Randomized effectiveness trial of a brief course of acupuncture for posttraumatic stress disorder.
Med Care. 2014 Dec ;52(12 Suppl 5):S57-64. PMID: 25397825
Charles C Engel, Elizabeth H Cordova, David M Benedek, Xian Liu, Kristie L Gore, Christine Goertz, Michael C Freed, Cindy Crawford, Wayne B Jonas, Robert J Ursano
Charles C Engel
BACKGROUND: Initial posttraumatic stress disorder (PTSD) care is often delayed and many with PTSD go untreated. Acupuncture appears to be a safe, potentially nonstigmatizing treatment that reduces symptoms of anxiety, depression, and chronic pain, but little is known about its effect on PTSD.
METHODS: Fifty-five service members meeting research diagnostic criteria for PTSD were randomized to usual PTSD care (UPC) plus eight 60-minute sessions of acupuncture conducted twice weekly or to UPC alone. Outcomes were assessed at baseline and 4, 8, and 12 weeks postrandomization. The primary study outcomes were difference in PTSD symptom improvement on the PTSD Checklist (PCL) and the Clinician-administered PTSD Scale (CAPS) from baseline to 12-week follow-up between the 2 treatment groups. Secondary outcomes were depression, pain severity, and mental and physical health functioning. Mixed model regression and t test analyses were applied to the data.
RESULTS: Mean improvement in PTSD severity was significantly greater among those receiving acupuncture than in those receiving UPC (PCLΔ=19.8±13.3 vs. 9.7±12.9, P<0.001; CAPSΔ=35.0±20.26 vs. 10.9±20.8, P<0.0001). Acupuncture was also associated with significantly greater improvements in depression, pain, and physical and mental health functioning. Pre-post effect-sizes for these outcomes were large and robust.
CONCLUSIONS: Acupuncture was effective for reducing PTSD symptoms. Limitations included small sample size and inability to parse specific treatment mechanisms. Larger multisite trials with longer follow-up, comparisons to standard PTSD treatments, and assessments of treatment acceptability are needed. Acupuncture is a novel therapeutic option that may help to improve population reach of PTSD treatment.
Article Published Date : Nov 30, 2014
How do parents influence their adolescents' use of over-the-counter analgesics: A review of the current literature.
J Clin Nurs. 2019 Jan 22;:
Authors: Skarstein S, Lagerløv P, Helseth S, Leegaard M
AIM AND OBJECTIVES: Continuous use of over-the-counter analgesics (OTCAs) may prevent adolescents from learning healthier options and might lead to lifelong use of such medicines. It is possible that parents' own use of OTCAs might influence adolescents, but little is known about this issue. Our research questions were; "What are the main factors leading to a high use of OTCAs among adolescents and how can health professionals support these adolescents in their pain management?"
BACKGROUND: Frequent consumption of OTCAs may cause health problems such as drug-induced headache and liver failure. Some adolescents frequently use non-prescribed pain medication and their attitudes towards use of OTCAs vary from responsible to careless DESIGN: A «systematic search and review» was conducted between March 2017 to May 2018. Quantitative and qualitative studies were included.
METHODS: We used the PRISMA Statement checklist, the PRISMA flow diagram and The Critical Appraisal Skills Programme for quality appraisal. Our search identified 3386 possible sources, 2043 articles were selected for title examination, and 70 articles underwent abstract review. Fourteen articles were reviewed entirety. Ten articles were of acceptable quality.
RESULTS: The importance of parental influence on adolescent use of OTCAs is significant. These findings seem to be independent of country and culture.
CONCLUSION: Parents are the most important source of information regarding the use of OTCAs, further they are the main supplier of the medicine. A broad understanding of human development, health, pain and use of pain medication is needed to develop targeted information and support adolescents with high consumption of non-prescription pain medication.
RELEVANCE TO CLINICAL PRACTICE: Information from professionals such as school nurses is important. Professionals must consider the physical, social and psychological aspects influencing the use of OTCAs. Information should be made available to adolescents, parents and society in general. This article is protected by copyright. All rights reserved.
PMID: 30667118 [PubMed - as supplied by publisher]
Drug-Induced Peripheral Neuropathy, a Narrative Review.
Curr Clin Pharmacol. 2019 Jan 21;:
Authors: Jones MR, Urits I, Wolf J, Corrigan D, Colburn L, Peterson E, Williamson A, Viswanath O
Peripheral neuropathy is a painful condition deriving from many and varied etiologies. Certain medications have been implicated in the iatrogenic development of drug induced peripheral neuropathy (DIPN) and include chemotherapeutic agents, antimicrobials, cardiovascular drugs, psychotropic, anticonvulsants, among others. In many cases, DIPN develops in a dose dependent fashion following continued use of a neurotoxic agent. The development of DIPN should be suspected in patients who are receiving drug treatment and report new onset symptoms of pain, paresthesia, or weakness. In patients in whom a history of DIPN is suspected, motor and sensory nerve conduction studies may support the clinical diagnosis. While difficult to prevent, DIPN is more likely to occur in patients with concomitant risk factors such as preexisting neuropathy, diabetes and associated genetically predisposing diseases. DIPN is often difficult to treat, however medications including duloxetine, and gabapentin are shown to reduce neuropathic pain. Advanced techniques of neuromodulation offer promise though further randomized and controlled studies are needed to confirm efficacy.
PMID: 30666914 [PubMed - as supplied by publisher]
Thromboembolism in children with cancer: a retrospective multicenter study in Korea.
J Thromb Thrombolysis. 2019 Jan 21;:
Authors: Choi HS, Kim HJ, Kang HJ, Lee JW, Shin HY, Park HJ, Park BK, Lee YH, Lee JA, Lim YJ, Park KD
Thromboembolism (TE) is a major cause of morbidity and mortality in adult cancer patients; however, there is a lack of sufficient knowledge on TE in pediatric cancer patients. We aimed to determine the epidemiology of TE in Korean children with cancer. Between January 2000 and July 2015, we retrospectively analyzed pediatric patients newly diagnosed with cancer at six tertiary hospitals in Korea. Of 3611 children with cancer, 33 (0.91%) had TE. A higher number of patients with acute lymphoblastic leukemia (n = 13), brain tumors (n = 6), lymphoma (n = 4), and bone/soft tissue sarcomas (n = 5) tended to develop TE. The male/female ratio was 17/16, and the median age at TE diagnosis was 10 years and 2 months. TE was detected a median of 2 months after cancer diagnosis. Symptoms including pain and swelling were present in 18 of the 33 patients. In terms of location, three intracerebral, 23 upper venous, six lower venous and one combined upper and lower venous system TEs were observed. Additional risk factors for TE included central venous catheter (CVC) use in 12 patients, steroid and/or L-asparaginase use in nine, and CVC and steroid and/or L-asparaginase use in seven. The TE incidence rate was quite low among Korean children with cancer, but higher than in the general pediatric population and among children hospitalized for diseases other than cancer. Further investigation of a larger pool of patients is warranted to determine the most effective strategies to prevent and treat TE in Korean children with cancer.
PMID: 30666552 [PubMed - as supplied by publisher]
The association between bullying victimization in childhood and fibromyalgia. Data from the nationwide Finnish health and social support (HeSSup) study based on a sample of 64,797 individuals.
J Psychosom Res. 2019 Feb;117:48-53
Authors: Varinen A, Kosunen E, Mattila K, Suominen S, Sillanmäki L, Sumanen M
BACKGROUND: Fibromyalgia is a functional pain syndrome presenting with various psychological symptoms. Several studies have shown that adverse life events are associated with fibromyalgia. The aim of the current study is to explore the association between self-reported bullying victimization in childhood and self-reported fibromyalgia in adulthood.
METHODS: The basic study setting is cross-sectional - with focused use of retrospective data - derived from a large on-going postal follow up survey (sample N = 64,797) initiated in Finland in 1998. Only respondents having answered the questions on fibromyalgia in both follow ups in 2003 and 2012 were included (N = 11,924). Severity of bullying was divided into three groups starting from no bullying followed by minor and severe bullying. Covariates having shown statistically significant associations with fibromyalgia in cross tabulation using Pearson's chi-squared test were included in the final multiple logistic regression analyses.
RESULTS: In our study, 50.6% of the respondents reported victimization of minor and 19.6% of severe bullying in childhood. Participants reporting fibromyalgia in adulthood reported more bullying, and in females alone this association was statistically significant (p = .027). In multiple logistic regression analysis statistically significant associations between bullying victimization in childhood (reference: no bullying) and fibromyalgia were found: adjusted odds ratio (OR) for minor bullying was 1.35 (95% CI 1.09-1.67) and for severe bullying 1.58 (95% CI 1.21-2.06). However, in log-linear and logistic regression interaction models the association between bullying and fibromyalgia was not statistically significant when depression was included in the models.
CONCLUSIONS: Our results suggest that peer bullying victimization might be associated with fibromyalgia. However, in logistic log linear and logistic interaction models there was no statistically significant association when depression was included. As a result, there is need for further, preferably prospective cohort studies. The findings also emphasize the importance of actions to prevent childhood bullying.
PMID: 30665596 [PubMed - in process]