No efficacy of biofield therapy in the treatment of warts of the hands and feet in adults: a randomized controlled trial.

Although biofield therapy is unexplained by scientific evidence, it has been practised for many years in numerous cultures for a variety of medical conditions. This study aimed to determine whether one session of biofield therapy with an experienced practitioner could treat warts on the hands and feet in adults. A single-blind, assessor-blind, placebo-controlled, randomized trial was performed between April 2016 and November 2018. The enrolled participants had at least one wart on the hand or foot that had been present for at least 90 days and they were not using any other therapy for the wart. The primary outcome of this trial was the disappearance of the original wart 3 weeks after session of proximal nontouch biofield therapy vs. a sham session. No original wart had disappeared 3 weeks after intervention (0/64), which made the study impossible to conclude on the primary objective. There were no significant differences between the two groups concerning wart disappearance 3 weeks (P = 0.49) or 6 weeks (P = 0.40) after the intervention. Reduction in wart size at Week 3 tended towards a better result for biofield therapy but this was not significant (P = 0.27). No related adverse effects were observed. The major limitation of this trial was the short follow-up time for measurement of clinical outcome, which did not allow verification of the hypothesis. However, this study shows that 3 weeks after a session of proximal nontouch biofield therapy is an insufficient length of time to assess biofield therapy in comparison with a sham session. Based on this study, biofield therapy cannot be recommended to treat warts within 3 weeks.

Practices for prevention, diagnosis and management of postpartum haemorrhage: impact of a regional multifaceted intervention.

OBJECTIVE: To evaluate the effectiveness of a multifaceted intervention on practices for prevention, diagnosis and management of postpartum haemorrhage (PPH) and on the prevalence of major PPH in a French perinatal network. DESIGN: Quasi-experimental before-and-after survey. SETTING: All maternity units (n = 19) of a French administrative region, operating as a perinatal network. SAMPLE: One representative sample of all women delivering in the network, one representative sample of women with PPH deliveries and an exhaustive sample of women with major PPH. METHODS: The multifaceted intervention took place between February 2003 and March 2004. Information was retrospectively collected for two periods, 2002 (before the intervention) and 2005 (after). MAIN OUTCOME MEASURES: Practices for prevention, diagnosis and management of PPH and prevalence of major PPH. RESULTS: After the intervention, the pharmacological prevention of PPH increased from 58.8% to 75.9% of vaginal deliveries (P < 10(-4)), and the use of blood collecting bags from 3.9% to 76.3% (P < 10(-4)), but initial PPH management did not change significantly. However, the median delay for second-line pharmacological treatment was significantly shortened [from 80 min (35-130) in 2002 to 32.5 min (20-75) in 2005]. An increase was observed in the use of surgery for PPH (0.06% versus 0.12% of deliveries; P = 0.03) and in blood transfusions (0.18% versus 0.33%; P = 0.01). The prevalence of major PPH did not change (0.80% versus 0.86% of deliveries; P = 0.62). CONCLUSIONS: The intervention was effective at improving PPH-related preventive and diagnostic practices in a perinatal network. Improving management practices and reducing the prevalence of major PPH might require a different intervention design.

[Impact of a new regional management for postpartum hemorrhages by an audit of severe cases: a before and after study (2002-2005)]. / Evaluation de la mise en place d'une prise en charge régionale des hémorragies du postpartum par un audit des cas graves : étude avant-après (2002-2005).

BACKGROUND: Postpartum haemorrhage (PPH) is still the first cause of maternal mortality in France. Most of these cases include inappropriate management. In 2004, regional guidelines were diffused to all the birthplaces in Basse-Normandie. To assess the impact of this regional management, an epidemiological study "before-after" (2002-2005) has been performed. Part of this study was the evaluation of the management of severe PPH. OBJECTIVE: This study assessed the quality of care for major PPH and the correct follow-up of the guidelines before and after 2004. MATERIAL AND METHODS: A clinical audit has been conducted in all the birthplaces from the region to assess the management of all severe PPH identified during 2002 and 2005. PPH were considered as severe when they presented one or more of the following: blood transfusion, uterine embolisation, hemostatic surgery, difference in hemoglobin rates greater than 4 g / dl, or maternal death. All of these cases have been analysed except those defined by hemoglobin difference. Assessment has been carried out by pairs of practitioners (obstetrician and anesthetist) blinded to the origin of the case. Criteria assessed were the quality of care for major PPH, the correct follow-up of the guidelines and the degree of severity of the PPH which was estimated as moderate or severe on clinical arguments. RESULTS: The number of severe PPH was 34 in 2002 and 63 in 2005. The quality of care was increased with rates of inadequate management falling from 32 to 13% (p < 0,02), respectively. The follow-up of the guidelines was correct in the whole area, most of the criteria having been respected in about 90% of cases in 2005. However, active management of the third stage of delivery was only conducted in 71% of cases. The rates of severe PPH were not significantly different between 2002 (44%) and 2005 (38%). CONCLUSION: The originality from this study is that the modifications of the practices were conducted at a regional level in order to enhance the management of PPH. The assessment which was performed showed that quality of care was improved all over the area but that there is still place to progress.

Biochemical characterization of integral membrane heparan sulfate proteoglycans in Sertoli cells from immature rat testis.

(35)S-Radiolabeled cultured Sertoli cells from immature rat testis were extracted with detergent and the different proteoheparan sulfate (HSPG) forms of the extract were discriminated and quantified on the basis of their high anionic charge, hydrodynamic size, lipophilic properties, susceptibility to trypsin and phosphatidylinositol phospholipase C (PI-PLC). Trypsin released 50% of total cellular HSPG corresponding to 80% of total hydrophobic HSPG. Trypsin-accessible HSPG were presumed to be integral membrane species. Trypsin-resistant HSPG, probably intracellular, distributed into non-lipophilic (37.5%) and lipophilic (12.5%) populations. Biochemical analysis of PG copurified with plasma membrane confirmed the existence of hydrophobic HSPG integrated into this structure. Among hydrophobic HSPG accessible to trypsin, 35% were PI-PLC released and radiolabeled by [(3)H]inositol indicating that about one third of integral membrane HSPG were intercalated into the plasma membrane through a phosphatidylinositol anchor (glypican type). PI-PLC-resistant forms represented HSPG inserted into the membrane through a hydrophobic segment of the core protein (syndecan type). No lipophilic PG was present in other cell compartments (culture medium, cell periphery, extracellular matrix). (125)I-Iodinated hydrophobic HSPG were deglycanated and submitted to SDS-polyacrylamide gel electrophoresis. In the glypican family, a core protein (64--65 kDa) was detected, whereas in the syndecan family, bands of 60 and 68 kDa were observed which may correspond to self-association of different core proteins. In Sertoli cell, specific functional attributes of different integral membrane HSPG forms remain to be investigated.

Expression of glypican-1, syndecan-1 and syndecan-4 mRNAs protein kinase C-regulated in rat immature Sertoli cells by semi-quantitative RT-PCR analysis.

In seminiferous tubules, Sertoli cells provide structural and nutritional support for the developing germinal cells. Cell to cell signalization and cell adhesion require proteoglycans expressed at the cell membrane. A preliminary biochemical and structural approach indicated that cell surface proteoglycans are mostly heparan sulfate (HSPG) in immature rat Sertoli cells. The present study focused on the qualitative and quantitative expression of three membrane HSPG, syndecan-1, syndecan-4 and glypican-1 in Sertoli cells of 20-day-old rat. A semi-quantitative multiplex RT-PCR strategy was developed to appreciate the effect of PKC activation on the mRNA expression of the three HSPG. Our data show that the syndecan-1 and glypican-1 mRNA expression is increased by the phorbol myristate acetate (PMA) suggesting a regulation of their expression by the phosphatidyl inositol pathway, as previously hypothesized (Fagen et al., Biochim. Biophys. Acta, 1472 (1999) 250-261). In addition, a physiological effector of the PKC as ATP gave similar effects. Thus, this over-expression could be related with paracrine factors secreted by germ cells.