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BACKGROUND: A novel Oregon Medicaid policy guiding back pain management combined opioid restrictions with emphasis on non-opioid and non-pharmacologic therapies. OBJECTIVE: To examine the effect of the policy on prescribing, health outcomes, and health service utilization. DESIGN: Using Medicaid enrollment, medical and prescription claims, prescription drug monitoring program, and vital statistics files, we analyzed the policy's association with selected outcomes using interrupted time series models. SUBJECTS: Adult Medicaid patients with back pain enrolled between 2014 and 2018. INTERVENTION: The Oregon Medicaid back pain policy. MAIN MEASURES: Opioid and non-opioid medication prescribing, procedural care, substance use and mental health conditions, and outpatient and inpatient healthcare utilization. KEY RESULTS: The policy was associated with decreases in the percentage of Medicaid enrollees with back pain receiving any opioids (- 2.68 percentage points [95% CI - 3.14, - 2.23] level, - 1.01 pp [95% CI - 1.1, - 0.92] slope), days of short-acting opioid use (- 0.4 days [95% CI - 0.53, - 0.26] slope), receipt of more than 7 days of short-acting opioids (- 2.36 pp [95% CI - 2.76, - 1.95] level, - 0.91 pp [95% CI - 1, - 0.83] slope), chronic opioid use (- 1.27 pp [95% CI - 1.59, - 0.94] level, - 0.46 [95% CI - 0.53, - 0.39 slope), and spinal surgeries and procedures. Among secondary outcomes, we found no increase in opioid overdose and a small, statistically significant trend decrease in opioid use disorders. There were small increases in non-opioid substance use and mental health diagnoses and visits but no increase in self-harm. CONCLUSIONS: A state Medicaid policy emphasizing evidence-based back pain management was associated with decreases in opioid prescribing, spinal surgeries, and opioid use disorder trends, but also short-term increases in mental health encounters and an increase in non-opioid substance use disorder trends. Such policies may help reinforce evidence-based care, but must be designed with consideration of potential harms.
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PURPOSE: The services defined as complementary and alternative medicine/healthcare (CAM) are used to varying degrees according to the nature of the health problem, and musculoskeletal disorders, in particular, often lead to the use of CAM. Chronic pain is often cited as a reason for using CAM, and it is also the cardinal symptom of patients with back pain referred for specialist care. However, previous studies do not consider the heterogeneity of back pain when examining the use of CAM. Thus, this study aimed to explore the associations between CAM use and clinical findings incl. ICD-10 diagnostic codes in such a context. METHODS: In a cross-sectional study, a logistic regression analysis examined associations between CAM use and clinical findings at a public outpatient spine department. Chi-squared test examined the association between self-reported reasons for CAM use and the diagnostic groups. RESULTS: Of the 432 patients in the study population, 23.8% reported using CAM within 12 months prior to clinical assessment. CAM use was associated with being female and of younger age. Seeking CAM was not associated with clinical findings nor diagnosis, and no statistically significant association between the reasons for seeking CAM and the diagnostic groups was described. CONCLUSIONS: Among patients referred to specialist care for back pain, this study provides no evidence that the spinal condition should be expected to lead to the use of CAM. Only the individual demographic findings, specifically age and gender, were associated with CAM use.
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Terapias Complementarias , Humanos , Femenino , Masculino , Terapias Complementarias/estadística & datos numéricos , Estudios Transversales , Persona de Mediana Edad , Adulto , Anciano , Enfermedades de la Columna Vertebral/diagnóstico , Enfermedades de la Columna Vertebral/terapia , Dolor de Espalda/terapia , Dolor de Espalda/diagnóstico , Dolor de Espalda/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricosRESUMEN
OBJECTIVE: This study aims to assess the effectiveness of traditional Chinese exercise therapy in alleviating pain, improving sleep quality, and reducing symptoms of anxiety and depression among fibromyalgia patients. METHODS: We conducted a comprehensive search across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge, VIP database, and Wanfang, to identify randomized controlled trials (RCTs) examining the impact of Traditional Chinese Exercise (TCE) interventions on fibromyalgia. Two independent authors extracted data from the selected studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3. RESULTS: The analysis encompassed 15 RCTs, comprising 936 participants. The meta-analysis revealed that TCE significantly surpassed the control group in reducing pain scores for fibromyalgia patients, as evidenced by improvements in FIQ [MD = -3.30, 95% CI (- 5.37, - 0.69), z = 2.53, p = 0.01] and VAS [MD = -1.87, 95% CI (- 2.12, - 1.61), z = 6.98, p < 0.00001]. Additionally, TCE demonstrated notable enhancements in sleep quality (PSQI) [MD = -2.23, 95% CI (- 2.86, - 1.61), z = 6.98, p < 0.0001], as well as in alleviating symptoms of anxiety and depression [MD = - 0.59, 95% CI (- 0.80, - 0.39), z = 5.63, p < 0.0001]. CONCLUSION: Traditional Chinese Exercise (TCE) exhibits significant efficacy in ameliorating pain, enhancing sleep quality, and alleviating symptoms of anxiety and depression in fibromyalgia patients.
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Fibromialgia , Humanos , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/terapia , China , Depresión/diagnóstico , Depresión/etiología , Depresión/terapia , Terapia por Ejercicio , Fibromialgia/diagnóstico , Fibromialgia/terapia , Dolor , Calidad del SueñoRESUMEN
Breast cancer remains a pressing global health issue, spurring exploration into innovative therapies. This review focuses on Lippia alba (Mill.) essential oil's potential as a complementary breast cancer treatment. With growing interest in natural approaches, Lippia alba shows promise in breast cancer management. The review will explore Lippia alba's multifaceted role in treatment, highlighting its anticancer effects on breast cancer cells, potential synergy with conventional treatments, safety profiles, and existing clinical evidence. It will also address knowledge gaps, stressing the need for further research to unlock Lippia alba's full therapeutic potential in breast cancer therapy. In a field craving novel therapies, this review offers a timely analysis. Despite the lack of existing reviews on this topic, Lippia alba's significance cannot be understated. As research progresses, this article will be a valuable resource for researchers and healthcare practitioners seeking to augment breast cancer management through complementary therapies.
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Neoplasias de la Mama , Terapias Complementarias , Lippia , Aceites Volátiles , Humanos , Femenino , Aceites Volátiles/farmacología , Aceites Volátiles/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Extractos VegetalesRESUMEN
Music therapy (MT) is a complementary therapy offered to children, young adults, and their families in pediatric oncology and palliative care. We performed a survey to collect information about MT in pediatric oncology in Italy. The outbreak of COVID-19 unavoidably changed the scenario of MT, suggesting some considerations presented in this survey. 27/32 (84.4%) centers belonging to the Infections and Supportive Therapy Working Group of Association of Pediatric Hematology and Oncology (AEIOP) completed in 2 different time points (T1 and T2) an online survey on MT, before and after COVID-19 pandemia. Different kinds of music approach were used taking care of patients in 21/27 centers, while in 14/21 (66%), a specific project of MT conducted by a music therapist was present. In 6/14 centers, MT activities were delivered for < 3 h/week, in 3 centers for > 3 and < 10 h/week, and in the remaining 5 for > 3 h/week. MT sessions were in different areas, day hospital, or ward (patient rooms, operating rooms, waiting rooms), on an individual basis or by groups. Patients were invited to MT by psychologists, caring physician, or nurse, or on equipé decision. MT was evaluated with tools self-made by music therapist in 11/14 centers. After COVID-19, MT has been withdrawn in 3 centers, sessions in the waiting rooms were reduced, individual sessions were preferred, and enrollment by multidisciplinary teams increased. CONCLUSION: This survey represents the starting platform to compare and discuss different experience of MT in AIEOP centers, to implement MT in pediatric oncology for a more qualified assistance to patients, and to improve quality of care. WHAT IS KNOWN: ⢠Music therapy in pediatric oncology and palliative care can be used for the management and prevention of various somatic and psychological symptoms of patients and often is provided to children together with their families. ⢠In Italy the application of Music therapy in the AIEOP pediatric oncology centers is constantly increasing, but due to the outbreak of Covid-19 Pandemic, Italian pediatric oncology departments were obliged to adopt restrictive measures. WHAT IS NEW: ⢠Although the majority of Centres did not abrogate MT interventions, judgment about limitation should be carefully taken since MT helps children and even more adolescents in their fight against cancer. ⢠The best practice of Music therapy in pediatric oncology requires communication and collaboration among qualified music therapists and multidisciplinary care team, using a model of family-centered care that actively involves parents/ caregivers in assessment, treatment planning, and care delivery.
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COVID-19 , Musicoterapia , Neoplasias , Niño , Adolescente , Adulto Joven , Humanos , Pandemias , COVID-19/terapia , COVID-19/epidemiología , Neoplasias/epidemiología , Italia/epidemiologíaRESUMEN
BACKGROUND: Yoga is a mind-body practice that can elicit robust health and wellbeing effects for older adults. As a result, there is increased public and academic interest into the potential benefits of yoga for older people with mild cognitive impairment (MCI) and dementia. METHODS: Literature searches in five databases (CENTRAL, PubMed and EBSCOHost indexing CINAHL Plus, PsycINFO, Psychology and Behavioural Sciences Collection) were conducted from the databases' date of inception through to 4 September 2020 to identify pre-post single and multigroup studies of yoga-based interventions involving people with MCI or dementia. Effects on cognitive, mental, and physical health were evaluated, as was safety and study quality. RESULTS: Database searches identified 1431 articles. Of these, 10 unique studies met inclusion criteria (total 421 participants). Four studies each implemented Kundalini yoga and chair yoga, while two employed Hatha yoga. Most programs ran for 12 weeks (n = 5) and compared yoga to a control group (n = 5). Most studies reported improved cognition, mood, and balance. However, these effects were marred by the high risk of bias identified in all articles. Four studies assessed safety, with one instance of dizziness reported. CONCLUSIONS: In this emerging field, these studies show that yoga may be safe and beneficial for the wellbeing of people with MCI or dementia. More high quality randomised controlled trials are needed to improve the evidence-base and overcome the limitations of existing studies.
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Disfunción Cognitiva , Demencia , Yoga , Humanos , Anciano , Disfunción Cognitiva/terapia , Cognición , Demencia/terapiaRESUMEN
Background: Neural mobilisation technique is effective in spinal nerve rehabilitation. However, no study has reported the effect of facial nerve mobilisation in acute Bell's palsy. Objectives: The objective of our study was to evaluate the effect of facial neural mobilisation over conventional therapy in improving facial symmetry in patients with acute Bell's palsy. Methods: A randomised controlled trial was conducted in the physical therapy department for 62 patients with acute Bell's palsy. The intervention included 10 days of drug therapy including 3 weeks of conventional therapy to the experimental and the control group. However, the experimental group received additional nerve mobilisation technique aimed at mobilising the facial nerve at the origin of external auditory meatus. All participants were assessed at baseline and after three weeks using the Sunnybrook facial grading system (SBS) and Kinovea Movement Analysis Software (KMAS). Results: For primary outcome, analysis of covariance with baseline data as covariate showed a significant difference between groups for the post-test mean scores of SBS after 3 weeks (between-group difference, 9.2 [95% CI, 5.1-13.3], p=0.001. Importantly, the effect size calculated by partial η2 for neural mobilisation was 0.258 (small effect size). For secondary outcomes, independent sample t-test showed a significant difference between groups for the scores on KMAS after 3 weeks for zygomatic muscle (between-group difference, -27.2 [95% CI, -31 to -22.6], p=0.001), frontalis muscle -16.7 [95% CI, -9.9 to -23.4], p=0.001, and orbicularis oris muscle -15.0 [95% CI, -11.1 to -18.8], p=0.001. Conclusion: Facial neural mobilisation is likely to be an effective adjunctive intervention in addition to conventional therapy in improving facial symmetry in acute Bell's palsy.
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Recent guideline on the management of urticaria recommends second-generation H1-antihistamine as the first-line therapy, with dose increases of up to fourfold if inadequately controlled. However, the treatment of chronic spontaneous urticaria (CSU) is often disappointing, so additional adjuvant therapies are needed to increase the effectiveness of first-line therapy, especially in patients who are refractory to the increase of antihistamine doses. Recent studies recommend various adjuvant therapy modalities for CSU, such as biological agents, immunosuppressants, leukotriene receptor antagonists, H2-antihistamine, sulfones, autologous serum therapy, phototherapy, vitamin D, antioxidants, and probiotics. This literature review was made to determine the effectiveness of various adjuvant therapies in managing CSU.
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Urticaria Crónica , Urticaria , Humanos , Enfermedad Crónica , Urticaria Crónica/inducido químicamente , Urticaria Crónica/tratamiento farmacológico , Urticaria/tratamiento farmacológico , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Terapia Combinada , Omalizumab/uso terapéuticoRESUMEN
Recent guideline on the management of urticaria recommends second-generation H1-antihistamine as the first-line therapy, with dose increases of up to fourfold if inadequately controlled. However, the treatment of chronic spontaneous urticaria (CSU) is often disappointing, so additional adjuvant therapies are needed to increase the effectiveness of first-line therapy, especially in patients who are refractory to the increase of antihistamine doses. Recent studies recommend various adjuvant therapy modalities for CSU, such as biological agents, immunosuppressants, leukotriene receptor antagonists, H2-antihistamine, sulfones, autologous serum therapy, phototherapy, vitaminD, antioxidants, and probiotics. This literature review was made to determine the effectiveness of various adjuvant therapies in managing CSU.
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Urticaria Crónica , Urticaria , Humanos , Enfermedad Crónica , Urticaria Crónica/inducido químicamente , Urticaria Crónica/tratamiento farmacológico , Urticaria/tratamiento farmacológico , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Terapia Combinada , Omalizumab/uso terapéuticoRESUMEN
There are about 10 million people with epilepsy (PWE) in China. In addition to therapies approved by the National Medical Products Administration, the use of complementary and alternative medicine (CAM) is prevalent in Chines PWE. These CAM therapies mainly comprise traditional Chinese medicine herbs (TCMHs), acupuncture, and music. A retrospective literature search was performed to summarize the updates of CAM in China in the past ten years, and sixty-two papers were finally included. In this following review, we listed the animal and clinical studies to summarize the antiepileptic mechanisms and clinical efficacy of CAM in Chines PWE. The main mechanisms of TCMHs and acupuncture included regulation of neurotransmitters and receptors, voltage-gated ion channels modulation, expression of apoptosis-related genes, antioxidant response, and anti-inflammation. Although there were enormous clinical studies on them, the current available clinical trials were small, short-term, heterogeneous, and had a high risk of bias. With regard to music, a few studies conducted by Chinese scholars suggested that it was beneficial for PWE as an add-on therapy, which was consistent with the results of foreign studies. Further randomized clinical trials in large populations are required to prove the effectiveness and safety of CAM.
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Terapias Complementarias , Epilepsia , Humanos , Estudios Retrospectivos , Terapias Complementarias/métodos , Epilepsia/tratamiento farmacológico , Anticonvulsivantes/uso terapéutico , ChinaRESUMEN
PURPOSE: Epilepsy is a chronic disorder that affects all domains of daily living. Especially, in the case of drug resistance, it is usually associated with impairment of quality of life (QOL). The opportunity to self-express is crucial for maintaining mental health. Therefore, many non-pharmaceutical interventions have been utilized to relieve psychiatric symptoms, such as fear, anxiety, and depression in persons with epilepsy. In this study, we aimed to investigate the effect of the occupational therapy program with drama activities (ODTA) on the QOL of patients with epilepsy. METHODS: In total, 15 patients with epilepsy from the region of Thrace, Greece, were enrolled in a 3-month OTDA program focusing on the relief of anxiety symptoms and self-regulation. Each patient's QOL was measured using the Quality of Life in Epilepsy Inventory (QOLIE-31) mean scores. The reliability change index was calculated and the Wilcoxon paired test was used to determine QOL changes post-intervention compared to pre-intervention. RESULTS: Statistically significant improvements were observed in fear of having a seizure (pâ¯=.004), overall quality (pâ¯=.001), emotional well-being (pâ¯=.004), energy fatigue (pâ¯=.014), and total QOLIE (pâ¯=.001) score after the intervention. The changes in the QOLIE score were more prominent among female individuals (male vs female: pâ¯=.028 vs pâ¯=.008). CONCLUSION: This study highlights the importance of providing an ODTA program in patients with epilepsy and proposes its broader combined application as a complementary intervention in such patients.
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Epilepsia , Terapia Ocupacional , Ansiedad/etiología , Ansiedad/psicología , Ansiedad/terapia , Epilepsia/psicología , Femenino , Humanos , Masculino , Calidad de Vida/psicología , Reproducibilidad de los ResultadosRESUMEN
Complementary and alternative medicine or therapies (CAM) are frequently used by skin cancers patients. Patient's self-administration of CAM in melanoma can reach up to 40%-50%. CAMs such as botanical agents, phytochemicals, herbal formulas ("black salve") and cannabinoids, among others, have been described in skin cancer patients. The objective of this review article was to acknowledge the different CAM for skin cancers through the current evidence, focusing on biologically active CAM rather than mind-body approaches. We searched MEDLINE database for articles published through July 2022, regardless of study design. Of all CAMs, phytochemicals have the best in vitro evidence-supporting efficacy against skin cancer including melanoma; however, to date, none have proved efficacy on human patients. Of the phytochemicals, Curcumin is the most widely studied. Several findings support Curcumin efficacy in vitro through various molecular pathways, although most studies are in the preliminary phase. In addition, the use of alternative therapies is not exempt of risks physicians should be aware of their adverse effects, interactions with standard treatments, and possible complications arising from CAM usage. There is emerging evidence for CAM use in skin cancer, but no human clinical trials support the effectiveness of any CAM in the treatment of skin cancer to date. Nevertheless, patients worldwide frequently use CAM, and physicians should educate themselves on currently available CAMs.
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Terapias Complementarias , Curcumina , Melanoma , Neoplasias Cutáneas , Humanos , Curcumina/efectos adversos , Terapias Complementarias/efectos adversos , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/etiología , Melanoma/tratamiento farmacológico , Melanoma/etiologíaRESUMEN
OBJECTIVE: Hard-to-heal wounds can be caused by persistent infections or an excess of inflammatory cytokines, proteases and oxidants, and can severely impact the quality of life (QoL) of patients. Due to the paucity of effective treatments and increased resistance to antibiotics, new and improved therapies are required to resolve infections and to simultaneously enhance the healing trajectory. Medical grade honey (MGH) may be a novel and effective treatment approach. METHODS: In this case series, we have described six cases of hard-to-heal wounds, and discussed the effects of MGH on infection, wound healing and factors influencing patient QoL (pain, odour and exudate). In all cases, the wounds had persisted for a long period, and previous treatments had been ineffective. Most of the patients had comorbidities, and the majority of the wounds were contaminated with (multiresistant) bacteria, both of which contributed to non-healing. All wounds were treated with L-Mesitran (MGH-based wound care products, Triticum Exploitatie BV, the Netherlands) either as monotherapy or as a complementary therapy. RESULTS: Hard-to-heal wounds started healing, infection was controlled and QoL was strongly improved (malodour, exudate levels and pain swiftly decreased) after the application of the MGH. All wounds healed relatively quickly, considering the severity of the wounds and general health of the patients. CONCLUSION: In this study, MGH was a useful alternative or complementary therapy to antibiotics and expedited the healing of hard-to-heal wounds.
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Miel , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Humanos , Dolor , Calidad de Vida , Cicatrización de HeridasRESUMEN
PURPOSE: Poor sleep is one of the most common side effects of cancer treatment. One increasingly popular approach to manage side effects of cancer treatment is use of medicinal cannabis (MC). DESIGN: Cancer patients using MC participated in semi-structured interviews to assess their experiences with MC (n = 24). A multi-stage thematic analysis was applied to interview transcripts. Themes related to use of MC for sleep were extracted. FINDINGS: The majority reported MC use for sleep. These participants reported that MC improved sleep initiation and continuity, resulted in decreased use of sleep medications, and that improved sleep led to better health. No participant reported MC was ineffectual for sleep or caused undesirable side effects when used for sleep. CONCLUSIONS: Cancer patients often utilize MC to specifically manage poor sleep. There is a need for rigorous studies assessing prevalence of use for this indication and clinical trials to assess comparative efficacy and safety.
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Marihuana Medicinal , Neoplasias , Actitud , Humanos , Marihuana Medicinal/efectos adversos , Neoplasias/tratamiento farmacológico , SueñoRESUMEN
BACKGROUND: Interest in the use of yoga to enhance engagement with and augment the benefits of psychological treatment has grown. However, a systematic approach to reviewing existing research examining the use of yoga with psychological treatment is lacking. MATERIALS AND METHODS: This mapping review identified and synthesised research trialling yoga as an integrated or adjunct therapy with evidence-based psychological interventions for the treatment of anxiety, depression, PTSD, and eating disorders. RESULTS: Overall, the review identified ten published and three unpublished studies, representing either single group or small quasi-experimental research designs. DISCUSSION: Limited but promising findings were shown for yoga with CBT for anxiety and depression, and the integration of yoga within intensive treatment models for PTSD. CONCLUSIONS: Future research is encouraged to focus on controlled trials that enable examination of the component effect of yoga when applied with evidence-based psychological treatment and acceptability and feasibility data to further knowledge regarding a role for yoga in clinical practice.
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Meditación , Trastornos Mentales , Trastornos por Estrés Postraumático , Yoga , Ansiedad/psicología , Trastornos de Ansiedad/terapia , Humanos , Trastornos Mentales/terapia , Trastornos por Estrés Postraumático/psicología , Yoga/psicologíaRESUMEN
Background and Objectives: In recent years, singing bowl sound interventions have been progressively implemented in the fields of well-being, therapy and education; however, the effectiveness has only scarcely been investigated. Therefore, this study was aimed at determining neurophysiological effects of a singing bowl massage. Materials and Methods: In this prospective cohort study 64-channel EEG, ECG and respiration was recorded from 34 participants (mean age 36.03 ± 13.43 years, 24 females/10 males) before, during and after a professional singing bowl massage. Further, subjective changes in well-being were assessed. EEG data were analyzed by determining the effect sizes of distinct frequency bands. Significant differences were calculated by a two-tailed t-test corrected for multiple comparisons. Heart rate variability metrics, heart rate and respiration rate were estimated and compared. Results: Overall EEG power decreased during the sound condition compared to a task-free resting state (d = −0.30, p = 0.002). After the intervention, global EEG power was further reduced (d = −0.46, p < 0.001), revealing a decrease in the beta 2 (d = −0.15, p = 0.002) and the gamma frequency band (d = −0.21, p = 0.004). The mean heart rate was significantly lower after the intervention (75.5 ± 19.8 vs. 71.5 ± 17.9, p < 0.001) and the respiration rate higher (13.5 ± 5.3 vs. 15.2 ± 6.3, p = 0.018). 91.2% of the participants felt more integrated, 97.1% more balanced and 76.5% more vitalized. Conclusions: The neurophysiological effects of a singing bowl sound massage may be interpreted as a shift towards a more mindful, meditative state of consciousness. The intervention was perceived as beneficial for the wellbeing.
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Masaje , Adulto , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto JovenRESUMEN
This paper explores how Catholic women in Argentina use assisted reproduction technologies (ARTs), and particularly the way in which they resort to biomedicine and religion as complementary sources of knowledge, support and assistance during reproductive treatments. It is concerned about the role of the Catholic religion in local reproductive itineraries, seeing that Catholicism has such significant social, political and cultural influence in the country. Drawing on a qualitative and ethnographic study of Catholic spaces of worship, a maternity hospital and in-depth interviews with former users from three metropolitan areas in Argentina, we examine how reproductive itineraries involve the users' agency in building health resources from religion, with reference to biomedicine. The data reveal that women address religion as an affective, social and therapeutic recourse intertwined with biomedical power. These findings highlight the multiple and complex forms reproduction acquires in specific social, cultural and normative contexts, and contribute to discussing the complementarity between religion and biomedicine in health experiences.
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Catolicismo , Reproducción , Femenino , Humanos , Embarazo , Catolicismo/psicología , Argentina , Antropología Médica , TecnologíaRESUMEN
OBJECTIVE: Fibromyalgia is a functional pain disorder in which patients suffer from widespread pain and poor quality of life. Fibromyalgia pain and its impact on quality of life are not effectively managed with current therapeutics. Previously, in a preclinical rat study, we demonstrated that exposure to green light-emitting diodes (GLED) for 8 hours/day for 5 days resulted in antinociception and reversal of thermal and mechanical hypersensitivity associated with models of injury-related pain. Given the safety of GLED and the ease of its use, our objective is to administer GLED as a potential therapy to patients with fibromyalgia. DESIGN: One-way crossover clinical trial. SETTING: United States. METHOD: We enrolled 21 adult patients with fibromyalgia recruited from the University of Arizona chronic pain clinic who were initially exposed to white light-emitting diodes and then were crossed over to GLED for 1 to 2 hours daily for 10 weeks. Data were collected by using paper surveys. RESULTS: When patients were exposed to GLED, but not white light-emitting diodes, they reported a significant reduction in average pain intensity on the 10-point numeric pain scale. Secondary outcomes were assessed by using the EQ-5D-5L survey, Short-Form McGill Pain Questionnaire, and Fibromyalgia Impact Questionnaire and were also significantly improved in patients exposed to GLED. GLED therapy was not associated with any measured side effects in these patients. CONCLUSION: Although the mechanism by which GLED elicits pain reduction is currently being studied, these results supporting its efficacy and safety merit a larger clinical trial.
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Fibromialgia , Adulto , Animales , Fibromialgia/terapia , Humanos , Dolor , Dimensión del Dolor , Calidad de Vida , Ratas , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
OBJECTIVE: Provide strategies for improving the care of perimenopausal and postmenopausal women based on the most recent published evidence. TARGET POPULATION: Perimenopausal and postmenopausal women. BENEFITS, HARMS, AND COSTS: Target population will benefit from the most recent published scientific evidence provided via the information from their health care provider. No harms or costs are involved with this information since women will have the opportunity to choose among the different therapeutic options for the management of the symptoms and morbidities associated with menopause, including the option to choose no treatment. EVIDENCE: Databases consulted were PubMed, MEDLINE, and the Cochrane Library for the years 2002-2020, and MeSH search terms were specific for each topic developed through the 7 chapters. VALIDATION METHODS: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE: physicians, including gynaecologists, obstetricians, family physicians, internists, emergency medicine specialists; nurses, including registered nurses and nurse practitioners; pharmacists; medical trainees, including medical students, residents, fellows; and other providers of health care for the target population. SUMMARY STATEMENTS: RECOMMENDATIONS.
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Terapias Complementarias , Ginecología , Femenino , Humanos , Estilo de Vida , Menopausia , PrescripcionesRESUMEN
Approximately 1.25 million people in the UK suffer from an eating disorder, yet the treatment options show limited efficacy, warranting the need for novel approaches. This study aimed to investigate the perspectives of people with eating disorders on the use of complementary therapies and psychedelic research and treatment. Two hundred participants with eating disorders took part in this web survey study. The majority of participants (70%) had used a complementary treatment to manage their eating disorder. Participants believed that psychedelic research was worthwhile in the context of a moderate level of concern. The most popular solutions to meet these concerns included providing education around psychedelics and their effects and use in psychiatry and experiencing endorsement from professionals in the area. Moreover, participant responses emphasized the need for a safe, monitored environment and the patient-therapist rapport in the context of psychedelic treatment. The findings are explored concerning future trials of psychedelics as a treatment for eating disorders.