scholarly journals In-Patient Treatment of Fibromyalgia: A Controlled Nonrandomized Comparison of Conventional Medicine versus Integrative Medicine including Fasting Therapy

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Andreas Michalsen ◽  
Chenying Li ◽  
Katharina Kaiser ◽  
Rainer Lüdtke ◽  
Larissa Meier ◽  
...  
Keyword(s):  
Integrative Medicine ◽  
Multimodal Treatment ◽  
Primary Outcome ◽  
Conventional Medicine ◽  
Fibromyalgia Impact Questionnaire ◽  
Treatment Strategies ◽  
Well Being ◽  
Patient Treatment ◽  
Beneficial Effects ◽  
Secondary Outcomes

Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM). We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM) approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ) score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P<0.014) and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.

scholarly journals Randomised clinical trial of early specialist palliative care plus standard care versus standard care alone in patients with advanced cancer: The Danish Palliative Care Trial

2017 ◽  
Vol 31 (9) ◽  
pp. 814-824 ◽  
Author(s):  
Mogens Groenvold ◽  
Morten Aagaard Petersen ◽  
Anette Damkier ◽  
Mette Asbjoern Neergaard ◽  
Jan Bjoern Nielsen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Palliative Care ◽  
Advanced Cancer ◽  
Standard Care ◽  
Primary Outcome ◽  
Randomised Clinical Trial ◽  
Sensitivity Analyses ◽  
Specialist Palliative Care ◽  
Beneficial Effects ◽  
Secondary Outcomes

Background: Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal. Aim: To investigate the effect of early specialist palliative care among advanced cancer patients identified in oncology departments. Setting/participants: The Danish Palliative Care Trial (DanPaCT) (ClinicalTrials.gov NCT01348048) is a multicentre randomised clinical trial comparing early referral to a specialist palliative care team plus standard care versus standard care alone. The planned sample size was 300. At five oncology departments, consecutive patients with advanced cancer were screened for palliative needs. Patients with scores exceeding a predefined threshold for problems with physical, emotional or role function, or nausea/vomiting, pain, dyspnoea or lack of appetite according to the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were eligible. The primary outcome was the change in each patient’s primary need (the most severe of the seven QLQ-C30 scales) at 3- and 8-week follow-up (0–100 scale). Five sensitivity analyses were conducted. Secondary outcomes were change in the seven QLQ-C30 scales and survival. Results: Totally 145 patients were randomised to early specialist palliative care versus 152 to standard care. Early specialist palliative care showed no effect on the primary outcome of change in primary need (−4.9 points (95% confidence interval −11.3 to +1.5 points); p = 0.14). The sensitivity analyses showed similar results. Analyses of the secondary outcomes, including survival, also showed no differences, maybe with the exception of nausea/vomiting where early specialist palliative care might have had a beneficial effect. Conclusion: We did not observe beneficial or harmful effects of early specialist palliative care, but important beneficial effects cannot be excluded.

scholarly journals Suprapatellar bursitis in a newborn

2021 ◽  
Vol 10 (2) ◽  
pp. 199-202
Author(s):  
IIya O. Erenkov ◽  
Ivan S. Denisov ◽  
Svetlana A. Zarubina
Keyword(s):  
Knee Joint ◽  
Blood Test ◽  
White Cell Count ◽  
Treatment Strategies ◽  
Rare Condition ◽  
Well Being ◽  
Patient Treatment ◽  
First Year ◽  
First Year Of Life

Introduction. One of the most frequent pathologies in childhood is bursitis of the knee joint. Such conditions may occur in infectious pathologies, traumatic disorders, overuse syndromes, and other various pathologies. Diagnostic and treatment strategies depend on the cause of bursitis development. Particular attention should be paid to bursitis cases in newborns since the frequency of such pathologies is casuistic and clinical guidelines for treating patients in this age group are absent. Materials and methods. A 26-day-old newborn arrived for consultation with complaints of knee joint pain and movement restrictions for four days. From five to 21 days of life, she has had in-patient treatment at another clinic because of pneumonia and a urinary tract infection. Intravenous and intramuscular injections of antibacterial drugs were prescribed for two weeks. The condition of the newborn was satisfactory upon consultation in our clinic. Her physical examination showed swelling and muscle tightness on the distal part of the thigh. The range of motion of the shinbone was restricted. Her blood test showed that her white cell count was unchanged. According to an X-ray examination of the knee, no pathology was detected. According to the US-examination, exudative suprapatellar bursitis was detected. The nonsteroidal anti-inflammatory drug, Nimesulid, was prescribed for seven days. Results. Daily remote monitoring of the patient's well-being during treatment was performed. Movement restrictions reduced the swelling on day 3 of treatment. A follow-up blood test on day 4 of treatment showed no pathology. According to the follow-up US-examination after six days of drug therapy, no signs of bursitis were detected. Conclusion. Inflammation of the suprapatellar bursa is a rare condition in newborns. In isolated cases of bursitis in children during the first year of life, a bacterial presence was noted, with the predominance of staphylococcal and streptococcal floras. However, in our opinion, there is a possibility of developing aseptic forms of bursitis in infants. In these cases, it may be prudent to refrain from prescribing courses of antibiotic therapy.

scholarly journals Characteristics of participants who benefit most from personalised nutrition: findings from the pan-European Food4Me randomised controlled trial

2020 ◽  
Vol 123 (12) ◽  
pp. 1396-1405 ◽  
Author(s):  
Katherine M. Livingstone ◽  
Carlos Celis-Morales ◽  
Santiago Navas-Carretero ◽  
Rodrigo San-Cristobal ◽  
Hannah Forster ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Plasma Concentrations ◽  
Well Being ◽  
Healthy Eating Index ◽  
Dietary Advice ◽  
Personalised Nutrition ◽  
Secondary Outcomes ◽  
Randomised Controlled

AbstractLittle is known about who would benefit from Internet-based personalised nutrition (PN) interventions. This study aimed to evaluate the characteristics of participants who achieved greatest improvements (i.e. benefit) in diet, adiposity and biomarkers following an Internet-based PN intervention. Adults (n 1607) from seven European countries were recruited into a 6-month, randomised controlled trial (Food4Me) and randomised to receive conventional dietary advice (control) or PN advice. Information on dietary intake, adiposity, physical activity (PA), blood biomarkers and participant characteristics was collected at baseline and month 6. Benefit from the intervention was defined as ≥5 % change in the primary outcome (Healthy Eating Index) and secondary outcomes (waist circumference and BMI, PA, sedentary time and plasma concentrations of cholesterol, carotenoids and omega-3 index) at month 6. For our primary outcome, benefit from the intervention was greater in older participants, women and participants with lower HEI scores at baseline. Benefit was greater for individuals reporting greater self-efficacy for ‘sticking to healthful foods’ and who ‘felt weird if [they] didn’t eat healthily’. Participants benefited more if they reported wanting to improve their health and well-being. The characteristics of individuals benefiting did not differ by other demographic, health-related, anthropometric or genotypic characteristics. Findings were similar for secondary outcomes. These findings have implications for the design of more effective future PN intervention studies and for tailored nutritional advice in public health and clinical settings.

scholarly journals A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain

2016 ◽  
Vol 31 (2) ◽  
pp. 186-196 ◽  
Author(s):  
Christina Emilson ◽  
Ingrid Demmelmaier ◽  
Stefan Bergman ◽  
Per Lindberg ◽  
Eva Denison ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Controlled Trial ◽  
Control Group ◽  
Behavioural Medicine ◽  
Behavioural Treatment ◽  
Beneficial Effects ◽  
Maximum Pain ◽  
Secondary Outcomes ◽  
Randomised Controlled

Objective: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting. Design: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants. Interventions: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition). Main measures: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes. Results: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome ( p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment ( p= 0.02), and at the 10-year follow-up ( p=0.03). Discussion: The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.

scholarly journals Randomized controlled trial of the “WISER” intervention to reduce healthcare worker burnout

2021 ◽  
Author(s):  
Jochen Profit ◽  
Kathryn C. Adair ◽  
Xin Cui ◽  
Briana Mitchell ◽  
Debra Brandon ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Well Being ◽  
Work Life ◽  
Web Based ◽  
Randomized Controlled ◽  
Intervention Efficacy ◽  
Secondary Outcomes

Abstract Objective Test web-based implementation for the science of enhancing resilience (WISER) intervention efficacy in reducing healthcare worker (HCW) burnout. Design RCT using two cohorts of HCWs of four NICUs each, to improve HCW well-being (primary outcome: burnout). Cohort 1 received WISER while Cohort 2 acted as a waitlist control. Results Cohorts were similar, mostly female (83%) and nurses (62%). In Cohorts 1 and 2 respectively, 182 and 299 initiated WISER, 100 and 176 completed 1-month follow-up, and 78 and 146 completed 6-month follow-up. Relative to control, WISER decreased burnout (−5.27 (95% CI: −10.44, −0.10), p = 0.046). Combined adjusted cohort results at 1-month showed that the percentage of HCWs reporting concerning outcomes was significantly decreased for burnout (−6.3% (95%CI: −11.6%, −1.0%); p = 0.008), and secondary outcomes depression (−5.2% (95%CI: −10.8, −0.4); p = 0.022) and work-life integration (−11.8% (95%CI: −17.9, −6.1); p < 0.001). Improvements endured at 6 months. Conclusion WISER appears to durably improve HCW well-being. Clinical Trials Number NCT02603133; https://clinicaltrials.gov/ct2/show/NCT02603133

Review of Constipation Treatment Methods with Emphasis on Laxative Foods

2020 ◽  
Vol 16 (5) ◽  
pp. 675-688
Author(s):  
Shamsi Abbasalizadeh ◽  
Behzad Ebrahimi ◽  
Aslan Azizi ◽  
Rogaye Dargahi ◽  
Maryam Tayebali ◽  
...  
Keyword(s):  
Well Being ◽  
Health Concern ◽  
Lifestyle Factor ◽  
Flax Seed ◽  
Lifestyle Modifications ◽  
Food Ingredients ◽  
Beneficial Effects ◽  
Daily Exercise

Constipation is a common public health concern experienced by all individuals during their life affecting the quality of life. In this paper, we aimed to provide an overview of the existing evidence regarding the role of food ingredients, including bran, prune, fig, kiwifruit, and flax-seed in constipation treatment. We searched Scopus, Pub Med, and Science Direct by using the keywords, “laxative foods” and “constipation”, for searching studies assessing laxative food ingredients and their beneficial effects on constipation treatment and/or control. Lifestyle modifications such as increasing dietary fiber and fluid intake and daily exercise are the proposed first line treatments for constipation. Optimizing ‘diet’ as an efficient lifestyle factor may contribute to the well-being of patients. The use of laxative food ingredients including bran, prune, fig, kiwifruit, flax-seed, probiotics, and prebiotics is a convenient alternative to cope with constipation. According to previous findings, laxative food ingredients could be considered as effective treatments for subjects suffering from constipation. Many studies have assessed the pharmacological and non-pharmacological roles of these ingredients in treating constipation, however, their importance has not been thoroughly investigated.

scholarly journals Effects of Evocative Audio-Visual Installations on the Restorativeness in Urban Parks

2021 ◽  
Vol 13 (15) ◽  
pp. 8328
Author(s):  
Massimiliano Masullo ◽  
Luigi Maffei ◽  
Aniello Pascale ◽  
Vincenzo Paolo Senese ◽  
Simona De Stefano ◽  
...  
Keyword(s):  
Social Inclusion ◽  
Road Traffic ◽  
Traffic Noise ◽  
Human Perception ◽  
Urban Parks ◽  
Well Being ◽  
Road Traffic Noise ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Experimental Laboratory

Road traffic noise is responsible for several negative health effects for citizens in modern cities. Inside urban parks, which citizens use for social inclusion and cohesion, psychological and physical restoration, and physical activities, road traffic noise may significantly reduce the potential of these places to induce or enhance well-being. Although access restriction schemes and screens could be effective solutions to limit noise inside urban park areas, preserving their potential regenerative role may engender mobility, social, aesthetic, and architectural issues. Due to the positive effects that natural elements and water sounds can have on human perception, and based on the previous findings of the beneficial effects of audio-visual installations, this paper investigates the possibility of using audio-visual installations that simply evoke some natural features to improve the restoration of individuals inside urban parks. The study has been carried out using immersive virtual environments in two different experimental laboratory sessions in Hong Kong (China) and Aversa (Italy). The results showed that the positive effects provided by evocative installations were similar to those provided by traditional installations. Furthermore, the effects on the restoration increased as the installations became larger and included enveloping shapes. Furthermore, we found that the amount of evocative water installations’ material was responsible for changes in restoration. In contrast, the Chinese groups were less influenced by these installations.

scholarly journals Healthy eating and lifestyle in pregnancy (HELP): a cluster randomised trial to evaluate the effectiveness of a weight management intervention for pregnant women with obesity on weight at 12 months postpartum

2021 ◽  
Author(s):  
Sharon A. Simpson ◽  
Elinor Coulman ◽  
Dunla Gallagher ◽  
Karen Jewell ◽  
David Cohen ◽  
...  
Keyword(s):  
Weight Management ◽  
Healthy Eating ◽  
Primary Outcome ◽  
Intervention Group ◽  
Control Group ◽  
Risky Drinking ◽  
Management Intervention ◽  
Cluster Randomised ◽  
Secondary Outcomes ◽  
Weight Management Intervention

Abstract Objective To assess whether a weight management intervention for pregnant women with obesity was effective in reducing body mass index (BMI) 12 months after giving birth. Methods Pragmatic, cluster randomised controlled trial (RCT) with embedded cost-effectiveness analysis. 598 women with a BMI of ≥30 kg/m2 (between 12 and 20 weeks gestation) were recruited from 20 secondary care maternity units in England and Wales. BMI at 12 months postpartum was the primary outcome. A range of clinical and behavioural secondary outcomes were examined. Interventions Women attending maternity units randomised to intervention were invited to a weekly weight management group, which combined expertise from a commercial weight loss programme with clinical advice from midwives. Both intervention and control participants received usual care and leaflets on diet and physical activity in pregnancy. Results Mean (SD) BMI at 12 months postpartum was 36.0 kg/m2 (5.2) in the control group, and 37.5 kg/m2 (6.7) in the intervention group. After adjustment for baseline BMI, the intervention effect was −0.02 (95% CI −0.04 to 0.01). The intervention group had an improved healthy eating score (3.08, 95% CI 0.16 to 6.00, p < 0.04), improved fibre score (3.22, 1.07 to 5.37, p < 0.01) and lower levels of risky drinking at 12 months postpartum compared to the control group (OR 0.45, 0.27 to 0.74, p < 0.002). The net incremental monetary benefit was not statistically significantly different between arms, although the probability of the intervention being cost-effective was above 60%, at policy-relevant thresholds. Conclusions There was no significant difference between groups on the primary outcome of BMI at 12 months. Analyses of secondary outcomes indicated improved healthy eating and lower levels of risky drinking. Trial registration: Current Controlled Trials ISRCTN25260464.

scholarly journals A113 ANNUAL COLONOSCOPY VOLUME IS NOT PREDICTIVE OF COLONOSCOPY QUALITY - FINDINGS FROM THE SOUTHWEST ONTARIO COLONOSCOPY COHORT

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 92-93
Author(s):  
M Sey ◽  
O Siddiqi ◽  
C McDonald ◽  
S cocco ◽  
Z Hindi ◽  
...  
Keyword(s):  
Predictive Value ◽  
Detection Rate ◽  
Primary Outcome ◽  
Case Mix ◽  
Operating Characteristics ◽  
Polyp Detection ◽  
Cecal Intubation ◽  
Polyp Detection Rate ◽  
Secondary Outcomes ◽  
Colonoscopy Quality

Abstract Background Performing a minimum number of colonoscopies annually has been proposed by some jurisdictions as a requirement for maintaining privileges. However, this practice is supported by limited evidence. Aims The objective of this study was to determine if annual colonoscopy volume was associated with colonoscopy quality metrics. Methods A population-based study was performed using the Southwest Ontario Colonoscopy cohort, which consists of all adult patients who underwent colonoscopy between April 2017 and Oct 2018 at 21 academic and community hospitals within the health region. Data were collected through a mandatory quality assurance form completed after each procedure and pathology reports were manually reviewed. Physician annualized colonoscopy volumes were compared by correlation analysis to each quality-related outcome, by means of the area under the receiver operating characteristics curve (AUROC), and logistic regression. The prognostic value of colonoscopy volume was also adjusted for case-mix and potential confounders in separate regression analyses for each outcome. The primary outcome was ADR. Secondary outcomes were polyp detection rate (PDR), sessile serrated polyp detection rate (SSPDR), and cecal intubation. Results A total of 47,195 colonoscopies were performed by 75 physicians (37.5% by gastroenterologists, 60% by general surgeons, 2.5% others). There were no clear relationships between annual colonoscopy volumes and study outcomes. Colonoscopy volume was not associated with ADR (OR 1.03, 95% CI 0.96–1.10, p=0.48) and corresponded to an AUROC not significantly different from the null (AUROC 0.52, 95% CI 0.43–0.61, p=0.65). Multi-variable regression adjusting for case-mix also demonstrated no predictive value of annual colonoscopy volume for the primary outcome (OR 1.03, 95% CI 0.94–1.12, p=0.55). Similarly, analyses of secondary outcomes failed to find an association between colonoscopy volume and PDR, SSPDR, or cecal intubation (Table 1). Conclusions Annual colonoscopy volumes do not predict ADR, PDR, SSPDR, or cecal intubation rate. Results of unconditional and conditional approaches for examining the predictive value of annual colonoscopy volume for quality related outcomes. Funding Agencies None

scholarly journals Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)—A Condition Associated with Heightened Sympathetic Activation

2021 ◽  
Vol 22 (8) ◽  
pp. 4241
Author(s):  
Revathy Carnagarin ◽  
Kearney Tan ◽  
Leon Adams ◽  
Vance B. Matthews ◽  
Marcio G. Kiuchi ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Metabolic Diseases ◽  
Treatment Strategies ◽  
Adverse Outcomes ◽  
Metabolic Dysfunction ◽  
Sympathetic Activation ◽  
Beneficial Effects ◽  
Adverse Health Outcomes

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common liver disease affecting a quarter of the global population and is often associated with adverse health outcomes. The increasing prevalence of MAFLD occurs in parallel to that of metabolic syndrome (MetS), which in fact plays a major role in driving the perturbations of cardiometabolic homeostasis. However, the mechanisms underpinning the pathogenesis of MAFLD are incompletely understood. Compelling evidence from animal and human studies suggest that heightened activation of the sympathetic nervous system is a key contributor to the development of MAFLD. Indeed, common treatment strategies for metabolic diseases such as diet and exercise to induce weight loss have been shown to exert their beneficial effects at least in part through the associated sympathetic inhibition. Furthermore, pharmacological and device-based approaches to reduce sympathetic activation have been demonstrated to improve the metabolic alterations frequently present in patients with obesity, MetSand diabetes. Currently available evidence, while still limited, suggests that sympathetic activation is of specific relevance in the pathogenesis of MAFLD and consequentially may offer an attractive therapeutic target to attenuate the adverse outcomes associated with MAFLD.

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