Acupuncture Treatment for Chemotherapy-Induced Peripheral Neuropathy – a Case Series

2006 ◽  
Vol 24 (2) ◽  
pp. 87-91 ◽  
Author(s):  
Raimond Wong ◽  
Stephen Sagar
Keyword(s):  
Peripheral Neuropathy ◽  
Acupuncture Treatment ◽  
Clinical Course ◽  
Case Series ◽  
Current Management ◽  
Autonomic Nervous System Dysfunction ◽  
Neurophysiological Mechanisms ◽  
Prospective Case Series ◽  
Chemotherapy Agents

Chemotherapy induced peripheral neuropathy (CIPN) occurs in 10 to 20% of cancer patients treated with neurotoxic chemotherapy. A mixture of sensory, sensorimotor and autonomic nervous system dysfunction can occur, resulting in deterioration in function and worsened quality of life. A major feature is discomfort and pain. Early termination of treatment and dose reduction of chemotherapy may be necessary. The clinical course is variable and depends on the chemotherapy agents and their cumulative dose. Although symptoms can resolve completely, in most patients CIPN is either only partially reversible or completely irreversible. Current management for CIPN is symptomatic using membrane stabilising medications and antidepressants. The use of nerve growth factors is still experimental. Dysaesthesia and pain involving the feet and hands are described in both traditional Chinese medicine (TCM) and Western biomedicine. In TCM, the pathogenesis is related to the inability to direct Qi and Blood to the extremities, and is associated with Qi, Blood, Yang and Kidney deficiencies. Acupuncture is moderately effective in treating diabetic neuropathy. However, to date, there is no report of the usefulness of acupuncture for CIPN. We report the result of a pilot prospective case series of five patients treated with an acupuncture protocol that aims to correct Qi, Blood and Yang deficiencies and directs Qi and Blood to the extremities, with the goal of improving the symptoms of CIPN. The responses were encouraging, and cannot be easily explained by the known neurophysiological mechanisms of acupuncture.

scholarly journals Application of Low-Intensity Modified Constraint-Induced Movement Therapy to Improve the Affecter Upper Limb Functionality in Infantile Hemiplegia with Moderate Manual Ability. Case Series

2020 ◽  
Author(s):  
Rocío Palomo-Carrión ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Piñero-Pinto ◽  
Purificación López-Muñoz ◽  
Helena Romay-Barrero ◽  
...  
Keyword(s):  
Upper Limb ◽  
Case Series ◽  
Movement Therapy ◽  
Low Intensity ◽  
Constraint Induced Movement Therapy ◽  
Case Series Study ◽  
Quality Of Movement ◽  
Prospective Case Series ◽  
Quest Scale

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified constraint-induced movement therapy(mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were: quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp-release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the QUEST scale, the SHUEE Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of 8 children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p<0.05). The greatest increase occurred in spontaneous use from assessment 1-4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb obtained a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 hours) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

scholarly journals Tectal gliomas: assessment of malignant progression, clinical management, and quality of life in a supposedly benign neoplasm

2018 ◽  
Vol 44 (6) ◽  
pp. E15 ◽  
Author(s):  
Malte Mohme ◽  
Friederike S. Fritzsche ◽  
Klaus C. Mende ◽  
Jakob Matschke ◽  
Ulrike Löbel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Course ◽  
Case Series ◽  
Diffuse Astrocytoma ◽  
The Mean ◽  
Mean Time ◽  
Tectal Glioma ◽  
Astrocytoma Grade

OBJECTIVETectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical course is highly variable and that there is a potential for a progressive biology.METHODSClinical data analysis of 23 cases of tectal glioma (involving 9 children and 14 adults) was performed retrospectively. Radiographic data were analyzed longitudinally and MR images were evaluated for tumor volume, contrast enhancement, and growth progression. Quality of life was assessed using the EORTC BN20 and C30 questionnaires during follow-up in a subgroup of patients.RESULTSThe patients’ mean age at diagnosis was 29.2 years. The main presenting symptom at diagnosis was hydrocephalus (80%). Six patients were treated by primary tumor resection (26.1%), 3 patients underwent biopsy followed by resection (13.1%), and 3 patients underwent biopsy only (13.1%). For additional treatment of hydrocephalus, 14 patients (60.9%) received shunts and/or endoscopic third ventriculostomy. Radiographic tumor progression was observed in 47.9% of the 23 cases. The mean time between diagnosis and growth progression was 51.5 months, and the mean time to contrast enhancement was 69.7 months. Histopathological analysis was obtained in 12 cases (52.2%), resulting in 5 cases of high-grade glioma (3 cases of glioblastoma multiforme [GBM], grade IV, and 2 of anaplastic astrocytoma, grade III), 5 cases of pilocytic astrocytoma, 1 diffuse astrocytoma, and 1 ganglioglioma. Malignant progression was observed in 2 cases, with 1 case progressing from a diffuse astrocytoma (grade II) to a GBM (grade IV) within a period of 13 years. Quality-of-life measurements demonstrated distinct functional deficits compared to a healthy sample as well as glioma control cohorts.CONCLUSIONSAnalysis of this case series shows that a major subpopulation of tectal gliomas show progression and malignant transformation in children as well as in adolescents. These tumors therefore cannot be considered inert lesions and require histological confirmation and close follow-up. Quality-of-life questionnaires show that tectal glioma patients might benefit from special psychological support in emotional, social, and cognitive functionality.

scholarly journals Blinded Ultrasound Examination of the Subscapularis Following Anatomic Shoulder Arthroplasty

2019 ◽  
Vol 3 ◽  
pp. 247154921983244
Author(s):  
Michael P O’Malley ◽  
Cameron Kia ◽  
Alex G Dukas ◽  
Mark Cote ◽  
Harlan Stock ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Shoulder Arthroplasty ◽  
Ultrasound Examination ◽  
Case Series ◽  
Subscapularis Tendon ◽  
Time Points ◽  
Final Study ◽  
The Status ◽  
Prospective Case Series

Background The subscapularis tendon is commonly released during shoulder arthroplasty, and its integrity and repair postoperatively have been shown important to help maximize patient function. However, diagnosing subscapular tendon failure can be difficult with magnetic resonance imaging secondary to metal artifact as well as very costly. Purpose The purpose of this study was to assess the utility of ultrasound imaging in evaluating subscapularis integrity at specific time points following shoulder arthroplasty, in a blinded fashion. Secondarily, we report on the correlation between the condition of the subscapularis and quality-of-life outcome measures. Study Design Prospective case series. Methods Ultrasounds were completed preoperatively and postoperatively at 1 week as well as at 1, 3, and 6 months. Each was read by a single musculoskeletal radiologist and categorized as “intact,” “torn,” or “unclear.” Clinical outcome was evaluated using the Western Ontario Osteoarthritis Shoulder (WOOS) index at these same time points. Results The final study group consisted of 35 procedures in 33 patients (19 females and 14 males, mean age 66 ± 9 years). Three patients had postoperative subscapularis failures that were confirmed in the operating room at the time of repair. Of 24 sonographs categorized as “unclear” in the postoperative period, the majority (n = 12, 50%) were taken at 1 week. Compared to preoperative scores, patients had lower WOOS scores at 1, 3, and 6 months postoperatively ( P < .001). Correlation analysis did not reveal an association between the ultrasound readings and the WOOS scores postoperatively. Conclusion The utility of ultrasound examination of the subscapularis tendon following shoulder arthroplasty is limited by timing and may be most useful when used by the physician within clinical context. Significant improvement was noted in disease-specific quality-of-life scores regardless of the status of the subscapularis tendon as read on ultrasound.

scholarly journals Improvement of Painful Bortezomib-Induced Peripheral Neuropathy Following Acupuncture Treatment in a Case Series of Multiple Myeloma Patients

2012 ◽  
Vol 24 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Ting Bao ◽  
Lixing Lao ◽  
Michelle Medeiros ◽  
Ruixin Zhang ◽  
Susan G. Dorsey ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Peripheral Neuropathy ◽  
Acupuncture Treatment ◽  
Case Series

Acupuncture for the Treatment of Trigger Finger in Adults: A Prospective Case Series

2016 ◽  
Vol 34 (5) ◽  
pp. 392-397 ◽  
Author(s):  
Motohiro Inoue ◽  
Miwa Nakajima ◽  
Tatsuya Hojo ◽  
Megumi Itoi ◽  
Hiroshi Kitakoji
Keyword(s):  
Acupuncture Treatment ◽  
Statistical Significance ◽  
Case Series ◽  
Tendon Sheath ◽  
Trigger Finger ◽  
Before And After ◽  
Vas Scores ◽  
Prospective Case Series ◽  
Clinically Significant ◽  
A1 Pulley

Objective To determine the effect of acupuncture performed at the synovial and ligamentous tendon sheath (A1 pulley site) on pain during snapping and the severity of the snapping phenomenon in patients with trigger finger. Methods In this observational study, changes in the patients’ condition were compared before and after acupuncture treatment. Acupuncture was performed on 19 fingers of 15 patients. Acupuncture needles were inserted into the radial and ulnar sides of the flexor tendon at the A1 pulley of the affected finger. Treatment was performed daily up to a maximum of five times. Before and after each treatment, pain during snapping and the severity of snapping were evaluated using a visual analogue scale (VAS). Results VAS scores for pain and snapping severity were significantly improved immediately after the first treatment (p<0.001). Pain during snapping, assessed before each treatment, improved over time, reaching statistical significance from the second treatment onwards (p<0.001); similarly, a significant improvement in the severity of snapping was observed, also from the second treatment (p<0.001). Patients with clinically significant improvements (≥50%) in pain and snapping severity had a significantly shorter duration of the disorder than those with <50% improvement (p<0.05). Conclusions Acupuncture at the impaired A1 pulley site may be an effective treatment for trigger finger. We postulate that acupuncture may reduce inflammation/swelling of the synovial membrane of the tendon sheath, which predominates when the disorder is of short duration. Further research is required to confirm the efficacy/effectiveness of acupuncture for trigger finger and its mechanisms of action.

Buccal Mucosal Grafts: Novel Treatment for the Repair of Rectovaginal Fistulas A Study Protocol (Preprint)

2021 ◽  
Author(s):  
Dr. Caitlin Cahill ◽  
Natalia Kruger ◽  
Dr. John Heine
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Treatment Modalities ◽  
Short Term ◽  
Patient Morbidity ◽  
Key Issues ◽  
Technical Details ◽  
Rectovaginal Fistulas ◽  
Prospective Case Series

BACKGROUND Rectovaginal fistulas (RVFs) are abnormal communications between the rectum/anus and the vagina. They are most frequently a result of obstetric injury and have deleterious impacts on patients’ quality of life. Despite several treatment modalities, RVFs remain difficult problems to manage, and many patients fail multiple attempts at surgical repair. Buccal mucosal grafts (BMGs) may be a solution to this problem. A BMG is oral mucosal tissue harvested from the inner cheek. There are two case reports that describe the successful use of BMGs in the repair of RVFs. OBJECTIVE Our objective is to validate these findings with a prospective case series, while also addressing key issues of indication, technical details, procedure safety, and short-term outcomes. METHODS Our objective is to validate these findings with a prospective case series, while also addressing key issues of indication, technical details, procedure safety, and short-term outcomes. RESULTS Two previous case reports have described the successful use of BMGs in the repair of RVFs. We have received ethics approval to attempt to validate these findings through a prospective case series. CONCLUSIONS Rectovaginal fistulas cause significant patient morbidity and are difficult problems to manage. Bolstered by the successful use of BMGs in urologic surgery and the previously published case reports demonstrating success in RVFs, we believe that BMGs may be a solution to RVFs.

scholarly journals Efficacy of low-dose chemotherapy with methotrexate and vinblastine for patients with extra-abdominal desmoid-type fibromatosis: a systematic review

2019 ◽  
Vol 50 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Koki Shimizu ◽  
Shunsuke Hamada ◽  
Tomohisa Sakai ◽  
Hiroshi Koike ◽  
Masahiro Yoshida ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Dose ◽  
Evaluation Criteria ◽  
Case Series ◽  
Evaluation Methodology ◽  
Adverse Event Rate ◽  
Prospective Case Series ◽  
Extra Abdominal Desmoid ◽  
Low Dose Chemotherapy

Abstract Objective The treatment modality for desmoid-type fibromatosis has shifted from surgery to conservative treatment. This systematic review aims to evaluate the efficacy of low-dose chemotherapy with methotrexate and vinblastine for patients with extra-abdominal desmoid-type fibromatosis. Methods We searched the pertinent literature from January 1990 to August 2017. Two reviewers evaluated and screened the literature independently for eligibility and extracted data. We evaluated the quality of body of evidence and made a recommendation according to the Grading of Recommendations Development and Evaluation methodology. Results The search yielded 40 studies, 9 of which were included after the first and second screenings. There were three prospective case series but no randomized controlled trials among the nine studies. There was no case–control report (vs. no treatment). According to Response Evaluation Criteria in Solid Tumors criteria, the mean response rate (complete remission or partial response) was 36% (11–57%). Including stable disease, namely, clinical benefit was consistently as high as 85% (69–100%). Mean adverse event rate of G3 or G4 according to CTCAE was 31%. One study reported improvement of pain (87.5%) because of this chemotherapy. Conclusion The efficacy of this chemotherapy was convincing. However, the overall evidence was weak, and this chemotherapy is not covered by insurance in Japan; we only weakly recommend low-dose chemotherapy with methotrexate and vinblastine in patients with extra-abdominal desmoid-type fibromatosis.

scholarly journals Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones: A systematic review

2013 ◽  
Vol 83 (6) ◽  
pp. 1074-1082 ◽  
Author(s):  
Farhan Bazargani ◽  
Ingalill Feldmann ◽  
Lars Bondemark
Keyword(s):  
Computed Tomography ◽  
Three Dimensional ◽  
Case Series ◽  
Rapid Maxillary Expansion ◽  
Three Dimensions ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Maxillary Expansion ◽  
Prospective Case Series

ABSTRACTObjective:To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging.Materials and Methods:The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies.Results:The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%–50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive.Conclusions:CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.

scholarly journals Surgical treatment of rheumatoid forefoot

2018 ◽  
Vol 12 (4) ◽  
pp. 310-15
Author(s):  
Rodrigo Sousa Macedo ◽  
Eduardo Araujo Pires ◽  
Rafael Barban Sposeto ◽  
Marcos Hideyo Sakaki ◽  
Alexandre Leme Godoy dos Santos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Case Series ◽  
Female Gender ◽  
Resection Arthroplasty ◽  
Functional Evaluation ◽  
Statistical Validation ◽  
Case Series Study ◽  
Quality Of Life Scale ◽  
Prospective Case Series

Objective: To evaluate the functional outcome and quality of life of patients with rheumatoid arthritis (RA) who underwent resection arthroplasty of the first to fifth metatarsal heads. Methods: Prospective case series study in which 8 feet of 5 patients underwent resection arthroplasty of the five metatarsal heads via a plantarapproach to the lateral rays and via a medial approach to the first metatarsal. Dressing and orthotics were used for 3 months to correct the position of the toes. Patients were evaluated in the preoperative period and at least one year after the procedure using two functional evaluation scales (AOFAS lesser toes and AOFAS hallux) and one quality of life scale (EQ-5D). All results were subjected to statistical validation using theMann-Whitney U test. Results: The subjects had a mean age of 71 years, with a prevalence of the female gender. The mean AOFAS lesser toe and AOFAS hallux scores increased from 38.6 and 24.5 preoperatively to 85.7 and 83.1 postoperatively, respectively (p<0.001). The quality of life scores measured through the EQ-5D improved from 8.0 to 5.6, on average. Conclusion: Resection arthroplasty of the five metatarsal heads improves the function and quality of life in the short term of patients with rheumatoid foot.Level of Evidence IV; Therapeutic Studies; Case Series.

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