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GST Primary GST Primary Best Strategies for Health Care Quality Im... Best Strategies for Health Care Quality Improvement - Diabetes Quality Improvement Strategies for Antibio... Kathryn McDonald, Stanford-UCSF Evidence-b... Systematic review assessing the effect of ... Quality Improvement Strategies for Antibiotics Management Kathryn McDonald, Stanford-UCSF Evidence-based Practice Center, 117 Encina Commons, Stanford, CA 94305-6019, Kathy.mcdonald@stanford.edu Systematic review assessing the effect of quality improvement strategies on appropriate prescribing of antibiotics and appropriate choice of antibiotics. Adherence Adherence Assistive Devices Assistive Devices Childhood Burn Hanson MacMillan Childhood Burn Hanson MacMillan CLSA_9 CLSA_9 Cyberabuse Cyberabuse Cognitive Behavioural Therapy for Violent ... This review included randomized trials abo... Cognitive Behavioural Therapy for Violent Men who Batter Their Partners This review included randomized trials about the effects of cognitive behavioral therapy on domestic violence. The intervention included programs based on the Duluth Model. The violence had to be committed by a male toward his female partner. The violence also had to be physical. The primary outcomes were new arrests and convictions, and new reports of violence. CABG vs PCI CABG vs PCI Quality Improvement Strategies for Prevent... Quality Improvement Strategies for Preventing Nosocomial Infections (Created 17-Feb-06) Quality Improvement Strategies for Asthma ... Quality Improvement Strategies for Asthma Control Erectile Dysfunction (Created 30-Jan-06) Erectile Dysfunction (Created 30-Jan-06) Inequality - Smoking Cessation to Reduce S... This review was the first part of a projec... Inequality - Smoking Cessation to Reduce Socio-Economic Differences This review was the first part of a project about inequality. It included randomized trials about the effect of smoking cessation interventions on reducing socio-economic differences. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Diet and Physical Activity to Reduce Socio... This review was the second part in a proje... Diet and Physical Activity to Reduce Socio-Economic Differences This review was the second part in a project about inequality. It included randomized trials about the effect of interventions on reducing socio-economic differences in diet and physical activity. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Workfare The data in SRS are not identical to the d... Workfare The data in SRS are not identical to the data in the published report. We used SRS only for an updated search. The review included randomized trials about the effect of welfare-to-work programs. Participants were welfare recipients. There were basically two types of programs. The educational type tried to build knowledge and skills in order to help the welfare recipients acquire jobs that could support them economically. The "work first" approach was more aimed at getting the participants quickly into a job. Exercise interventions for the management ... The objective of this systematic review wa... Exercise interventions for the management of frailty The objective of this systematic review was to examine the effectiveness of current exercise interventions on the management of frailty. A comprehensive search of Medline, Embase, Psycinfo, Cinahl, Scopus, Ageline, Eric, and SportDiscus databases was conducted and produced 1808 citations. So far we have completed 2 levels of “title and abstract” screening and we ended up with 262 articles. We have just started the full text screening. Eligibility criteria included original studies whose participants were identified as frail or prefrail with specific criteria and in which structured physical activity was included as at least one component of the intervention. Create a free account, build a dictionary with saved terms to re-use later! Public Domestic Violence - Using Cognitive Behavior Therapy Smoking Cessation to Reduce Socio-Economic Differences Diet and Physical Activity to Reduce Socio-Economic Differences Workfare Exercise Interventions for the Management of Frailty Search     Simple Advanced Refine (6 coded questions)  Any of these:   Exact Phrase: All of these: None of these: Author: Periodical: Projects: No restrictions   Libraries: Public   Select SRS Projects Show Saved Terms Select Library Show articles that do not have abstracts  Intervention Patient education Communication and counselling Patient involvement through self-monitoring Reminders Reinforcement or rewards Other (e.g. combined education and reminders) Unknown Educational Materials Group threrapy Couples threrapy Individual threrapy Healthy eating Increased physical activity Not Diet or Exercise Welfare-to-work program Ages All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined Language English French German Italian Japanese Russian Spanish Afrikaans Albanian Unknown Arabic Armenian Azerbaijani Bosnian Bulgarian Catalan Chinese Croatian Czech Danish Dutch Esperanto Estonian Finnish Georgian Greek, Modern Hebrew Hindi Hungarian Icelandic Indonesian Kinyarwanda Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maori Multiple Languages Norwegian Persian Polish Portuguese Pushto Romanian Sanskrit Scottish gaelic Serbian Slovak Slovenian Swedish Thai Turkish Ukrainian Vietnamese Not English Not French Type of Article Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. 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Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT Humans or Animals Humans Animals Patient Demograhics Welfare recipients Unknown Not on welfare Mean Age Percent high school diploma Percent GED or high school diploma Mean number of years of education Results(1-25 of 25,000) Sort By: Publication Date Relevance Took: 3.124 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 1000 1 2 3 4 > Last >> (25000 articles found) Sedatives for opiate withdrawal in newborn infants 2005 Osborn, D. A., Jeffery, H. E., and Cole, M. J. BACKGROUND: Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. Treatments used to ameliorate symptoms and reduce morbidity include opiates, sedatives and no... ( view more )n-pharmacological treatments. OBJECTIVES: To assess the effectiveness and safety of using a sedative compared to a non-opiate control for NAS due to withdrawal from opiates, and to determine which type of sedative is most effective and safe. SEARCH STRATEGY: The standard search strategy of the Neonatal Review Group was used. This update included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005), MEDLINE 1966-March 2005 and abstracts of conference proceedings. SELECTION CRITERIA: Trials enrolling infants with NAS born to mothers with an opiate dependence, with > 80% follow up and using random or quasi-random allocation to sedative or control. Control could include another sedative or non-pharmacological treatment. DATA COLLECTION AND ANALYSIS: Each author assessed study quality and extracted data independently. Primary outcomes included treatment failure (failure to achieve symptom control or use of additional drug treatment), seizure occurrence, mortality and neurodevelopment. Treatment effect was expressed using (RR), risk difference (RD), mean difference (MD) and weighted mean difference (WMD). Meta-analysis was performed using a fixed effect model. MAIN RESULTS: Six studies enrolling a total of 305 patients met inclusion criteria (Coyle 2002; Finnegan 1984; Kahn 1969; Kaltenbach 1986; Khoo 1995; Madden 1977); however, two (Finnegan 1984; Kaltenbach 1986) may be sequential reports that include some identical patients. Methodological concerns included the use of quasi-random allocation methods in four studies, and sizeable, largely unexplained differences in reported numbers allocated to each group in three studies.Phenobarbitone compared to supportive care alone has not been shown to reduce treatment failure or time to regain birthweight (one study). However, the duration of supportive care given to infants was significantly reduced (MD -162.1 mins/day, 95% CI -249.2, -75.1). Comparing phenobarbitone to diazepam, meta-analysis of two studies found phenobarbitone produced a significant reduction in treatment failure (typical RR 0.39, 95% CI 0.24, 0.62). There was no significant difference in duration of treatment or hospital stay. Comparing phenobarbitone with chlorpromazine, one study found no significant difference in treatment failure rate. No data for neurodevelopment reported by treatment group of allocation were available. No trials were eligible that assessed clonidine for NAS. In infants treated with an opiate, a small quasi-random study reported a reduced severity of withdrawal. Infants were weaned from an opiate more quickly which allowed earlier hospital discharge and reduced hospital costs. These findings may reflect the low dose of opiate used for initial treatment and the policy of discharging infants home on phenobarbitone but not morphine. AUTHORS' CONCLUSIONS: In newborn infants with NAS, there is no evidence that phenobarbitone compared with supportive care alone reduces treatment failure; however, phenobarbitone may reduce the daily duration of supportive care needed. Phenobarbitone, compared to diazepam, reduces treatment failure. In infants treated with an opiate, the addition of phenobarbitone may reduce withdrawal severity. Further trials are required to determine if this finding is applicable when a higher initial dose of opiate is used, and determine the effects of phenobabritone on infant development. There is insufficient evidence to support the use of chlorpromazine or clonidine in newborn infants with NAS. Clonidine and chlorpromazine should only be used in the context of a randomised clinical trial. This review should be taken in conjunction with the review "Opiate treatment for opiate withdrawal in newborn infants" (Osborn 2002a) which indicates that an opiate is the preferred initial therapy for NAS. PLAIN LANGUAGE SUMMARY: When a sedative is needed to ameliorate symptoms in newborn infants with an opiate withdrawal due to maternal opiate use in pregnancy, phenobarbitone is preferred.Use of opiates (commonly prescribed methadone or illicit heroin) by pregnant women may result in a withdrawal syndrome in their newborn infants. This may result in disruption of the mother-infant relationship, sleeping and feeding difficulties, weight loss and seizures. Treatments for newborn infants used to ameliorate these symptoms and reduce complications include opiates, sedatives (phenobarbitone or diazepam) and supportive treatments (swaddling, settling, massage, relaxation baths, pacifiers or waterbeds). Trials of sedatives have generally been of poor quality. Individual studies have reported that use of phenobarbitone compared to supportive care alone reduces the amount time an infant needs supportive care, is better than diazepam at preventing treatment failure and reduces the severity of withdrawal in infants treated with a opiate. However, the long term effects of use of phenobarbitone on an infant's development have not been determined ( view less ) View Full Abstract View Article Details   Related Articles Opiate treatment for opiate withdrawal in newborn infants 2005 Osborn, D. A., Jeffery, H. E., and Cole, M. BACKGROUND: Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. Treatments used to ameliorate symptoms and reduce morbidity include opiates, sedatives and no... ( view more )n-pharmacological treatments. OBJECTIVES: To assess the effectiveness and safety of using an opiate, compared to a sedative or non-pharmacological treatment, for treatment of NAS due to withdrawal from opiates. SEARCH STRATEGY: The previous review was updated with additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005), MEDLINE (1966-December 2004) and EMBASE (1980-December 2004) supplemented by searches of conference abstracts and citation lists of published articles. SELECTION CRITERIA: Trials enrolling infants with NAS born to mothers with an opiate dependence, with > 80% follow up and using random or quasi-random allocation to opiate or control. Control could include an opiate, sedative or non-pharmacological treatment. DATA COLLECTION AND ANALYSIS: Each author assessed study quality and extracted data independently. Primary outcomes included control of symptoms, seizure occurrence, mortality and neurodevelopment. Treatment effect was expressed using relative risk (RR), risk difference (RD), mean difference (MD) and weighted mean difference (WMD). Meta-analysis was performed using a fixed effect model. MAIN RESULTS: Seven studies enrolling a total of 585 infants met inclusion criteria (Carin 1983; Finnegan 1984; Jackson 2004; Kaltenbach 1986; Kandall 1983; Khoo 1995; Madden 1977); however, two (Finnegan 1984; Kaltenbach 1986) may be sequential reports that include some identical patients. The studies enrolled infants of mothers who had used opiates with or without other drugs during pregnancy. Methodological concerns included the use of quasi-random rather than random patient allocation methods in three studies; sizeable, largely unexplained differences in reported numbers allocated to each group in four studies; and imbalances in group characteristics after randomisation in one study.Opiate (morphine) vs supportive care only: One study (Khoo 1995) found no significant effect on treatment failure (RR 1.29, 95% CI 0.41, 4.07), a significant increase in hospital stay (MD 15.0 days, 95% CI 8.9, 21.1) and significant reductions in time to regain birthweight (MD -2.8 days, 95% -5.3, -0.3) and duration of supportive care (MD -197.2 minutes/day, 95% CI -274.2, -120.3).Opiate vs phenobarbitone: Meta-analysis of four studies found no significant difference in treatment failure (typical RR 0.76, 95% CI 0.51, 1.11). One of these studies (Finnegan 1984) reported that opiate treatment resulted in a significant reduction in treatment failure among infants of mothers who had used only opiates; however, as this was a post-hoc analysis, this result should be interpreted with caution. One study (Jackson 2004) reported a significant reduction in duration of treatment and admission to the nursery for infants receiving morphine compared to phenobarbitone. One study (Kandall 1983) reported a reduction in seizures, of borderline statistical significance, with the use of opiate.Opiate vs diazepam: Meta-analysis of two studies found a significant reduction in treatment failure (RR 0.43, 95% CI 0.23, 0.80) with the use of opiate.No study reported neurodevelopment by allocated treatment group. AUTHORS' CONCLUSIONS: Opiates, as compared to supportive care only, appear to reduce the time to regain birth weight and reduce the duration of supportive care, but increase the duration of hospital stay; there is no evidence of effect on treatment failure. When compared to phenobarbitone, opiates may reduce the incidence of seizures but, overall, there is no evidence of effect on treatment failure. One study reported a reduction in duration of treatment and nursery admission for infants on morphine. When compared to diazepam, opiates reduce the incidence of treatment failure. A post-hoc analysis generates the hypothesis that treatment effects may vary according to whether the population includes infants born to all opiate users (i.e. with or without other drug exposure) or is restricted to infants of mothers who used opiates only. In view of the methodologic limitations of the included studies the conclusions of this review should be treated with caution. PLAIN LANGUAGE SUMMARY: An opiate such as morphine or dilute tincture of opium should probably be used as initial treatment to ameliorate withdrawal symptoms in newborn infants with an opiate withdrawal due to maternal opiate use in pregnancy.Use of opiates (commonly prescribed methadone or illicit heroin) by pregnant women may result in a withdrawal syndrome in their newborn infants. This may result in disruption of the mother-infant relationship, sleeping and feeding difficulties, weight loss and seizures. Treatments for newborn infants used to ameliorate these symptoms and reduce complications include opiates, sedatives (phenobarbitone or diazepam) and supportive treatments (swaddling, settling, massage, relaxation baths, pacifiers or waterbeds). Trials of opiates compared to sedatives or other non-pharmacological treatments have generally been of poor quality. Individual trials have reported that using an opiate compared to phenobarbitone may reduce the incidence of seizures, duration of treatment and nursery admission rate. However, no overall effect was found on treatment failure rate. When compared to diazepam, opiates reduced the incidence of treatment failure. Opiates such as morphine or dilute tincture of opium should probably be used as initial treatment for opiate withdrawal in newborn infants ( view less ) View Full Abstract View Article Details   Related Articles Compression therapy for treating stage I and II (Widmer) post-thrombotic syndrome 2003 Kolbach, D. N., Sandbrink, M. W. C., Neumann, H. A. M., and Prins, M. H. BACKGROUND: Post-thrombotic syndrome (PTS) is a long-term complication of deep vein thrombosis characterised by chronic complaints, swelling, and skin changes in the affected limb. One in every three people with deep vein thrombosis develops post-thrombotic complications within five years. OBJECTIV... ( view more )ES: To assess the effectiveness of compression therapy in people with stage I and II post-thrombotic syndrome according to the classification of Widmer. Interventions of interest included elastic compression stockings and mechanical devices, compared with no intervention and with each other. SEARCH STRATEGY: The authors searched the Cochrane Peripheral Vascular Diseases Specialised Trials Register (last searched November 2006), and the Cochrane Central Register of Controlled Trials (CENTRAL) (last searched Issue 4, 2006). In addition, journals, conference proceedings and bibliographies were handsearched. Personal contact with other investigators involved in the clinical area was sought to get information about missed or unpublished studies. SELECTION CRITERIA: Trials that evaluated compression therapy for stage I and II (Widmer) post-thrombotic syndrome. Primary outcomes were leg ulceration, or deterioration of post-thrombotic syndrome. There were no restrictions on date or language. One author (DNK) assessed titles and abstracts for relevance. This was verified independently by a second author (MWCS). DATA COLLECTION AND ANALYSIS: Details of eligible studies were extracted and summarised using data extraction sheets. Data extraction was undertaken by one author (DNK) and verified by a second author (MHP). MAIN RESULTS: Only two trials were identified that addressed physical treatment of post-thrombotic syndrome. Both trials were initiated by the same group of investigators. A cross-over study lasting two months compared low and high pressure with intermittent compression units for severe post-thrombotic syndrome. This showed a beneficial effect of higher pressures. The second study, in people with mild to moderate post-thrombotic symptoms, showed no effect of elastic compression stockings (30-40 mm Hg at the ankle region) when compared to 'placebo' stockings that were one to two sizes too large. AUTHORS' CONCLUSIONS: There is some evidence of a beneficial effect of intermittent pneumatic compression units, but the study was too small and of too short a duration to draw strong conclusions. Further research is needed in order to assess whether intermittent pneumatic compression units give long term reduction and relief of the symptoms caused by post-thrombotic syndrome, and prevent deterioration and leg ulceration. The use of elastic compression stockings to treat post-thrombotic syndrome cannot be supported on the basis of the currently available data. PLAIN LANGUAGE SUMMARY: Compression therapy for treating post-thrombotic syndrome of mild to moderate severityPeople who have had a deep vein thrombosis (DVT) can develop post-thrombotic syndrome. This is caused by long-term clots in the affected leg and poor venous blood flow, resulting in leg pain, swelling ankles and hardened discoloured skin. The symptoms are worsened with prolonged standing or sitting and may limit lifestyle and day-to-day activities. In severe cases, venous ulcers, open sores that do not heal, also develop. Wearing circular bandages or compression stockings after initial blood thinning (anticoagulant) treatment for DVT is used to reduce the likelihood of post-thrombotic syndrome and reduce symptoms. With severe swelling of the leg (oedema), a machine can be used to apply pressure to the leg to improve blood circulation. The review authors identified two trials investigating the effectiveness of these physical treatments for post-thrombotic syndrome. The first trial randomized 12 women and three men with a mean age of 60 years to receiving mechanical pressure using an extremity pump applying either a therapeutic 50 mm Hg pressure or low 15 mm Hg pressure twice daily for 20 minutes for one month. The participants then changed to the other pressure for a month. Twelve of the 15 participants preferred therapeutic pressure levels and nine continued to use the compression pump after the trial had finished, with small improvements in symptoms. The second trial randomly assigned 35 men and women who had experienced a DVT 12 months previously to wearing elastic compression stockings, knee or thigh high, or placebo stockings that were one to two sizes too large. Wearing correct fitting compression stockings showed no differences from placebo. After three months, 11 of 18 people wearing compression stockings failed to have improved symptoms or were still prevented from performing their daily activities for five or more days in any three month period compared with 10 of 17 wearing placebo stockings. No adverse effects were reported. The studies were too small and of too short a duration to draw strong conclusions ( view less ) View Full Abstract View Article Details   Related Articles Aerobic exercise training programmes for improving physical and psychosocial health in adults with Down syndrome 2005 Andriolo, R. B., El Dib, R. P., and Ramos, L. R. BACKGROUND: Although physical fitness has been suggested to improve physical and psychosocial health for a variety of population profiles, there is a lack of information about the safety and effectiveness of aerobic exercise for adults with Down syndrome. OBJECTIVES: To evaluate the effectiveness a... ( view more )nd safety of aerobic exercise training programmes for physiological and psychosocial outcomes in adults with Down syndrome. SEARCH STRATEGY: Search terms and synonyms for "aerobic exercise" and "Down syndrome" were used within the following databases:CENTRAL (2005, Issue 2); MEDLINE (1966 to March 2005); EMBASE (2005 to April 2005); CINAHL (1982 to March 2005); LILACS (1982 to March 2005); PsycINFO (1887 to March 2005); ERIC (1966 to March 2005); CCT (March 2005); Academic Search Elite (to March 2005), C2- SPECTR (to March 2005 ), NRR (2005 Issue 1), ClinicalTrials.gov (accessed March 2005)and within supplements of Medicine and Science in Sports and Exercise. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials using supervised aerobic exercise training programmes with behavioral components accepted as co-interventions. DATA COLLECTION AND ANALYSIS: Two reviewers selected relevant trials, assessed methodological quality and extracted data. Where appropriate, data was pooled using meta-analysis with a random effects model MAIN RESULTS: The two studies included in this trial used different kinds of aerobic activity: walking/jogging and rowing training. One included study was conducted in the USA, the other in Portugal. In the meta-analyses, only maximal treadmill grade, a work performance variable, was improved in the intervention group after aerobic exercise training programmes (-4.26 [95% CI -6.45, -2.06]) grade. The other outcomes in the meta-analysis showed no significant differences between intervention and control groups, as expressed by weighted mean difference: VO2 peak -0.30 (95% CI -377, 3.17) mL·Kg·min-1; peak heart rate, -2.84 (95% CI -10.73, 5.05) bpm; respiratory exchange ratio, 0.01 (95% CI -0.04, 0.06); pulmonary ventilation, -5.86 (95% CI -16.06, 4.34) L·min-1. 30 other measures including work performance, oxidative stress and body composition variables could not be combined in the meta-analysis. Trials reported no significant improvements in these measures. AUTHORS' CONCLUSIONS: There is insufficient evidence to support improvement in physical or psychosocial outcomes of aerobic exercise in adults with Down syndrome. Although evidence exists which supports improvements in physiological and psychological aspects from strategies using mixed physical activity programmes, well-conducted research which examines long-term physical outcomes, adverse effects, psychosocial outcomes and costs are required before informed practice decisions can be made. PLAIN LANGUAGE SUMMARY: Many people with Down syndrome have poor strength, poor muscle mass, and high body fat percentage and so are disposed to cardiovascular health problems. Although physical fitness has been suggested to improve physical and psychosocial health for a variety of population profiles, information about the safety and effectiveness of aerobic exercise for adults with Down syndrome is lacking. This review identified only two small trials of good quality. Results of meta-analyses showed only maximal treadmill grade, a work performance variable, was improved after aerobic exercise training programs. Further well-designed research on larger population samples is urgently required ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Therapeutic ultrasound for treating patellofemoral pain syndrome 2001 Brosseau, L., Casimiro, L., Robinson, V., Milne, S., Shea, B., Judd, M., Wells, G., and Tugwell, P. BACKGROUND: Therapeutic ultrasound is one of several rehabilitation interventions suggested for the management of pain due to patellofemoral knee pain syndrome. OBJECTIVES: To assess the effectiveness and side effects of ultrasound therapy for treating patellofemoral knee pain syndrome. SEARCH STRA... ( view more )TEGY: We searched the Cochrane Musculoskeletal Review Group register, Cochrane Field of Physical and Related Therapies register, Cochrane Controlled Trials Register, MEDLINE, EMBASE, HealthSTAR, Sports Discus, CINAHL,and PEDro databases (to December 2000) according to the sensitive search strategy for RCTs designed for the Cochrane Collaboration. The search was complemented with handsearching of the reference lists. Key experts in the area were contacted for any further articles. SELECTION CRITERIA: All randomized controlled trials (RCTs), controlled clinical trials (CCTs), case-control and cohort studies comparing therapeutic ultrasound against placebo or another active intervention in people with patellofemoral pain syndrome were selected according to an a priori protocol. DATA COLLECTION AND ANALYSIS: Two reviewers determined the studies to be included based on a priori inclusion criteria. Data were independently extracted by the same two reviewers and checked by a third reviewer (BS) using a previously developed form. The same two reviewers independently assessed the methodological quality of the RCTs and CCTs using a validated scale. The data analysis was performed using Peto odds ratios. MAIN RESULTS: The search retrieved 85 articles. Of the eight that were potentially relevant, only one RCT, including 53 participants with patellofemoral pain syndrome, was identified for this review. All participants received an exercise program as concurrent therapy. Ultrasound combined with ice massage contrast (n of 13), where n equals the number of participants, was not statistically different from ice massage alone (n = 16) in terms of participant-rated pain relief or quadriceps and hamstring strengthening. In the ultrasound and ice massage group, 46% (6 of 13) reported improved pain relief compared to 31% (4 of 13) in the ice massage alone group. This difference of 15% does not meet international standards for clinically important improvements in osteoarthritis, which is 20%. Side effects were not reported. AUTHORS' CONCLUSIONS: Ultrasound therapy was not shown to have a clinically important effect on pain relief for people with patellofemoral pain syndrome. These conclusions are limited by the poor reporting of the therapeutic application of the ultrasound and low methodological quality of the one trial included. No conclusions can be drawn concerning the use, or non-use, of ultrasound for treating patellofemoral pain syndrome. More well-designed studies are needed. PLAIN LANGUAGE SUMMARY: Ultrasound therapy had no clinical benefit on pain relief or muscle strength in people with patellofemoral knee pain syndromeTherapeutic ultrasound is a commonly used modality in treating patellofemoral knee pain syndrome. Only one RCT, including 53 participants with patellofemoral pain syndrome, was identified for this review. All participants received an exercise program as concurrent therapy. Ultrasound combined with heat and ice massage was not different from ice massage alone in terms of participant-rated pain relief or quadriceps and hamstring strengthening. These conclusions are limited by poor reporting of the characteristics of application of the therapeutic ultrasound and poor methodological quality of the single trial ( view less ) View Full Abstract View Article Details   Related Articles A population survey of bipolar disorder in persons with and without Down syndrome 1996 Pary, Robert J., Strauss, David, and White, James F. Examined the rate of bipolar disorder diagnoses in a population of 154,420 individuals (aged 0-51+ yrs) who received services from the California Department of Developmental Services, which included 11,277 persons with Down syndrome. Whereas 0.2% of the control group had a diagnosis of bipolar diso... ( view more )rder there was not a single case among persons with Down syndrome who carried this diagnostic label. A second analysis using the target symptom of hyperactivity (excluding individuals treated with stimulants) was performed. Although hyperactivity is a nonspecific symptom, a previous study found that hyperactivity was the most common presenting complaint in persons with mental retardation and bipolar disorder. Again, a significant decrease of over activity was found in persons with Down syndrome compared to controls. Implications and limitations of the findings are discussed. (PsycINFO Database Record (c) 2005 APA, all rights reserved) ( view less ) View Full Abstract View Article Details   Related Articles Megestrol acetate for the treatment of anorexia-cachexia syndrome 2005 Berenstein, E. G. and Ortiz, Z. BACKGROUND: Megestrol acetate (MA) is currently used to improve appetite and to increase weight in cancer-associated anorexia. In 1993 MA was approved by the USA's Federal Drug Administration for the treatment of anorexia, cachexia, or unexplained weight loss in patients with AIDS. The mechanism by... ( view more ) which MA increases appetite is unknown, and its effectiveness for anorexia and cachexia in neoplastic and AIDS patients is under investigation. OBJECTIVES: To evaluate the efficacy, effectiveness and safety of MA in palliating anorexia-cachexia syndrome in patients with cancer, AIDS and other underlying pathologies. SEARCH STRATEGY: Studies were sought thorough an extensive search of the electronic databases, journals, reference lists, contact with investigators and other search strategies outlined in the methods. The most recent search was carried out on October 2002. SELECTION CRITERIA: Studies were included in the review if they assessed megestrol acetate compared to placebo or other drug treatments in randomized controlled trials of patients with a clinical diagnosis of anorexia-cachexia related to cancer, AIDS or another underlying pathology. DATA COLLECTION AND ANALYSIS: Data extraction was conducted by two independent authors, and methodological quality evaluated. Quantitative analyses were performed using appetite and quality of life as a dichotomous variable, and weight gain was analysed as continuous and dichotomous variables. Studies with more than 50% of patients lost to follow-up were excluded from the analysis. MAIN RESULTS: Thirty trials met the inclusion criteria (4123 patients). Twenty-one trials compared MA at different doses with placebo; four compared different doses of MA versus other drugs; two compared MA with other drugs and placebo; and three compared different doses of MA. For all patient conditions, meta-analysis showed a benefit of MA compared with placebo, particularly with regard to appetite improvement and weight gain in cancer patients. Analysing quality of life, clinical and statistical heterogeneity was found and discussed. There was insufficient information to define the optimal dose of MA. AUTHORS' CONCLUSIONS: This review demonstrates that MA improves appetite and weight gain in patients with cancer. No overall conclusion about quality of life (QOL) could be drawn due to heterogeneity. The small number of patients, methodological shortcomings and poor reporting have not allowed us to recommend megestrol acetate in AIDS patients or with other underlying pathologies. PLAIN LANGUAGE SUMMARY: Megestrol acetate for the treatment of anorexia-cachexia syndrome.Megestrol acetate improves appetite and weight gain in patients with anorexia cachexia syndrome related to cancer.The mechanism of action of the drug is unknown. The review found that megestrol acetate significantly increased appetite and weight gain in cancer patients but there was not enough evidence to reach a conclusion about the effect on quality of life and the optimal dose. There was too little information on AIDS patients and on patients with other underlying pathologies. A low incidence of adverse effects was found ( view less ) View Full Abstract View Article Details   Related Articles Immunologic status correlates with severity of physical symptoms and perceived illness burden in chronic fatigue syndrome patients 2000 Cruess, S. E., Klimas, N., Antoni, M. H., Helder, L., Maher, K., Keller, R., and Fletcher, M. A. The purpose of the present study was to investigate the relationship between immunologic status and physical symptoms in Chronic Fatigue Syndrome (CFS) patients. Twenty-seven patients diagnosed with CFS were included. Participants completed a questionnaire including selected subscales of the Sickne... ( view more )ss Impact Profile, the Cognitive Difficulties Scale, and frequency and severity of CFS-related physical symptoms. Cellular immune markers measured included number and percent of T-helper/inducer cells (CD3+CD4+), T-cytotoxic/suppressor cells (CD3+CD8+), activated T-lymphocytes (CD26+CD2+CD3+), activated T cytotoxic/suppressor cells (CD38+HLA-DR+CD8+), and CD4/CD8 ratio. Spearman's correlation coefficients revealed significant associations between a number of immunologic measures and severity of illness suggesting that the degree of cellular immune activation was associated with the severity of CFS-related physical symptoms, cognitive complaints, and perceived impairment secondary to CFS. Specifically, elevations in T-helper/inducer cells, activated T-cells, activated cytotoxic/suppressor T-cells, and CD4/CD8 ratio were associated with greater severity of several symptoms. Furthermore, reductions in T-suppressor/cytotoxic cells also appeared related to greater severity of some CFS-related physical symptoms and illness burden. Multiple regression analyses demonstrated that decreased percentage of CD3+CD8+ cells and increased number of CD38+HLA-DR+CD8+ cells were the strongest predictors of total illness burden and fatigue severity, accounting for almost 30% of the variance in these measures ( view less ) View Full Abstract View Article Details   Related Articles - Neuromyasthenia and chronic fatigue syndrome (CFS) in Northern Nevada/California: A ten-year follow-up of an outbreak. [References] 2001 Strickland, Paula S., Levine, Paul H., Peterson, Daniel L., O'Brien, Karen, and Fears, Thomas - Notes that in 1984-87, an outbreak of debilitating fatigue was reported by 2 private practice physicians of internal medicine in Incline Village, Nevada. Follow-up questionnaires were sent in 1995 to the 259 patients in this outbreak. Results were analyzed to determine how many Ss met the Centers... ( view more ) for Disease Control and Prevention (CDC) case definition for Chronic Fatigue Syndrome (CFS), Idiopathic Chronic Fatigue (ICF), or Prolonged Fatigue (PF), and how many Ss had recovered from their illness after approximately 10 yrs. This experiment also sought to determine if there was a relationship between this outbreak and a subsequent increased incidence of brain tumors and non-Hodgkins lymphoma. Data were analyzed separately for Ss living in the Lake Tahoe area and Ss referred from other locales. Results show that of the 123 Ss (mean age 49 yrs) returning questionnaires, 41% met the CDC case definition for CFS, 56% met the criteria for the subgroup ICF, and 3% experienced PF. In the population-based Lake Tahoe group, symptomatic women were more likely to have CFS than ICF, whereas symptomatic men were likely to fit ICF criteria. Also in this group, full recovery was reported more often among Lake Tahoe Ss classified as having ICF (43%) than Ss classified as having CFS (15%). (PsycINFO Database Record (c) 2005 APA, all rights reserved) ( view less ) View Full Abstract View Article Details   Related Articles Quality of life--ageing and Down syndrome 2001 Brown, R., Taylor, J., and Matthews, B. This article, based on pilot qualitative research, examines the quality of life of people with Down syndrome who are in the upper age bracket (45-70 years). Through use of a questionnaire, the current life experience and interests of a small group of individuals are noted, along with some of their ... ( view more )perceptions concerning their past and present, including their views on the ageing process. Recommendations are made particularly in relation to the need to recognise the principles of variability, perception and choice, while providing support to encourage dignified and active lifestyles ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Reading with Abby: a case study of individual tutoring with a young adult with Down syndrome 2002 Gallaher, K. M., van, KraayenoordCE, Jobling, A., and Moni, K. B. This case study examined the impact of a series of tutoring sessions on the literacy development of a young woman with Down syndrome. The sessions were conducted within the LATCH-ON (Literacy and Technology-Hands On) program at the Schonell Special Education Centre at the University of Queensland a... ( view more )nd made use of technology resources in addition to other methods of instruction. The first author assumed the role of participant observer through the reported sessions and acted as an individual tutor to the young woman. Data obtained from an initial screening indicated that the young woman had only limited word decoding strategies when reading text, and consequently, had significant problems with comprehension. Instruction during individual tutoring sessions focused primarily on phonics instruction, as well as other decoding strategies, such as sight word recognition. Specific instructional strategies employed by the first author are discussed. Within the context of the LATCH-ON program, the impact of individual instruction on the development of literacy is examined and discussed ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Relationships of cognitive difficulties to immune measures, depression and illness burden in chronic fatigue syndrome 1995 Lutgendorf, Susan, Klimas, Nancy G., Antoni, Michael, Brickman, Andrew, and Fletcher, Mary A. Investigated whether 65 patients (mean age 42.5 yrs) with chronic fatigue syndrome (CFS) complaining of greater cognitive difficulties would show greater impairments in cell-mediated immunity and a greater degree of immune system dysregulation and determined if these cognitive difficulties would co... ( view more )rrelate with the other non-affective measures of CFS-associated illness burden. It was also examined whether these relationships would hold independent of depression. Self-assessment of cognitive difficulties, depression and illness burden, and clinician-assessed depression and CFS symptoms, lymphocyte phenotype, proliferative response to mitogens, serum levels of cytokines and neopterin were performed. Results show that CFS patients with higher cognitive difficulty scores had more immune and clinical dysfunction than those patients with less cognitive difficulty, and that these relationships were independent of depression. (PsycINFO Database Record (c) 2005 APA, all rights reserved) ( view less ) View Full Abstract View Article Details   Related Articles Long-term disability for chronic fatigue syndrome 1997 Manu, P. To determine the quality of medical evaluations leading to long-term disability payments for chronic fatigue syndrome (CFS) we conducted a structured cross-sectional study of 76 patients receiving such benefits for an average of 2.1 years. Most of the subjects were middle-aged, white (99%), women (... ( view more )87%) who had been previously employed in "white collar" jobs (96%). In all cases the claim of disability was based on subjective reports of substantial impairment in exercise tolerance and cognitive ability. The quality of disability determinations was judged by the fulfillment of four requirements: correct CFS diagnosis, psychiatric evaluation, neuro-psychological testing and physical capacity measurement. The analysis indicated that none of the claims had been fully evaluated and that in 34% of cases none of the requirements had been fulfilled. The diagnosis of CFS was incorrect in 38% of cases. The majority of claimants (84%) had active psychiatric disorders, but only 32% had been evaluated by psychiatrists. Only 14% of claimants had their physical capacity objectively assessed and only 11% had formal testing of their cognitive abilities. The data suggests that most medical evaluations resulting in disability payments for CFS are flawed as a result of the overdiagnosis of CFS, the insufficient attention given the comorbid psychiatric disorders, and the infrequent objective testing of physical capacity and cognitive function ( view less ) View Full Abstract View Article Details   Related Articles Nickel allergy is found in a majority of women with chronic fatigue syndrome and muscle pain- and may be triggered by cigarette smoke and dietary nickel intake 2001 Regland, B., Zachrisson, O., Stejskal, V., and Gottfries, C.-G. Two hundred and four women with chronic fatigue and muscle pain, with no signs of autoimmune disorder, received immune stimulation injections with a Staphylococcus vaccine at monthly intervals over 6 months. Good response was defined as a decrease by at least 50% of the total score on an observer's... ( view more ) rating scale. Nickel allergy was evaluated as probable if the patient had a positive history of skin hypersensitivity from cutaneous exposure to metal objects. The patient's smoking habits were recorded. Fifty-two percent of the patients had a positive history of nickel contact dermatitis. There were significantly more good responders among the non-allergic non-smokers (39%) than among the allergic smokers (6%). We also present case reports on nickel-allergic patients who apparently improved after cessation of cigarette smoking and reducing their dietary nickel intake. Our observations indicate that exposure to nickel, by dietary intake or inhalation of cigarette smoke, may trigger systemic nickel allergy and contribute to syndromes of chronic fatigue and muscle pain. (C) 2001 by The Haworth Press, Inc ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A screening instrument for chronic fatigue syndrome: Reliability and validity 1997 Jason, Leonard A., Ropacki, Michael T., Santoro, Nicole B., Richman, Judith A., Heatherly, Wendy, Taylor, Renee, Ferrari, Joseph R., Haney-Davis, Trina M., Rademaker, Alfred, Dupuis, Josee, Golding, Jacqueline, Plioplys, Audrius V., and Plioplys, Sigita Developed and evaluated a screening instrument and 2nd-stage medical assessment to estimate the prevalence of chronic fatigue syndrome (CFS). The instrument is a combination of existing and new measures, including demographic items, the Fatigue Scale, and a list of symptoms associated with CFS. Ss ... ( view more )were 4 groups of 15 Ss: patients with CFS (mean age 42.8 yrs), lupus (mean age 43.7 yrs), or multiple sclerosis (MS), and a healthy control group. Ss were interviewed twice over a 2-wk period with the new CFS screening questionnaire. The results showed the instrument had excellent test-retest and interrater reliability, and therefore has utility for CFS community-based epidemiologic research. However, while the instrument differentiated patients with CFS from healthy Ss, it was less likely to distinguish CFS from other autoimmune diseases, especially lupus. Thus, future community-based CFS prevalence studies should encompass both a screening and a medical examination to adequately differentiate CFS from other illnesses with overlapping symptomatology. The authors recommend a 2-stage research design with both a screening instrument with good sensitivity and medical assessments of CFS positives from stage I to deal with the specificity problem. (PsycINFO Database Record (c) 2005 APA, all rights reserved) ( view less ) View Full Abstract View Article Details   Related Articles Residential rehabilitation courses in the self-directed management of chronic fatigue syndrome: A preliminary evaluation 2002 Harrison, S., Smith, A., and Sykes, R. Residential rehabilitation courses in self-directed illness management offer a potentially useful patient-centered and multidisciplinary therapeutic option for Chronic Fatigue Syndrome. A retrospective survey of the data from the courses run by Westcare UK between 1995 and 1998 was undertaken to gi... ( view more )ve a preliminary evaluation of outcomes and acceptability. The outcome results, for 49 participants, show improvements, at 12 months, on the Fatigue and Emotional Distress subscales of the PFRS. (Fatigue: before course: mean 3.66, s.d. 1.14; 12 months later: mean 3.11, s.d. 1.57; F(1,48) = 11.19 p < 0.005. Emotional distress: before course: mean 2.53, s.d. 1.46; 12 months later: mean 2.04, s.d. 1.39; F(1,48) = 5.96 p < 0.01.) Participants also reported a high level of general satisfaction with the course: 89.4% gave a rating of five or six, out of six. These results describe both long- and short-term benefits, and support the continued use of these courses and the implementation of a further more rigorous study. (C) 2002 by The Haworth Press, Inc. All rights reserved ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Role of mycoplasmal infections in fatigue illnesses: Chronic fatigue and fibromyalgia syndromes, Gulf War illness and rheumatoid arthritis 2000 Nicolson GL, Nasralla MY Franco AR De Meirleir Bacterial and viral infections are purported to be associated with several fatigue illnesses, including Chronic Fatigue Syndrome (CFS), Fibromyalgia Syndrome (FMS), Gulf War Illness (GWI) and Rheumatoid Arthritis (RA), as causative agents, cofactors or opportunistic infections. We and others have l... ( view more )ooked for the presence of invasive pathogenic mycoplasmal infections in patients with CFS, FMS, GWI and RA and have found significantly more mycoplasmal infections in CFS, FMS, GWI and RA patients than in healthy controls. Most patients had multiple mycoplasmal infections (more than one species). Patients with chronic fatigue as a major sign often have different clinical diagnoses but display overlapping signs/symptoms similar to those found in CFS/FMS. When a chronic fatigue illness, such as GWI, spreads to immediate family members, they present with similar signs/symptoms and mycoplasmal infections. CFS/FMS/GWI patients with mycoplasmal infections generally respond to particular antibiotics (doxycycline, minocycline, ciprofloxacin, azithromycin and clarithromycin), and their long-term administration plus nutritional support, immune enhancement and other supplements appear to be necessary for recovery. Examination of the efficacy of antibiotics in recovery of chronic illness patients reveals that the majority of mycoplasma-positive patients respond and many eventually recover. Other chronic infections, such as viral infections, may also be involved in various chronic fatigue illnesses with or without mycoplasmal and other bacterial infections, and these multiple infections could be important in causing patient morbidity and difficulties in treating these illnesses ( view less ) View Full Abstract View Article Details   Related Articles Tobacco sensitivity in chronic fatigue syndrome (CFS) 2000 Baraniuk JN, Naranch K. Background: Mechanisms responsible for sensitivity to irritants such as tobacco smoke are poorly understood. A Tobacco Score quenstionnaire was developed to identify and characterize subjects with this sensitivity. For this pilot study, scores were assessed in populations of self-selected controls ... ( view more )and a group with irritant sensitivity (Chronic Fatigue Syndrome, CFS). Method: Subjects graded the severity of 21 symptoms associated with tobacco exposure. Results were compared with other instruments and a measure of pain severity (dolorimetry) in 116 control and 103 CFS subjects. Results: The Tobacco Score was positive in 16% of control and 51% of CFS subjects. Significant correlations were found between Tobacco Score, Irritant Rhinitis Score, and history of sinusitis. Intermediate relationships were found with history of allergic rhinitis, Systemic Complaints Score, and Multiple Chemical Sensitivity. Factors having no influence included gender, the severity of CFS symptoms, pain thresholds, and allergy skin tests. Conclusions: Tobacco sensitivity was correlated with measures of upper airway irritation and nonallergic sensitivity to triggers such as weather changes. The spectrum of symptoms, high prevalence in CFS, and absence of a relationship to atopy suggest that these nonallergic irritant syndromes may share a common neuropathophysiology ( view less ) View Full Abstract View Article Details   Related Articles Chronic fatigue syndrome and cancer. 2000 Levine PH, Pilkington D. Several studies have indicated a link between chronic fatigue syndrome (CFS) and cancer, most of them based on anecdotal observations. We have attempted to use more population-based data to determine if the reported relationship is meaningful. Two outbreaks of a fatiguing illness which included wel... ( view more )l documented cases of CFS were evaluated ten years after the reporte outbreak for long-term effects, particularly cancer. We found an unusual pattern of cancer which, in view of an increased incidence of brain tumors and non-Hodgkin's lymphoma (NHL) reported in other studies involving CFS, indicates the need for further study. At the present time this link, which is often presumed to be due to immune dysfuction, has not yet been documented. Not all CFS patients have apparent dysregulation of the immune systme and a single causative agent is highly unlikely, making the study of two heterogeneous illnesses, CFS and cancer, highly problematic. With the continuing focus on subgroups, however, this area of research may prove to be more productive ( view less ) View Full Abstract View Article Details   Related Articles Exercise for treating fibromyalgia syndrome 2002 Busch, A. J., Barber, K. A. R., Overend, T. J., Peloso, P. M. J., and Schachter, C. L. BACKGROUND: Fibromyalgia (FMS) is a syndrome expressed by chronic widespread body pain which leads to reduced physical function and frequent use of health care services. Exercise training is commonly recommended as a treatment. OBJECTIVES: The objective of this systematic review was to examine the ... ( view more )efficacy of exercise training as an treatment for FMS. SEARCH STRATEGY: We searched 6 electronic bibliographies for studies of exercise training in FMS: MEDLINE (1966-12/2000), CINAHL (1982-12/2000), HealthSTAR (1990-12/2000), Sports Discus (1975-05/2000), EMBASE (1974-05/2000) and the Cochrane Controlled Trials Register (2000, issue 4). We also reviewed the reference lists from identified articles including reviews and meta-analyses of treatment studies. SELECTION CRITERIA: Randomized trials focused on cardiorespiratory endurance, muscle strength and/or flexibility as treatment for FMS were selected. DATA COLLECTION AND ANALYSIS: Two reviewers independently identified trials meeting inclusion criteria, rated the methodologic quality using 2 standardized validated instruments, evaluated the adequacy of the exercise training stimulus using the American College of Sports Medicine (ACSM) criteria and evaluated the results. Disagreements were resolved through active discussion and consensus. High quality training studies had scores of 50% or greater on van Tulder methodologic criteria and met the minimum training standards of ACSM. Outcome variables were grouped into 7 constructs: pain, tender points, physical function, global well being, self efficacy, fatigue & sleep, and psychological function. Two reviewers independently extracted data on study characteristics, results and point estimates for selected variables, and used consensus to address discrepancies. MAIN RESULTS: Sixteen trials involving a total of 724 participants were assigned at random to: exercise intervention groups (n=379), control groups (n=277), or groups receiving an alternate treatment (n=68). Seven studies were high quality training studies: 4 aerobic training, 1 a mixture of aerobic, strength and flexibility training, 1 strength training and 2 with exercise training as part of a composite treatment. Flexibility protocols were never described in sufficient detail to allow evaluation. The four high quality aerobic training studies reported significantly greater improvements in the exercise groups versus control groups in aerobic performance (17.1% increase in aerobic performance with exercise versus 0.5% increase in the control groups), tender point pain pressure threshold (28.1% increase versus 7.0% decrease) and improvements in pain (11.4% decrease in pain versus 1.6% increase). Poor description of exercise protocols was common, with insufficient information on intensity, duration, frequency and mode of exercise. Adverse events were also poorly reported. AUTHORS' CONCLUSIONS: Supervised aerobic exercise training has beneficial effects on physical capacity and FMS symptoms. Strength training may also have benefits on some FMS symptoms. Further studies on muscle strengthening and flexibility are needed. Research on the long-term benefit of exercise for FMS is needed. PLAIN LANGUAGE SUMMARY: Aerobic exercise helps decrease symptoms of fibromyalgia.Individuals with fibromyalgia benefit from aerobic fitness training. There is evidence from well-defined and conducted studies that some of the symptoms of fibromyalgia (FMS) are improved by short-term aerobic fitness training. The most consistent improvements were noted in pain threshold using pressure, global well being (including ratings of general improvement in FMS) and aerobic performance. Muscle strengthening also holds promise as a treatment but requires further study. To date, limited examination of flexibility training prohibits conclusions about its benefits as a treatment for FMS ( view less ) View Full Abstract View Article Details   Related Articles Association Between Fennel Phase Inventory Scores and Immune and RNase-L Parameters in Chronic Fatigue Syndrome 2004 Van Hoof E, Coomans All patients suffering from a chronic condition, are challenged to manage the reality of their disease, the accompanying anxiety, the problems of daily living, and the effect on relationships. Therefore, when confronted with debilitating complaints, patients suffering from chronic fatigue syndrome ... ( view more )(CFS) need to adapt to a new way of living during the course of their illness. Fennell developed an integrated model to manage CFS. This article is a follow-up of a study by Jason et al. (9, 10) to verify the existence of the different phases. Although not all differences are statistically significant, a clear distinction is made according to the conclusions drawn by Jason et al. (9, 10). Relationships between these distinctions and measures of symptoms, disability, psychological distress, coping, and immune parameters were revealed using non-parametric statistical tests ( view less ) View Full Abstract View Article Details   Related Articles Clinical and Biochemical Characteristics Differentiating Chronic Fatigue Syndrome from Major Depression and Healthy Control Populations: Relation to Dysfunction and RNase L Pathway 2004 Suhadolnik RJ, Peterson DL Reichenbach NL Roen Patterns of immune dysfunction have emerged in chronic fatigue syndrome (CFS) that include an immune activation state (evidenced by increased activated T lymphocytes and circulating cytokines) and poor cellular function (low natural killer (NK) cell cytotoxicity and impaired T lymphocyte response t... ( view more )o mitogens). Therefore, the aim of the current study was to examine the relationship between clinical and functional characteristics, immune abnormalities and status of the RNase L pathway in CFS compared with healthy control and depression control populations. All study participants were assessed with respect to their general health, functional status, blood count and chemistry, biochemical and immune parameters. The CFS group (N = 66) demonstrated clinical, functional and biochemical abnormalities distinct from the healthy (N = 62) and depression (N = 51) control groups. The CFS group showed marked functional impairment compared with both control groups (P < .001) as measured by the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) (P < .001). The CFS group also showed decreased cognitive performance on a computerized test battery compared to healthy (P < .001) and depression controls (P < .009) and significantly higher 37/80 kDa RNase L ratio (P < .001) compared with both control groups. The odds ratios of a 37/80 kDa RNase L ratio > 2 compared with the CFS patients were 3.9 for the healthy controls (95% confidence limit (CL) 1.0-15.2, P < .05) and 65.8 for the depression controls (95% CL 10.7-406.6, P < .001). The CFS group demonstrated low NK cell cytotoxicity compared to healthy controls (P = .045). The correlation between abnormalities in the RNase L pathway and impaired NKcell function (r = .21, P < .006) suggests that both may be part of the same underlying disease mechanism, at least in this homogeneous population of very disabled CFS patients. Healthy contact-control subjects who had exposure to CFS patients showed a number of characteristics similar to the CFS patients, including an increased mean 37/80 kDa RNase L ratio (P < .04) and prevalence of the 37/80 kDa RNase L ratio > 2 (P < .03). In these contact-control subjects, the 37/80 kDa RNase L ratio was correlated with the interferon-a levels (r = .58, P < .02), suggestive of activation of the interferon pathway. The results of the present study support the cytokine/immune activation model in this well-characterized CFS patient group ( view less ) View Full Abstract View Article Details   Related Articles - Risk for delirium tremens in patients with Alcohol Withdrawal Syndrome. [References] 6-20-2002 Fiellin, David A., O'Connor, Patrick G., Holmboe, Eric S., and Horwitz, Ralph I. - To determine the characteristics associated with an increased risk for delirium tremens (DT) we performed a case-control study at the detoxification units of two hospitals. Cases met DSM-IV criteria for DT. For each case (n=15; males aged 35-77 yrs), 3 controls (n=45; males aged 23-71 yrs) were c... ( view more )hosen. Eligibility criteria were applied equally to cases and controls. Cases were more likely than controls to report a prior complicated withdrawal (DT or alcohol withdrawal seizure) (53 vs. 27%, OR 3.1, 95% CI 0.94-10.55), have a systolic blood pressure greater than 145 mm Hg on admission (60 vs. 27%, OR 4.1, 95% CI 1.21-14.06), and have comorbidity scores of at least 1 (60 vs. 18%, OR 6.9, 95% CI 1.92-25.08). Zero cases (0%) and 15 (33%) controls had no prior complicated withdrawals and no adverse clinical features (systolic blood pressure >145 or comorbidity score >1). Compared to this group, the odds of being a case and having both prior complicated withdrawal and at least 1 adverse clinical feature was 44.8 (95% CI 4.36-460). Elevated blood pressure, prior complicated alcohol withdrawal and medical comorbidity, alone and in combination, are associated with an increased risk of delirium tremens. (PsycINFO Database Record (c) 2005 APA, all rights reserved) ( view less ) View Full Abstract View Article Details   Related Articles Association between gamma -glutamyl transpeptidase activity and status of disorders constituting insulin resistance syndrome. [References] 2003 Yokoyama, Hirokazu, Moriya, Susumu, Homma, Yasuhiko, and Ogawa, Tetsuhei Serum gamma -glutamyl transferase ( gamma GTP) activity is a well-established marker of alcohol consumption. However, recently, a correlation between serum gamma GTP activity and insulin resistance status has been demonstrated. To determine whether serum gamma GTP activity could be associated with ... ( view more )the status of various disorders caused by increased insulin resistance levels, namely, insulin resistance syndrome, a cross-sectional study for 11,884 Japanese men was performed. They were divided into three groups by their age, and associations between gamma GTP and various indexes of insulin resistance syndrome were studied by multiple logistic regression analysis in which subjects' drinking styles were corrected for in each age bracket. In the results, consuming ethanol more than 40 g/day, body mass index more than 25.9 kg/m2, and triglyceride levels more than 150 mg/dl were significant risk factors accounting for increased gamma GTP activity (more than 78 IU/liters) irrespective of age. It is concluded that there are significant associations between gamma GTP and the status of insulin resistance syndrome. In addition to excessive alcohol consumption, the status of insulin resistance syndrome could affect subjects' gamma GTP activities. (PsycINFO Database Record (c) 2005 APA, all rights reserved) ( view less ) View Full Abstract View Article Details   Related Articles Personality and symptom sensitivity predictors of alprazolam withdrawal in panic disorder 2003 Roy-Byrne, P. BACKGROUND: Discontinuation of benzodiazepine (BZ) treatment results in a well-characterized withdrawal syndrome in 40-50% of anxious patients. While numerous studies have established the role of BZ dose, treatment duration, half-life, potency, rate of withdrawal and severity of underling anxiety d... ( view more )isorder in predicting severity of withdrawal symptoms, fewer studies have examined the role of psychological and personality factors. METHOD: In 123 panic disorder patients undergoing gradual tapered discontinuation of alprazolam in conjunction with pre-treatment with carbamazepine or placebo, the relationship between measures of 'symptom sensitivity' and 'harm avoidance', and severity of withdrawal symptoms measured as peak severity of symptoms, time before taper needed to be slowed due to symptoms, and ability to complete taper, was examined. RESULTS: After controlling for the less substantial effects of dose, treatment duration, pre-taper anxiety and panic attack frequency, measures of symptom sensitivity and harm avoidance accounted for an additional 3-6% of withdrawal variance. CONCLUSIONS: These results show an effect of symptom sensitivity and harm avoidance on BZ withdrawal symptoms, comparable to prior findings linking dependent personality characteristics to withdrawal severity. Failure to show the expected effect on ability to complete taper may be due to either the more symptomatic nature of the patients in this study ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Page 1 of 1000 1 2 3 4 > Last >> (25000 articles found)

      
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