Acupuncture fails to reduce but increases anaesthetic gas required to prevent movement in response to surgical incision.

Background: Acupuncture is used for clinical pain relief but has not been evaluated under clinical anaesthesia. This study was designed to compare movement in response to surgical incision in anaesthetized patients subjected to electro-acupuncture (EA) or sham procedures. Our hypothesis was that EA stimulation would reduce the requirements for anaesthetic gas. Methods: Forty-six healthy women, scheduled for laparoscopic sterilization at a Swedish county hospital, were randomized to have either the electro-acupuncture (n = 23) or sham (n = 23) procedure between the induction of general anaesthesia and the start of surgery. The minimal alveolar concentration (MAC) of sevoflurane required to prevent neck or major limb movements in response to surgical incision was determined in each group of patients. Results: The MAC for sevoflurane was found to be higher in the group given acupuncture than in the control group (2.1 ± 0.3% vs. 1.8 ± 0.4%; P = 0.008). Conclusion: Electro-acupuncture given during general anaesthesia with sevoflurane failed to reduce but instead increased the clinical need for anaesthetic gas, possibly by reducing the anaesthetic effect of sevoflurane and/or by facilitating nociceptive transmission and/or reflex activity

Validation of the Danish Version of the Fibromyalgia Impact Questionnaire Revised

Simon Stockmann Poulsen,1 Hanne Irene Jensen,1,2 Karin Due Bruun,3,4 Morten Rune Blichfeldt-Eckhardt,1,3,4 Nina Kvorning1,5 1Department of Anesthesia, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark; 2Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; 3Pain Center of Southern Denmark, Odense University Hospital, Odense, Denmark; 4Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 5Department of Anesthesia and Intensive Care, Hospital of Nykøbing Falster, Nykøbing Falster, DenmarkCorrespondence: Nina Kvorning, Department of Anesthesia and Intensive Care, Slagelse Hospital, Fælledvej 11, Slagelse, DK, 4200, Denmark, Tel +45 51919022, Fax +45 65413028, Email [email protected]: Increasing recognition of chronic pain diseases, including Fibromyalgia, warrants the need for tools to monitor the impact of the disease as well as the efficacy of interventions. The Revised Fibromyalgia Impact Questionnaire (FIQR) has previously proved to be a valuable tool in both clinical and research settings. The study objective was to translate and validate the FIQR in Danish.Patients and Methods: A forward/backward translation, following the WHO-guidelines, was used to develop the Danish version of FIQR. The Danish translation of FIQR was answered by 101 patients suffering from fibromyalgia. The patients simultaneously answered the Hospital Anxiety and Depression Scale (HADS) and the 36-Item Short-Form Health Survey (SF-36) for validation.Results: The Danish FIQR showed excellent internal consistency, and reliability with Interclass Correlation Coefficients above 0.9. The correlations to HADS and SF-36 ranged from fair to very good. All results were found to have a p-value < 0.05.Conclusion: The present version of the Danish FIQR presents a valid and reliable tool for monitoring the impact of fibromyalgia.Keywords: fibromyalgia, questionnaire, chronic pain, evaluation, validation, translatio

Effect of static and dynamic stretching during a full warm-up on athletic performance in athletes

Introduction: Significant evidence indicates that static muscle stretching can acutely reduce muscle force/power production whilst dynamic stretching may increase it. However, study designs have not been appropriate in the majority of studies to determine whether muscle stretching affects performance when it is performed within a full, sports-specific warm-up (Behm et al. 2016). We aimed to determine the effects of static and dynamic stretching during a ’sport-specific warm-up” on running, jumping, agility and flexibility performances in athletes. Methods: Twenty men competing in running-based sports completed a familiarization and four weekly testing sessions. Using a randomized, cross-over design the subjects performed 5-s static passive stretches of lower limb muscles, 3x10-s static stretches, dynamic stretches (5 reps/leg, identical body positions to static stretches) or a non-stretch control condition within a warm-up (5-min general warm-up before stretch, and test-specific, progressive warm-up including maximal efforts after stretch). Researchers were blinded to the warm-up condition, and subjects nominated which condition they believed would yield best performance before the study (subject-level bias) as well as their perception of ‘preparedness’ (1-10 scale) after each warm-up condition. Results: Eighteen of 20 subjects believed that dynamic stretching would yield best performances, however no between-condition differences (p=0.23-0.99) were detected in: (1) 5 m, 20 m or 10-20 m sprint times, (2) squat, countermovement or 3-step running jump heights, or (3) agility T-test time. Magnitude-based inference statistics showed a high likelihood of ‘trivial’ changes. Small and equal post-warm-up increases in sit-and-reach flexibility (1.9-2.4 cm, p5.2/10) for testing when some stretching was performed (no stretch=3.9/10), with no differences between conditions. Discussion: No stretch-specific effect on performance was observed when a warm-up protocol that included low-intensity exercise before muscle stretching was followed by a progressive, test-specific warm-up to maximum exercise intensity in athletes. Thus, although subjects felt better prepared for exercise, short- (5 s) or moderate-duration (30 s) static stretching or dynamic stretching had no group-level effect on performance when used in a full warm-up. Subject belief (i.e. subject-level bias) also did not influence test performances. Based on current and previous data, and contradictory to (some) current recommendations, muscle stretching appears not to influence physical performance when used as part of a full ’sport-specific warm-up’ in athletes. Reference Behm D., Blazevich AJ., Kay AD., McHugh M. (2016). Appl Physiol Nutr Metab, 41, 1-11. Contact [email protected]

Pregnancy-related pelvic girdle pain: an update

A large number of scientists from a wide range of medical and surgical disciplines have reported on the existence and characteristics of the clinical syndrome of pelvic girdle pain during or after pregnancy. This syndrome refers to a musculoskeletal type of persistent pain localised at the anterior and/or posterior aspect of the pelvic ring. The pain may radiate across the hip joint and the thigh bones. The symptoms may begin either during the first trimester of pregnancy, at labour or even during the postpartum period. The physiological processes characterising this clinical entity remain obscure. In this review, the definition and epidemiology, as well as a proposed diagnostic algorithm and treatment options, are presented. Ongoing research is desirable to establish clear management strategies that are based on the pathophysiologic mechanisms responsible for the escalation of the syndrome's symptoms to a fraction of the population of pregnant women

Specific heat of 2D interacting Majorana fermions from holography

Majorana fermions are a fascinating medium for discovering new phases of matter. However, the standard analytical tools are very limited in probing the non-perturbative aspects of interacting Majoranas in more than one dimensions. Here, we employ the holographic correspondence to determine the specific heat of a two-dimensional interacting gapless Majorana system. To perform our analysis we first describe the interactions in terms of a pseudo-scalar torsion field. We then allow fluctuations in the background curvature thus identifying our model with a (2 + 1)-dimensional Anti-de Sitter (AdS) geometry with torsion. By employing the AdS/CFT correspondence, we show that the interacting model is dual to a (1 + 1)-dimensional conformal field theory (CFT) with central charge that depends on the interaction coupling. This non-perturbative result enables us to determine the effect interactions have in the specific heat of the system at the zero temperature limit

Acupuncture facilitates neuromuscular and oculomotor responses to skin incision with no influence on auditory evoked potentials under sevoflurane anaesthesia.

Background: More sevoflurane was recently found to be required to prevent movement in response to surgical incision in anaesthetized patients subjected to electro-acupuncture (EA) than to sham procedures. The present study was designed to compare differences in movement, dilatation of the pupils, divergence of the eye axes and activity of auditory evoked potentials (AEPs) between patients given and those not given EA under standardized sevoflurane anaesthesia. Methods: Neuromuscular, oculomotor and AEP responses to skin incision were assessed with and without a bilateral 2-Hz burst EA in patients under steady-state anaesthesia maintained with 1.8% of sevoflurane. Forty-five healthy patients, scheduled for laparoscopic sterilization, were randomized for EA (n = 22) or sham (n = 23) procedures between induction of anaesthesia and start of surgery. Middle latency AEP activity was recorded and interpreted by the A-line ARX (autoregression with exogenous input) index (AAI). Results: More acupuncture than sham patients were found to respond to skin incision with movement of the neck or limbs (77% vs. 43%; P = 0.021), dilatation of the pupils (77% vs. 39%; P = 0.001) and divergence of the eye axes (72% vs. 39%; P = 0.023), whereas there was no difference in AAI response. Conclusion: Electro-acupuncture facilitates physiological responses to nociceptive stimulation under sevoflurane anaesthesia. Differences in neuromuscular and oculomotor responses between acupuncture and sham patients under general anaesthesia are probably not associated with interaction between EA and the depth of anaesthesia, as AEP activity was similar in the two groups