Ision-making regarding their children's health care needs, including vaccination. Results A total of 73.8 of children had visited a complementary medicine (CM) practitioner (48.3 ) or used a CM product (68.5 ) in the previous 12 months. Many children had also consulted a general practitioner (89.9 ), community health nurse (31.29 ), paediatrician (30.3 ), and other medical specialist (38.8 ). Children had also visited a naturopath/herbalist (30.4 ), chiropractor (18.4 ), homeopath (11.6 ), nutritionist (6.8 ) or traditional Chinese medicine practitioner (8.2 ) and 52 of parents did not disclose the use of CM to their primary health care physician. A high number of children (35.6 ) were not vaccinated with safety concerns being the most common reason (76.6 ). Naloxegol oxalate Visits to a CM practitioner (OR 0.16; CI 0.07, 0.36; PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/8068869 p < 0.001) and the use of CM products (OR 0.25; CI 0.09, 0.64; p = 0.004) were more likely if childhood vaccinations were not up to date. Conclusions Poor vaccination uptake is associated with the use of CM in this sample and nationally representative studies are needed to confirm these findings. Research is also needed to determine if these associations are due to CM practitioner attitudes to vaccination or parental health beliefs. P53 The effects of modulated electro-hyperthermia on hepatocellular carcinoma in vitro and in vivo models Lilla F eki, Eva Kiss, Tamas Vancsik, Tibor Krenacs 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, 1085, Hungary Correspondence: Lilla F eki BMC Complementary and Alternative Medicine 2017, 17(Suppl 1):P53 Modulated electro-hyperthermia (mEHT) is an PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/15303251 integrative approach to chemo- and radiotherapy. Electromagnetic field and the concomitant heat (<42 ) can target malignancies due to their elevated ionconcentration (Warburg-effect) and electric conductivity. We tested the effects of mEHT on a hepatocellular carcinoma cell line (HepG2) in vitro and in vivo. HepG2 culture was treated in vitro three times for 60 minutes (42 ) during two days. Heat-stress was measured by western blot for Hsp70. Cells were counted for viability in B ker-chamber using resazurin assay. Tumor cell proliferation was assessed using Ki67 immunocytochemistry. Flow cytometry for annexin-V/propidium iodide (PI) was used to determine the apoptotic per necrotic rates. HepG2 xenografts in SCID mice were treated with mEHT for 30 minutes. Formalin-fixed, paraffin.embedded tumors were tested 24 and 96 hours after treatment using hematoxillin-eosin based morphometry and immunhistochemistry to identify proliferating (Ki67) and apoptotic (cleaved caspase-3) cell fractions. mEHT treatment in vitro resulted in a significant destruction and loss of tumor cells. Elevated release of stress-associated Hsp70 was also observed. Annexin-V/PI measurements confirmed elevated apoptotic cell death rate. Directly after mEHT treatment there was a transitional elevation of resazurin uptake in tumor cells which later decreased to the control level. This phenomenoncould be a residual effect on enzyme activity after the thermal impact. The proliferation of the tumor cells was reduced based on the Ki67 assessment. In vivo, mEHT treatment induced caspase-3-mediated tumor-destruction and reduced tumor cell proliferation. Further studies are under way to clarify the mechanism of action of mEHT on HEPG2 cells. P54 Preliminary findings from an active surveillance reporting system among spinal manipulative therapy.