Acupuncture Studies on Pain

1997 ◽  
Vol 15 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Moolamanil Thomas
Keyword(s):  
Chronic Pain ◽  
Randomised Controlled Trials ◽  
Sensory Stimulation ◽  
Complementary Therapy ◽  
Controlled Trials ◽  
Clinical Use ◽  
Basic Understanding ◽  
History Of ◽  
Randomised Controlled ◽  
Peripheral Sensory

The relegation of acupuncture to complementary therapy ignores the history of its development and restricts possibilities for its clinical use and further research. Clinical studies with randomised, controlled trials and double blinding require reconsideration and adaptation when using acupuncture for treatment when multiple patient and treatment variables are involved. Ample experimental evidence exists for acupuncture to be considered as a modality of peripheral sensory stimulation, but present clinical research has not incontrovertibly validated the use of acupuncture on patients with chronic pain. A basic understanding of the neuro-physiology of pain and its differentiation does provide better indications for its use. More consistent results may then be obtained, as seen from a few recent studies.

Seksueel onaangepast gedrag bij een patiënt met dementie: literatuurreview en casusrapport

2021 ◽  
Author(s):  
C. SEAUX ◽  
K. GOEDSEELS ◽  
J. DE LEPELEIRE
Keyword(s):  
Case Studies ◽  
Randomised Controlled Trials ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Controlled Trials ◽  
Pharmacological Treatments ◽  
Pharmacological Interventions ◽  
Drug Of Choice ◽  
Cochrane Database ◽  
History Of ◽  
Randomised Controlled

Sexually inappropriate behaviour in a patient with dementia: literature review and case report In this paper, the medical history of a 75-year-old man with dementia and sexually inappropriate behaviour (SIB) is described. An overview of the literature regarding the approach and treatment of SIB in persons with dementia was performed. PubMed, Web of Science and the Cochrane database were consulted, and thirteen articles selected. There are no randomised controlled trials available. The literature is limited to case studies and reviews of case studies. Non-pharmacological treatments are perceived to be the first step, although they are rarely studied. There is no consensus regarding a pharmacological approach. However, all studies suggest the paradigm of “start low and go slow”. A variety of drugs have been described. When starting a pharmacological treatment, it is recommended to keep in mind comorbidities and possible side-effects. Selective serotonin reuptake inhibitors (SSRIs) seem to be the preferred first line treatment if the behaviour is not too harmful. If the behaviour is intrusive, anti-androgens seem to be the drug of choice. Further research is needed: a consensus regarding the definition and the development of a screening tool could support randomised controlled trials concerning pharmacological and non-pharmacological interventions. Research concerning ethical dilemmas should, however, not be neglected.

scholarly journals Mesh fixation techniques for inguinal hernia repair: an overview of systematic reviews of randomised controlled trials

Hernia ◽  
2021 ◽  
Author(s):  
A. Alabi ◽  
N. Haladu ◽  
N. W. Scott ◽  
M. Imamura ◽  
I. Ahmed ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Systematic Reviews ◽  
Randomised Controlled Trials ◽  
Mesh Fixation ◽  
Controlled Trials ◽  
Fixation Techniques ◽  
Randomised Controlled

Abstract Purpose Inguinal hernia repair using surgical mesh is a very common surgical operation. Currently, there is no consensus on the best technique for mesh fixation. We conducted an overview of existing systematic reviews (SRs) of randomised controlled trials to compare the risk of chronic pain and recurrence following open and laparoscopic inguinal hernia repairs using various mesh fixation techniques. Methods We searched major electronic databases in April 2020 and assessed the methodological quality of identified reviews using the AMSTAR-2 tool. Results We identified 20 SRs of variable quality assessing suture, self-gripping, glue, and mechanical fixation. Across reviews, the risk of chronic pain after open mesh repair was lower with glue fixation than with suture and comparable between self-gripping and suture. Incidence of chronic pain was lower with glue fixation than with mechanical fixation in laparoscopic repairs. There were no significant differences in recurrence rates between fixation techniques in open and laparoscopic mesh repairs, although fewer recurrences were reported with suture. Many reviews reported wide confidence intervals around summary estimates. Despite no clear evidence of differences among techniques, two network meta-analyses (one assessing open repairs and one laparoscopic repairs) ranked glue fixation as the best treatment for reducing pain and suture for reducing the risk of recurrence. Conclusion Glue fixation may be effective in reducing the incidence of chronic pain without increasing the risk of recurrence. Future research should consider both the effectiveness and cost-effectiveness of fixation techniques alongside the type of mesh and the size and location of the hernia defect.

scholarly journals How reliable are randomised controlled trials for studying the relationship between diet and disease? A narrative review

2016 ◽  
Vol 116 (3) ◽  
pp. 381-389 ◽  
Author(s):  
Norman J. Temple
Keyword(s):  
Cohort Studies ◽  
Randomised Controlled Trials ◽  
Critical Evaluation ◽  
Epidemiological Studies ◽  
Dietary Factors ◽  
Controlled Trials ◽  
Large Numbers ◽  
History Of ◽  
Randomised Controlled

AbstractLarge numbers of randomised controlled trials (RCT) have been carried out in order to investigate diet–disease relationships. This article examines eight sets of studies and compares the findings with those from epidemiological studies (cohort studies in seven of the cases). The studies cover the role of dietary factors in blood pressure, body weight, cancer and heart disease. In some cases, the findings from the two types of study are consistent, whereas in other cases the findings appear to be in conflict. A critical evaluation of this evidence suggests factors that may account for conflicting findings. Very often RCT recruit subjects with a history of the disease under study (or at high risk of it) and have a follow-up of only a few weeks or months. Cohort studies, in contrast, typically recruit healthy subjects and have a follow-up of 5–15 years. Owing to these differences, findings from RCT are not necessarily more reliable than those from well-designed prospective cohort studies. We cannot assume that the results of RCT can be freely applied beyond the specific features of the studies.

scholarly journals Effects of presurgical interventions on chronic pain after total knee replacement: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033248 ◽  
Author(s):  
Jane Dennis ◽  
Vikki Wylde ◽  
Rachael Gooberman-Hill ◽  
AW Blom ◽  
Andrew David Beswick
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Moderate Quality ◽  
Total Knee ◽  
Randomised Controlled ◽  
Quality Evidence

ObjectiveNearly 100 000 primary total knee replacements (TKR) are performed in the UK annually. The primary aim of TKR is pain relief, but 10%–34% of patients report chronic pain. The aim of this systematic review was to evaluate the effectiveness of presurgical interventions in preventing chronic pain after TKR.DesignMEDLINE, Embase, CINAHL,The Cochrane Libraryand PsycINFO were searched from inception to December 2018. Screening and data extraction were performed by two authors. Meta-analysis was conducted using a random effects model. Risk of bias was assessed using the Cochrane tool and quality of evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation.Primary and secondary outcomesPain at 6 months or longer; adverse events.InterventionsPresurgical interventions aimed at improving TKR outcomes.ResultsEight randomised controlled trials (RCTs) with data from 960 participants were included. The studies involved nine eligible comparisons. We found moderate-quality evidence of no effect of exercise programmes on chronic pain after TKR, based on a meta-analysis of 6 interventions with 229 participants (standardised mean difference 0.20, 95% CI −0.06 to 0.47, I2=0%). Sensitivity analysis restricted to studies at overall low risk of bias confirmed findings. Another RCT of exercise with no data available for meta-analysis showed no benefit. Studies evaluating combined exercise and education intervention (n=1) and education alone (n=1) suggested similar findings. Adverse event data were reported by most studies, but events were too few to draw conclusions.ConclusionsWe found low to moderate-quality evidence to suggest that neither preoperative exercise, education nor a combination of both is effective in preventing chronic pain after TKR. This review also identified a lack of evaluations of other preoperative interventions, such as multimodal pain management, which may improve long-term pain outcomes after TKR.PROSPERO registration numberCRD42017041382.

Sign in / Sign up

Export Citation Format

Share Document