Topical NSAIDs for acute pain: a meta-analysis

BACKGROUND: A previous systematic review reported that topical NSAIDs were effective in relieving pain in acute conditions like sprains and strains, with differences between individual drugs for efficacy. More trials, a better understanding of trial quality and bias, and a reclassification of certain drugs necessitate a new review. METHODS: Studies were identified by searching electronic databases and writing to manufacturers. We selected randomised double blind trials comparing topical NSAID with either placebo or another active treatment in adults with acute pain, and extracted dichotomous information approximating to a 50% reduction in pain at one week, together with details of adverse events and withdrawals. Relative benefit and number-needed-to-treat (NNT), and relative risk and number-needed-to-harm (NNH) were calculated, with sensitivity analyses where appropriate to investigate differences between individual drugs and aspects of trial design. RESULTS: Twenty-six double blind placebo controlled trials had information from 2,853 patients for evaluation of efficacy. Topical NSAID was significantly better than placebo in 19 of the 26 trials, with a pooled relative benefit of 1.6 (95% confidence interval 1.4 to 1.7), and NNT of 3.8 (95% confidence interval 3.4 to 4.4) compared with placebo for the outcome of half pain relief at seven days. Results were not affected by outcome reported, or condition treated, but smaller trials yielded a larger estimate of efficacy. Indirect comparisons of individual topical NSAIDs showed that ketoprofen was significantly better than all other topical NSAIDs, while indomethacin was barely distinguished from placebo. Three trials, with 433 patients, compared topical with oral NSAID (two trials compared the same drug, one compared different drugs) and found no difference in efficacy. Local adverse events, systemic adverse events, or withdrawals due to an adverse event were rare, and no different between topical NSAID and placebo. CONCLUSIONS: Topical NSAIDs were effective and safe in treating acute painful conditions for one week

Capacidade Funcional: estudo prospectivo em idosos residentes em uma instituição de longa permanência

The Short Physical Performance Balance - SPPB has been largely used in researches related to the effects of aging, as a practical and efficient instrument to estimate the physical conditions and screening of elderly people with future disability risk. The SPPB estimates the performance of lower limbs in three aspects: muscle strength, gait and balance, all recognized as fundamental to achieve good quality of life, being accepted as universal indicators to value the health conditions of the elderly. PURPOSE: Analyze the SPPB effectiveness to detect functional capacity changes among institutionalized elderly patients and how it is influenced by cognitive, clinical and global functional variables. METHODS: a prospective study, involving 30 residents of a philanthropic long-term care facility in São Paulo (17 women and 13 men), with ages above 60 years old (43% older than 80 years old) and an average of seven years of residence. After 18 months, these old people were reevaluated and data were compared. RESULTS: Considering the evaluated elderly who had good performance (17%), all of them showed up loss of strength during the research. It was observed that there was an improvement of 16% and 1%, respectively, in the balance and in gait, respectively. There was one or more falls in 47% of them. Comparing the Katz's Index of Independency in the Daily Living, the SPPB was more sensitive to the functional decline, indicating 39%, as compared to the 14% of the loss indentified by Katz. CONCLUSIONS: the data confirm the previous studies, which indicate the functional capacity decline of institutionalized elderly and for the SPPB applicability in the routine of functional attendance of this population.A Short Physical Performance Balance - SPPB vem sendo utilizada largamente em pesquisas sobre o envelhecimento, como instrumento prático e eficaz na avaliação do desempenho físico e rastreamento de idosos com riscos futuros de incapacidades. Ela avalia o desempenho de membros inferiores em três aspectos: força muscular, marcha e equilíbrio, reconhecidos como componentes fundamentais para a qualidade de vida, sendo aceitos como indicadores universais do estado de saúde em idosos. OBJETIVO: Analisar a eficácia da SPPB em detectar alterações na capacidade funcional do idoso institucionalizado e como esta é influenciada pelas variáveis cognitivas, clínicas e funcionais globais. METODOLOGIA: estudo prospectivo do qual participaram 30 residentes de uma instituição de longa permanência, filantrópica, em São Paulo (17 mulheres e 13 homens), com idades acima de 60 anos ou mais (43% maiores de 80 anos) e média de sete anos de residência. Após 18 meses, estes idosos foram reavaliados e os dados, comparados. RESULTADOS: Dos idosos avaliados que obtiveram bom desempenho (17%), todos apresentaram perda de força ao longo do seguimento. Quanto ao equilíbrio e marcha, notou-se melhora de 16% e 1%, respectivamente. Apresentaram uma ou mais quedas, 47% dos sujeitos. Quando comparada com o Índex de Independência nas Atividades de Vida Diária de Katz, a SPPB se mostrou mais sensível em relação ao declínio funcional, apontando 39% em comparação aos 14% de perda identificada pelo Katz. CONCLUSÃO: os dados corroboram estudos anteriores, que apontam para o declínio da capacidade funcional de idosos institucionalizados e para a aplicabilidade da SPPB na rotina de acompanhamento funcional dessa população.Universidade Federal de São Paulo (UNIFESP) Curso de Especialização em Reabilitação GerontológicaLar Escola São Francisco Centro de Reabilitação Setor de Reabilitação GerontológicaUniversidade de São Paulo Faculdade de Medicina Hospital das ClínicasUNIFESP, Curso de Especialização em Reabilitação GerontológicaSciEL

Updated measurements of exclusive J/ψ and ψ(2S) production cross-sections in pp collisions at √s = 7 TeV

The differential cross-section as a function of rapidity has been measured for the exclusive production of J/ψ and ψ(2S) mesons in proton–proton collisions at √s = 7 TeV, using data collected by the LHCb experiment, corresponding to an integrated luminosity of 930 pb−1. The cross-sections times branching fractions to two muons having pseudorapidities between 2.0 and 4.5 are measured to be where the first uncertainty is statistical and the second is systematic. The measurements agree with next-to-leading order QCD predictions as well as with models that include saturation effects

Measurement of the CKM angle γ\gamma using B0→DK∗0B^0 \rightarrow D K^{*0} with D→KS0π+π−D \rightarrow K^0_S \pi^+ \pi^- decays

A model-dependent amplitude analysis of the decay $B^0\rightarrow D(K^0_S\pi^+\pi^-) K^{*0}$ is performed using proton-proton collision data corresponding to an integrated luminosity of 3.0fb$^{-1}$, recorded at $\sqrt{s}=7$ and $8 TeV$ by the LHCb experiment. The CP violation observables $x_{\pm}$ and $y_{\pm}$, sensitive to the CKM angle $\gamma$, are measured to be \begin{eqnarray*} x_- &=& -0.15 \pm 0.14 \pm 0.03 \pm 0.01, y_- &=& 0.25 \pm 0.15 \pm 0.06 \pm 0.01, x_+ &=& 0.05 \pm 0.24 \pm 0.04 \pm 0.01, y_+ &=& -0.65^{+0.24}_{-0.23} \pm 0.08 \pm 0.01, \end{eqnarray*} where the first uncertainties are statistical, the second systematic and the third arise from the uncertainty on the $D\rightarrow K^0_S \pi^+\pi^-$ amplitude model. These are the most precise measurements of these observables. They correspond to $\gamma=(80^{+21}_{-22})^{\circ}$ and $r_{B^0}=0.39\pm0.13$, where $r_{B^0}$ is the magnitude of the ratio of the suppressed and favoured $B^0\rightarrow D K^+ \pi^-$ decay amplitudes, in a $K\pi$ mass region of $\pm50 MeV$ around the $K^*(892)^0$ mass and for an absolute value of the cosine of the $K^{*0}$ decay angle larger than $0.4$.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://lhcbproject.web.cern.ch/lhcbproject/Publications/LHCbProjectPublic/LHCb-PAPER-2016-007.htm

Search for dark photons produced in 13 TeV pppp collisions

Searches are performed for both promptlike and long-lived dark photons, A 0 , produced in proton-proton collisions at a center-of-mass energy of 13 TeV, using A 0 → μ þ μ − decays and a data sample corresponding to an integrated luminosity of 1 . 6 fb − 1 collected with the LHCb detector. The promptlike A 0 search covers the mass range from near the dimuon threshold up to 70 GeV, while the long-lived A 0 search is restricted to the low-mass region 214 <m ð A 0 Þ < 350 MeV. No evidence for a signal is found, and 90% confidence level exclusion limits are placed on the γ – A 0 kinetic-mixing strength. The constraints placed on promptlike dark photons are the most stringent to date for the mass range 10 . 6 <m ð A 0 Þ < 70 GeV, and are comparable to the best existing limits for m ð A 0 Þ < 0 . 5 GeV. The search for long-lived dark photons is the first to achieve sensitivity using a displaced-vertex signature