scholarly journals The experience with repetitive peripheral magnetic stimulation in subjects with lumbosacral radiculopathy

2020 ◽  
Vol 10 (2) ◽  
pp. 31-38
Author(s):  
V. N. Blokhina ◽  
M. M. Kopachka ◽  
E. M. Troshina ◽  
D. S. Kanshin ◽  
S. G. Nikolaev
Keyword(s):  
Functional Status ◽  
Magnetic Stimulation ◽  
Randomized Study ◽  
Pain Syndrome ◽  
Duration Of Treatment ◽  
Traditional Treatment ◽  
Lumbosacral Radiculopathy ◽  
Significant Difference ◽  
Reduction Of Pain ◽  
Inflammatory Drugs

Introduction. Lumbosacral radiculopathy is а leading cause of long-term disability. Taking into a consideration the duration of treatment radiculopathy, the risk of developing adverse reactions when taking analgesics, non-steroidal anti-inflammatory drugs, the physiotherapeutic method — repetitive peripheral magnetic stimulation may become a promising method of therapy.Aim of the study. Assessment of the effectiveness of the complex treatment for patients with lumbosacral radiculopathy using the course of the repetitive peripheral magnetic stimulation.Materials and methods. Forty patients with lumbosacral radiculopathy were enrolled in the open non-randomized study, were divided into 2 parallel groups. The patients of the 1st group received a course of traditional treatment and a course of the repetitive peripheral magnetic stimulation. The patients of the 2nd group were treated with the traditional treatment without the course of the stimulation. A magnetic stimulator MagPro (Magventure, Denmark) was used for repetitive peripheral magnetic stimulation.Results. A significant difference (p <0.001) was registered regarding the reduction of pain syndrome and the improvement of the functional status after treatment in both groups. 14 (70 %) patients of the first group achieved a pain visual analogue scale relief by 50 % after 10 repetitive peripheral magnetic stimulation sessions, while 6 (30 %) patients did this after 15 repetitive peripheral magnetic stimulation sessions. We did not observed a statistically significant differences (p >0.05) in pain syndrome, functional status, anxiety level at the end of follow-up between the groups.Conclusion. We did not receive the benefits of the repetitive peripheral magnetic stimulation course in comparison with a traditional treatment of a lumbosacral radiculopathy. Further placebo-controlled studies to study the effect of repetitive peripheral magnetic stimulation on pain and anxiety in patients with back pain and radiculopathy are required.

scholarly journals ORTHVOLTAGE X-RAY THERAPY FOR THE TREATMENT OF 0-2 GONARTHRITIS STAGES: LONGTERM RESULTS OF A RANDOMIZED TRIAL. THE DYNAMICS OF A PAIN SYNDROME

2019 ◽  
pp. 86-93
Author(s):  
M. V. Makarova ◽  
L. V. Titova ◽  
M. Yu. Valkov
Keyword(s):  
Randomized Study ◽  
Combined Treatment ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Symptomatic Therapy ◽  
X Ray ◽  
Disability Group ◽  
Reduction Of Pain

The aim of the study was the comparative analysis of treatment for gonarthritis of 0–2 stages by symptomatic therapy (Symptomatic slow acting drugs for osteoarthritis — SYSADOA) and in combination with orthovoltage x-ray therapy (OVRT) within an open randomized study.Material and methods. The study included patients with clinically confirmed gonarthritis. Patients were randomly divided into 2 groups, each of them was administered a combined SYSADOA glucosamine (500 mg) and chondroitin (400 mg) sulfate, OVRT was prescribed to patients of second group. OVRT was performed on X-ray machine Xstrahl-200, a single dose was 0,45 Gy, in 10 sessions to a total dose of 4,5 Gy. The pain syndrome was evaluated by VAS, WOMAC scales, efficiency of the treatment by OARSI/OMERACT (reduction of VAS and WOMAC by more than 20% of the baseline). Disability and the number of endoprosthesis replacement were also analyzed. Evaluation was performed before, after treatment, 6, 12 and 36 months.Results. There were selected 300 patients, 150 in each group, eight people were lost. By the end of the treatment there were no statistically significant differences in the reduction of pain syndrome evaluating by VAS and WOMAC A. After 6–36 months degree of pain reduction was significantly higher in the OVRT group. After three years in the OVRT group, WOMAC A levels, VAS, VAS 20%, WOMAC A 20% were 21,9, 21,2, 69%, 78%, in the SYSADOA group 53,5, 54,9, 25%, 32%, p<0,0001. In the SYSADOA group, by the end of follow-up, 48 (32,9%) patients had a disability group, 42 (28,8%) underwent endoprosthesis replacement, in the combined treatment group — four and four cases (2,7%), respectively, p<0,0001.Conclusion: there was stable reduction of pain syndrome level among patients underwent OVRT, and improvement of the functional state of the joint, which allows to reduce the frequency of disability and knee endoprosthesis replacement.

Acupuncture Needling versus Lidocaine Injection of Trigger Points in Myofascial Pain Syndrome in Elderly Patients – a Randomised Trial

2007 ◽  
Vol 25 (4) ◽  
pp. 130-136 ◽  
Author(s):  
Hyuk Ga ◽  
Ji-Ho Choi ◽  
Chang-Hae Park ◽  
Hyun-Jung Yoon
Keyword(s):  
Elderly Patients ◽  
Myofascial Pain ◽  
Randomised Trial ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Upper Trapezius ◽  
Significant Difference ◽  
Lidocaine Injection ◽  
Reduction Of Pain

Aim To compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome of elderly patients. Methods Thirty nine participants with myofascial pain syndrome of one or both upper trapezius muscles were randomised to treatment with either acupuncture needling (n=18) or 0.5% lidocaine injection (n=21) at all the trigger points on days 0, 7 and 14, in a single-blinded study. Pain scores, range of neck movement, pressure pain intensity and depression were measured up to four weeks from the first treatment. Results Local twitch responses were elicited at least once in 94.9% of all subjects. Both groups improved, but there was no significant difference in reduction of pain in the two groups at any time point up to one month. Overall, the range of cervical movement improved in both groups, apart from extension in the acupuncture needling group. Changes in depression showed only trends. Conclusion There was no significant difference between acupuncture needling and 0.5% lidocaine injection of trigger points for treating myofascial pain syndrome in elderly patients.

scholarly journals Comparison of the Effects on Rib Fracture between the Traditional Japanese Medicine Jidabokuippo and Nonsteroidal Anti-Inflammatory Drugs: A Randomized Controlled Trial

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Hajime Nakae ◽  
Aya Yokoi ◽  
Hiroyuki Kodama ◽  
Akira Horikawa
Keyword(s):  
Treatment Duration ◽  
Injury Severity ◽  
Healthcare Expenditure ◽  
Controlled Trial ◽  
Randomized Study ◽  
Rib Fracture ◽  
Duration Of Treatment ◽  
Traditional Japanese Medicine ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Jidabokuippo is a traditional Japanese medicine used for contusion-induced swelling and pain. This open multicenter randomized study was designed to compare the efficacies of jidabokuippo and nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rib fracture by analyzing the treatment duration. Our study involved 170 rib fracture patients capable of oral ingestion divided randomly into 2 groups: the jidabokuippo and NSAID groups. We compared the duration of treatment and healthcare expenditure between these 2 groups. Medication was continued in both groups until the visual analogue scale score decreased to less than 50% of the pretreatment score. We excluded the patients in whom medication was prematurely discontinued. We analyzed 81 patients belonging to the jidabokuippo and NSAIDs groups. No significant intergroup differences were observed in age, gender, severity (injury severity score), and presence/absence of underlying disease. The treatment duration was significantly shorter in the jidabokuippo group than in the NSAIDs group (P=0.0003). Healthcare expenditure was significantly lower in the jidabokuippo group than in the NSAIDs group (P<0.0001). Our results suggest that compared to NSAIDs, jidabokuippo can shorten the duration of treatment in patients with rib fracture and is a promising analgesic agent based on the medical economic viewpoint.

scholarly journals Evaluation of effectiveness of thioctic acid use in combined therapy of angiodistonia and polyneuropathy syndrome

2020 ◽  
Vol 37 (4) ◽  
pp. 17-25
Author(s):  
Natal'ja N. Malyutina ◽  
Arina F. Bolotova ◽  
Roman B. Eremeev ◽  
Dmitriy Yu. Sosnin
Keyword(s):  
Standard Therapy ◽  
Comparison Group ◽  
Combined Therapy ◽  
Randomized Study ◽  
Pain Syndrome ◽  
Main Group ◽  
Thioctic Acid ◽  
Results Of Treatment ◽  
Significant Difference ◽  
Additional Therapy

Objective. The aim of the study was to investigate the effectiveness of the preparation of thioctic acid combined with standard therapy among patients with angiodistonic syndrome and vegetative-sensory polyneuropathy of the extremities due to the influence of general vibration. Materials and methods. A prospective randomized study of two groups of patients with vibration disease was conducted: the main group (n = 30) and the comparison group (n = 30). All patients received standard therapy, while the main group received additional therapy with octolipen (300 mg per os 2 times a day). Results. The results of questionnaires and objective examination of patients did not establish the occurrence of any side effects when including the drug in the therapy. The survey data proved statistically significant differences in the assessment of pain syndrome at rest and in the occurrence of night pains (p = 0.022). At the same time, when assessing the severity of paresthesia, no statistically significant difference was found between the groups (p = 0.5536). The therapy was accompanied by normalization of the antioxidant status (AOS) in both groups: in the main group, the median AOS increased by 1.342 times and in the comparison group by 1.267 times. In the statistical evaluation, the inclusion of thioctic acid in the treatment was accompanied by a statistically significant increase in the AOS not only with the initial data (p 0.00001), but also in comparison with the results of treatment of patients in the comparison group (p = 0.0387). The data from the reovasographic study also showed that the therapy was more effective with additional inclusion of thioctic acid drug to it. Conclusions. Thus, the data obtained justify the feasibility and effectiveness of using thioctic acid preparation in the treatment of angiodistonia and polyneuropathy syndromes.

Efficacy and safety of nab-paclitaxel plus S-1(nab-P/S-1) versus nab-paclitaxel plus gemcitabine (nab-P/Gem) for first-line chemotherapy in advanced pancreatic ductal adenocarcinoma (aPDAC): A randomized study.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 717-717 ◽  
Author(s):  
Yuan Zong ◽  
Zhi Peng ◽  
Xicheng Wang ◽  
Lin Shen ◽  
Jun Zhou
Keyword(s):  
Phase Ii ◽  
Randomized Study ◽  
Locally Advanced ◽  
Primary Lesion ◽  
Ductal Adenocarcinoma ◽  
Hematologic Toxicity ◽  
Phase Ii Trials ◽  
Duration Of Treatment ◽  
Significant Difference

717 Background: Nab-P/Gem significantly improved survival compared with gem in patients (pts) with metastatic PDAC, but the ORR was limited to 23% with increased myelosuppression. Two phase II trials demonstrated high ORR of 50.0-53.1% with nab-P/S-1 and showed less hematologic toxicity. Methods: A randomized (1:1) phase II trial was conducted. Eligibility required treatment-naïve pts with unresectable PDAC. Pts received nab-P 125mg/m2on day 1 + S-1 80-120mg orally per day on day 1-7 every 2 weeks or nab-P 125mg/m2+ Gem 1000mg/m2 on days 1,8 every 3 weeks. With an increase of ORR from 25% to 50%, 100 pts were required for 90% power at a two-sided significance level of 0.05. We enrolled 40 pts for a pilot study. Primary endpoints were ORR and 6-month PFS rate. Secondary endpoints were ORR of primary lesion, DCR, PFS, OS and safety. Results: 40 pts were enrolled between 06/2018 and 06/2019, including locally advanced (27.5%) and metastatic (72.5%) PDACs. 42.5% were male and the median age was 61 (range, 36-75) years old. The median duration of treatment was 2.3 months in nab-P/S-1 (n = 20) and 2.7 months in nab-P/Gem (n = 20). In the intention-to-treat (ITT) population, the ORR and DCR were 35.0% vs 25.0% ( P= 0.49) and 70.0% vs 70.0%, respectively.The ORR of primary lesion was 30.0% vs 25.0% ( P= 0.72). In the evaluable pts (nab-P/S-1 n = 18, nab-P/Gem n = 18), the ORR, DCR and the ORR of primary lesion were 38.9% vs 27.8%, 77.8% vs 77.8% and 35.3% vs 29.4%, respectively.With the median follow-up of 5.0 (range 0.3-11.4) months, the median PFS and 6-month PFS rate was 6.3 vs 5.7 months and 56.1% vs 36.2%( P= 0.61) for nab-P/S-1 and nab-P/Gem, respectively. The median OS have not reached. Grade 3/4 toxicities occurred in 30.0% nab-P/S-1 and 30.0% nab-P/Gem: leukopenia/neutropenia(15.0% vs 25.0%), febrile neutropenia (0 vs 5.0%), rash (0 vs 5.0%) and diarrhea (10.0% vs 0). Conclusions: Compared with nab-P/Gem, nab-P/S-1 had higher ORR, ORR of primary lesion and longer PFS without significant difference. Nab-P/S-1 developed a trend towards less hematologic toxicity. Follow up for survival is ongoing. Clinical trial information: 03636308.

scholarly journals Therapeutic niche of hyaluronic acid derivatives in osteoarthritis

2021 ◽  
pp. 123-132
Author(s):  
I. G. Krasivina ◽  
L. N. Dolgova ◽  
N. V. Dolgov
Keyword(s):  
Hyaluronic Acid ◽  
Pain Syndrome ◽  
Reduction Of Pain ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Viscoelastic Substances ◽  
Local Use ◽  
Point Of Intersection ◽  
Therapeutic Doses

Osteoarthritis (OA) is a widespread disease of synovial joints, the treatment of which determines a significant number of tactical and strategic directions. Currently, there is experience in the local use of so-called synovial fluid (SF) prostheses, which are viscoelastic substances that improve the cushioning properties of the native intra-articular environment. The overwhelming majority of viscoelastic additives are represented by hyaluronic acid (HA) derivatives, a natural component of SF, whose biological role consists in maintaining the rheological properties of fluid and the presence of anti-inflammatory, anti-nociceptive and chondro-protective properties. In the development of HA drugs, the main goals are the sustained and controlled release of therapeutic doses of the drug, taking into account the choice of carrier, drug molecule and target articular tissue. Assessing the quality and physiological feasibility of introducing a particular viscoelastic drug into the joint involves determining the so-called crossover frequency - the point of intersection of the viscosity modulus G’ and the elastic modulus G” (G’/G”), which reflects changes in the viscoelastic properties of the SF with increasing load frequency when transitioning from walking to running. Physiological range of frequencies out of the majority of investigated medical products corresponds to a single one, among which there are also variants of domestic production. Numerous studies of local application of some HA drugs in patients with OA confirm their effectiveness and safety, in particular, reduction of pain syndrome, reduction of the need for nonsteroidal anti-inflammatory drugs, improvement of the quality of life. However, unfortunately, most HA drugs available on the market have not undergone full-fledged clinical trials, so there is a need to study the comparative effectiveness of drugs of this group approved for use and determine their place in the treatment of OA with different variants of the course.

Associations between clinical outcome and tractography based on navigated transcranial magnetic stimulation in patients with language-eloquent brain lesions

2020 ◽  
Vol 132 (4) ◽  
pp. 1033-1042 ◽  
Author(s):  
Nico Sollmann ◽  
Alessia Fratini ◽  
Haosu Zhang ◽  
Claus Zimmer ◽  
Bernhard Meyer ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Brain Tumors ◽  
Risk Stratification ◽  
Magnetic Stimulation ◽  
Diffusion Tensor ◽  
Tumor Resection ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Language Mapping ◽  
Significant Difference ◽  
Related Pathway

OBJECTIVENavigated transcranial magnetic stimulation (nTMS) in combination with diffusion tensor imaging fiber tracking (DTI FT) is increasingly used to locate subcortical language-related pathways. The aim of this study was to establish nTMS-based DTI FT for preoperative risk stratification by evaluating associations between lesion-to-tract distances (LTDs) and aphasia and by determining a cut-off LTD value to prevent surgery-related permanent aphasia.METHODSFifty patients with left-hemispheric, language-eloquent brain tumors underwent preoperative nTMS language mapping and nTMS-based DTI FT, followed by tumor resection. nTMS-based DTI FT was performed with a predefined fractional anisotropy (FA) of 0.10, 0.15, 50% of the individual FA threshold (FAT), and 75% FAT (minimum fiber length [FL]: 100 mm). The arcuate fascicle (AF), superior longitudinal fascicle (SLF), inferior longitudinal fascicle (ILF), uncinate fascicle (UC), and frontooccipital fascicle (FoF) were identified in nTMS-based tractography, and minimum LTDs were measured between the lesion and the AF and between the lesion and the closest other subcortical language-related pathway (SLF, ILF, UC, or FoF). LTDs were then associated with the level of aphasia (no/transient or permanent surgery-related aphasia, according to follow-up examinations).RESULTSA significant difference in LTDs was observed between patients with no or only surgery-related transient impairment and those who developed surgery-related permanent aphasia with regard to the AF (FA = 0.10, p = 0.0321; FA = 0.15, p = 0.0143; FA = 50% FAT, p = 0.0106) as well as the closest other subcortical language-related pathway (FA = 0.10, p = 0.0182; FA = 0.15, p = 0.0200; FA = 50% FAT, p = 0.0077). Patients with surgery-related permanent aphasia showed the lowest LTDs in relation to these tracts. Thus, LTDs of ≥ 8 mm (AF) and ≥ 11 mm (SLF, ILF, UC, or FoF) were determined as cut-off values for surgery-related permanent aphasia.CONCLUSIONSnTMS-based DTI FT of subcortical language-related pathways seems suitable for risk stratification and prediction in patients suffering from language-eloquent brain tumors. Thus, the current role of nTMS-based DTI FT might be expanded, going beyond the level of being a mere tool for surgical planning and resection guidance.

scholarly journals Lysine clonixinate versus dipyrone (metamizole) for the acute treatment of severe migraine attacks: a single-blind, randomized study

2008 ◽  
Vol 66 (2a) ◽  
pp. 216-220 ◽  
Author(s):  
Abouch Valenty Krymchantowski ◽  
Henrique Carneiro ◽  
Jackeline Barbosa ◽  
Carla Jevoux
Keyword(s):  
Acute Treatment ◽  
Rescue Medication ◽  
International Headache Society ◽  
Randomized Study ◽  
Group 13 ◽  
Lysine Clonixinate ◽  
Inflammatory Drugs ◽  
Rectal Indomethacin ◽  
Single Blind ◽  
Severe Migraine

BACKGROUND AND OBJECTIVE: Nonsteroidal anti-inflammatory drugs (NSAID) are effective to treat migraine attacks. Lysine clonixinate (LC) and dipyrone (metamizol) have been proven effective to treat acute migraine. The aim of this study was to evaluate the efficacy and tolerability of the intravenous formulations of LC and dipyrone in the treatment of severe migraine attacks. METHOD: Thirty patients (28 women, 2 men), aged 18 to 48 years with migraine according the International Headache Society (IHS) (2004) were studied. The patients were randomized into 2 groups when presenting to an emergency department with a severe migraine attack. The study was single-blind. Headache intensity, nausea, photophobia and side effects were evaluated at 0, 30, 60 and 90 minutes after the drug administration. Rectal indomethacin as rescue medication (RM) was available after 2 hours and its use compared between groups. RESULTS: All patients completed the study. At 30 minutes, 0% of the dipyrone group 13% of the LC group were pain free (p=0.46). At 60 and 90 minutes, 2 (13%) and 5 (33%) patients from the dipyrone group and 11 (73%) and 13 (86.7%) patients from the LC group were pain free (p<0.001). At 60 minutes, significantly more patients from the LC group were nausea-free (p<0.001). Regarding photophobia, there were no differences between groups at 60 minutes (p=0.11). The use of RM at 2 hours did not differ among groups (p=0.50). Pain in the site of the injection was reported by more patients of the LC group compared to the dipyrone group (p<0.0001). CONCLUSION: LC is significantly superior to dipyrone in treating severe migraine attacks. LC promotes significantly more burning at the site of the injection.

scholarly journals Intracameral Bevacizumab Versus Sub-Tenon’s Mitomycin C as Adjuncts to Trabeculectomy: 3-Year Results of a Prospective Randomized Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2054
Author(s):  
Gerasimos Kopsinis ◽  
Dimitrios Tsoukanas ◽  
Dimitra Kopsini ◽  
Theodoros Filippopoulos
Keyword(s):  
Mitomycin C ◽  
Primary Outcome ◽  
Randomized Study ◽  
Primary Outcome Measure ◽  
Complication Rates ◽  
Filtration Surgery ◽  
Significant Difference ◽  
Exfoliative Glaucoma

Conjunctival wound healing determines success after filtration surgery and the quest for better antifibrotic agents remains active. This study compares intracameral bevacizumab to sub-Tenon’s mitomycin C (MMC) in trabeculectomy. Primary open-angle or exfoliative glaucoma patients were randomized to either bevacizumab (n = 50 eyes) or MMC (n = 50 eyes). The primary outcome measure was complete success, defined as Intraocular Pressure (IOP) > 5 mmHg and ≤ 21 mmHg with a minimum 20% reduction from baseline without medications. Average IOP and glaucoma medications decreased significantly in both groups at all follow-up points compared to baseline (p < 0.001), without significant difference between groups at 3 years (IOP: bevacizumab group from 29 ± 9.4 to 15 ± 3.4 mmHg, MMC group from 28.3 ± 8.7 to 15.4 ± 3.8 mmHg, p = 0.60; Medications: bevacizumab group from 3.5 ± 0.9 to 0.5 ± 1, MMC group from 3.6 ± 0.7 to 0.6 ± 1.1, p = 0.70). Complete success, although similar between groups at 3 years (66% vs. 64%), was significantly higher for bevacizumab at months 6 and 12 (96% vs. 82%, p = 0.03; 88% vs. 72%, p = 0.04, respectively) with fewer patients requiring medications at months 6, 9 and 12 (4% vs. 18%, p = 0.03; 6% vs. 20%, p = 0.04; 8% vs. 24%, p = 0.03, respectively). Complication rates were similar between groups. In conclusion, intracameral bevacizumab appears to provide similar long-term efficacy and safety results as sub-Tenon’s MMC after trabeculectomy.

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