Acupuncture in the Treatment of Fibromyalgia in Tertiary Care – a Case Series

Aims Fibromyalgia is a common cause of chronic widespread pain. The benefit of medication is often limited by its side effects, and the improvements obtained with exercise and education are inconsistent. Many patients seek acupuncture treatment, which is reported to be helpful in some cases. This study aimed to explore the acceptability and benefits of acupuncture offered in the setting of a tertiary referral clinic. Methods An open, uncontrolled observational study was conducted among patients who met the usual fibromyalgia criteria and who had a pain score of at least 30 on a 100mm Visual Analogue Scale (VAS). Patients were allowed to continue other treatments but not to introduce new ones. Acupuncture was given using a Western approach according to a protocol developed by consensus. Patients were offered eight treatments in eight weeks. Outcome measures included VAS of pain intensity and Fibromyalgia Impact Questionnaire (range 0 – 100), and were taken before and after treatment, and at 14, 20 and 34 weeks from enrolment. Results Twenty four eligible patients were enrolled in a 12 month period. Baseline mean pain VAS score for these 24 patients was 74 (SD 18) and mean Fibromyalgia Impact Questionnaire score 78 (SD 12.4). Only 14 patients completed the course of treatment within about 10 weeks. Compliance was poor in the remaining patients because of difficulty attending clinic, and in two cases because of exacerbation of pain. Completion of outcome measures was variable and therefore the analysis of data is limited. Five patients scored at least 20% reduction in Fibromyalgia Impact Questionnaire score which is a clinically relevant improvement. Two of these scored at least 50% reduction. Conclusion Acupuncture appears to offer symptomatic improvement to some patients with fibromyalgia in a tertiary clinic who have failed to respond to other treatments. In view of its safety, further acupuncture research is justified in this population.

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Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1145 ◽

2013 ◽

Vol 6 (1) ◽

pp. 32-40 ◽

Cited By ~ 3

Author(s):

NV Deepthi ◽

Indudharan R Menon

Keyword(s):

Computed Tomography ◽

Pilot Study ◽

Endoscopic Sinus Surgery ◽

Medical Center ◽

Tertiary Care ◽

Objective Evaluation ◽

Symptomatic Improvement ◽

Sinus Surgery ◽

Tertiary Care Medical Center ◽

Before And After

ABSTRACT Background Chronic rhinosinusitis (CRS) is diagnosed on the basis of symptoms, nasal endoscopic findings and computed tomography of the paranasal sinuses (CT PNS). Where indicated, functional endoscopic sinus surgery (FESS) is the surgical treatment. Objective To determine correlations between subjective symptom severity and objective endoscopic and radiologic findings in CRS and to compare these before and after FESS. Materials and methods Analysis of prospectively collected data of 20 patients undergoing FESS at a tertiary care medical center followed up for a minimum period of 6 months after surgery. RSI questionnaire-based symptom score, Lund-Mackay system-based endoscopic and CT finding scores were recorded preoperatively and at 8 weeks and 6 months postoperatively. Results Significant positive correlation was noted between the three parameters before surgery, especially endoscopic and radiological scores (r = 0.94 in the latter, p < 0.01 in all three). Postoperative improvement was statistically significant for all three parameters, even at the 6 months stage (p < 0.001). Postoperative correlations reduced significantly, especially between endoscopic and radiological scores. Conclusion This study showed the relevance of objective evaluation of routine parameters of CRS, preoperatively. It also confirmed the usefulness of FESS in indicated cases, in terms of statistical improvement of these parameters. However, repeat CT scans and the methods of scoring used by us may not be equally applicable in the long-term postoperative scenario. How to cite this article Deepthi NV, Menon UK, Menon IR. Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study. Clin Rhinol An Int J 2013;6(1):32-40.

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Acupuncture in the Management of Anxiety Related to Dental Treatment: A Case Series

Acupuncture in Medicine ◽

10.1136/aim.2009.001933 ◽

2010 ◽

Vol 28 (1) ◽

pp. 3-5 ◽

Cited By ~ 19

Author(s):

Palle Rosted ◽

Mads Bundgaard ◽

Sian Gordon ◽

Anne Marie Lynge Pedersen

Keyword(s):

Acupuncture Treatment ◽

Dental Treatment ◽

Case Reports ◽

Dental Anxiety ◽

Case Series ◽

Randomised Clinical Trial ◽

Common Phenomenon ◽

Inexpensive Method ◽

Before And After ◽

Severe Anxiety

Background Anxiety related to dental treatment is a common phenomenon that has a significant impact on the provision of appropriate dental care. The aim of this case series was to examine the effect of acupuncture given prior to dental treatment on the level of anxiety. Methods Eight dentists submitted 21 case reports regarding the treatment of dental anxiety. The level of anxiety was assessed by the Beck Anxiety Inventory (BAI). Only patients with moderate to severe anxiety (BAI score ≥16) were included. The remaining 20 patients, 16 women and 4 men, with a mean age of 40.3 years, had a median BAI score of 26.5 at baseline. The BAI score was assessed before and after the acupuncture treatment. All patients received acupuncture treatment for 5 min prior to the planned dental treatment using the points GV20 and EX6. Results There was a significant reduction in median value of BAI scores after treatment with acupuncture (26.5 reduced to 11.5; p<0.01), and it was possible to carry out the planned dental treatment in all 20 cases after acupuncture treatment. Previously this had only been possible in six cases. Conclusion Acupuncture prior to dental treatment has a beneficial effect on the level of anxiety in patients with dental anxiety and may offer a simple and inexpensive method of treatment. However, the present results need to be tested in a larger randomised clinical trial in order to evaluate the effectiveness of the acupuncture treatment in patients with dental anxiety.

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A Conscious Sedation Protocol for Videolaryngostroboscopy in Pediatric Patients

International Journal of Otolaryngology ◽

10.1155/2010/643123 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Samantha Anne ◽

Lawrence M. Borland ◽

Laura Haibeck ◽

Joseph E. Dohar

Keyword(s):

Outcome Measures ◽

Pediatric Patients ◽

Conscious Sedation ◽

Treatment Plan ◽

Tertiary Care ◽

Case Series ◽

Diagnostic Information ◽

Secondary Outcome ◽

Sedation Protocol

Objective. To determine best sedation protocol for videolaryngostroboscopy in children unable to tolerate non-sedated evaluation.Materials and Methods.Consecutive case series of 10 children with voice disturbances, unable to tolerate nonsedated videolaryngostroboscopy at an academic tertiary care children’s hospital. Flexible fiberoptic videolaryngostroboscopy was performed and interpreted by pediatric otolaryngologist and speech and language pathologist. Sedation was administered with newly described protocol that allowed functional portion of evaluation.Main Outcome Measures: ability to follow commands and tolerate flexible fiberoptic videolaryngostroboscopy.Secondary Outcome Measures: total phonation time, complications, need for subsequent videolaryngostroboscopic attempts, clinical outcomes, and follow-up.Results. 10 children underwent procedure under conscious sedation. 9/10 children were able to perform simple tasks and maintain adequate phonation time to complete stroboscopic exam. 1/10 patients failed to complete exam because of crying during entire exam. Mean exam time was 2 minutes 52 seconds (SD 86 seconds), phonation time is 1 minute 44 seconds (SD 60 seconds), and number of tasks completed was 10.5 (SD 8.6).Conclusions. Conscious sedation for videolaryngostroboscopy can be safely and effectively performed in children unable to comply with nonsedated examination. Such studies provide valuable diagnostic information to make a diagnosis and to devise a treatment plan.

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

Acupuncture in Medicine ◽

10.1136/acupmed-2016-011068 ◽

2016 ◽

Vol 34 (5) ◽

pp. 392-397 ◽

Cited By ~ 4

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.

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Outcome Measures for Acute Submassive Pulmonary Embolisms at a Community-Based Hospital Using Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis

Vascular and Endovascular Surgery ◽

10.1177/1538574419885275 ◽

2019 ◽

Vol 54 (2) ◽

pp. 135-140

Author(s):

Brandon Hooks ◽

Vinay Sharma ◽

Gavin Taylor ◽

Sumeet Wadhwani ◽

Muhammad Ehtesham

Keyword(s):

Outcome Measures ◽

Low Dose ◽

Tertiary Care ◽

Interventional Cardiology ◽

Community Based ◽

Before And After ◽

Response Team ◽

Hospital Systems ◽

Pulmonary Embolisms ◽

Tertiary Care Centers

Purpose: Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis (USAT) appears to provide promising results for the management of acute submassive pulmonary embolisms (ASMPEs) at tertiary care centers. This study assessed outcome measures at a community-based hospital systems and compared results to known studies. Materials and Methods: This is a single-center, retrospective study assessing clinical outcomes of the EkoSonic Endovascular System intervention for ASMPEs performed by three surgical 3 subspecialties (interventional radiology, interventional cardiology, and vascular surgery) part of a pulmonary embolism response team (PERT). We reviewed 146 PERT activations from June 2013 to December 2017. Eighty-three patients with ASMPEs underwent USAT. Results: Our study showed greater differences ( P = .01) between baseline and follow-up pulmonary artery systolic pressures (20.9 ± 9.8 mm Hg [n = 14]) compared to the ULTIMA study (12.3 ± 10 mm Hg [n = 30]). Our length-of-stay measures were shorter (6.1 ± 5.1 [n = 83]; P = .0001) compared to the SEATTLE II study (8.8 ± 5.0 [n = 150]). Preprocedure transthoracic echocardiograms (TTEs) were performed for 54 (65%) of 83 patients. Postprocedure TTEs at 48 hours was performed for 52 (62%) of 83 patients. Use of TTEs before and after intervention did not change outcomes. Intracranial hemorrhage was not observed in our patient population. There was no difference in outcomes between the three subspecialties in our study. Conclusions: Use of USAT in a community-based hospital PERT has similar outcomes to tertiary care centers. Furthermore, similar outcomes were observed between the three subspecialties suggesting development of a comprehensive care team for management of ASMPEs.

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Preliminary Evaluation of a New Orthotic for Patellofemoral and Multicompartment Knee Osteoarthritis

Rehabilitation Research and Practice ◽

10.1155/2021/5923721 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Aleksandra R. Budarick ◽

Emily L. Bishop ◽

Marcia L. Clark ◽

Christopher D. Cowper-Smith

Keyword(s):

Physical Activity ◽

Knee Osteoarthritis ◽

Physical Function ◽

Outcome Measures ◽

Case Series ◽

Secondary Outcome ◽

Preliminary Evaluation ◽

Activity Levels ◽

Knee Oa ◽

Before And After

Purpose. Traditional knee osteoarthritis (OA) braces are usually indicated for a minority of patients with knee OA, as they are only suitable for those with unicompartmental disease affecting the tibiofemoral joint. A new assistive brace design is intended for use in a wider range of knee OA patients with heterogeneous symptoms characteristic of patellofemoral, tibiofemoral, or multicompartmental knee OA. The purpose of this case series was to explore whether the use of this novel “tricompartment offloader” (TCO) brace was associated with clinically relevant improvements in pain and function. Materials and Methods. A retrospective analysis of individuals with knee OA ( n = 40 ) was conducted to assess pain, function, physical activity, and use of medication and other treatments before and after brace use. Validated outcome measures including the Visual Analog Scale (VAS) and Lower Extremity Functional Scale (LEFS) were used to assess pain and physical function (primary outcome measures). Exploratory measures were used to quantify physical activity levels and use of medication and other treatments (secondary outcome measures). Results. Average total pain (VAS) scores decreased by 36.6 mm and physical function (LEFS) scores increased by 16.0 points following the use of the TCO brace. Overall, 70% of the participants indicated increased weekly physical activity and 60% reported a decrease in their use of at least one other treatment. Conclusions. Results from this case series suggest that the TCO brace shows strong potential to fill a conservative treatment gap for patients with heterogeneous symptoms of knee OA that are characteristic of patellofemoral or multicompartment disease. Further investigation is warranted.

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Olfactory and Gustatory Dysfunction as An Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study

10.1101/2020.05.13.20100198 ◽

2020 ◽

Author(s):

Chenghao Qiu ◽

Chong Cui ◽

Charlotte Hautefort ◽

Antje Haehner ◽

Jun Zhao ◽

...

Keyword(s):

Tertiary Care ◽

Case Series ◽

Symptomatic Improvement ◽

Olfactory Testing ◽

Adults And Children ◽

International Multicenter Study ◽

Tertiary Care Hospitals ◽

Chemosensory Function ◽

International Multicenter

Abstract Objective: Evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in COVID-19 patients Study Design: Multicenter Case Series Setting: 5 tertiary care hospitals (3 in China, 1 in France, 1 in Germany) Subjects and Methods: 394 PCR confirmed COVID-19 positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and Visual Analogue Scale (VAS) were used to quantify olfactory and gustatory dysfunction respectively. All subjects at one hospital (Shanghai) without subjective olfactory complaints underwent objective testing. Results: Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n=239), German (n=39) and French (n=116) cohorts were 32%, 69%, and 49% 138 respectively. The median age of included subjects was 39 years old, 92/161 (57%) were male, and 10/161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10/90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. 43% (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. Conclusions: Olfactory and/or gustatory disorders may represent early or isolated symptoms of SARS-CoV-2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.

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Effects of Physiotherapy vs. Acupuncture in Quality of Life, Pain, Stiffness, Difficulty to Work and Depression of Women with Fibromyalgia: A Randomized Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm10173765 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3765

Author(s):

Elisa María Garrido-Ardila ◽

María Victoria González-López-Arza ◽

María Jiménez-Palomares ◽

Agustín García-Nogales ◽

Juan Rodríguez-Mansilla

Keyword(s):

Quality Of Life ◽

Outcome Measures ◽

Acupuncture Treatment ◽

Controlled Trial ◽

Fibromyalgia Impact Questionnaire ◽

Joint Stiffness ◽

Core Stability ◽

Control Group ◽

Physiotherapy Program

Background: Fibromyalgia is a chronic clinical condition characterized by pain and other associated symptoms that have a negative impact on the quality of life of the affected person. The objective of this study was to assess the effectiveness of a core stability training physiotherapy program compared to an acupuncture treatment on quality of life, pain, joint stiffness, difficulty to work and depression of women with fibromyalgia. Methods: This was a single-blind, randomized clinical controlled trial. Women with fibromyalgia were randomized to a core stability physiotherapy program group (n = 45), an acupuncture treatment group (n = 45) and a control group (n = 45) for 13 weeks. Measurements were taken at baseline (week 0), post-intervention (week 6) and at follow-up (week 13). The primary outcome measure was quality of life (Spanish Fibromyalgia Impact Questionnaire). The secondary outcome measures were pain, joint stiffness, difficulty to work and depression (Visual Analogue Scale). Results: In total, 103 participants completed the study. The results, from a descriptive perspective, showed improvements in all the outcome measures in both intervention groups (physiotherapy and acupuncture) at weeks 6 and 13 in relation to week 0 and in comparison to the control group. Only the difficulty to work measure in the acupuncture group showed a slight decrease at week 13. In particular, mean (±SD) Spanish Fibromyalgia Impact Questionnaire score at 6 weeks was 62.89 ± 16.91 for the physiotherapy group, 62.5 ± 18.09 for the acupuncture group and 67.45 ± 17.07 for the control group. However, these improvements were not statistically significant. Conclusion: Core stability-based physiotherapy and acupuncture showed non-significant improvements in quality of life, pain, joint stiffness, difficulty to work and depression in women with fibromyalgia.

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Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study

Otolaryngology ◽

10.1177/0194599820934376 ◽

2020 ◽

Vol 163 (4) ◽

pp. 714-721 ◽

Cited By ~ 14

Author(s):

Chenghao Qiu ◽

Chong Cui ◽

Charlotte Hautefort ◽

Antje Haehner ◽

Jun Zhao ◽

...

Keyword(s):

Tertiary Care ◽

Case Series ◽

Symptomatic Improvement ◽

Olfactory Testing ◽

Adults And Children ◽

Polymerase Chain ◽

International Multicenter Study ◽

Tertiary Care Hospitals ◽

Chemosensory Function

Objective To evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in coronavirus disease 2019 (COVID-19) patients. Study Design Multicenter case series. Setting Five tertiary care hospitals (3 in China, 1 in France, 1 in Germany). Subjects and Methods In total, 394 polymerase chain reaction (PCR)–confirmed COVID-19-positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and visual analog scale (VAS) were used to quantify olfactory and gustatory dysfunction, respectively. All subjects at 1 hospital (Shanghai) without subjective olfactory complaints underwent objective testing. Results Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n = 239), German (n = 39), and French (n = 116) cohorts was 32%, 69%, and 49%, respectively. The median age of included subjects was 39 years, 92 of 161 (57%) were male, and 10 of 161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10 of 90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. Forty-three percent (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. Conclusions Olfactory and/or gustatory disorders may represent early or isolated symptoms of severe acute respiratory syndrome coronavirus 2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.

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