Search

Background: Fibromyalgia (FM) is a multifunctional chronic musculoskeletal pain condition characterised by sensory hypersensitivity. Photobiomodulation (PBM) has shown a positive impact on relieving pain; however, no studies to our knowledge have analysed a whole-body PBM intervention in subjects with FM. The aims of the study were to compare the effects of whole-body PBM with placebo PBM on pain, functionality and psychological symptoms in patients suffering from FM. Methods: Forty-two subjects were recruited from a private care practice. The design of the study is a randomised, triple-blinded, placebocontrolled clinical trial. Participants received 12 treatment sessions. Pain, quality of life, level of physical activity and psychological factors were assessed at baseline (T0), after session 6 (T1), after treatment (T2) and at 2-week (T3) followup. Results: There were statistically significant differences in pain at 4 weeks (p B 0.001) (T2) and the 2-week follow-up (T3) (p B 0.001). In relation to the quality of life, there were statistically significant improvements after session 6 (p B 0.001) (T1), immediately after treatment (p B 0.001) (T2) and at the 2-week (T3) follow-up (p B 0.001). Kinesiophobia presented significant differences between groups immediately after treatment (p B 0.001) (T2) and at the 2-week (T3) follow-up (p B 0.001), with self-efficacy only showing significant differences between groups 2 weeks after the treatment (p = 0.01) (T2). There were no differences between groups when comparing pain catastrophising at any time. Conclusion: Whole-body PBM resulted in a significant reduction in pain and an improvement in quality of life in those participants suffering from FM after receiving 4 weeks of treatment. Furthermore, psychological factors such as kinesiophobia and self-efficacy were also improved. Thus, a whole-body PBM treatment is presented as a possible new multifactorial treatment with potential benefits for those with FM and more studies are needed to corroborate our findings.

To identify and summarize the evidence on the cost-effectiveness of photobiomodulation (PBM) therapy for the prevention and treatment of cancer treatment-related toxicities. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE). Scopus, MEDLINE/PubMed, and Embase were searched electronically. A total of 1490 studies were identified, and after a two-step review, 4 articles met the inclusion criteria. The included studies analyzed the cost-effectiveness of PBM therapy used in the context of lymphedema for breast cancer and oral mucositis (OM) induced by chemotherapy and radiotherapy. Better outcomes were associated with PBM therapy. The incremental cost-effectiveness ratio ranged from 3050.75 USD to 5592.10 USD per grade 3–4 OM case prevented. PBM therapy cost 21.47 USD per percentage point reduction in lymphedema in comparison with 80.51 USD for manual lymph drainage and physical therapy. There is limited evidence that PBM therapy is cost-effective in the prevention and treatment of specific cancer treatment-related toxicities, namely, OM and breast cancer-related lymphedema. Studies may have underreported the benefits due to a lack of a comprehensive cost evaluation. This suggests a wider acceptance of PBM therapy at cancer treatment centers, which has thus far been limited by the number of robust clinical studies that demonstrate cost-effectiveness for the prevention and treatment of toxicities.

Background: The development of an integral and global treatment to improve the quality of life in those with fibromyalgia syndrome (FMS) is challenging.Methods: This study is a randomized, placebo-controlled clinical trial. Participants will be recruited in a private care practice and randomized to receive either a whole body Photobiomodulation (PBM) therapy program or placebo. Primary out comes will be pain (NumericPain Rating Scale; Widespread Pain Index; Symptom Severity Score), functionality (Fibromyalgia Impact Questionnaire; The Leisure Time Physical Activity Instrument), quality of soft tissue (elastography) and central sensitisation (pain pressure threshold and the Autonomic Symptom Profile). Secondary outcomes will be psychological factors (Pain Catastrophising scale, Tampa Scale, Self-Efficay questionnaire). Assessments will be at baseline (T1), after session 6 (T2), after treatment (T3) and 2 weeks (T4), 3 (T5) and 6 (T6) month´ follow-up.Discussion: PBM therapy has been shown to reduce pain and inflammation and to increase the rate of tissue repair for a wide range of conditions, but its potential use as a whole body treatment in FM is yet to be explored. This trial will investigate whether whole body PBM therapy is effective at reducing pain intensity, improving functionality, quality of soft tissue, central sensitisation symptoms and psychological measurements. Furthermore, 3 and 6 months follow up will investigate long-term efficacy of this treatment.Trial registration: NCT04248972. Registered on January 29, 2020, https://clinicaltrials.gov/ct2/show/NCT04248972?term=navarro-ledesma+santiago&draw=2&rank=2.

To identify and summarize the evidence on the cost-effectiveness of photobiomodulation (PBM) therapy for the prevention and treatment of cancer treatment-related toxicities.This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE). Scopus, MEDLINE/PubMed, and Embase were searched electronically.A total of 1490 studies were identified, and after a two-step review, 4 articles met the inclusion criteria. The included studies analyzed the cost-effectiveness of PBM therapy used in the context of lymphedema for breast cancer and oral mucositis (OM) induced by chemotherapy and radiotherapy. Better outcomes were associated with PBM therapy. The incremental cost-effectiveness ratio ranged from 3050.75 USD to 5592.10 USD per grade 3-4 OM case prevented. PBM therapy cost 21.47 USD per percentage point reduction in lymphedema in comparison with 80.51 USD for manual lymph drainage and physical therapy.There is limited evidence that PBM therapy is cost-effective in the prevention and treatment of specific cancer treatment-related toxicities, namely, OM and breast cancer-related lymphedema. Studies may have underreported the benefits due to a lack of a comprehensive cost evaluation. This suggests a wider acceptance of PBM therapy at cancer treatment centers, which has thus far been limited by the number of robust clinical studies that demonstrate cost-effectiveness for the prevention and treatment of toxicities.

INTRODUCTION The causative factor leading to venous ulceration appears to be the laying down of fibrin around the dermal capillaries, which reduces oxygenation to the tissues resulting in local ischemia and tissue damage. The onset of ulceration is characterised by pigmentation of the skin, dilated subdermal venulesand induration of the subcutaneous tissue. It is therefore apparent that the slightest injury to the fragile tissue will lead to ulceration.

John Hamwee. Published by Singing Dragon, Jessica Kingsley, 2012, £12.99. Paperback, pp 160. ISBN: 978-1-84819-102-0. eISBN: 978-0-85701-083-4. Listen to patients’ stories. Treat them as friends. They may need a dose of the strongest drug of all: the doctor. Michael Balint, Hungarian psychoanalyst, 1957 ![Graphic][1] Having been in clinical practice for a few years, it is inevitable that some of the simple joys of the profession are lost in the midst of the job. Our time is spent just keeping ahead of developments and new ideas, managing an ever-increasing workload, targets and demands, and managing the clinical conundrums presented in every day practice by our patients. Little time is left to reflect over the more enjoyable aspects of our careers, namely the contact we have with people and the privileged position this affords us, in all walks of medicine. Although this book is targeted at those setting out in the clinical practice of acupuncture only, much can be gleaned from its pages for those in all areas of medicine, not just acupuncturists. The author, an experienced acupuncturist, has written this book to try and alleviate some of the worries and teething problems that may … [1]: /embed/inline-graphic-1.gif

Integrating East Asian medicine into contemporary healthcare Edited Volker Scheid Hugh MacPherson. Published by Elsevier, 2012. Paperback 244 pp. ISBN 978 0 7020 3021 5 > ‘but health is whatever works/and for as long…’ > > John Stone ‘He Makes a House Call’ Although Western medical acupuncture (WMA) is based on a more ‘mainstream’ biomedical approach to diagnosis and management of a problem, there are still some obvious overlaps with traditional Chinese medicine (TCM). Take for example, the nomenclature of specific points and meridians, used in both WMA and TCM, which allows us to record treatment plans identifying previously needled points for future reference, which would be understood by either practitioner. The concept of qi is also used in both WMA and TCM. However, digging deeper there appear to be few further similarities between the two, with many of the TCM concepts of diagnosis and management of a problem being somewhat of an enigma, without the appropriate training and experience. Is it possible to merge the two, to obtain the best of both worlds? Are they really so different? What are the potential benefits and pitfalls? Is it just about integrating TCM into Western medicine, or evolving TCM into a more modern version of itself by and for its own practitioners? With a book titled Integrating East Asian Medicine into Contemporary Healthcare …

Clinical research in complementary and integrative medicine: a practical training book Claudia M Witt, Klaus Linde. Published by Elsevier, Munich, September 2011, £53.99. ISBN: 978-0-7020-3476-3. > “Somewhere, something incredible is waiting to be known.” Dr Carl Sagan, American astronomer, writer and scientist. 1934–1996 Planning and managing a research project can seem like a daunting undertaking, especially as we have little exposure to the techniques required for success during our professional training. It would be tempting to leave the research to those who find their career paths progressing into the world of laboratories and clinical trials. This seems a shame as there may be many of us who could provide interesting and important contributions, if we had a little help to start us off! With rising use of complementary and alternative treatments by the public, and little in the way of good clinical evidence to support, or indeed, fund it, it seems like a good time to encourage more professionals and practitioners to discover their ‘inner scientist’, and learn the art of a conducting a good and fruitful research project. So where do we start? Clinical Research In Complementary and Integrative Medicine, A Practical Training Book (CM Witt, K Linde) is a book written for this very purpose. The authors are experienced researchers, and having also established their own summer research training course in 2007, are ideally placed to educate us on this subject. This is neatly done in a …

Acupuncture pocketbook: point location Christopher M. Norris. 2nd Edition. Published by Norris Associates, 2011. ISBN 9780955012. Beginning to practice acupuncture may at times be overwhelming with so many points to remember. The anatomical positions of over 380 classical acupuncture points would be challenging for a fair few of us to keep at the forefront of our memory, especially those which are used less frequently. How helpful to have such a book available to provide an aide memoire! Christopher Norris is obviously an experienced practitioner given his role as approved tutor for the Acupuncture Association of Chartered Physiotherapists, and his position on the British Acupuncture Council. He has written a book, now in its second edition, to provide a handy reference for other practitioners. Although slightly larger than the average pocket, this is a neat, portable light weight book which is helpful for those requiring a little help with remembering …

Current therapy for condylomata acuminata (genital warts) is not consistently effective. Therefore, we conducted a randomized, double-blind trial to compare interferon alpha-2b with placebo in the treatment of this disorder. Our rationale was that interferon has both antiproliferative and antiviral properties. The placebo or interferon (1 X 10(6) IU) was injected directly into one to three warts three times weekly for three weeks. The injections were well tolerated by both groups of patients. The side effects of fever, chills, myalgia, headache, fatigue, and leukopenia occurred more commonly in the interferon group than in the placebo group, but such effects rarely disrupted daily routines. Only 13 of 296 patients (4 percent) discontinued therapy because of side effects (11 in the interferon group and 2 in the placebo group). Twenty-six other patients were excluded from analysis because of a loss to follow-up or other deviations from protocol, thus leaving 257 patients in the final evaluation. At one week after the completion of therapy, interferon had produced a large and significantly greater reduction in mean wart area (a 62.4 percent decrease), as compared with placebo (a 1.2 percent increase in mean area) (P less than 0.001). At the conclusion of the study (13 weeks after the completion of therapy), the mean wart area was still decreased 39.9 percent below the initial size in the interferon group, whereas it had increased by 46 percent over base-line measurements in the placebo group (P less than 0.001). At the same time, all treated warts had completely cleared in 36 percent of the interferon recipients and in 17 percent of the placebo recipients (P less than 0.001), whereas treated warts progressed in 13 percent of the interferon recipients and in 50 percent of the placebo recipients (P less than 0.001). We conclude that injection of interferon alpha-2b directly into genital warts appears to be an effective and fairly well-tolerated form of therapy.

Multiple gastric biopsies and gastric juice aspirates were taken in 108 patients undergoing routine or review gastroscopy for a variety of upper gastrointestinal disorders. The gastric juice was measured for free and total bile acids and the biopsies examined for premalignant mucosal changes. Total bile acid levels were significantly higher in patients with atrophic gastritis, intestinal metaplasia and dysplasia but not chronic gastritis. There was no correlation between the severity of the dysplasia and total bile acid levels. Free bile acid levels were significantly higher in patients with atrophic gastritis but not in patients with chronic gastritis, intestinal metaplasia or dysplasia. These results suggest that intragastric bile acids may be implicated in premalignant histological changes of gastric mucosa and thus play a part in gastric carcinogenesis.