A prospective, non-randomized evaluation of a novel low energy radiofrequency treatment for nasal obstruction and snoring.

BACKGROUND: Weak or inward-bent cartilage of the nasal sidewall at the level of the internal nasal valve (INV) can produce narrowness or collapse of the nasal valve. This is a common cause of impaired nasal breathing during daily activities and there is also an established connection between nasal obstruction and snoring. The condition is often difficult to treat, although even a small enlargement of the lumen at the nasal valve can lead to a significant improvement in the ease of nasal breathing. METHODS: The primary objective of this prospective study was to evaluate the safety and efficacy of the Vivaer system for the treatment of narrowed nasal valves and to measure changes in the symptoms of nasal obstruction and snoring. The Vivaer system uses low energy radiofrequency to remodel the nasal sidewall in order to improve airflow. RESULTS: The study involved 31 patients presenting from 1st September 2017 to 1st May 2018 with symptoms of nasal obstruction and snoring. In all patients, an improvement was observed in nasal breathing measured by NOSE score, sleep quality by SOS questionnaire and quality of life as measured by EQ-5D and SNOT-22. CONCLUSION: Vivaer intranasal remodeling can provide a durable and well-tolerated non-invasive treatment for those patients who are suffering congestion due to narrowness or collapse of the INV.

Neuropattern: a new translational tool to detect and treat stress pathology. II. The Teltow study.

The present study was designed to test the clinical utility of Neuropattern (NP), a newly developed translational diagnostic tool. NP consists of biological and psychological measures that facilitate the identification of functional changes (called "neuropatterns") in patients with stress-related health problems. In this prospective, randomized control trial, we expected NP to improve therapeutic efficacy, as compared with the usual treatment. NP was applied to 101 in-patients suffering from various mental disorders (mainly depression, anxiety disorders, and adjustment disorders), and scoring high on the Symptom Checklist-90-R (SCL-90-R) somatization scale. The patients (73% females, mean ± standard deviation age 46 ± 9.03 years) were randomly assigned to two groups: in the experimental group (n = 51), physicians received results from NP diagnostics, while in the control group (n = 50), this information was not available until discharge from the hospital. Improvements of symptoms in consequence of treatment were monitored by two self-rating scales, the SCL-90-R and Short Form-12 health survey, and a physician's clinical global rating (Beeinträchtigungs-Schwere Score). There was a significantly greater improvement in the experimental group in the self-rating assessments on symptom severity (p = 0.03) and quality of life (p = 0.05), but not in the observer rating of emotional, physical, and social-communicative functioning (p = 0.13). Treatment efficacy in patients can be improved by providing the attendant physician and the patient with diagnostic information and treatment recommendations by NP. The role of concrete mediators of treatment efficacy awaits further research.

Associations of the cortisol awakening response (CAR) with cortical activation asymmetry during the course of an exam stress period.

The cortisol awakening response (CAR) is a cortisol rise which is distinct from the circadian rise in hypothalamus-pituitary-adrenal (HPA) axis activity before awakening. The CAR has been shown to be related to experiences of stress and negative affect, and activation of neocortical networks has been suggested as a mechanism. Right-sided cortical activation has been shown to be correlated with negative affect, and an association of electroencephalogram (EEG) asymmetry measures with cortisol secretion has been demonstrated. Therefore, we investigated for associations of the CAR with lateralised trait-like cortical activation and with changes in EEG asymmetry during a putative stressful period. We examined 37 undergraduate students before, during, and after an academic exam period. CARs were measured five times and EEG was measured both about 6 weeks before the beginning of the exams and 1 day before an exam. Trait-like interindividual differences in posterior cortical asymmetry were differentially associated with CARs at different measurement occasions. Participants with greater right centroparietal cortical trait activation showed an increased CAR in anticipation of the exams, whereas all other participants showed an increased CAR in response to the exams. Furthermore, EEG measures taken directly before the exam revealed that greater right frontal cortical activation was related to higher cortisol levels after awakening. The results suggest that lateralised cortical activation moderates CAR changes during the course of a stressful period. Lateralised cortical activation may be an important link between the CAR and health-related variables like experiences of stress and negative affect.

Effects of psychological treatment on recurrent abdominal pain in children - a meta-analysis.

Recurrent abdominal pain in children has a high prevalence, thought to be about 10%. Untreated, there is a high risk that the symptoms become chronic and may lead in some cases to co-morbid mental disorders. Evidence-based treatments are therefore urgently needed. The objective of this study was to examine the effectiveness of psychological therapies for pain reduction in children with recurrent abdominal pain (RAP) by a meta-analysis of intervention studies. Ten controlled studies fulfilling minimum methodical criteria were included. The results of the analysis showed that psychological therapies, mainly cognitive-behavioural, have a moderate effect on the reduction of pain in children with RAP. After analysing homogeneity and significance with the fixed effect model, the medium effect size, calculated with Hedges g, was 0.58 (σ=0.16), demonstrating highly significant (p<.01) effects. The study showed that psychological therapies are effective in treating children with chronic abdominal pain. The empirical basis in this field needs to be broadened.