Efficacy of cupping therapy in patients with the fibromyalgia syndrome-a randomised placebo controlled trial

© 2016 The Author(s). This study aimed to test the efficacy of cupping therapy to improve symptoms and quality of life in patients diagnosed with the fibromyalgia syndrome. Participants were randomly assigned to cupping therapy, sham or usual care. Cupping was administered five times at twice weekly intervals on the upper and lower back. The primary outcome measure was pain intensity at day 18. Secondary outcomes included functional disability, quality of life, fatigue and sleep quality as well as pressure pain sensitivity, satisfaction and safety at day 18 and 6 months. Altogether 141 patients were included in this study (139 females, 55.8 ± 9.1 years). After 18 days patients reported significant less pain after cupping compared to usual care (difference-12.4; 95% CI:-18.9;-5.9, p < 0.001) but not compared to sham (difference-3.0; 95% CI:-9.9, 3.9, p = 0.396). Further effects were found for quality of life compared to usual care. Patients were mildly satisfied with cupping and sham cupping; and only minor side effects were observed. Despite cupping therapy being more effective than usual care to improve pain intensity and quality of life, effects of cupping therapy were small and comparable to those of a sham treatment, and as such cupping cannot be recommended for fibromyalgia at the current time

Effect of kaolin clay on migrant alate aphids (Hemiptera: Aphididae) in blueberry fields in the context of Blueberry scorch virus

The efficacy of kaolin clay (Surround® WP) in reducing the number of migrant aphids on blueberry, Vaccinium corymbosum L. (Ericaceae) and the incidence of Blueberry scorch virus (BlScV) was determined. Two applications of kaolin clay reduced the number of alatae collected on treated ‘Berkeley’ plants by as much as a factor of eight between 4 June and 16 August. However, five of 100 test plants located near infected fields and exposed only to migrant alatae between 10 May and 16 August became infected with BlScV: three controls and two treated with kaolin clay. The work demonstrates the importance of migrant alatae in the spread of BlScV; 5% transmission is consistent with previous estimates of annual virus spread by winged and non-winged aphids. Three of the plants became infected between 10 and 27 May (one control and two treated with kaolin clay), indicating the importance of aphid flights in May for virus transmission. Rainfall removed much of the kaolin clay and this may have affected its efficacy. The aphid data demonstrated that migrant alatae are able to discriminate between untreated and kaolin—treated blueberry plants, and that Ericaphis fimbriata (Richards), which utilizes blueberry as a host, discriminates better than other migrant species. Water trap data do not necessarily reflect the total migrant aphid composition found on plants in the field. Plant growth was not affected by the kaolin clay, but the fruit had clay residues amongst the bracts of the calyx limiting the use of this product on producing fields to the period before fruit set. Kaolin clay may be best suited to protection of nursery stock, but further work is needed to improve efficacy during wet weather and determine optimal application frequency.Note: Use of trade names or trademarks does not imply endorsement of the companies or products named nor criticism of similar ones not named

Chemical properties and protective effect of Rosmarinus officinalis: mitigation of lipid peroxidation and DNA-damage from arsenic exposure

Recent studies have implicated dietary factors in the cause and prevention of important diseases, with strong evidence that plant’s compounds can protect against these diseases. Moreover, food security and environmental contamination are topics in focus at the moment. In this view, contamination by arsenic (As) has received much attention as well as some spices with medicinal properties. Among these plants, the use of Rosmarinus officinalis L. has demonstrated antioxidant properties besides being used for circulatory disorders. Therefore, we measured the mitotic index of Allium cepa L. and characterized the antioxidant effects to determine the capacity of R. officinalis to ameliorate arsenic-induced DNA damage. R. officinalis extract showed no mutagenic effects and exhibited antimutagenic potential, reducing the DNA damage, anaphase-telophase briges and micronuclei chromosome aberrations that result from treatment with the arsenic. Additionally, reduction in arsenic- induced lipid peroxidation was also observed

Systematic review with meta-analysis: cytokines in fibromyalgia syndrome

<p>Abstract</p> <p>Background</p> <p>To perform a systematic review and meta-analysis on cytokine levels in patients with fibromyalgia syndrome (FMS).</p> <p>Methods</p> <p>Through December 2010 we systematically reviewed the databases PubMed, MEDLINE, and PsycINFO and screened the reference lists of 22 review articles for suitable original articles. Original articles investigating cytokines in patients with FMS were included. Data were extracted by two independent authors. Differences of the cytokine levels of FMS patients and controls were summarized by standardized mean differences (SMD) using a random effects model. Study quality was assessed applying methodological scores: modified Center of Evidence Based Medicine, Newcastle-Ottawa-Scale, and Würzburg Methodological Quality Score.</p> <p>Results</p> <p>Twenty-five articles were included investigating 1255 FMS patients and 800 healthy controls. Data of 13/25 studies entered meta-analysis. The overall methodological quality of studies was low. The results of the majority of studies were not comparable because methods, investigated material, and investigated target cytokines differed. Systematic review of the selected 25 articles revealed that FMS patients had higher serum levels of interleukin (IL)-1 receptor antagonist, IL-6, and IL-8, and higher plasma levels of IL-8. Meta-analysis of eligible studies showed that FMS patients had higher plasma IL-6 levels compared to controls (SMD = -0.34 [-0.64, -0.03] 95% CI; p = 0.03). The majority of investigated cytokines were not different between patients and controls.</p> <p>Conclusions</p> <p>The pathophysiological role of cytokines in FMS is still unclear. Studies of higher quality and with higher numbers of subjects are needed.</p

Friends with benefits: implementing corecursion in foundational proof assistants

We introduce AmiCo, a tool that extends a proof assistant, Isabelle/HOL, with flexible function definitions well beyond primitive corecursion. All definitions are certified by the assistant’s inference kernel to guard against inconsistencies. A central notion is that of friends: functions that preserve the productivity of their arguments and that are allowed in corecursive call contexts. As new friends are registered, corecursion benefits by becoming more expressive. We describe this process and its implementation, from the user’s specification to the synthesis of a higher-order definition to the registration of a friend. We show some substantial case studies where our approach makes a difference

The Maintaining Musculoskeletal Health (MAmMOTH) Study: Protocol for a randomised trial of cognitive behavioural therapy versus usual care for the prevention of chronic widespread pain

Background Cognitive behavioural therapy (CBT) has been shown to improve outcomes for patients with fibromyalgia, and its cardinal feature chronic widespread pain (CWP). Prediction models have now been developed which identify groups who are at high-risk of developing CWP. It would be beneficial to be able to prevent the development of CWP in these people because of the high cost of symptoms and because once established they are difficult to manage. We will test the hypothesis that among patients who are identified as at high-risk, a short course of telephone-delivered CBT (tCBT) reduces the onset of CWP. We will further determine the cost-effectiveness of such a preventative intervention. Methods The study will be a two-arm randomised trial testing a course of tCBT against usual care for prevention of CWP. Eligible participants will be identified from a screening questionnaire sent to patients registered at general practices within three Scottish health boards. Those returning questionnaires indicating they have visited their doctor for regional pain in the last 6 months, and who have two of, sleep problems, maladaptive behaviour response to illness, or high number of somatic symptoms, will be invited to participate. After giving consent, participants will be randomly allocated to either tCBT or usual care. We aim to recruit 473 participants to each treatment arm. Participants in the tCBT group will have an initial assessment with a CBT therapist by telephone, then 6 weekly sessions, and booster sessions 3 and 6 months after treatment start. Those in the usual care group will receive no additional intervention. Follow-up questionnaires measuring the same items as the screening survey questionnaire will be sent 3, 12 and 24 months after start of treatment. The main outcome will be CWP at the 12 month questionnaire. Discussion This will be the first trial of an intervention aimed at preventing fibromyalgia or CWP. The results of the study will help to inform future treatments for the prevention of chronic pain, and aetiological models of its development

Evaluation of a self-management patient education program for patients with fibromyalgia syndrome: study protocol of a cluster randomized controlled trial

Background Fibromyalgia syndrome (FMS) is a complex chronic condition that makes high demands on patients’ self-management skills. Thus, patient education is considered an important component of multimodal therapy, although evidence regarding its effectiveness is scarce. The main objective of this study is to assess the effectiveness of an advanced self-management patient education program for patients with FMS as compared to usual care in the context of inpatient rehabilitation. Methods/Design We conducted a multicenter cluster randomized controlled trial in 3 rehabilitation clinics. Clusters are groups of patients with FMS consecutively recruited within one week after admission. Patients of the intervention group receive the advanced multidisciplinary self-management patient education program (considering new knowledge on FMS, with a focus on transfer into everyday life), whereas patients in the control group receive standard patient education programs including information on FMS and coping with pain. A total of 566 patients are assessed at admission, at discharge and after 6 and 12 months, using patient reported questionnaires. Primary outcomes are patients’ disease- and treatment-specific knowledge at discharge and self-management skills after 6 months. Secondary outcomes include satisfaction, attitudes and coping competences, health-promoting behavior, psychological distress, health impairment and participation. Treatment effects between groups are evaluated using multilevel regression analysis adjusting for baseline values. Discussion The study evaluates the effectiveness of a self-management patient education program for patients with FMS in the context of inpatient rehabilitation in a cluster randomized trial. Study results will show whether self-management patient education is beneficial for this group of patients