scholarly journals Filiform-Fire Needle for Upper Extremity Spastic Paralysis After Stroke: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Siqiao Cao ◽  
Chen Xia ◽  
Shenxu Chen ◽  
Xiyi Yu ◽  
Ying Yuan ◽  
...  
Keyword(s):  
Acupuncture Therapy ◽  
Upper Extremity ◽  
Daily Life ◽  
The Other ◽  
Spastic Paralysis ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Fire Needle ◽  
Better Than

Abstract Background: Filiform-fire-needle（FFN）has been used in clinical treatment of upper extremity spastic paralysis after stroke(UESPAS). This study will evaluate the effect of filiform-fire-needle in the treatment of UESPAS under the background of standardized clinical research, and study the relationship between the efficacy and the course of treatment, so as to provide high-quality evidence-based basis for further clinical treatment and future research design.Methods: A prospective randomized controlled study was conducted to evaluate the clinical efficacy of FFN acupuncture therapy for patients with UESPAS. UESPAS patients were recruited in Changhai Hospital, Shanghai, China and they were randomly divided into FFN acupuncture group (F group), filiform needle acupuncture group (A group) or rehabilitation treatment group (R group). During the 20-day treatment, the same acupoints were taken in A group and F group. F group was treated once every 2 days for a total of 10 times, while A group and R group were treated 8 d in a row and then rest for for 2 days for a total of 16 times. In this study, the primary outcome indicators were modified Ashworth scale (MAS), secondary results including Fugl-Meyer assessment of Upper Extremity Motor Function (FMA-UE), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI). The above scales were evaluated before treatment, 10 days and 20 days after treatment. The safety was evaluated by self-made acupuncture adverse reaction observation table.Results: A significant difference was observed in MAS, FMA-UE, BI, NIHSS in the three groups from pre- to post treatment. From the evaluation of the changes of MAS, the curative effect of F group was better than the other two groups after 10 days of treatment, and F group was better than the R group on the 20th day, but there was no significant difference among the three groups after follow-up. The the difference of FMA-UE score showed F group was higher than the other two groups after 20 days of treatment and follow-up. The change of BI score in group F was higher than that in group R after 10 days of treatment, and the change of BI score in group F was higher than that in the other two groups after 20 days of treatment and follow-up. No significant change in the score of NIHSS was found in three groups.Conclusions: FFN acupuncture therapy has an advantage in relieving upper limb spasm and improving the activities of daily life of stroke patients in the short term, and in the long term, FFN has advantages in improving the motor ability of spastic limbs and improving the ability of daily life of patients.

scholarly journals Rehabilitation of executive function in chronic paediatric brain injury: a randomized controlled trial

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Anne E. Brandt ◽  
Torun G. Finnanger ◽  
Ruth E. Hypher ◽  
Torstein B. Rø ◽  
Eva Skovlund ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Executive Function ◽  
Brain Injury ◽  
Daily Life ◽  
Controlled Trial ◽  
Executive Dysfunction ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background Impaired executive functions (EFs, i.e., purposeful, goal-directed behaviour) cause significant disability after paediatric acquired brain injury (pABI) warranting efficient interventions. Goal Management Training (GMT) is a metacognitive protocol proven effective for executive dysfunction in adults. This pre-registered, blinded, parallel-randomized controlled trial evaluated efficacy of a paediatric adaptation (pGMT) compared to a psychoeducative control (paediatric Brain Health Workshop, pBHW) to improve EF. Methods Children aged 10 to 17 years with pABI (e.g., traumatic brain injury, brain tumour), ≥ 1 year post-onset or ended treatment, with parent-reported EF complaints were eligible. Participants were randomized (computer-algorithm) to either group-based pGMT (n = 38) or pBHW (n = 38). The active control was tailored to keep non-specific factors constant. Thus, both treatments comprised of 7 sessions at hospitals over 3 consecutive weeks, followed by 4 weeks of telephone counselling of participants, parents, and teachers. Parent-reported daily life EF, assessed by the questionnaire Behavior Rating Inventory of Executive Function (BRIEF; Behavioral Regulation Index (BRI) and Metacognition Index (MI)), were co-primary outcomes 6 months post-intervention. Secondary outcomes included neuropsychological tests and a complex naturalistic task (Children’s Cooking Task). Results Seventy-three participants (96%) completed allocated interventions and 71 (93%) attended the 6-month follow-up. The results demonstrated no significant difference in effectiveness for the two interventions on parent-reported EF: For BRIEFBRI, mean (SD) raw score for pGMT was 42.7 (8.8) and 38.3 (9.3) for pBHW. Estimated difference was − 2.3 (95% CI − 5.1 to 0.6). For BRIEFMI, the corresponding results were 80.9 (20.4) for GMT and 75.5 (19.3) for pBHW. Estimated difference was − 1.4 (95% CI −8.5 to 5.8). In performance-based tests, pGMT was associated with improved inhibition and executive attention, while pBHW was associated with fewer errors in the naturalistic task. Conclusions In pABI, metacognitive training (pGMT) did not demonstrate additional effectiveness on parent-reported daily life EF at 6-month follow-up, when compared to a psychoeducative control. Both interventions were well-tolerated and demonstrated distinct improvements at different EF assessment levels. To conclude on pGMT efficacy, larger studies are needed, including further investigation of appropriate assessment levels and possible differences in effect related to treatment duration, developmental factors, and injury characteristics. Trial registration ClinicalTrials.gov, NCT0321534211, 11 July 2017

scholarly journals Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6645
Author(s):  
Giulia Foccardi ◽  
Marco Vecchiato ◽  
Daniel Neunhaeuserer ◽  
Michele Mezzaro ◽  
Giulia Quinto ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Exercise Testing ◽  
Text Messages ◽  
Control Group ◽  
Stand Test ◽  
Randomized Controlled ◽  
Sit To Stand ◽  
Significant Difference

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.

Effectiveness of Virtual Resilience Training on Assertiveness in Student Girls Aged 9–10 Years: A 1-Month Follow-Up

2021 ◽  
pp. 105984052110135
Author(s):  
Shima Gadari ◽  
Jamile Farokhzadian ◽  
Parvin Mangolian Shahrbabaki
Keyword(s):  
Experimental Study ◽  
Internal Stress ◽  
Intervention Group ◽  
The Other ◽  
Hormonal Changes ◽  
Emotional Instability ◽  
Other Hand ◽  
Significant Difference ◽  
Resilience Training

Girls between the ages of 9 and 10 begin to experience physical, physiological, and hormonal changes that may lead to internal stress. At this age, children are struggling for autonomy; on the other hand, they may experience emotional instability, and for these reasons, they may be vulnerable in many ways. This experimental study aimed to investigate the effect of resilience training on assertiveness in student girls aged 9–10. Data were collected before, immediately after, and 1 month after the intervention in the control ( n = 40) and intervention ( n = 37) groups. There was a significant difference between the assertiveness of the intervention immediately (26.80 ± 3.73) and 1 month after the intervention (27.05 ± 3.73), and assertiveness significantly increased in the intervention group ( p = .0001). Resilience training leads to improvements in assertiveness in student girls aged 9–10.

The effect of displacement of the esophagus by transoesophageal echocardiography probe in cryoablation of atiral fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Sun ◽  
X.M Yin ◽  
L.J Gao ◽  
X.J Xiao ◽  
X.H Yu ◽  
...  
Keyword(s):  
Lower Risk ◽  
Transoesophageal Echocardiography ◽  
The Other ◽  
Esophageal Injury ◽  
Funding Source ◽  
Success Rates ◽  
Procedure Time ◽  
Mechanical Displacement ◽  
Significant Difference

Abstract Background Esophageal injury caused by cryoballoon-based PVI is common. Cryoablation guided by transoesophageal echocardiography (TEE) for occlusion of the pulmonary vein (PV) is safe and effective. Objective To investigate the protective effect of mechanical displacement of the esophagus by TEE probe in cryoablation of atiral fibrillation. Methods Fifty patients with paroxysmal AF (PAF) were enrolled in the present study. 25 patients underwent cryoablation without TEE (non-TEE group) and the other 25 underwent with TEE (TEE group) for PV occlusion guidance and displacement of the esophagus. In the TEE group during the procedure, TEE was used to guide the movement of the balloon to achieve PV occlusion. And before freezing, the probe of the TEE was moved to displace the esophagus away from the PV being freezed in order to reduce the risk of cryoinjury. All patients underwent esophagogastroscopy within 2 days of the procedure. The patients were followed up in our center at regularly scheduled visits every 2 months. Results There was no significant difference between the TEE group and non-TEE group in regard to the procedure time. The fluoroscopy time in the TEE group was less compared to the non-TEE group (4.1±3.3 min vs. 16.6±6.9 min, P&lt;0.05), and the amount of contrast agent in the TEE group was less than the non-TEE group (4.7±5.7ml vs. 17.9±3.4 ml, P&lt;0.05). The incidence of esophageal injury was significantly lower in TEE group compared with non-TEE group (0 vs. 20%, P&lt;0.05). At a mean of 14.0 months follow-up, success rates were similar between the TEE group and non-TEE group (80.0% vs. 84.0%, P=0.80). Conclusion Cryoablation of AF with TEE for protecting the esophagus from cryoinjury is safe and effective. Lower risk of esophageal injury can be achieved with the help of TEE probe movement for mechanical displacement of the esophagus during freezing. Funding Acknowledgement Type of funding source: None

A two different chemoprophylaxis approaches after phacoemulsification surgery in one thousand patients in Iraq

2020 ◽  
Vol 1 (3) ◽  
pp. 154-159
Author(s):  
Suzan Amana Rattan ◽  
◽  
Mahir Kadhim Mutashar ◽  
Keyword(s):  
Treated Group ◽  
The Other ◽  
Eye Drops ◽  
Topical Medication ◽  
Group Methods ◽  
Significant Difference ◽  
Infection And Inflammation ◽  
Group 2 ◽  
Age Range

AIM: To evaluate the effectivity of the combination of intracameral moxifloxacin 0.1% with subconjunctival triamcinolone acetonide 4 mg as prophylaxis of infection and inflammation after phacoemulsification in comparison with topical medication treated group. METHODS: A total one thousand patients with age range from 38 to 70 years old who scheduled for phacoemulsification were divided into 2 groups of no statistically significant differences in age, preoperative intraocular pressure (IOP) and central macular thickness (CMT), P=0.6, 0.9 and 0.8 respectively. The surgeries were done by 2 surgeons each one planned to use one method of prophylaxis at Eye Speciality Private hospital, Baghdad, Iraq. For the 1st group of patients (500) a topical moxifloxacin hydrochloride 0.5% and dexamethasone 0.1% eye drops were prescribed four times a day for 1mo postoperatively. For the 2nd group intracameral (IC) diluted moxifloxacin at 0.1% with subconjunctival (SC) triamcinolone 4mg in 0.4 cc were administered at the conclusion of the surgery. Follow up visits were on the first postoperative day, 1wk, 1mo, and 3mo postoperatively. Anterior chamber (AC) reaction was examined during the 4 visits while IOP was measured during the last 3 and CMT was measured only in the last one. RESULTS: The current clinical trial study compared 2 samples with 2 different prophylaxis methods. No endophthalmitis case reported in both group. By a 2-Sample t-test, the IC-treated group (group 2) had statistically significant lower AC cells at the 1st day postoperative visit than the other group while there were no statistically significant differences at 1wk, 1 mo and 3mo visits between the 2 groups. There was no statistically significant difference at 3mo visits in IOP and CMT between the two groups. A breakthrough inflammation rate with the topical medication was (9.6%) while in the other group (IC treated ) was 4.0%. A significant IOP elevation ≥10 mm Hg at 1mo in 2.4% within the topical medication group which was higher than the rate in the other group (0.8%). CONCLUSION: In addition to the safety and effectivity of the combination of intracameral moxifloxacin and subconjunctival triamcinolone in preventing infection and inflammation after cataract surgery. The majority (480) of our included patients didn’t require any topical postoperative medication that is cost saving for the patient, helped patients who were unable to administer topical medication, and decreased chance of complication related to patient poor adherence to postoperative medication.

scholarly journals The added value of cognition-targeted exercise versus symptom-targeted exercise for multiple sclerosis fatigue: A randomized controlled pilot trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258752
Author(s):  
Azza Alketbi ◽  
Salah Basit ◽  
Nouran Hamza ◽  
Lori M. Walton ◽  
Ibrahim M. Moustafa
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Outcome ◽  
Outcome Measures ◽  
Recruitment Rate ◽  
Control Group ◽  
Entire Study ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Intervention Protocol

Background Fatigue is considered one of the most common symptoms of multiple sclerosis (MS) and lacks a current standardized treatment. Therefore, the aim of this study was to examine the feasibility and effectiveness of a cognition-targeted exercise versus symptom-targeted exercise for MS fatigue. Methods In this Pilot, parallel-group, randomized controlled trial, sixty participants with multiple sclerosis, were randomly assigned to either a Cognition-Targeted Exercise (CTE) (N = 30, mean age 41) or a Symptom-Targeted Exercise (STE) (N = 30, mean age 42). The participants in the experimental group received eight, 50-minute sessions of weekly Cognitive Behavior Therapy (CBT) in addition to a CTE Program; whereas, participants in the control group received eight, 50-minute sessions of weekly CBT in addition to the standardized physiotherapy program (STE Program). Feasibility was assessed through recruitment rate, participant retention, adherence and safety, in addition to clinical outcome measures, including: (1) Modified Fatigue Impact Scale (MFIS), (2) Work and Social Adjustment Scale (WSAS), (3) Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS). All outcome measures were assessed at baseline (pretreatment), following completion of the eight visit intervention protocol, and at 3-months follow-up. Results The recruitment rate was 60% and 93% of participants completed the entire study. The recruited participants complied with 98% of the required visits. No adverse events were recorded. A Generalized Estimation Equation Model revealed a significant difference over time as an interaction term during the post and follow up visit for all clinical outcome measures (p < .001). Conclusion The addition of CTE to CBT exhibited positive and more lasting influence on MS fatigue outcomes compared to Symptom-Targeted Exercise (STE). Feasibility and efficacy data from this pilot study provide support for a full-scale RCT of CTE as an integral component of Multiple Sclerosis fatigue management.

scholarly journals PERBANDINGAN KUALITAS PRODUK DAN MINAT MENABUNG PADA LPD DESA ADAT TAJUN DENGAN DESA ADAT TEGAL

2020 ◽  
Vol 4 (1) ◽  
pp. 59-67
Author(s):  
Eka Swarnadi Luh ◽  
Ketut Budi Susrusa ◽  
Ida Ayu Listia Dewi
Keyword(s):  
Product Quality ◽  
Financial Institutions ◽  
Rapid Development ◽  
Research Data ◽  
The Other ◽  
Physical Evidence ◽  
Significant Difference ◽  
The Difference ◽  
Better Than

LPDs are non-bank financial institutions that are regulated and approved by the Regional Regulations of the Province of Bali. The management of LPD is fully handed over to the relevant Pakraman village. In line with the rapid development of LPDs, it turns out that on the other hand it shows diverse performance, so that LPDs need to pay attention to the level of product quality and customer interest in the products offered.            The purpose of the study was to determine the comparison of product quality and interest in saving at the Tajun Traditional Village LPD with the Traditional Village of Tegal. The number of samples from Tajun Adat Village LPD was 98 people and the LPD of Tegal Traditional Village was 84 people. The research data were analyzed by the Mann-Whitney Test. The results showed that there was a significant difference between the quality of the products of the Adat Village of Tajun LPD and the Traditional Village of Tegal. This difference is indicated by indicators of physical evidence, reliability, responsiveness and empathy. The product quality of Tajun Adat Village's LPD is better than the traditional village of Tegal. There is a significant difference between the interest in saving the traditional village of Tajun LPD and the traditional village of Tegal. The difference is in the indicator of confidence. Interest in Saving Tajun Indigenous Village LPD is higher than the Traditional Village of Tegal.

Mitomycin C–Enhanced Revision Endoscopic Dacryocystorhinostomy

2012 ◽  
Vol 147 (5) ◽  
pp. 937-942 ◽  
Author(s):  
Sameh M. Ragab ◽  
Hossam S. Elsherif ◽  
Emad M. Shehata ◽  
Ahmed Younes ◽  
Ahmed M. Gamea
Keyword(s):  
Mitomycin C ◽  
Controlled Study ◽  
Safe Procedure ◽  
Endoscopic Dacryocystorhinostomy ◽  
Randomized Controlled ◽  
Group I ◽  
Significant Difference ◽  
Endoscopic Dcr ◽  
Causes Of Failure

Objectives (1) To conduct an adequately powered randomized controlled trial investigating the safety and efficacy of mitomycin C–enhanced revision endoscopic dacryocystorhinostomy (DCR) and (2) to analyze causes of failure after primary endoscopic DCR. Study Design A randomized controlled study. Setting General hospital. Subjects and Methods Seventy-six revision endoscopic DCRs were randomized into 2 groups: endoscopic DCR with mitomycin (group I), where 0.5 mg/mL mitomycin C was applied for 10 minutes, and endoscopic DCR without mitomycin (group II). Follow-up settings were done to document the patient’s subjective improvement, to judge ostium patency on irrigation, and to record any complications. Results Causes of failure in the original 92 patients included canalicular obstruction (14%), small misplaced bony window (43%), very small nasolacrimal stoma due to development of synechia (23%), and complete closure of nasolacrimal stoma with tough fibrous tissue (63%). There was no significant difference between the 2 groups in subjective and objective success rates and adverse events. Group I demonstrated a significantly longer operative time and a significantly lower number of debridement sessions (mean of 1.2 vs 1.9). Conclusions Recurrent nasolacrimal duct obstruction after primary endoscopic DCR is mainly due to reclosure of the nasolacrimal stoma with synechia and fashioning of the small misplaced bony window. Mitomycin C does not increase the success rate of revision endoscopic DCR. It is a safe procedure and may be of value only in patients inaccessible to strict follow-up because it induces a better healing profile in terms of mucosal recovery, wound healing, and less need for debridement sessions.

scholarly journals Drug-Eluting Balloons versus Second-Generation Drug-Eluting Stents for Treating In-Stent Restenosis in Coronary Heart Disease after PCI: A Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Wen-Juan Xiu ◽  
Hai-Tao Yang ◽  
Ying-Ying Zheng ◽  
Yi-Tong Ma ◽  
Xiang Xie
Keyword(s):  
Observational Studies ◽  
Second Generation ◽  
Meta Analysis ◽  
Drug Eluting Stents ◽  
Randomized Controlled ◽  
Stent Restenosis ◽  
Significant Difference ◽  
Drug Eluting ◽  
In Stent Restenosis

Background. In-stent restenosis (ISR) remains a common problem following percutaneous coronary intervention (PCI). However, the best treatment strategy remains uncertain. There is some controversy over the efficacy of drug-eluting balloons (DEBs) and second-generation drug-eluting stents (DESs) for treating ISR. Methods. A meta-analysis was used to compare the efficacy of the DEB and second-generation DES in the treatment of ISR. The primary endpoint is the incidence of target lesion revascularization (TLR). The secondary endpoint is the occurrence of target vessel revascularization (TVR), myocardial infarction (MI), all-cause death (ACM), cardiac death (CD), major adverse cardiac events (MACEs), minimum luminal diameter (MLD), late luminal loss (LLL), binary restenosis (BR), and percent diameter stenosis (DS%). Results. A total of 12 studies (4 randomized controlled trials and 8 observational studies) including 2020 patients with a follow-up of 6–25 months were included in the present study. There was a significant difference in the MLD between the two groups during follow-up (P=0.007, RR = 0.23, and 95% CI: 0.06–0.4 mm). There was no significant difference in LLL, BR, or DS% and the overall incidence of MACEs between the two groups. Subgroup analysis showed no significant difference in the incidence of primary and secondary endpoints when considering RCTs or observational studies only. Conclusions. The efficacy of the DEB and second-generation DES in the treatment of ISR is comparable. However, our results need further verification through multicenter randomized controlled trials.

Improvement of Acupuncture Therapy on Relapse of P atients with G outy A rthritis: A Pairwise and Bayesian Network Meta analysis

2021 ◽  
Author(s):  
Zhihui Li ◽  
Min Chen ◽  
Chunzhi Tang
Keyword(s):  
Acupuncture Therapy ◽  
Bayesian Network ◽  
Meta Analysis ◽  
Gouty Arthritis ◽  
Serum Urate ◽  
Cochrane Library ◽  
Future Research ◽  
Fire Needle ◽  
The Impact

Objective: The aim of this study is to investigate the impact of acupuncturetherapy on relapse of patients with gouty arthritis (GA). Methods: “gout ORgouty arthritis” AND “a cupuncture therapy OR acupuncture OR moxibustionOR electroacupuncture OR fire needle OR acupotomology OR blood lettingpuncture OR plum blossom needle” were used as search strategies forsearching related studies. Twenty two studies involving 2394 patient s wereenrolled in this research through the analysis of databases of CNKI, Wanfang,VIP, PubMed, Embase and Cochrane Library. Results: The results of pairwise metaanalysis and network meta analysis (NMA) indicated that patients withacupuncture therapy had a significantly lower relapse rate (RR) compared withthose without acupuncture therapy (OR = 0.21, 95% CI: 0.16 0.26, P <0.00001); the follow up time (TFU) and serum urate concentration (SUA)before treatment had no significant effect on the reductio n of RR caused byacupuncture therapy (P > 0.05); and patients treated with acupuncture plusWestern medicine (WM) had the lowest RR (surface under the cumulativeranking [SUCRA] = 85.0%), followed by acupuncture plus traditional Chinesemedicine (TCM, SUC RA = 73.5%), acupuncture only (SUCRA = 72.8%),fourthly acupuncture plus TCM and WM (SUCRA = 33.0%), then TCM(SUCRA = 28.7%), finally WM (SUCRA = 7.0%). Conclusion: Our findingmay facilitate the application of acupuncture therapy in patients with GA. Ourresearch also offered some information for the future research.

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