Efficacy of acupuncture in the treatment of chronic neck pain

Bu çalışmanın amacı kronik boyun ağrılı hastalarda akupunktur ve plasebo akupunkturun etkinliğini karşılaştırmaktı. Çalışma tasarımı: Prospektif, randomize kontrollü olarak yapılan çalışmaya 30 kronik boyun ağrılı hasta alındı. 15 hastaya geleneksel akupunktur, 15 hastaya yüzeyel plasebo akupunktur 20 dakika süreyle, haftada 2 seans toplam 8 seans uygulandı. Hastalar tedavi öncesi, tedavi sonrası ve tedavi bitiminden 1 ay sonra ağrı ve fonksiyonel durum yönünden Vizüel Analog Skala (VAS) ile değerlendirilerek karşılaştırıldı. Bulgular: Ağrı şiddeti yönünden hem akupunktur hem de plasebo aku- punktur grubunda tedavi öncesi-tedavi sonrası, tedavi öncesi-bir ay sonraki kontrol karşılaştırmalarında anlamlı iyileşme elde edildi. (p<0.001). Tedavi sonrası-bir ay sonraki kontrol karşılaştırmalarda ise akupunktur grubunda anlamlı farklılık saptandı (p<0.05). Plasebo aku- punktur grubunda ise anlamlı farklılık bulunmadı. Fonksiyonel kapasite yönünden karşılaştırıldığında hem akupunktur hem de plasebo aku- punktur grubunda tedavi öncesi-tedavi sonrası, tedavi öncesi-bir ay sonraki 'kontrol karşılaştırılmalarında anlamlı iyileşme elde edildi. (Aku- punktur grubunda p<0.001, Plasebo Akupunktur grubunda p<0.05). Tedavi sonrası-bir ay sonraki kontrol karşılaştırmalarında ise her iki grupta da anlamlı fark saptanmadı. Akupunktur ile plasebo akupunktur ağrı şiddeti ve fonksiyonel kapasite yönünden karşılaştırıldığında her üç karşılaştırmada da anlamlı farklılık bulunmadı. Sonuç: Çalışmamızda kronik boyun ağrısında akupunktur ve plasebo akupunkturun etkinliği arasında anlamlı farklılık bulunmadı. Bu konuda metodolojik kalitesi yüksek, geniş hasta gruplarını kapsayan randomize kontrollü çalışmalar? gereksinim vardır.Objectives: To compare the efficacy of acupuncture and placebo acupuncture in patients with mechanical chronic neck pain. Studydeslng: Thirty patients with chronic neck pain were randomiyal located into acupuncture and placebo acupuncture groups. Fifteen patients were treated with traditional acupuncture and 15 patients with placebo acupunture tor 20 minutes, twice a week of, total 8 sessions. Both groups were evaluated and compared lor pain and functional status before, at the end of treatment and &ouml;ne month after treatment. Pain and functional status were evaluated with Visual Analogue Scale (VAS). Results: Pain scores ofboth groups atbaseline and posttreatment, at baseline and &ouml;ne month after treatment showed significant difference (p&lt;0.001). Posttreatment and &ouml;ne month after treatment showed significant difference in acupunture group. VVhereas there was no significant difference in the placebo acupuncture group. The functional status scores of both acupuncture and placebo acupuncture group at baseline and posttreatment, at baseline and &ouml;ne month after treatment showed significant difference (p&lt;0.001 in acupuncture group, p&lt;0.05 in place-bo acupuncture group). Both acupuncture group and placebo group at posttreatment and one month after treatment did not show significant difference. When acupuncture group was compared with placebo acupuncture group according to pain and functional status, no significant difference was found. Conclusions: No significant difference mas found between efficacy of acupuncture and placebo acupuncture tor the treatment of chronic neck pain. Further randomized, controlled, high methodologic quality trials are needed

The comparison of the efficacy aerobic exercises versus strengthening, stretching and mobilization exercises in subacute and chronic low back pain

The aim of this study was to investigate and compare the efficacy of aerobic exercises versus strengthening, stretching and mobilization exercises in patients with subacute or chronic low back pain. Forty patients were recruited for the study and randomly allocated to two groups. All patients were evaluated at admission, mid-treatment and termination of the program by visual analog scale (VAS), face scale, weekly analgesic intake and Million visual analog scale for pain. They were also scored by Roland-Morris scale and Oswestry scale for functional impairment. Beck depression inventory was used to evaluate depression and lumbar range of motion was measured by inclinometry, Schober, finger tip to floor distance. The aerobic exercise group was also evaluated for VO2max and anaerobic threshold levels. Both groups showed significant improvement in all parameters at termination. Comparison between groups showed a higher significant improvement in depression and functional improvement parameters in the group given strengthening, stretching and mobilization exercises by physiatrist

Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis, knee osteoarthritis and fibromyalgia syndrome

WOS: 000248905700004PubMed: 17910141Objective: To measure the effects of depression and anxiety on quality of life (QoL) in patients with rheumatoid arthritis (RA), knee osteoarthritis (OA) andfibromyalgia syndrome (FMS). Methods: One hundred and fifty-four patients with RA, knee OA, and FMS who presented to the physical medicine and rehabilitation department were studied For evaluation of the patients, Beck depression scale, Beck anxiety scale, and Short Form-36 were used. Results: Twenty-two per cent ofpatients (n = 34) were diagnosed with of RA, 52.6% (n = 81) knee OA and 25.3% (n = 39) FMS. Except for the subscales, of physical and emotional role, there were statistically significant differences among diagnostic groups in the rest of the SF-36 subscales. In the physical functioning subscale, the highest score was obtained in the fibromyalgia group and the lowest in the RA group (p < 0.001). However in the bodily pain subscale, the lowest score was recorded in the fibromyalgia group (p = 0.019). In all diagnostic groups, the scores of SF-36 subscales were significantly low in patients who scored above the threshold value of Beck depression scale (p < 0.001). A strong negative correlation was detected between scores of Beck anxiety scale and the scores of all SF-36 subscales in patients with RA and knee OA. On the other hand, in patients with FMS, anxiety scores correlated negatively with only physical and somatic function scores of SF-36. Conclusion: Quality of life is significantly low in patients with RA, knee OA and FMS, whose depression and/or anxiety scores are high. Therefore, these patients should be managed using a multidisciplinary approach including psychiatric support

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (&gt; 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72&nbsp;h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide