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Transepidermal water loss (TEWL) is widely used to assess and quantify skin insensible water loss to assess skin's barrier function integrity. Low TEWL values are normally indicative of intact skin and a healthy functional barrier, whereas an increased TEWL reveals a disturbed or disrupted skin barrier. Because most skin sites at which these measurements are made have eccrine glands present, the contribution of the sweat gland activity to these measurements is variable and, in most cases, unknown. The separation between the contribution of water loss that is reflective of the skin barrier integrity versus that contributed via eccrine activation is not easy and is made more difficult since both components increase with increasing skin and environmental temperature. Endogenous factors that impact eccrine sweat gland activity include sympathetic nervous system activity, emotional stress, physical activity, eccrine gland density, and age. Exogenous factors that impact eccrine gland activity include ambient temperature and humidity and the climate where one resides. The aforementioned variables impact eccrine gland activity positively or negatively and therefore alter TEWL values accordingly. Although it may be theoretically possible to control all these factors, the difficulty in doing so results in only a few being controlled during most TEWL measurements. Such confounding processes may have impacted historical TEWL reference ranges and values previously reported. Thus, the impact of eccrine activation on standardly measured TEWL values is at this juncture unclear and may be a component contributing to some reported variability in TEWL values. To help clarify the issues, a literature review was conducted to investigate and summarize relevant prior research efforts and outcomes with respect to ways to consider eccrine activity in TEWL measurements and estimate the contribution of eccrine gland activity to TEWL values. Online databases such as Excerpta Medica Database (EMBASE), Public/Publisher Medline (PubMed), Elton B. Stephans Company (EBSCO), Google Scholar, and Wiley Online Library were searched with "transepidermal water loss" or "TEWL" in the title combined with "eccrine glands" or "sweat" anywhere in the text. The present findings indicate a multiplicity of biological and environmental variables impacting eccrine gland activity and thereby potentially affecting measured TEWL values. Even if laboratory conditions adhere to various guidelines and recommendations, it is not yet possible to separate the eccrine activation component from the parameter of true interest in the assessment of the skin's physiological barrier function except for full gland deactivation. The amount that such eccrine gland activation impacts the measured value of TEWL is generally not determined using currently available methods and the only sure way to eliminate a confounding effect is to inactivate the glands during such TEWL measurements. Because such eccrine gland deactivating approach is not usually desirable or even possible, other approaches would be recommended. One would be the development of a measuring device that could distinguish between the component of TEWL that is associated with the skin barrier function and the other that is attributable to sweat gland activation. Further research and development along these lines appear warranted.

Thismanuscript focuses on the physiological, environmental, nutritional, circadian, and aging factors affecting skin tissue water and hydration parameters. The literature findings indicate a multiplicity of interacting processes among these parameters, ultimately impacting skin hydration in normal skin and playing a role in conditions such as atopic dermatitis and psoriasis. The maintenance of adequate skin hydration, aided by the proper functioning of the skin's protective barrier, is facilitated by stratum corneum integrity with the presence of tight junctions and lipids such as ceramides, each of which is impacted by changes in most of the evaluated parameters. Abnormalities in aquaporin 3 (AQP3) expression and associated deficits in skin hydration appear to have a role in atopic dermatitis and psoriasis. AQP3 hydration-related aspects are influenced by circadian rhythms via modulations associated with CLOCK genes that alter AQP3 protein expression. Ultraviolet exposure, aging, and low temperatures are among those factors that affect skin ceramide composition, potentially leading to increased transepidermal water loss and negatively impacting skin hydration. Vitamin C, collagen, and probiotics may increase ceramide production and improve skin hydration. The extent to which each of the different evaluated factors affects skin hydration varies but is usually large enough to consider their potential effects when investigating skin in research and clinical settings.

The primary goal of this study was to quantify circumferential (medial, anterior, lateral) and measurement depth variations (0.5 mm, 1.5 mm, 2.5 mm) in tissue dielectric constant (TDC) values as an aid to their use to assess the presence and progression of lower extremity edema and lymphedema. Measurements were done in 30 healthy non-edematous women to provide reference data to estimate expected values and thresholds when evaluating clinical edematous or lymphedematous conditions. A second goal was to determine the extent to which TDC values evaluated at lower leg sites depend on body mass index (BMI). The study protocol (#12180901) was approved by the university's institutional review board and subjects were evaluated after signing an approved informed consent. The study group had an age range of 19-54 years with a mean age and SD of 30.6 ± 10.1 years and had a BMI between 18.1-44.1 Kg/m

The practice of intermittent fasting continues to grow as a widely practiced diet trend due to its feasibility and reported high success rate. By practicing intermittent fasting, levels of sirtuin proteins (SIRTs), also known as the longevity protein, rise in the body and bring numerous health benefits. Currently, seven SIRTs have been described in humans in different locations of the cell with a wide variety of corresponding functions including gene transcription, DNA repair, and protection against oxidative damage. SIRT activators, such as resveratrol found in red wine, are also commonly consumed to amplify the health benefits associated with protection against diabetes and age-related disease processes. The purpose of this review is to explore the interaction of intermittent fasting on SIRT levels and how the increase in these proteins impacts age-related disease processes. The understanding of SIRTs is continuously evolving as more interactions and SIRT-specific activators are being revealed. New discoveries are crucial for forming potential therapeutics that delay many common diseases and promote healthy living.

Cardiovascular disease (CVD) has been a prominent global health challenge in the last decade, and many risk factors and outcomes of CVD have been studied in that timeframe. Recent research has explored the association between sugar-sweetened beverage (SSB) consumption and CVD; however, there is a lack of updated reviews regarding SSB consumption impacts on CVD outcomes and the possible mechanisms affecting the disease state. In turn, this review aims to summarize the relevant published research from the last decade regarding linkages between SSB consumption and CVD outcomes and the potential underlying mechanisms, as well as to highlight opportunities for future exploration with respect to those outcomes and mechanisms. In this review, we searched PubMed, Embase, and Web of Science for peer-reviewed articles published from January 2012 to March 2022 regarding SSB consumption and its association with CVD. The results of our search reveal strong evidence that the consumption of SSB is positively associated with increased risks of CVD and that the magnitude of that risk is increased in a dose-dependent manner. These increased risks range from elevated triglyceride levels to inclined risk of CVD-related mortality. Although the depth of the mechanisms responsible for these increased risks have been less explored thus far, there is some evidence supporting SSB implications in cardiovascular factors, including vascular function, coronary artery calcification, triglyceride levels, inflammatory processes, arterial stiffness, and genetic polymorphisms.

Tissue dielectric constant (TDC) measurements are a convenient, reliable, and accurate way to noninvasively access local tissue water content and its change with time or treatment. The method has been widely used for upper extremity lymphedema assessments but less so for lower extremities. For lower extremity assessments, it would be useful to have an estimate of the expected inter-leg TDC differentials of normal non-affected legs to help interpret measured inter-leg differentials when such measurements are done in patients with lower extremity edema or lymphedema. The goals of this study were to determine normal inter-leg TDC differences, quantify TDC temporal changes during 60 minutes of supine lying in a group of 10 middle-aged women (42-57 years), and evaluate the change in TDC values as measured throughout the day from 0800 to 2000 hours in a group of 10 younger women (23-28 years). The overall findings indicate that TDC measurements, as an assessment parameter of lower extremity localized skin-to-fat tissue water, are only minimally dependent on potential confounding factors such as 60-minute supine lying or the time of day at which the measurements are made. If the small sample size of the present study is reflective of the larger population, an inter-leg TDC ratio exceeding a value of 1.2 is suggested as a threshold for judging unilateral lower extremity edema or lymphedema. This possibility needs assessment in women with these conditions.

Anthropometric indices are used as predictors of cardiovascular disease (CVD). The most used indices are body mass index (BMI) and waist circumference (WC); however, there are limitations regarding their validity to address different body shapes, fat and lean mass distribution. A body shape index (ABSI) has been proposed as an alternative parameter to reflect differences in body shape and potentially be more useful for predicting CVD. ABSI is calculated by ABSI = WC / (BMIThe sample population was from the baseline interview and health examination included in the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Patients (n=5,924, 52% female) were aged 18-80 years (47.4 ± 18.4 years) who completed a series of questionnaires on a spectrum of health-related risks. After the interview, health technicians performed a standardized examination of the participants to collect data on weight, height, BMI, WC, and sagittal abdominal diameter (SAD). Statistical analysis was done using R Studio, version 0.99.903 (RStudio, Inc. Boston, MA). Using logistic regression, the correlation between each predictor (ABSI, BMI, WC, SAD) as a continuous variable, and CVD outcomes was evaluated with two models: a univariable model and a multivariable model. In a secondary analysis, ABSI was reclassified into categorical values based on quartiles of the NHANES dataset. Logistic regressions were again run for overall CVD and all CVD sub-categories, followed by chi-square tests for significance. For comparison, BMI categories of normal, overweight, obese, and severely obese were tested with overall CVD and all CVD subcategories as outcome measures, followed by chi-square tests for significance.Approximately 10% of the sample population had at least one prior manifestation of CVD, the most common being myocardial infarction (MI) (4.0%). ABSI showed little correlation with weight, BMI, WC, and SAD (r0.3), while BMI had a strong correlation with weight, BMI, WC, and SAD (r ≈ 0.9). In univariable logistic regression, ABSI showed the most robust associations of all predictors with overall CVD and all CVD subcategories. ABSI demonstrated stronger correlations than BMI for all CVD outcomes (except CHF in the multivariable model). This study attempted to create classifications of ABSI and compare them to the normative classifications of BMI. In this categorical analysis, ABSI was also stronger than BMI in all logistic regression analyses for CVD outcomes, except for CHF in the multivariable model. Severe obesity (BMI ≥40 kg/mAn ABSI parameter in the upper three quartiles increases the risk of CVD manifestations more significantly than an elevated BMI per category of overweight, obese, and severely obese, respectively. Since the categories for ABSI were created based on quartiles of a large sample size reflecting the US population, this suggests that the increased risk from an elevated ABSI is more widespread than previously understood. Thus, ABSI should be monitored more closely and managed in preventative medical care than BMI alone.

Breast edema most commonly occurs after breast cancer treatment involving breast-conserving therapy, although it may have a variety of other causes. As compared to research on breast cancer treatment-related lymphedema, breast edema and its objective measurement and diagnosis is far behind. Consequences of this disparity contribute to uncertainty and variability in its diagnosis, its treatment, and even the characterization of its incidence and morbidity. Moreover, consensus on a standardized definition, objective diagnostic method, and treatment techniques for breast edema has not yet been reached, making it difficult to provide appropriate guidelines with respect to its management. Given the recent rise in breast edema incidence as an outcome of the increasing use of breast-conserving therapy, this timely review examines the current state of breast edema assessment and makes a case for standardization in part via quantitative methods to diagnose and track breast edema.

The use of electromagnetic field therapy (EMFT) is a non-invasive, potential alternative or complementary choice in the treatment of wounds, chronic pain, neuropathy, and other medical conditions, including tissue repair and cell proliferation. Static magnetic fields (SMFs) have been reported to increase microcirculatory blood flow by mediating vasodilation via nitric oxide. Studies report that SMF exposure causes homeostatic, normalizing effects on the vascular tone that may have beneficial effects in situations where tissue perfusion is limited, such as may be present in diabetes. Pulsed electromagnetic fields (PEMFs) have also shown promise in treating diabetic wounds by improving wound healing rates and other attributes. Our purpose was to critically review prior applications of EMFT for relevancy and effectiveness in treating diabetic complications. The goal was to provide information to allow for informed decisions on the possible use of these modalities in the treatment of persons with diabetic complications. The focus was on the following major areas: wound healing, neuropathy, blood glucose control, blood flow, inflammation and oxidative stress.

Fluid retention is common in patients with heart failure (HF) and diuretics are a major source of management and stabilization. Diuretic resistance (DR) is defined as a failure to achieve therapeutically desired congestion relief despite using an appropriate diuretic dose. In this study, the underlying mechanisms of DR in HF patients are described and several currently available evidence-based strategies to mitigate this condition are provided. Specific aims were to investigate how DR occurs in patients with HF, how HF medications interfere with diuretic treatment, and what alternative methods are available for patients with DR while undergoing treatment for HF. Results provide several rationales for novel strategies used to help reach a state of euvolemia where there is a proper amount of blood in the circulatory system. These include reducing sodium intake, changing the timing of drug administration, and modifying diuretic dose.

Breast cancer-related lymphedema (BCRL) presents as swelling in the arm, hand, trunk, or breast at varying times after completion of breast cancer treatment. Its reported incidence varies widely in part due to its dependence on the type and extent of the treatment, co-present pre-treatment risk factors, and the criteria used to define its presence. Central to this issue is the quantitative measures that are variously used to specify lymphedema thresholds for its detection and tracking over time and during treatment. The goal of this paper is to discuss these issues and the methods available for the non-invasive quantitative assessment of BCRL. Operational principles and advantages and limitations of the various methods and their clinical history of use and effectiveness are discussed.

Male breast cancer (MBC) is unfamiliar to most men, and its optimal treatment options are not well recognized by many treating physicians. The lack of MBC specific clinical trials contributes to the limitations of understanding MBC specific pathology, treatment options, and outcomes. This state-of-affairs contribute to perpetuating the use of treatment methods derived from our existing knowledge of female breast cancer (FBC). Previous studies demonstrate that men are often undertreated or disproportionately treated using more invasive surgical procedures even in the early stages of MBC. The purpose of this investigation was to thoroughly discuss current MBC treatment options, provide an evidence-based summary of their outcomes, note recent improvements, discuss important considerations and recommendations. Our goal is to aid the treatment decision process for patients and treating physicians.

Background Annually about 280,000 women are diagnosed with breast cancer. Treatment options depend on age, comorbidities, tumor stage, grade, size, and other factors. Often, patients must decide between two surgical treatment options: mastectomy or lumpectomy-with-radiation herein simply called a lumpectomy. Since both offer similar survival outcomes, the choice ultimately is the patient's. However, most rely on inputs from doctors, family, friends, personal research, and other actions. We believe decision-making processes for future patients will be aided if experiences of prior breast cancer survivors are known. This study's aim is to provide such information. Methods Feedback from prior breast cancer survivors was obtained using a 19-question survey distributed online to multiple breast cancer support groups. It focused on issues relevant to choosing between the two surgical options including, post-surgical complications, breast reconstruction, chronic pain, cosmetics, and surgery-choice satisfaction. Results Respondents (N=1606) had a median age of 49 years (range 26 to 88 years) and had a median body mass index (BMI) of 26.6 Kg/m2. There were 978 mastectomy patients (60.9%) and 628 lumpectomy patients (39.1%). With regard to post-surgical reconstruction, 64.2% of mastectomy respondents and 13.5% of lumpectomy respondents decided to undergo breast cancer reconstruction following breast cancer surgery. Almost all (99.8%) of lumpectomy respondents had radiation side-effects; with skin irritation and thickening and chest wall tenderness being the most common. Among mastectomy patients, 94.3% had one or more complications; loss-or-changes in nipple or breast sensation, uneven breasts, chest wall tenderness, and breast swelling were the most common complications. Post-surgical pain lasting six months or more was experienced by a smaller percentage of mastectomy vs. lumpectomy patients (64.1% vs. 78%, p

Radiological procedures utilizing intravenous iodinated contrast agents are being widely utilized for both therapeutic and diagnostic purposes. This has resulted in an increasing incidence of procedure-related, contrast-induced nephropathy (CIN). CIN is commonly defined as a decline in kidney function occurring in a narrow time window after administration of iodinated contrast agents. Although self-limiting in most cases, CIN carries a risk of more permanent renal insufficiency, dialysis, and death. It remains a common and serious complication among at-risk patients after exposure of contrast agents. Therefore, it is important to identify patients who are at risk during early stages to implement preventative strategies to decrease the incidence of CIN. Minimizing the amount of contrast administered and providing adequate hydration are the cornerstones of an effective preventative approach. This review focuses on the basic concepts of CIN and summarizes the current understanding of its pathophysiology. In addition, it provides practical recommendations with respect to CIN prevention and management.

There is some evidence that pulse wave velocity (PWV) is increased in gastrointestinal conditions such as Helicobacter pylori (H. pylori) infections and inflammatory bowel disease (IBD). However, the limited number of well-designed studies and sometimes inconsistent results have yielded more questions than answers highlighting a need for further investigation. The purpose of this review is to clarify the effects of H. pylori infections and IBD on PWV and arterial wall stiffness. The goal is to highlight the extent of the linkage between these gastrointestinal conditions and PWV and to help evaluate the practicality of PWV as a potential clinical diagnostic aid when examining arterial stiffness. PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and Biomedical Reference Collection: Comprehensive were used to search for the full-text English language articles using keywords “pulse wave velocity” combined with either “H. pylori” or “IBD” present anywhere in the abstracts. A total of 59 papers matched the search criteria and were retrieved for evaluation. These were screened based on their relevance and availability of published papers. Full papers were analyzed based on inclusion criteria with a total of 10 articles selected and included in this review. In younger populations, H. pylori seropositivity might play a role in the development of arterial stiffness, as assessed by PWV; while in older populations, the effect of H. pylori on arterial stiffness seems to be minimal, with aging playing a major role in these older patients. PWV does not appear to be an accurate parameter to assess arterial stiffness in older patients with H. pylori. On the other hand, PWV might be useful to assess the efficacy of anti-tumor necrosis factor-alpha (anti-TNF-alpha) immunotherapy in reducing the degree of arterial stiffness caused by inflammation in patients with IBD.

Cardiovascular disease (CVD) is currently the leading cause of death worldwide. Although many well-known conditions cause CVD, recent research has suggested that alterations to the gut microbiome may also promote CVD. The gastrointestinal tract houses trillions of bacteria, some of which in large numbers are considered to be part of a healthy gut microbiome profile. These “good” bacteria have the ability to process and digest complex carbohydrates into short-chain fatty acids (SFCA). These SCFA serve as signaling molecules, immune-modulating molecules, and sources of energy. However, with gut dysbiosis, there is an overgrowth of certain bacteria and these bacteria overly produce phosphatidylcholine, choline, and carnitine into the waste product trimethylamine-N-oxide (TMAO). Elevated TMAO levels are associated with an increased risk of atherosclerosis, myocardial infarction, thrombosis, and stroke. Therefore, introducing therapeutic interventions that alter a dysbiotic gut profile back to a healthy gut microbiome may be the key to reducing the incidence of cardiovascular disease in some conditions. The purpose of this review is to critically examine and consolidate the relevant information bearing on this concept. Our goal is to provide the informational framework for the possible use of microbiome modification as an optional therapeutic modality.

Melasma is a benign yet psychologically debilitating skin condition that is prevalent among women of darker phenotypes, and particularly in Asian women. This potentially preventable condition can lead to skin discoloration that is hard to treat and can frequently recur. This review aims to (1) highlight the pathophysiology of melasma, (2) describe its important risk factors, and (3) identify prevention methods, available treatment options, and potential complications of melasma. By raising awareness of this condition, we hope that physicians and patients will be able to be better informed to discuss screening options and to avoid preventable risk factors, especially in patients who are predisposed to the disease.

Background Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder of pregnancy. It occurs when bile flow from the liver is obstructed, causing bile acid to accumulate. ICP usually presents with itching that lasts for the remainder of pregnancy. Untreated ICP has been shown to increase the incidence of adverse outcomes for the baby, including respiratory distress, meconium aspiration, neonatal intensive care unit hospitalization, and stillbirth. The probability of these events increases when bile acid levels are greater than 40 mmol/L. The current standard of care for ICP patients is a combination of ursodeoxycholic acid by mouth and early delivery, as the risk of stillbirth due to ICP increases in the last weeks of pregnancy. ICP has been linked to preeclampsia and gestational diabetes; studies have shown that the occurrence of both diseases is greater when the baby is male. The purpose of this study was to investigate if the occurrence, timing of diagnosis, peak bile acid levels, or severity of itching is dependent on the baby's sex in mothers who had ICP. Methods An online question-set (survey) was offered to women who had had ICP and were members of three different online support groups. Results A total of 1,502 women responded for a total of 2,289 documented ICP pregnancies, in which there were 1,059 female babies and 1,230 male babies. Based on chi-square analysis of differences in frequencies, no difference was found between pregnancies with male versus female babies regarding the occurrence, timing of diagnosis, peak bile acid levels, or severity of itching in the evaluated population. However, surprisingly, the findings revealed that first-trimester diagnosis of ICP was made in 5.6% of the pregnancies, and there were 30 (1.8%) cases of ICP diagnosed in the absence of itching. Conclusions The findings suggest that the baby's sex does not impact the occurrence, timing of diagnosis, peak bile acid levels, or itch severity in ICP. The findings that 5.6% of the ICP pregnancies in the present study were diagnosed in the first trimester and 1.8% were diagnosed without the presence of itching reinforce the need to investigate these less common presentations. More studies are needed to determine if these findings are consistent across other populations.

Background E-cigarette use, or vaping, is known to be associated with potentially life-threatening lung injury, with the Centers for Disease Control and Prevention reporting 2,807 hospitalizations and 68 deaths in the United States due to e-cigarette or vaping-associated lung injury. Vaping is also a risk factor for and is implicated in the spreading of COVID-19. Despite the consequences of vaping, the views and training of medical students regarding vaping is unclear. This study sought to investigate the knowledge and perception of vaping amongst future health care providers. Methods An anonymous, online survey was administered to 259 first through fourth year medical students at Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine via a secure website link in October 2019 and January 2020. The survey consisted of two sections. All participants answered section one, involving nine questions. This first section addressed sociodemographic characteristics, personal views on vaping, rating and impact of vaping medical education, and whether students had ever tried vaping. If students had ever vaped, they proceeded to section two of the survey including nine additional questions. Students that reported no past vaping use ended the survey and did not proceed to section two. Section two focused on evaluating vaping habits of users by questioning age of first usage, use frequency and nature, reasons for first trying and/or continuing to use, plans for quitting, personal impact of use, and current use. Data was analyzed with frequency and percentage distributions. Results Most respondents were of age 18-25 years (66.8%) and female (60.2%). Almost all students (96.5%) were aware of the negative health consequences of vaping. More than two thirds of students (68.7%) rated their vaping medical education as inadequate and the majority (76.1%) indicated their medical school curriculum did not impact their view on the matter. Most students (71.0%) reported a more negative stance on vaping due to recent news and media. Of the respondents, over two thirds (37.5%) vaped at least once and were labeled "vapers." The most commonly stated reason for first trying vaping was recreational (60.8%). Half of vapers (50.5%) admitted to vaping in the past year and most vapers (90.6%) did not think their vaping impacted others. Current vaping use was reported in almost one-third of vapers (32.3%) despite knowing its dangers, and several (6.3%) did not consider vaping dangerous. Conclusion The findings from this pilot study conducted at a single medical school indicate possible deficiencies in vaping education, at least as perceived by the respondents and demonstrated by their vaping-related actions. It is unknown if the stated vaping views and practices of these medical students would be positively impacted by better vaping education or if these practices are generalizable to other students. However, the data suggests there is a need to consider more extensive analyses of medical school curriculums with respect to vaping education and training of students in these and related areas. Recommendations to enhance medical school curriculums include vaping-focused respiratory and gastrointestinal lectures, problem-based case studies on vaping, standardized patient encounters, and a community education program taught by medical students.

Background Based on prior reports of the use of magnets to treat pain, our goal was to determine if a concentric rare-earth alternating-pole magnet reduced period pain versus a sham-magnet. Methods Participants were females (N=36, 18 to 35 years) who regularly experienced menstrual period pain ≥ six on the numeric pain rating scale (NPRS) of 0-10. Subjects were excluded if they took pain medication on the study day or had implanted pacemakers/metallic devices or secondary dysmenorrhea. Participants were randomized to wear a concentric neodymium-iron boron active-magnet (surface-field of 0.4 Tesla) or a sham magnet. The participant and investigator applying the device were blinded to the device used. The device was placed at the abdominal location of the reported greatest pain for 40-minutes, during which time the subject was able to conduct the normal activity. Pain scores were reported prior to device wearing and afterward. Participants with post-treatment NPRS ratings reduced by ≥ 35% from their pretreatment pain ratings were scored as having reduced pain; reductions < 35% were scored as no meaningful pain change. The threshold of 35% was chosen based on a survey of 10 women as to the level of pain reduction they viewed as meaningful to them. Of the 36 women in this pilot study, 19 wore an active-magnet and 17 wore a sham-magnet. Analyses were based on chi-square and Mann-Whitney statistical tests. Results Pre-treatment pain scores (mean ± SD) were similar for both groups. Magnet-vs-sham pre-treatment scores were, respectively, 7.16 ± 0.85 vs. 6.94 ± 1.20 (p=0.330). Corresponding median values for the magnet (N=19) and sham (N=17) groups respectively were seven pre-treatment and four post-treatment vs. six pre-treatment and six post-treatment. Post-treatment scores for magnet treated subjects (4.16 ± 2.20) were significantly less (p=0.027) than for sham-treated (5.53 ± 1.50). Of the 19 who wore a magnet, 11 experienced meaningful pain-reduction, and eight did not. Of the 17 who wore a sham, three experienced meaningful pain-reduction, and 14 did not. Magnet and sham wearing responses were statistically significant via chi-square analysis (chi-square=6.12, p=0.013). Percentage reduction in pain score was 41.8% ± 31.1% for magnet-treated vs. 20.8% ± 16.1%, for sham-treated (p