scholarly journals The effect of lumbosacral manipulation on growing pains

2015 ◽  
Vol 20 (1) ◽  
Author(s):  
Dawid De Beer ◽  
Charmaine M. Bester
Keyword(s):  
Tibialis Anterior Muscle ◽  
Specific Treatment ◽  
Conclusive Evidence ◽  
Self Report ◽  
Response To Treatment ◽  
Rank Test ◽  
Positive Effects ◽  
Pressure Algometer ◽  
Growing Pains

Background: Growing pains are a frequent clinical presentation that continues to puzzle practitioners, with very little conclusive evidence in any medical field, including chiropractic.Objective: The aim of this study was to determine whether lumbosacral manipulations have an effect on growing pain symptoms.Methods: Thirty participants with growing pains between the ages of 4 and 12 years were recruited. The participants were placed into two groups of 15 participants each. Group 1 received lumbosacral manipulations to restricted joints as determined by motion palpation, while Group 2 never received any professional intervention. Often parent(s)/guardian(s) of children who suffer from growing pains will rub the child's legs and offer verbal reassurance in an attempt to console their children. Parent(s)/guardian(s) of both groups were encouraged to continue to do this throughout the duration of the trial. Instructions were given to the parents so that the same rubbing technique and rubbing cream (aqueous cream) were used. Subjective changes were tracked using a pain diary that the parent(s)/guardian(s) were asked to complete, a six-week post-study follow-up question regarding children's growing pains and the Oucher self-report pain scale. Objective measures consisted of pressure algometer readings of the tibialis anterior muscle belly.Results: The statistical data was analysed using the Friedman test, Manne—Whitney test and the Wilcoxon Signed-Rank test. The results demonstrated that both groups responded favourably to their specific treatment over time. However, the group that received lumbosacral manipulations proved to show a quicker response to treatment; and the post study follow-up of this same group showed markedly more positive feedback than the group that did not receive the treatment. These results highlighted the positive effects of chiropractic manipulation on growing pain symptoms.Conclusion: The results from this study, specifically the feedback from parent(s)/guardians(s) and the pain diaries, indicated that spinal manipulation is beneficial in the treatment of growing pains. The results also showed that other methods of treating growing pains, such as simple leg rubs, may also bring relief.

scholarly journals A HOME-VISIT PILOT INTERVENTION TO PROMOTE COMMUNICATION SKILLS AND WELL-BEING FOR DEMENTIA FAMILY CAREGIVERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S676-S676
Author(s):  
Jung-Ah Lee ◽  
Priscilla Kehoe ◽  
Lisa Gibbs
Keyword(s):  
Family Caregivers ◽  
Communication Skills ◽  
Caregiver Burden ◽  
Self Efficacy ◽  
Home Visit ◽  
Home Visits ◽  
Well Being ◽  
Rank Test ◽  
Positive Effects

Abstract Dementia takes a significant toll on caregivers resulting in their suffering from chronic stress and depression due to responsibility for care for persons with dementia (PWD). Behaviors of PWD could be aggravated by inappropriate responses by family caregivers such as correcting PWD’s memories. The study purpose is to examine the feasibility of a home-visit-based intervention designed to promote communication skills with PWD and well-being in family caregivers. This pilot study used a single-arm experimental pre-post design to test the feasibility of 4 weekly home visits for 13 female family caregivers in Southern California (spouse, n=7; adult children, n=6; mean age=64.3, ranging 46-82). Trained home visitors used video scenarios for behavioral education for caregivers. All caregivers completed the entire home visit program. Significantly caregiver burden was decreased from baseline (M(SD)=51.38(4.58)) to follow-up at 5 weeks (M=43.31(5.67), Wilcoxon signed rank test: p=.04). Additionally, caregiver-reported PWD’s negative behaviors were reduced from baseline to follow-up (Mbase=22.31(3.52), Mfolllowup=19.31(4.4), p=.13). There were other improvements (non-significant) in greater caregiver self-efficacy and less depressive symptoms from baseline to follow-up. Caregiver satisfaction with the intervention was high (M=4.6(0.65) of 5). Qualitatively, participants appreciated the home visits for educational sessions and welcomed the empathy provided. Caregivers expressed better communications and responsiveness to the PWDs. The results showed the home-visit-based caregiver intervention was feasible and had a potential effectiveness on reduction of caregiver burden and possibly on self-efficacy and well-being. A larger-scale study will be needed to demonstrate long term positive effects on caregiver interactive skills and their well-being.

The Impact of Cannabis in the Early Stages of Schizophrenia: A 3-Year Longitudinal Study on Cannabis Influence on Relapse Rates

2017 ◽  
Vol 41 (S1) ◽  
pp. S196-S197
Author(s):  
M. Gomez Revuelta ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
V. Gajardo Galan ◽  
G. Pardo de Santayana Jenaro ◽  
...  
Keyword(s):  
Intervention Program ◽  
Response To Treatment ◽  
Rank Test ◽  
First Episode ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Early Stages ◽  
Increased Risk ◽  
The Impact

IntroductionThe first five years after the onset of a first episode of psychosis (FEP) are crucial for long term outcome. In this period, the risk of relapse is particularly high. Consequences of relapse include an increased risk of neurotoxicity, chronicity, hospitalization, decreased response to treatment, increased economic burden and functional impairment.ObjectivesTo discern the influence of cannabis on relapse as it may contribute to adopt specific measures in patients during early stages of the illness.Material and methodsPAFIP is an early intervention program for patients with a FEP. Between January 2005 and January 2011, 163 patients were recruited for this study. They were followed-up during 3 years at intervals of three months. The sample was divided into three groups: (1) those non-cannabis users neither before the FEP nor during follow-up (nn), (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences between the three groups were observed but a trend (P = 0.057) towards a more enduring survival in Group 3 (sn). (Kaplan–Meier curve and detailed Log Rank Test results will be included in the final poster).ConclusionsCannabis has a detrimental effect on schizophrenia. The interruption of its use could contribute to improve the outcome of the disease, as the results of our study suggest.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Little Good News - Relationships During Early Stages of COVID-19 Pandemic

2021 ◽  
Author(s):  
Diane Holmberg ◽  
Kathryn M Bell ◽  
Kim Cadman
Keyword(s):  
Romantic Relationships ◽  
Romantic Relationship ◽  
Self Report ◽  
Good News ◽  
Negative Effects ◽  
Positive Effects ◽  
The Gift ◽  
Final Time Point ◽  
The Relationship

Media attention has highlighted the Covid-19 pandemic’s negative effects on romantic relationships (e.g., increased partner aggression). The current mixed-method study also explored potential positive effects, and how the relative balance of positive versus negative effects might have changed over time during the first pandemic wave. Individuals (N = 186) who participated in a pre-COVID study were recruited through MTurk to participate in a four-wave longitudinal follow-up, every two weeks from mid-April to late May 2020. Participants completed an 8-item self-report measure assessing perceived negative and positive effects of the pandemic on their romantic relationship. Multi-level models revealed that perceived positive effects were substantially higher than perceived negative effects at each timepoint, even amongst those who reported being more heavily impacted by the pandemic. Both positive and negative effects were stable across time. Open-ended questions at the final time point were coded for common themes. The most common negative theme centered on increased stress or tension in the relationship, while the most common positive theme discussed the importance of focusing on and appreciating the relationship, including taking advantage of the gift of increased time together the pandemic had brought. Amongst all of the pandemic’s bad news, it is refreshing to consider the possibility of pandemic-related benefits for people’s romantic relationships.

scholarly journals Longitudinal Assessment of the Effectiveness of a Tobacco Prevention Programme among school-aged adolescents

2020 ◽  
Vol 20 (2) ◽  
pp. 38-48
Author(s):  
Isabel Sousa ◽  
Vânia Rocha ◽  
Catarina Samorinha ◽  
José Cunha-Machado ◽  
Henedina Antunes ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Smoking Prevention ◽  
Self Report ◽  
Control Group ◽  
Longitudinal Assessment ◽  
Effective Prevention ◽  
Positive Effects ◽  
Experimental Group

Implementing effective prevention programmes is critical to prevent tobacco use. Objectives. This study aims to assess the long-term effectiveness of the "SmokeOut-I" programme in the smoking prevention of school-aged adolescents, by gender. Methodology. A quasi-experimental study was conducted including a pre-test and a post-test, as well as a experimental group (N = 163) and a control group (N = 148) of adolescents attending the 6th grade at Braga schools in 2014/2015. A follow-up was conducted three years later. A self-report questionnaire was administered to both groups before and after the programme implementation, and at the follow-up. The programme was only administered to the experimental group. Results. The programme has shown long-term effectiveness in preventing smoking experimentation, and in enhancing smoking refusal skills. There was a lower prevalence of tobacco use and intention to smoke in the experimental group than in the control group, although not statistically significant. It was found that the experimental group maintained adequate knowledge about smoking over time. Conclusions. The positive effects on health and on the environment justify the broad implementation of this programme, which implies the involvement and commitment of governmental institutions.

scholarly journals P0196ACUTE TUBULOINTERSTITIAL NEPHRITIS (ATIN) INDUCED BY CHECKPOINT INHIBITORS (ICI) VERSUS CLASSICAL ATIN. ARE THEY THE SAME DISEASE?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Laura Martinez Valenzuela ◽  
Juliana Draibe ◽  
Clara Garcia Carro ◽  
Irene Agraz ◽  
Xavier Fulladosa ◽  
...  
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Checkpoint Inhibitors ◽  
Laboratory Data ◽  
Specific Treatment ◽  
Latency Period ◽  
Response To Treatment ◽  
Acute Tubulointerstitial Nephritis ◽  
Diagnostic Time ◽  
Renal Histology

Abstract Background and Aims The incidence of acute tubulointerstitial nephritis (ATIN) related to drugs has dramatically increased during the past years. A new subtype of ATIN apparently different from classical drug related ATIN has emerged, which has been related to the administration of immune check point inhibitors (ICI). We herein investigated these differences between ICI related ATIN and non-ICI related ATIN, in terms of clinical features, response to treatment with steroids, and the kidney function evolution. Method A total of 47 patients diagnosed with acute tubulointerstitial nephritis (ATIN) from two centers were recruited. Of these, 13 patients presented with ATIN during the treatment with ICI, and 34 patients were diagnosed with ATIN attributed to other drugs. The main demographical, clinical and analytical variables such as gender, age, and current medication were recorded. The type of malignancy, oncological treatment, dose of ICI, and presence of extra-renal immune-related adverse-events were also reviewed. Renal biopsy diagnostic, time to drug withdrawal and ATIN specific treatment, as well as laboratory data during the follow-up were also studied. Results Patients diagnosed with ICI related ATIN presented with lower creatinine (ICI ATIN 3.8±1.03mg/dl vs. classical ATIN 5.98±4.15, p=0.007) at diagnostic and higher urinary leukocyte count (ICI ATIN 263.2±418.04 vs. classical ATIN 133.55±284.62, p=0.048) as compared to patients with non-ICI related ATIN. Time elapsed from the initiation of the culprit drug to the ATIN diagnostic was longer in ICI ATIN compared to classical ATIN (197.07±184.99 vs 114.4±352.16 days, p=0.006). In addition, during follow-up, the slope of decreasing creatinine over time was lower in ICI related ATIN compared to non-ICI related patients. Conclusion In this study we analyzed the differences between ICI ATIN and the classical ATIN. We found that ICI ATIN patients presented a larger latency period after offending drug initiation, milder acute kidney injury, and slower creatinine amelioration as compared to the classical ATIN. These results may be in part ascribed to potential differences in the pathological mechanisms in ATIN development, suggesting that ICI ATIN and the classical ATIN may be different disease with similar renal histology.

scholarly journals Acute tubulointerstitial nephritis induced by checkpoint inhibitors versus classical acute tubulointerstitial nephritis: are they the same disease?

2020 ◽  
Author(s):  
Juliana B Draibe ◽  
Clara García-Carro ◽  
Laura Martinez-Valenzuela ◽  
Irene Agraz ◽  
Xavier Fulladosa ◽  
...  
Keyword(s):  
Tubulointerstitial Nephritis ◽  
Checkpoint Inhibitors ◽  
Laboratory Data ◽  
Specific Treatment ◽  
Latency Period ◽  
Response To Treatment ◽  
Acute Tubulointerstitial Nephritis ◽  
Oncological Treatment ◽  
Culprit Drug

Abstract Background The incidence of acute tubulointerstitial nephritis (ATIN) related to drugs has dramatically increased over recent years. A new subtype of ATIN, apparently different from classical drug-related ATIN, has emerged that has been related to the administration of immune checkpoint inhibitors (ICIs). We investigated these differences between ICI-related ATIN (ICI ATIN) and non-ICI-related ATIN in terms of clinical features, response to treatment with steroids and the evolution of kidney function. Methods A total of 47 patients diagnosed with ATIN from two centres were recruited. Of these, 13 patients presented with ATIN during ICI treatment and 34 were diagnosed with ATIN attributed to other drugs. The main demographic, clinical and analytical variables such as gender, age and current medication were recorded. The type of malignancy, oncological treatment, ICI dose and presence of extrarenal immune-related adverse events were also reviewed. Renal biopsy diagnosis, time to drug withdrawal and ATIN-specific treatment, as well as laboratory data during follow-up, were also studied. Results Patients diagnosed with ICI ATIN presented with lower creatinine (ICI ATIN 3.8 ± 1.03  versus classical ATIN 5.98 ± 4.15 mg/dL, P = 0.007) at diagnosis and higher urinary leucocyte counts (ICI ATIN 263.2 ± 418.04 versus classical ATIN 133.55 ± 284.62, P = 0.048) compared with patients with non-ICI-related ATIN. Time from initiation of the culprit drug to ATIN diagnosis was longer in patients with ICI ATIN than in those with classical ATIN (197.07 ± 184.99 versus 114.4 ± 352.16 days, P = 0.006). In addition, during follow-up, the slope of decreasing creatinine over time was lower for ICI ATIN compared with non-ICI-related ATIN. Conclusions In this study, we analysed differences between ICI ATIN and classical ATIN. We found that patients with ICI ATIN presented with a larger latency period after culprit drug initiation, milder acute kidney injury and slower creatinine amelioration compared with those with classical ATIN. These results may, in part, be ascribed to potential differences in the pathological mechanisms involved in ATIN development, suggesting that ICI and classical ATIN may be different diseases with similar renal histologies.

scholarly journals Re-bleeding and its predictors after capsule endoscopy in patients with obscure gastrointestinal bleeding in long-term follow-up

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Panu Wetwittayakhlang ◽  
Jirapat Wonglhow ◽  
Nisa Netinatsunton ◽  
Naichaya Chamroonkul ◽  
Teerha Piratvisuth
Keyword(s):  
Specific Treatment ◽  
Rank Test ◽  
Gi Bleeding ◽  
Free Survival ◽  
Log Rank Test ◽  
Negative Study ◽  
Long Term Follow Up ◽  
Bleeding Episodes

Abstract Background Capsule endoscopy (CE) is the preferred diagnostic test of choice in the investigation of obscure gastrointestinal bleeding (OGIB). Although, a conservative strategy is recommended in the short-term, for cases with a negative result from CE, the impact of CE on long-term re-bleeding still remains unclear. Hence, the aim of this study was to determine the long-term re-bleeding rate along with predictors after CE in patients with OGIB. Methods We retrospectively reviewed 216 patients with OGIB, whom had received a CE examination, so as to investigate the cause of obscure GI bleeding; between July 2008 and March 2018. The patient’s characteristics, medication use, CE finding, treatments strategy, re-bleeding episodes and follow-up information were collected from the institutional electronic medical chart and CE database. Re-bleeding free survival was evaluated using Kaplan-Meier curves with log rank test, whilst predictors associated with the re-bleeding episodes were analyzed via the use of Cox proportional hazard model. Results One hundred and thirty-three patients with OGIB, having received CE were enrolled in the analysis. The pool rate of re-bleeding was 26.3% (35/133) during a follow-up duration of 26 months after CE. Patients with positive CE study, without specific treatment, had higher rates of re-bleeding (47.6%) than those with positive study whom received specific treatment (25.7%), and negative study (20.8%) (p = 0.042). Although, the re-bleeding free survival was not significantly different among the groups (log rank test; P = 0.10). Re-bleeding events occurring within 6, 12, and 24 months after CE were 36, 64 and 92%, respectively. The high-frequency re-bleeding etiologies were the small bowel angiodysplasias and abnormal vascular lesions. Furthermore, independent predictors for re-bleeding after CE were patients with cirrhosis (hazard ratio, HR 4.06), incomplete CE visualization (HR 2.97), and a history of previous GI bleeding (HR 2.80). Conclusions The likelihood of re-bleeding after CE was higher in patients with positive CE study than those with negative study. Specific treatments, or therapeutic interventions for patients with detectable lesions reduced the probability of re-bleeding episodes in long-term follow-up. Close follow-up for recurrent bleeding is recommeded for at least 2 years after CE.

Changes in lymphocyte/monocyte ratio, prognostic marker to predict overall survival in patients with advanced cancer treated with immune checkpoint inhibitor.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 3047-3047
Author(s):  
Sandip H. Patel ◽  
Mingjia Li ◽  
Songzhu Zhao ◽  
Lai Wei ◽  
Jarred Thomas Burkart ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Microenvironment ◽  
Advanced Cancer ◽  
Immune Checkpoint ◽  
Peripheral Blood ◽  
Checkpoint Inhibitors ◽  
Response To Treatment ◽  
Rank Test ◽  
Comparison Results

3047 Background: Immunosuppressive factors within the tumor microenvironment (TME) pose a barrier to response to treatment with immune checkpoint inhibitors (ICI). Monocytes alter the TME to promote cancer progression through local immune suppression and angiogenesis. Peripheral blood lymphocyte-to-monocyte ratio (LMR) may reflect the interaction between host immunity, represented by lymphocytes, and the tumor microenvironment, represented by monocytes. A low LMR in the peripheral blood may serve as a surrogate biomarker and has been associated with poor prognosis in various cancers; however, its role has not been well defined in the era of treatment with ICI. Methods: We retrospectively evaluated 1034 patients with advanced cancer treated with ICI from 2011 to 2017. We calculated LMR as ratio of absolute lymphocyte/monocyte counts at baseline and median of 21 days after first cycle of ICI (on-treatment LMR) and considered low if < 2. Overall survival (OS) was calculated from the initiation of ICI to date of death or censored at last follow-up. Median OS with 95% confidence intervals (CI) was estimated using the Kaplan-Meier method. Log rank test was used for group comparison. Results: 536 pts (52%) with LMR < 2 at baseline had shorted median OS compared to 498 (48%) with LMR≥2 (median OS 8.4 months vs 17.8 months, p < 0.001). Of 1034 pts with baseline LMR, 837 had follow up LMR evaluable. In patients with baseline and on-treatment LMR, those with baseline LMR < 2, who had on treatment LMR ≥2, had OS of 16.8 months (95% CI 10.3-23.5) compared to median OS 8.0 months (95% CI 6-9.4) for patients with on treatment LMR < 2 after first cycle of ICI, p < 0.001. Patients with baseline LMR≥2, who had on treatment LMR ≥ 2, had median OS of 23 months (95% CI 19.7-28.9), but median OS was 9.4 months (95% CI 7.1-11.1) for patients with on-treatment LMR < 2 after first cycle of ICI, p < 0.001. Conclusions: We observed a statistically significant association between not only baseline LMR but also change in LMR from baseline after first cycle of ICI and overall survival in cancer patients treated with ICI. The role of LMR at baseline and on-treatment LMR should be evaluated in further studies incorporating known additional prognostic factors for ICI therapy. [Table: see text]

Hyperhidrosis: A Case Study and Theoretical Formulation

1992 ◽  
Vol 9 (2) ◽  
pp. 87-95
Author(s):  
Ann Moylan ◽  
Mark R. Dadds
Keyword(s):  
Cognitive Therapy ◽  
Self Report ◽  
Social Situations ◽  
Theoretical Formulation ◽  
Self Monitoring ◽  
Positive Effects ◽  
Suitable Treatment

A case study is presented of a 20-year-old male who experienced marked increases in body temperature and profuse sweating of the forehead and trunk when in formal social situations. No other physiological nor psychological manifestations of anxiety were admitted to and no situational avoidance was reported. Pretreatment, posttreatment, and follow-up self-report measures and daily self-monitoring of intensity and frequency of sweating were collected to evaluate treatment effects. Treatment was conducted over a period of 20 weeks. Cued conditioning and desensitisation were initially employed, however treatment effect was difficult to determine. The effects of an inadvertent in vivo exposure in week 6 of treatment and the subsequent change in treatment to exposure and cognitive therapy are discussed. The positive effects of treatment, which led to a decrease in the frequency and intensity of the sweating response, were evident at the completion of treatment and well maintained at 60 weeks follow-up. The use of exposure and cognitive therapy as a suitable treatment for this disorder are discussed in light of other anxiety disorders.

scholarly journals Dermoscopic evaluation of therapeutic response to intralesional triamcinolone acetonide in the treatment of Alopecia areata

2017 ◽  
Vol 4 (4) ◽  
pp. 1175 ◽  
Author(s):  
Sweksha Srivastava ◽  
Sheena Goyal ◽  
K. S. Dhillon ◽  
Nishant Singh
Keyword(s):  
Triamcinolone Acetonide ◽  
Alopecia Areata ◽  
Response To Treatment ◽  
Treatment Modalities ◽  
Rank Test ◽  
Intralesional Injection ◽  
Percentage Area ◽  
Signed Rank Test ◽  
Severity Of The Disease

Background: Alopecia areata is a common auto-immune condition, characterized by circumscribed, patches of hair loss usually of the scalp. There are various treatment modalities available but no treatment is fully curative or preventive. Also, alopecia areata can have devastating effects on the patient’s quality of life and self-esteem. The aim of this study was to determine dermoscopy findings of alopecia areata that could be used as a clinical indicator of disease and also to evaluate the efficacy of intralesional injection Triamcinolone acetonide in the treatment of alopecia areata.Methods: Seventy patients with alopecia areata, aged between 11 and 56 years were injected with intralesional triamcinolone acetonide at a 4 weeks interval. Treatment response was evaluated using re-growth scale approach. Dermlite DL3 dermoscope was used to assess disease activity, response to treatment and side effects. Using Wilcoxon signed rank test, changes were assessed in the severity of the disease during follow-ups.Results: Baseline mean percentage area of scalp involved was 23.21±10.70. All the patients had black dots, 98.6% had yellow dots, 27.1% had broken hair, 74.3% had tapering hair and only 71.4% had vellus hair. At baseline, 15 (21.4%) patients had Alopecia Grading Score (AGS) 1, 29 (41.4%) had score 2 and 26 (37.1%) had a score of 3. Injection Triamcinolone acetonide (5 mg/ml) was injected at 1 cm intervals with 0.1 ml on each site and the procedure was repeated every 4 weeks for a maximum period of 24 weeks. From baseline level to the last follow up, proportion of patients with black dots reduced from 100% to 4.3%, yellow dots from 98.6% to 0%, broken hair from 17% to 0% and tapering hair from 74.3% to 0%. Vellus hair increased from 71.4% to 100%. Overall success rate in terms of achievement of re-growth Ssore 4 at last follow up was 60%.Conclusions: Dermoscopic characteristics, such as black dots, yellow dots, broken hair, tapering hair and clustered short vellus hair are primary indicators of alopecia areata.

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