Economic analysis of acupuncture for migraine prophylaxis

BACKGROUND: Acupuncture has become a viable option for migraine prophylaxis in Europe; however, despite its wide use, more data on the short- and long-term cost-effectiveness are needed when considering the perspectives of a paying third-party, the patient, and of society in general. The aim was to evaluate the cost and effectiveness of adjuvant acupuncture to pharmacologic treatment vs pharmacologic treatment alone in migraine patients after a 3-month acupuncture course and a 6-month follow-up from all perspectives. METHODS: The study involved an open-label randomized clinical trial of patients receiving acupuncture (n=42), and a waiting list control group (n=44). The number of migraine days during the last 28 days, as well as direct and indirect costs were considered. The trial was registered under DRKS00009803. RESULTS: The total cost per patient reached €696 vs €285 after 3 months of acupuncture and €66 vs €132 in the acupuncture and control groups after a 6-month follow-up, respectively (P=0.071). The trends observed in effectiveness and costs from all perspectives are discussed. CONCLUSION: The inclusion of acupuncture in health care results beneficial mainly for its observed trend in reduced losses of productivity and income, with the latter often exceeding the costs of acupuncture treatment. As such, acupuncture may be recommended as an adjuvant treatment in migraine prophylaxis to standard pharmacotherapy

Effect of expectation on short- and long-term treatment response to Acupuncture in migraine patients

Introduction: There are relatively few studies addressing the relationship between the patient's expectation and the short and long-term response to treatment with acupuncture. The aim of this study was to assess the association between pre- and post-treatment expectation of acupuncture and post-treatment and post-follow-up patient outcomes. Methods: This was an open-label, randomized controlled clinical trial conducted at the Czech-Chinese Centre for Traditional Chinese Medicine at the University Hospital Hradec Kralove between October 2015 and April 2017. Non-specific factors were examined in the intervention arm using regression analysis. Results: Post-treatment positive expectation concerning the success of the treatment, as well as the affective status of the patient, is one of the most significant nonspecific factors contributing to an increased post-treatment effectiveness of acupuncture; however, this positive expectation decreased with time. On the other hand, the post-follow-up effect of acupuncture was significantly improved by the patients’ positive perception of the TCM practitioner. Conclusions: Correct calibration of a patient's expectation, good mental status, and patients' perceptions of an acupuncturist's skills reduced the number of migraine days in patients treated with acupuncture. Understanding non-specific treatment effects can potentially help clinicians to integrate them in to practice and thus optimise treatment effectiveness. Future research is needed to clarify whether interventions targeting modifiable non-specific factors prior to and during acupuncture treatment can result in better patient outcomes and future cost-savings.</p

Ethanol fixation method for heart and lung imaging in micro-CT

Purpose The soft tissue imaging in micro-CT remains challenging due to its low intrinsic contrast. The aim of this study was to create a simple staining method omitting the usage of contrast agents for ex vivo soft tissue imaging in micro-CT. Materials and methods Hearts and lungs from 30 mice were used. Twenty-seven organs were either fixed in 97% or 50% ethanol solution or in a series of ascending ethanol concentrations. Images were acquired after 72, 168 and 336h on a custom-built micro-CT machine and compared to scans of three native samples. Results Ethanol provided contrast enhancement in all evaluated fixations. Fixation in 97% ethanol resulted in contrast enhancement after 72 h; however, it caused hardening of the samples. Fixation in 50% ethanol provided contrast enhancement after 336 h, with milder hardening, compared to the 97% ethanol fixation, but the visualization of details was worse. The fixation in a series of ascending ethanol concentrations provided the most satisfactory results; all organs were visualized in great detail without tissue damage. Conclusions Simple ethanol fixation improves the tissue contrast enhancement in micro-CT. The best results can be obtained with fixation of the soft tissue samples in a series of ascending ethanol concentrations

International comparison CCQM K52: carbon dioxide in synthetic air

61 p. : il.The first key comparison on carbon dioxide in nitrogen dates from 1993-1994 (CCQM-K1b) [1]. It is in fact one of the first types of gas mixtures that was used in an international (key) comparison. Since then, numerous National Metrology Institutes (NMIs) have been setting up facilities for gas analysis, and have developed claims for their Calibration and Measurement Capabilities (CMCs) for these mixtures. Also, in 2003 a comparison (CCQM-P41 [2, 3]) was carried out between NMIs and WMO laboratories for the determination of greenhouse gases showing a good overall agreement between the participants. In the April 2005 meeting of the CCQM Gas Analysis Working Group, a policy was proposed to repeat key comparisons for stable mixtures every 10 years. Consequently, this comparison is consistent with the proposed policy and enables NMIs that could not participate in the previous comparison to take part. This report describes the results of a key comparison for carbon dioxide in synthetic air (oxygen + nitrogen). The amount–of–substance fraction level of carbon dioxide chosen for this key comparison (360 μmol/mol) represents the ambient level of this component in air. This key comparison aims to support CMC-claims for carbon dioxide in both nitrogen or air (synthetic and purified) from 100 μmol/mol to 20 cmol/mol