Longer versus shorter daily durations of electrical stimulation during task-specific practice in moderately impaired stroke.

OBJECTIVE: To examine and compare efficacy of 30-, 60-, and 120-minute repetitive task-specific practice (RTP) sessions incorporating use of an electrical stimulation neuroprosthesis (ESN) on affected upper-extremity (UE) movement. DESIGN: Prospective, single-blinded, randomized controlled trial. SETTING: Outpatient rehabilitation hospital. PARTICIPANTS: Chronic stroke subjects (N=32) exhibiting moderate, stable affected UE motor deficits. INTERVENTIONS: Subjects participated in 30-, 60-, or 120-minute therapy sessions involving RTP incorporating the ESN, occurring every weekday for 8 weeks. During sessions, they wore the ESNs to enable performance of valued activities that they had identified. A fourth group participated in a 30-minute per weekday home exercise program. MAIN OUTCOME MEASURES: Outcomes were evaluated using the UE section of the Fugl-Meyer Assessment of Sensorimotor Impairment (FM), the Arm Motor Ability Test (AMAT), the Action Research Arm Test (ARAT), and Box and Block (B&B) 1 week before and 1 week after intervention. RESULTS: After intervention, subjects in the 120-minute condition were the only ones to exhibit significant score increases on the FM (P=.0007), AMAT functional ability scale (P=.002), AMAT quality of movement scale (P=.0002), and ARAT (P=.02). They also exhibited the largest changes in time to perform AMAT tasks and in B&B score, but these changes were nonsignificant, (P=.15 and P=.10, respectively). CONCLUSIONS: One hundred and twenty minutes a day of RTP augmented by ESN use elicits the largest and most consistent UE motor changes in moderately impaired stroke subjects.

A randomized, double-blind, parallel trial comparing capsaicin nasal spray with placebo in subjects with a significant component of nonallergic rhinitis.

OBJECTIVE: To investigate the efficacy and safety of ICX72 or Sinus Buster, a proprietary homeopathic preparation of Capsicum annum and Eucalyptol, versus placebo administered continuously over 2 weeks in subjects with a significant component of nonallergic rhinitis (NAR). METHODS: Forty-two consented subjects meeting inclusion/exclusion criteria were randomized to ICX72 (n = 20) or control (n = 22) administered twice daily over 2 weeks. The primary endpoint was change in total nasal symptom scores (TNSS) from baseline to end of study. Secondary endpoints included changes in individual symptom scores (ISS) over 2 weeks and average time to first relief. Mean TNSS and ISS were recorded after single dosing at different intervals over 60 minutes. Rhinitis quality-of-life, rescue medication, and safety endpoints were analyzed. RESULTS: ICX72 versus placebo subjects exhibited significant differences in changes from baseline to end of study for TNSS and each ISS (P < .01), had an average time to first relief of 52.6 seconds (P < .01), and improvement in nasal congestion, sinus pain, sinus pressure, and headache at 5, 10, 15, and 30 minutes, persisting at 60 minutes for nasal congestion and sinus pain (P < .05). No difference between groups in adverse events or rescue medication was observed. ICX72 versus placebo subjects experienced no rebound congestion or impaired olfaction at the end of the study. CONCLUSION: This is the first controlled trial demonstrating intranasal capsaicin, when used continuously over 2 weeks, rapidly and safely improves symptoms in rhinitis subjects with a significant NAR component.

Analysis of short-term influences of ambient aeroallergens on pediatric asthma hospital visits.

The objective of our study was to investigate the association between daily pediatric asthma hospital visits and daily concentrations of aeroallergens and their specific species. Records of daily asthma visits in Cincinnati area were retrieved from Cincinnati Children's Hospital Medical Center and aeroallergen sampling was performed by the Button Inhalable Sampler. The Poisson generalized linear model was carried out in which the log of the number of asthma hospital visits was related to aeroallergen level, treated as a continuous variable with adjustment for seasonal time trend, day of the week, ozone and PM(2.5) concentrations, temperature and humidity. The aeroallergens having a significant impact on asthma hospital visits were ragweed, oak/maple and Pinaceae pollen. Their relative risks on asthma hospital visits with respect to a 100 counts/m(3) increase in concentration were in the range of 1.23 to 1.54. The effects in causing the asthma exacerbation were delayed by 3 or 5 days.

Disinfection of immature teeth with a triple antibiotic paste.

This study assessed the efficacy of a triple antibiotic paste in the disinfection of immature dog teeth with apical periodontitis. The canals were sampled before (S1) and after (S2) irrigation with 1.25% NaOCL and after dressing with a triple antibiotic paste (S3), consisting of metronidazole, ciprofloxacin, and minocycline. At S1, 100% of the samples cultured positive for bacteria with a mean CFU count of 1.7 x 10. At S2, 10% of the samples cultured bacteria-free with a mean CFU count of 1.4 x 10. At S3, 70% of the samples cultured bacteria-free with a mean CFU count of only 26. Reductions in mean CFU counts between S1 and S2 (p < 0.0001) as well as between S2 and S3 (p < 0.0001) were statistically significant. These results indicate the effectiveness of a triple antibiotic paste in the disinfection of immature teeth with apical periodontitis.

Lack of correlation between regional pollen counts and percutaneous reactivity to tree pollen extracts in patients with seasonal allergic rhinitis.

BACKGROUND: Although seasonal patterns of tree pollination have been reported, it is unknown if aerobiologic data correlate with patterns of in vivo sensitization. OBJECTIVE: To evaluate the relationship between regional tree pollen exposure and patterns of in vivo percutaneous reactivity to specific tree pollen extracts in a local patient population with seasonal allergic rhinitis. METHODS: Patients with spring seasonal allergic rhinitis and percutaneous sensitivity to 1 or more regional tree pollens were studied. Tree pollen counts were collected at the same urban site from 1997 to 2002 and at a suburban site in 2002. Patients underwent skin prick testing with commercial extracts of 15 indigenous tree species. Serum specific IgE measurements were assayed in a subset of sensitized patients. RESULTS: Of 127 patients who reported symptoms consistent with seasonal allergic rhinitis during the spring pollen season, 93 qualified based on demonstration of at least 1 positive skin prick test result. Mean 5-year pollen counts (1997-2001) and 2002 urban counts were highly correlated (Spearman r = 0.95, P < .001), indicating that year-to-year pollen counts were consistent. No significant correlation was found between mean seasonal pollen counts (urban site, 1997-2001) and frequencies of skin prick test reactivity to specific tree pollen allergens (Spearman r = -0.03, P = .93). No significant relationship was found between 5-year mean tree pollen counts and positive serum specific IgE tests for specific tree pollens (Spearman r = -0.42, P = .30). Eight of 15 species elicited percutaneous reactions in more than 50% of patients (ie, satisfying definition of a major in vivo allergen). However, 6 of the 8 major tree allergens each represented 5% or less of 5-year mean total tree pollen counts. CONCLUSION: No correlation was found between overall frequencies of in vivo sensitization to tree pollen allergens in a local population and regional pollen exposure data.

Use of acupuncture for the treatment of adductor spasmodic dysphonia: a preliminary investigation.

Ten subjects with adductor spasmodic dysphonia participated in a study examining the effects of an acupuncture treatment protocol on their voice disorder. Treatment consisted of eight sessions, and it was designed and performed by two physicians certified in acupuncture. Voice characteristics were evaluated pretreatment and posttreatment using the CSL Motor Speech Profile (MSP), Unified Spasmodic Dysphonia Rating Scale, and Voice Handicap Index (VHI). Subjects also answered a posttreatment questionnaire regarding their experience. Significant pretreatment and posttreatment differences occurred for some MSP measures. Significant differences were found on all three subtests of the VHI, and the average total scores pretreatment and posttreatment differed by 17 points (considered significant according to VHI standardization). Seven of 10 subjects reported improvements in voice production, although expert raters did not detect perceptual changes in voice quality. Possible reasons for the discrepancies between objective measures and self ratings, and implications for further research, are discussed.

Mortality of workers occupationally exposed to refractory ceramic fibers.

This study was prompted by refractory ceramic fibers (RCF) inhalation studies at high dose levels in animals that demonstrated positive effects for lung fibrosis, mesothelioma, and lung cancer. Current and former male workers employed between 1952 and 2000 at two RCF manufacturing facilities were followed to investigate a possible excess in mortality. The mortality analytic methods included: (1) standardized mortality ratios comparing this cohort to the general and state populations, and (2) a proportional hazards model that relates risk of death to the lifetime cumulative fiber-months/cc exposure among the RCF cohort, adjusted for age at hire and for race. There was no excess mortality related to all deaths, all cancers, or malignancies or diseases of the respiratory system including mesothelioma, but there was a statistically significant association with cancers of the urinary organs SMR = 344.8 (95% CL of 111.6, 805.4). The quality of the data for job history, exposure, and smoking history were very high. Although the cohort was relatively small and young with an average age of 51, the mean latency period was over 21 years. Because of these limitations, the preliminary findings warrant the continuation of this mortality registry for future analyses.

Pregnancy hormone metabolite patterns, pregnancy symptoms, and coffee consumption.

Because of contradictory reports of pregnancy outcomes and coffee intake, this study was designed to determine how hormone metabolite levels, symptoms, and coffee consumption patterns are related. Eligible subjects were recruited in Cincinnati, Ohio, from 1996 to 1998, aged 18-40 years, and nonsmokers; drank at least 18 ounces (1 ounce = 29.6 ml) of coffee per week (including decaffeinated) at the last menstrual period; and were enrolled by 9 weeks from the last menstrual period. Beverage consumption and pregnancy symptoms were recorded daily. Weekly, first-morning urine samples were collected to assess human chorionic gonadotropin, estrone-3-glucuronide, and pregnanediol-3-glucuronide. A time-dependent, repeated measures analysis was performed to test several associations. Data from 92 subjects were analyzed with the following results. 1) Coffee consumption was significantly, inversely associated with weekly levels of estrone-3-glucuronide and human chorionic gonadotropin. 2) Weekly hours of nausea were significantly, directly associated with human chorionic gonadotropin and inversely with estrone-3-glucuronide and pregnanediol-3-glucuronide. 3) Weekly coffee consumption was significantly associated with vomiting but not with nausea or appetite loss. 4) Weekly levels of pregnanediol-3-glucuronide were 32.2% lower in subjects who drank at least 8 ounces of coffee/day at the last menstrual period, though above what was necessary to maintain those pregnancies. This study shows the significance of these important variables to be considered in future research.