Mehrnoosh Zakerkish, Davood Raeisi, Shahram Rafie, Mohammad Jafar Shaterzadeh Yazdi, Zahra Kosarian, Shirin Rahimzadeh Telegrafchi and Saeed Hesam
Background and aims: Diabetic peripheral neuropathic pain (DPNP) is one of the most common complications of diabetes and is difficult to treat. Existing treatments are often inadequate at controlling pain and limited by side-effects and drug tolerance. This study assessed the efficacy of nortriptyline versus Transcutaneous Electrical Nerve Stimulation (TENS) in patients with DPNP.
Material and method: This is a randomized clinical trial study conducted on 39 patients with DPNP referring to Golestan Hospital in Ahvaz in 2017. Patients were randomly treated with TENS (18 sessions, each session 30 minutes; n=20) or nortriptyline (25 to 75 mg, once daily; n=19) for 6 weeks. Patients were evaluated for side effects and pain relief using visual analog scale (VAS).
Results: There was a significant improvement in pain with both treatments compared with baseline (p˂0.001). The patients in nortriptyline group experienced more pain relief (7.21±1.51 to 0.84±1.34) than the TENS group (7.6±1.47 to 2.75 ±2.43) (P=0.001). The 50% pain relief was observed in 14 patients (73%) in nortriptyline group, 6 patients (30%) in TENS group. Moreover, the side effects were seen in 15% of TENS and 55% of patients in nortriptyline groups (P=0.019).
Conclusion: Both TENS and nortriptyline were effective and safe in the management of DPNP. But nortriptyline showed a better performance on pain relief.
Luca Coppeta, Luca Di Giampaolo, Stefano Rizza, Ottavia Balbi, Savino Baldi, Antonio Pietroiusti and Andrea Magrini
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Burdelak W, Bukowska A, Krysicka J, Peplonska B. Night work and health status of nurses and midwives. cross-sectional study. Med Pr 63, 517–529, 2012.
Chang YS, Chen HL, Wu YH, Hsu CY, Liu CK, Hsu C. Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study. BMC Psychiatry 14, 218, 2014.
Fatourechi V. Upper limit of normal serum thyroid-stimulating hormone: a moving and now an aging target? J Clin Endocrinol Metab 92, 4560
Dominique Breilh, Patrick M. Honore, David De Bels, Jason A. Roberts, Jean Baptiste Gordien, Catherine Fleureau, Antoine Dewitte, Julien Coquin, Hadrien Rozé, Paul Perez, Rachid Attou, Sebastien Redant, Luc Kugener, Marie-Claude Saux, Herbert D. Spapen, Alexandre Ouattara, Olivier Joannes-Boyau and on behalf of the IVOIRE study group
°C until assayed.
Plasma and ultrafiltrate concentrations of anti-infective agents were determined with reversed-phase high-performance liquid chromatography (HPLC) using an adapted ultraviolet (UV) detection method. [ 13 , 14 , 15 ] Plasma samples were extracted by SPE ? with Phenomenex Strata-X™ or Varian Plexa™ cartridges (for azoles) or ultra-filtered with Microcon™ devices. Dialysate/ultrafiltrate samples underwent no extraction but were directly injected into the system. Chromatographic separation was performed on Prontosil AQ+ 150 x 4
concurrently delivered via the device during SIP. The step height measurements were derived from hip flexion data captured by the sensor and the accuracy of the stepping height was compared to and validated by kinematic video analysis software. [ 20 ] The results show that PD subjects tend to have a significantly lower stepping height relative to controls under all conditions. The dual-task performance of PD freezers was particularly worse than PD non-freezers and the controls during concurrent serial 7 subtractions, even controlled for disease severity. [ 18 , 20
Guoxin Wang, Xiang Liu, Sheng Wang, Nan Ge, Jintao Guo and Siyu Sun
access the excluded stomach with deployment of a LAMS over a wire to create a gastrogastric or jejunogastric fistula, which allowed passage of the duodenoscope through the LAMS and performance of conventional ERCP. [ 75 ] Jah et al . [ 76 ] have reported EUS-guided drainage of an abdominal fluid collection following a Whipple procedure using an Olympus GF-UCT240 EUS endoscope (GF-UCT240, Olympus, UK), which was passed through the gastrojejunostomy. The serosanguinous collection was completely aspirated using a 19-gauge Echotip-Ultra needle (Wilson-Cook, Ireland
With the rise in long-term conditions, health care systems around the world are under pressure to curb health care costs while maintaining quality. In response, many countries have introduced pay for performance (P4P) programs that incentivize institutions and professionals to provide high quality care and to mitigate the potential weaknesses of other payment mechanisms such as fee for service. [ 3 ] P4P programs have been widely adopted internationally in low, middle, and high income countries such as UK, US, Thailand, Germany, and Australia
1. Gosselink R, Troosters T, Decramer M. Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med 1996;153:976-80.
2. Clark CJ, Cochrane LM, Mackay E, Paton B. Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training. Eur Respir J 2000;15:92-7.
3. Debigaré R, Maltais F. The major limitation to exercise performance in COPD is lower limb muscle dysfunction. J Appl Physiol 2008; 105: 751-3.
4. Donaldson AV, Maddocks M, Martolini D, Polkey MI, Man WD
Objectives: First objective was better understanding of the indications of chemotherapy in elderly with advanced cancer, tolerability and toxicity of chemotherapy in this age group. The second objective was to define current practice in chemotherapy for elderly people with advanced cancer for a selected group of patients treated in Institute of Oncology Bucharest (IOB). Materials and Methods: The study makes a clinical analysis of medical records of 27 patients from the archive of Institute of Oncology Bucharest treated by the same doctor. Patients were selected according to: age ≥ 65 years, ECOG performance status 0-1, normal blood counts and blood biochemistry, histological confirmation of the diagnosis of cancer, patients should received at least 3 cycles of chemotherapy. We extract characteristics of the patients to see if they were a homogeneous group of patients and to compare them with data from the literature. Overall survival was calculated by the Kaplan Meyer curve. Results: 295 patients more then 65 years were treated in our site in 2 years 2011, 2012. 93 patients received chemotherapy and only 27 patients were enrolled in this study following inclusion criteria. Common sites of cancer were lung and breast. The most used cytostatics for lung cancer was gemcitabine and carboplatine and cyclophosphamide, metotrexat and 5 fluorouracil for breast cancer. Toxicity was mild with the prevalence of hematologic toxicity. Overall survival without taking into account the type of cancer was 27.7 month. Conclusions: For selected patients, chemotherapy was well tolerated and appears to prolong survival regardless of the location of cancer. The relatively small number of elderly patients who received chemotherapy is probably due to lack of compliance to treatment, the increased number of co-morbidities and evaluation of performance status only by the ECOG index known not to be good enough to establish the indication of chemotherapy.
Jaspreet Kaur, Shailendra Kumar Singh and Jaspreet Singh Vij
Background and Aims: diabetes mellitus one of the non-communicable disorders which is spreading globally irrespective of nation being developed or developing. The aim of this study was to optimize the exercise protocols and to find the efficacy of these protocols on glucose control, balance, gait and proprioception in patients suffering from type 2 diabetes mellitus.
Material and Methods: 40 individuals with type 2 DM with age 35 to 60 were randomly allotted to four groups with 10 subjects in each. Cycle ergometer based aerobic exercises were given with duration of 20 or 30 minutes twice or thrice weekly for 6 weeks. Pre and post intervention was collected using Fullerton Advanced Balance scale for balance, spatiotemporal gait parameters for gait, Continuous passive motion for Proprioception and High Performance Liquid Chromatography in the laboratory.
Results: data was analysed using Design Expert software. Full factorial design was used to compare role of duration and frequency of exercise on each patient. The results showed significant effect of exercises on balance, gait, proprioception and glycated haemoglobin (HbA1c).
Conclusion: Aerobic exercises if given for 30 minutes and thrice weekly can show a significant improvement in complications in Diabetics.
Sorina Maria Aurelian, Ana Capisizu, Andreea Zamfirescu and Dan Cheţa
With age, arteries become more rigid and pulse waves propagate faster. The pathogenic mechanisms that causes vascular stiffness in type 2 diabetes are complex but incompletely understood. An important element in the development of this phenomenon appears to be insulin resistance. One of the first line health problems that persist in the present is the failure to detect cardiovascular diseases in the preclinical stage which is important since more frequent cardiac events (myocardial infarction, sudden death) occur in people without obvious cardiovascular pathology in the medical history. One of the degenerative diseases with the greatest impact on the autonomy is dementia of elderly people. Recent studies have shown the association and even the possible involvement of cardiovascular risk factors and arterial stiffness in the pathogenesis of dementia and cognitive impairment. Although pulse wave velocity in the aorta is related to subclinical coronary atherosclerosis (being an important biomarker of cardiovascular risk in asymptomatic individuals), arterial stiffness is also a predictor of cognitive performance, cognitive decline or dementia.