -0.16, 95% CI -0.44 to 0.12; the original benefit was probably overestimated). Soreness was lower (g = -0.58, p = 0.006; a medium effect), though the trials disagreed widely (I² = 87%) and the certainty of evidence was rated very low. The evidence has clear limits: 362 of 375 participants were male, participants could not be blinded to cold water, several trials were tiny, and only one immersion with follow-up of 72 hours or less was studied. The authors suggest the soreness effect is the most plausible benefit and the temporary jump decrement is the main drawback. Repeated use during training and its effect on muscle adaptation were not examined, and they call for larger trials that include women and standardize temperature and duration.

Ilse N Ganzevoort et al. (2026) · The British journal of general practice : the journal of the Royal College of General Practitioners

This randomised controlled trial with 152 Dutch children explored whether home-based guided hypnotherapy, added to usual care from a general practitioner (GP), helps children with functional abdominal pain (recurring stomach pain with no underlying disease found) or irritable bowel syndrome (IBS, abdominal pain linked to bowel habit changes). Both conditions are disorders of gut-brain interaction, meaning the gut and the nervous system influence one another, and in children they are linked with anxiety, school absence and lower quality of life. Hypnotherapy is a state of focused attention in which therapeutic suggestions are used to influence sensation, emotion and thought. It is already available in secondary care, but its effect in primary care had not been tested. Children aged 7 to 17 with a GP diagnosis were randomly assigned to usual care alone (education, reassurance and symptom monitoring) or usual care plus hypnotherapy. Of the 152 children, 46 came through GPs and 106 through social media; median age was 9.4 years. The hypnotherapy group listened to five audio exercises on a website, one for breathing and relaxation and four visualisation exercises, for 15 to 20 minutes on at least five days a week for three months. The main outcome was adequate relief of abdominal pain at 12 months; pain severity was rated from 0 to 10. At 12 months the main result was not statistically significant: 79.5% of the hypnotherapy group reported adequate relief versus 74.3% of the usual care group (adjusted odds ratio 1.47, 90% confidence interval 0.74 to 2.93; the interval includes no difference). Earlier, differences were larger. At 3 months 73.2% versus 56.8% reported relief (odds ratio 2.74, meaning higher odds of relief), and at 6 months 77.6% versus 58.6% (odds ratio 4.26). Pain severity scores were lower in the hypnotherapy group by 1.38 points at 6 months and 0.89 points at 12 months, but not significantly at 3 months. Pain threat beliefs were lower and more children fell asleep within 20 minutes. Anxiety, depression, quality of life and school absence were similar between groups. No adverse events were spontaneously reported, but children were not asked about them directly. The authors suggest that hypnotherapy added to usual care may bring earlier relief and lower pain at low cost, and note that relief at 12 months was high in both groups. The trial had limits: it recruited fewer children than planned, so the significance threshold was relaxed to 10%, which raises the chance of false positives. Participants and clinicians knew who received hypnotherapy, and most families preferred it, so placebo effects are possible. More than 40% of pain diary data were missing. The authors call for research on which children benefit most and on possible adverse effects.

José de Oliveira Vilar Neto et al. (2025) · Nutrients

This systematic review of 10 clinical studies (483 men in total) examined whether Tribulus terrestris supplements improve erectile dysfunction (ED, difficulty achieving or keeping an erection) and testosterone levels. Tribulus is a plant used for centuries in India and China as a sexual stimulant. Its steroidal saponins (plant compounds with hormone-like structure) are proposed to raise testosterone and to boost nitric oxide, a molecule that relaxes blood vessels and supports erections, though the authors note the mechanism is not fully understood. The review asked whether the evidence supports either claim, and it looked at men with and without low testosterone. Researchers searched 13 databases for studies in which men took Tribulus on its own, without other supplements or drugs. Ten studies qualified: nine clinical trials and one study without a control group, conducted in Egypt, Bulgaria, Brazil, Australia, India, China and Spain. Participants were aged 16 to 70: healthy men, men with ED (some also with low testosterone), and men with low sperm counts or unexplained infertility. Doses ran from 400 mg to 12 g per day for 4 weeks to 3 months. Study quality was graded with the Jadad scale, a 5-point checklist of randomization, blinding and dropouts. Three of the five studies that measured erectile function found improvement, and all three enrolled men with ED. One trial using 500 mg daily for 3 months raised International Index of Erectile Function (IIEF-5) scores against placebo, with significance already at 4 weeks (p = 0.0119) and stronger by the end (p < 0.0001). Eight of ten studies found no significant testosterone change, and those men did not have low testosterone at the start. Two studies in men with low testosterone found rises of about 58 to 71 ng/dL (27 to 33%), a small increase in clinical terms (roughly from 215 to 273 and 213 to 284 ng/dL), and both scored poorly for methodological quality (Jadad 2 and 0). None of the studies reported side effects, and lipid and liver tests showed no impairment. The authors conclude that evidence for improved erectile function at 400 to 750 mg per day is of low level and that no solid evidence shows Tribulus raises testosterone. Half of the studies had a high risk of bias, samples were small, saponin content varied between products, and no meta-analysis was possible. The authors state that Tribulus is not a substitute for first-line treatment of severe ED and call for well-controlled randomized trials to define dose and duration, including trials in men with low testosterone.

Peerapat Lertwiram et al. (2025) · PloS one

This cross-over randomized trial with 32 children and teenagers explored whether Traditional Thai Massage could help improve walking in kids with spastic cerebral palsy (CP), a lifelong condition affecting muscle control and movement. Physical therapy is the usual treatment, but it takes significant time and trained staff — resources that are often scarce, especially in rural areas — so researchers tested whether a hands-on Thai bodywork technique, based on centuries-old pressure-and-stretch methods along the body's energy lines, could work as well. Each participant tried both treatments in turn: 30-minute Thai massage sessions twice a week for 6 weeks, and standard physical therapy sessions (stretching, strengthening, and walking practice) three times a week for 6 weeks, with a 6-week break in between so the effects of one treatment wouldn't carry over into the next. To measure results precisely, researchers used a 3D motion-capture system (the same kind of technology used in movie special effects) to score each child's walking pattern, plus muscle sensors, a treadmill breathing test, and a pressure-sensing walkway. The Thai massage group ended up with noticeably better walking scores than the physical therapy group — a meaningful improvement close to the threshold doctors consider clinically important — and their thigh muscles showed more activity during walking. Neither treatment beat the other on muscle stiffness, foot pressure, or how much oxygen the children used while walking. No one had any injuries or complications from either treatment, and families stuck with the program well, completing over 80% of sessions. This is an encouraging early sign that a low-cost, low-tech massage approach rooted in traditional Thai medicine might help children with cerebral palsy walk better — potentially as well as, or even slightly better than, standard physical therapy over the same timeframe. However, this was a small study, more than 1 in 5 participants didn't complete every follow-up visit, and the physical therapy given may have been too brief to show its best possible results. Bigger studies are needed before Thai massage could be recommended as a routine treatment.

Min He et al. (2022) · European journal of medical research

This systematic review and meta-analysis combined 30 randomised controlled trials with 4,413 participants to test whether acupuncture helps allergic rhinitis — the sneezing, congestion and runny nose caused by an allergic reaction in the lining of the nose. What sets it apart is that the authors then stress-tested their own findings using trial sequential analysis, a method that asks whether enough participants have been studied for a pooled result to be trusted rather than treated as a chance finding. Trials came mostly from China (22 of 30), with others from Germany, Australia, South Korea and Sweden, ranging from 24 to 981 participants and lasting between two and twelve weeks. Three needling approaches were used: standard needle acupuncture, electroacupuncture, and warm needling, in which mugwort is burned on the needle to heat it. Acupuncture was compared against no treatment, against sham needling at non-acupuncture points, and against antihistamines including cetirizine and loratadine. Symptoms were scored with the Total Nasal Symptom Score and quality of life with the Rhinoconjunctivitis Quality of Life Questionnaire. Against no treatment, acupuncture improved both nasal symptoms and quality of life in adults. Against sham needling it also came out ahead, improving nasal symptoms (mean difference -0.60, 95% CI -1.16 to -0.04, from 489 participants) and quality of life (mean difference -8.47, 95% CI -14.91 to -2.03, from 248 participants) — both statistically significant, since neither confidence interval crosses zero. Against cetirizine or loratadine no clear difference appeared, suggesting acupuncture performs about as well as standard antihistamines. But the trial sequential analysis failed to confirm any of these results, meaning the pooled evidence has not yet accumulated enough participants to be considered reliable. Effects in children and adolescents could not be determined at all. The honest summary is a promising signal that has not yet been confirmed. Performance and attrition bias were serious in most of the included trials, and the authors' own robustness check contradicted their own positive findings. For an adult who would rather not take daily antihistamines, acupuncture is a defensible option on current evidence; it is not yet a demonstrated one. Larger and better-conducted trials, especially in children, are what would settle the question.

Ping-Tao Tseng et al. (2023) · Advances in nutrition (Bethesda, Md.)

This network meta-analysis pooled 40 randomized controlled trials with 6,616 migraine sufferers to answer a question few doctors are asked but many patients wonder: can fish-oil omega-3s genuinely compete with prescription drugs for preventing migraines? Migraine affects roughly one in ten people worldwide, and standard preventive medications work for only 40–50% of those who try them, often with side effects that drive people to quit. Network meta-analysis is a technique that connects every studied treatment through shared comparison arms — here, 40 trials from the United States, Iran, Brazil, France, Norway and beyond, covering omega-3 supplements (EPA and DHA, the two main long-chain omega-3 fatty acids) alongside FDA-approved preventives like topiramate, valproate, amitriptyline, and propranolol. Participants averaged 35 years old and 79% were women, matching migraine's real-world demographics. Treatments ran 8 to 16 weeks, with migraine frequency and dropout rates as the primary measuring sticks. High-dose EPA/DHA ranked first in the entire network on every efficacy measure. It cut migraine frequency more than any drug (standardized mean difference −1.36 versus placebo, 95% CI −2.32 to −0.39 — a large effect) and reduced attack severity even more decisively (SMD −2.23, 95% CI −3.17 to −1.30). Just as important, people stuck with it: dropout was identical to placebo (odds ratio 1.00), while every prescription preventive in the network lost more patients along the way. The trade-off for honesty: the omega-3 trials were smaller than the drug trials, and the confidence intervals around these estimates are wide. This analysis moves high-dose omega-3 supplementation from "can't hurt" folk advice to a first-line candidate with top-of-network evidence, most relevant where preventive-drug side effects have been limiting. The benefit tracked the high-dose regimens, not the small amounts found in a typical daily fish-oil capsule.

Kiyoshi Suzuki et al. (2020) · Journal of alternative and complementary medicine (New York, N.Y.)

This study evaluated the effectiveness and safety of Okada Purifying Therapy (OPT), a biofield therapy, for symptom relief across diverse ethnicities and cultures. The research is significant as it addresses the unclear scientific understanding of biofield therapies and their potential benefits in improving physical and psychological well-being. The findings indicate that a majority of participants reported symptom improvement, particularly in Spanish/Portuguese speaking countries, while confirming the therapy's safety with low exacerbation rates. The study employed a cross-sectional design, involving 11,303 participants aged 16 and older from 14 countries, with no specific exclusion criteria. Participants received a single session of OPT, which lasted 30 minutes or longer, administered by certified practitioners. Outcomes were measured using self-reported questionnaires, including a demographic questionnaire, a 5-point Likert-type scale for symptom severity, and the MQL-10 questionnaire for quality of life assessment, all conducted before and after the OPT session. Results showed that 77.5% of participants reported overall symptom improvement (p < 0.0083), with the highest improvement rates observed in Chile/Peru (95.0%) and the lowest in Japan (72.3%). Secondary outcomes indicated that 75.6% reported improvement in physical pain, 78.4% in anxiety/depression, and 73.8% in dizziness/palpitation, all statistically significant (p < 0.0083). Non-significant findings included gender differences in symptom improvement (males 66.6% vs. females 78.3%, p = 0.051) and no significant age impact (p = 0.40). Adverse events were minimal, with 228 participants experiencing symptom exacerbation, none requiring emergency treatment. The authors suggest OPT may have a role as a noninvasive approach, particularly in culturally diverse settings. The authors note that cultural background appears to influence outcomes. Key limitations include the use of convenience sampling, potential biases in self-reported data, and the absence of a control group. Future research should aim to validate these findings with more rigorous methodologies and explore the underlying mechanisms of OPT's effectiveness.