scholarly journals Musculoskeletal Ultrasonography in CRPS: Assessment of Muscles Before and After Motor Function Recovery with Dry Needling as the Sole Treatment

2016 ◽  
Vol 1;19 (1;1) ◽  
pp. E163-E179
Author(s):  
Lakshmi Vas
Keyword(s):  
International Association ◽  
Small Sample Size ◽  
Motor Impairment ◽  
Pain Syndrome ◽  
Small Sample ◽  
Retrospective Data ◽  
Dry Needling ◽  
Before And After ◽  
Musculoskeletal Ultrasonography ◽  
And Gender

Background: Motor impairment is an important criterion in the Clinical Diagnostic Criteria (CDC) of Complex Regional Pain Syndrome type-1 (CRPS-1) as defined by International Association for Study of Pain (IASP). Objective: To describe the changes in musculoskeletal ultrasonography (MSKUSG) in CRPS-1 before and after treatment with ultrasound-guided dry needling (USGDN) in retrospective data from 44 patients. Study Design: Patients irrespective of age, gender, or cause of CRPS were included in this retrospective data analysis; the Budapest criteria for the diagnosis of CRPS were stringently adhered to. Setting: The analysis was done at Ashirvad Institute for Pain Management and Research with the database of CRPS patients who were treated between December 2005 and December 2014. Methods: The CDC, range of motion at upper extremity joints, dynamometry, Disability of arm, shoulder and hand score (DASH) and ultrasonography were documented on days one, 15, and 45. MSKUSG demonstrated loss of myoarchitecture and reduced bulk. Results: All 44 patients received USGDN as the sole intervention with medications and physiotherapy. MSKUSG at 15 and 45 days after starting USGDN showed a return of normalcy to the myoarchitecture and muscle bulk increase that coincided with the disappearance of CDC and a progressive and predictable improvement of the DASH scores in all the 44 patients. Limitation: The analysis focuses on only 2 parameters: the musculoskeletal changes of the forearm flexors and extensors on ultrasound guidance and the efficacy of the dry needling treatment. It is not a comparative study with another accepted form of treatment or intervention. We have not looked into the age and gender predilection of the condition owing to the small sample size of the study. Analysis of long term maintenance of relief and rehabilitation of the disability were limited to one year. Conclusion: Myofascial pathology of co-contraction appears to cause CDC of CRPS and probable ischemic loss of myoarchitecture. Relief of co-contraction with USGDN allowed resolution of tenosynovitis causing the CDC and return of normal myoarchitecture. Key words: CRPS-1, co-contraction, motor impairment, disability, dry needling, musculoskeletal ultrasonography

Participant Reactions to Suicide-Focused Research

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 367-374
Author(s):  
Sarah P. Carter ◽  
Brooke A. Ammerman ◽  
Heather M. Gebhardt ◽  
Jonathan Buchholz ◽  
Mark A. Reger
Keyword(s):  
Medical Records ◽  
Research Study ◽  
Small Sample Size ◽  
Psychiatric Inpatient ◽  
Small Sample ◽  
Inpatient Unit ◽  
Online Laboratory ◽  
Psychiatric Inpatient Unit ◽  
Before And After ◽  
Participant Reactions

Abstract. Background: Concerns exist regarding the perceived risks of conducting suicide-focused research among an acutely distressed population. Aims: The current study assessed changes in participant distress before and after participation in a suicide-focused research study conducted on a psychiatric inpatient unit. Method: Participants included 37 veterans who were receiving treatment on a psychiatric inpatient unit and completed a survey-based research study focused on suicide-related behaviors and experiences. Results: Participants reported no significant changes in self-reported distress. The majority of participants reported unchanged or decreased distress. Reviews of electronic medical records revealed no behavioral dysregulation and minimal use of as-needed medications or changes in mood following participation. Limitations: The study's small sample size and veteran population may limit generalizability. Conclusion: Findings add to research conducted across a variety of settings (i.e., outpatient, online, laboratory), indicating that participating in suicide-focused research is not significantly associated with increased distress or suicide risk.

scholarly journals O-225 Effects of SARS-Corona virus 2 on IVF treatment parameters: A cohort study of post COVID-19 patients

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Y Kabalkin ◽  
M Gil ◽  
E Lifshitz ◽  
A Moav ◽  
M Kabessa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Virus Disease ◽  
Small Sample Size ◽  
Sperm Concentration ◽  
Small Sample ◽  
Cycle Performance ◽  
Ang Ii ◽  
P Values ◽  
Corona Virus ◽  
Before And After

Abstract Study question Does recovery from SARS–Corona virus 2 (SARS–CoV-2) infection negatively effect IVF cycle parameters? Summary answer Female IVF treatment parameters were comparable to the pre-Covid-19 infection cycle performance. Sperm concentration and motility demonstrated lower mean counts following Covid-19 infection. What is known already Corona-virus disease-19 (Covid-19) is a global pandemic caused by SARS–Corona virus 2 (SARS–CoV-2). The virus primarily affects the respiratory system, but other systemic and immune mediated effects have been reported. The spikes of SARS-CoV-2 have strong affinity for the Angiotensin converting enzyme (ACE) 2 receptor, leading to an increased Angiotensin II (Ang II) mediated pro-inflammatory response. ACE2 receptors exist in the human reproductive tract (more in males) and pose a regulatory role together with Ang II. So far, reports have been inconsistent regarding testicular effects. Other implications involving fertility and fertility treatment post infection are scarce. Study design, size, duration In this retrospective cohort study, IVF cycle performance was compared before and after Corona-virus disease-19. Patients were included only in cases where an IVF cycle was initiated within 3 months of Covid-19 recovery, between March 2020-December 2020. Participants/materials, setting, methods The study was conducted in a University affiliated IVF unit. Post Covid- 19 cycle parameters were compared to previous cycles of the same individual prior to infection. If previous cycles were not available, parameters were compared to non-exposed patients of same age, same treatment and identical indication. Sperm concentration and motility were compared before and after infection. Non exposure was defined by a lack of past Covid-19 diagnosis and a negative PCR throughout the treatment. Main results and the role of chance All together, including the matched cycles, we compared 40 cycles which started within 3 months of recovery: 26 fresh stimulation cycles and 14 frozen thawed transfer cycles. In 28 of these cycles the patient could serve as its own control. Mean age for the female partner was 33.2 years ±6.5 years. Eight male partners presented post infection and provided fresh samples for a cycle involving fertilization. We compared stimulation parameters including maximal Estradiol level, stimulation length, FSH dosage, number of oocytes retrieved, fertilization rates, number of embryos created, high quality embryo number and endometrial thickness. All of these were comparable to non-exposed cycles (generalized estimating equations, p values >0.1). No complications were recorded, specifically no thromboembolic events or respiratory complications. A total of 8 patients conceived: 1 was a chemical pregnancy, 1 extra-uterine pregnancy, 3 miscarriages and 3 ongoing, of those 1 was complicated by early bleeding. Male sperm analyses showed a trend towards lower post disease parameters, not reaching a statistical significance: 23mil/ml compared to 13.6 and 20.7% progressive motility compared to 12.3% (p values 0.09 and 0.17, respectively). Limitations, reasons for caution Current results are based on a small sample size, still insufficient for deducing definite conclusions or guidelines. Pregnancy outcome following IVF treatment in Covid-19 recoverees should further be studied. By the time of the conference, the number of cases is expected to be significantly higher. Wider implications of the findings This study provides preliminary data regarding the effects of SARS-COV-2 infection on IVF treatment outcomes. Despite the small sample size, treatment parameters seem unaffected, however, sperm performance seems to be compromised. Health policy and patients’ decisions regarding whether or not to postpone IVF procedures necessitates additional data. Trial registration number Not applicable - retrospective

scholarly journals A Pilot Placebo Controlled Randomized Trial of Dexamethasone for Chronic Subdural Hematoma

2016 ◽  
Vol 43 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Michel Prud’homme ◽  
François Mathieu ◽  
Nicolas Marcotte ◽  
Sylvine Cottin
Keyword(s):  
Conservative Treatment ◽  
Adverse Events ◽  
Small Sample Size ◽  
Chronic Subdural Hematoma ◽  
Symptomatic Patient ◽  
Placebo Treatment ◽  
Small Sample ◽  
Chi Square ◽  
Serious Adverse Events ◽  
Before And After

AbstractBackground: Current opinions regarding the use of dexamethasone in the treatment of chronic subdural hematomas (CSDH) are only based on observational studies. Moreover, the use of corticosteroids in asymptomatic or minimally symptomatic patient with this condition remains controversial. Here, we present data from a prospective randomized pilot study of CSDH patients treated with dexamethasone or placebo. Methods: Twenty patients with imaging-confirmed CSDH were recruited from a single center and randomized to receive dexamethasone (12 mg/day for 3 weeks followed by tapering) or placebo as a conservative treatment. Patients were followed for 6 months and the rate of success of conservative treatment with dexamethasone versus placebo was measured. Parameters such as hematoma thickness and clinical changes were also compared before and after treatment with chi-square tests. Adverse events and complications were documented. Results: During the 6-month follow-up, one of ten patients treated with corticosteroids had to undergo surgical drainage and three of ten patients were treated surgically after placebo treatment. At the end of the study, all remaining patients had complete radiological resolution. No significant differences were observed in terms of hematoma thickness profile and impression of change; however, patients experienced more severe side effects when treated with steroids as compared with placebo. Dexamethasone contributed to many serious adverse events. Conclusions: Given the small sample size, these preliminary results have not shown a clear beneficial effect of dexamethasone against placebo in our patients. However, the number of secondary effects reported was much greater for corticosteroids, and dexamethasone treatment was responsible for significant complications.

Abstract 13215: Gender-affirming Hormones Are Associated With Increased Risk of QT Prolongation in Transgender Females

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Antwi Amoabeng ◽  
Ahmed Hanfy ◽  
Munadel Awad ◽  
Bryce D Beutler ◽  
Amneet Rai ◽  
...  
Keyword(s):  
Qt Interval ◽  
Small Sample Size ◽  
Qt Prolongation ◽  
Small Sample ◽  
Rank Test ◽  
Qt Interval Prolongation ◽  
Northern Nevada ◽  
Increased Risk ◽  
Before And After ◽  
Signed Rank Test

Introduction: Women have a longer QT interval than men. This sex-specific difference is attributed to hormones associated with the biological female sex. Male-to-female transgender individuals often take antiandrogens such as spironolactone or goserelin in addition to estrogens to suppress testosterone effects while increasing feminine features. Effects of gender-affirming hormone therapy (GHT) on the QT interval in these individuals remains to be elucidated. Hypothesis: We assessed the hypothesis that the use of GHT is associated with an increased risk for QT interval prolongation in transgender females. Methods: We identified 46 transgender females through a search of the electronic medical records of a Veterans Administration hospital in Northern Nevada. Patients with a diagnosis of congenital long QT syndrome were excluded. Of these, 13 patients had ECGs before and after initiation of GHT and were included. We adapted the Tisdale score using the auto-calculated corrected QT interval (QTc) to estimate the risk of QT prolongation. Age, QTc, and Tisdale scores before and after GHT initiation were compared using the Wilcoxon signed-rank test. All tests were performed as two-tailed at a 5% level of significance. Results: All 13 study patients were taking estrogens. Of these, 3 (23.1%) were taking goserelin and 9 (69.2%) were taking spironolactone. Mean ± SEM age at ECG acquisition was 45.0 ± 4.4 and 47.7 ± 4.7 years before and after the initiation of GHT respectively. Mean ± SEM QTc after initiation of GHT was significantly higher compared to the baseline (467.5 ± 12.8 ms vs. 428.2 ± 7.1 ms) (Figure 1A). The average baseline Tisdale score was significantly smaller on follow-up (1-point vs. 3 points) (Figure 1B). Conclusions: GHT appears to be associated with increased QTc in transgender women. This needs to be interpreted with caution owing to the very small sample size in this study. Further studies to investigate the strength of this association, if it exists, are warranted.

Workplace Satisfaction Before and After Move to an Open Plan Office - Including Interactions with Gender and Introversion

2017 ◽  
Vol 61 (1) ◽  
pp. 455-459 ◽  
Author(s):  
Nathan Bos ◽  
Kylie Molinaro ◽  
Alexander Perrone ◽  
Kelly Sharer ◽  
Ariel Greenberg
Keyword(s):  
Ad Hoc ◽  
Additional Data ◽  
Small Sample Size ◽  
Small Sample ◽  
Workplace Satisfaction ◽  
Flexible Support ◽  
Before And After ◽  
Open Plan ◽  
Data Source ◽  
Insight Into

Open plan offices are both popular and controversial. We studied the response of a group moving from shared, but closed offices to an open plan office. The main data source reported here is a workplace satisfaction survey given pre-move, post-move, and to a lab baseline comparison group at the same organization, with some additional data from observations and interviews. Workers moving to the open plan office appreciated the flexible support for collaboration and the space’s appearance. There was lower satisfaction related to space for private concentrated work, temperature control, and ability to have private conversations. There were also some statistical interactions suggesting more positive responses by males and less positive responses by introverts; analysis was limited by small sample size. Observations and interviews gave further insight into open plan “neighborhoods” and the design of ad hoc spaces.

Is increased screen time associated with the development of anxiety or depression in young people?

2017 ◽  
Vol 41 (S1) ◽  
pp. S530-S531 ◽  
Author(s):  
J. Khouja ◽  
M. Munafò ◽  
K. Tilling ◽  
N. Wiles ◽  
C. Joinson ◽  
...  
Keyword(s):  
Young People ◽  
Screen Time ◽  
Maternal Education ◽  
Small Sample Size ◽  
Small Sample ◽  
Anxiety And Depression ◽  
Parents And Children ◽  
Increased Risk ◽  
Before And After ◽  
Competing Interest

IntroductionEmerging evidence suggests that sedentary behaviour, specifically time spent taking part in screen-based activities, such as watching television, may be associated with mental health outcomes in young people [1]. However, recent reviews have found limited and conflicting evidence for both anxiety and depression [2].ObjectivesThe purpose of the study was to explore associations between screen time at age 16 years and anxiety and depression at 18.MethodsSubjects (n = 1958) were from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK-based prospective cohort study. We assessed associations between screen time (measured via questionnaire at 16 years) and anxiety and depression (measured in a clinic at 18 years using the Revised Clinical Interview Schedule) using ordinal logistic regression, before and after adjustment for covariates (including sex, maternal education, family social class, parental conflict, bullying and maternal depression).ResultsAfter adjusting for potential confounders, we found no evidence for an association between screen time and anxiety (OR = 1.02; 95% CI 0.95–1.09). There was weak evidence that greater screen time was associated with a small increased risk of depression (OR = 1.05, 95% CI 0.98–1.13).ConclusionsOur results suggest that young people who spend more time on screen-based activities may have a small increased risk of developing depression but not anxiety. Reducing youth screen time may lower the prevalence of depression. The study was limited by screen time being self-reported, a small sample size due to attrition and non-response, and the possibility of residual confounding. Reverse causation cannot be ruled out.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Effects of Hypoxia on the Behaviour, Mortality and Plasma Electrolyte Concentrations of Goldlined Seabream, Rhabdosargus sarba

2008 ◽  
Vol 13 ◽  
pp. 73
Author(s):  
Hamed M. Al-Gheilani ◽  
Colin Waring ◽  
Abdulaziz Al-Kindi ◽  
Shehla Amer
Keyword(s):  
Treatment Time ◽  
Small Sample Size ◽  
Plasma Concentrations ◽  
Small Sample ◽  
Low Oxygen ◽  
Hypoxic Conditions ◽  
Plasma Electrolyte ◽  
Mean Size ◽  
And Gender ◽  
Ventilation Rates

The behaviour, mortality rates and plasma electrolyte concentrations of goldlined seabream Rhabdosargus sarba challenged with low dissolved oxygen (DO) conditions was studied in an experimental setup, comprising a control (7.9 ml/l DO) and two hypoxic (2 ml/l and 1 ml/l DO) treatments. Increased ventilation rates and decreased swimming activity were observed in hypoxic treatments, but some fish exhibited strenuous avoidance actions. No mortalities were observed after 3 h, 6 h, or 24 h, but 50% of males and 18% of females died in the 48 h treatment at 1 ml/l DO. The mean size of surviving fish (305± 32.1 g total weight) was significantly smaller than those that died (425 ± 33.1 g). The plasma concentrations of Na+, Cl- and Mg2+ did not vary significantly relative to treatment, exposure time, fish size and gender, or interactions among treatment, time and gender. Ca2+ concentrations increased significantly after 48 h at 1 ml/l, but this result may be artificial because of the small sample size. The results suggest that R. sarba is comparatively tolerant of the low oxygen or hypoxic conditions that often occur in the coastal waters of Oman, where seasonal upwellings and  high primary productivity have in the past caused mass mortalities of demersal fishes.  

Epidemiology of psoriatic arthritis

2018 ◽  
Author(s):  
Elaine Husni ◽  
Madonna Michael
Keyword(s):  
Psoriatic Arthritis ◽  
Primary Care Physicians ◽  
Small Sample Size ◽  
Epidemiological Studies ◽  
Case Definition ◽  
Small Sample ◽  
Contributing Factors ◽  
Wide Range ◽  
And Gender ◽  
High Level

The epidemiological studies of psoriatic arthritis (PsA) is quite challenging as our understanding of the disease is evolving. A wide range of incidence and prevalence is reported among different countries suggesting genetic and environmental factors influencing the epidemiology of PsA. Other contributing factors accounting for the wide range and variation of PsA epidemiology include age and gender variations, ethnicity, lack of precise case definition, and small sample size. A high level of suspicion in patients with pre-existing psoriasis, and collaborative efforts shared between primary care physicians (PCP), dermatologist, and rheumatologist, will enhance early detection and management of PsA, subsequently improving overall patient outcomes, and quality of life.

scholarly journals Frequency of the LRRK2 G2019S mutation in late-onset sporadic patients with Parkinson’s disease

2014 ◽  
Vol 72 (5) ◽  
pp. 356-359 ◽  
Author(s):  
Hsin Fen Chien ◽  
Tamires Rocha Figueiredo ◽  
Marianna Almeida Hollaender ◽  
Fabiano Tofoli ◽  
Leonel Takao Takada ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Late Onset ◽  
Small Sample Size ◽  
Clinical Manifestations ◽  
Small Sample ◽  
Genetical Analysis ◽  
G2019s Mutation ◽  
Lrrk2 Gene ◽  
And Gender

Mutations in the LRRK2 gene, predominantly G2019S, have been reported in individuals with autosomal dominant inheritance and sporadic Parkinson’s disease (PD). The G2019S mutation has an age-dependent penetrance and evidence shows common ancestry. The clinical manifestations are indistinguishable from idiopathic PD. Its prevalence varies according to the population studied ranging from less than 0.1% in Asians to 41% in North African Arabs. This study aimed to identify G2019S mutation in Brazilian idiopathic PD patients.Method:We sampled 100 PD patients and 100 age- and gender-matched controls. Genetical analysis was accomplished by polymerase chain reaction (PCR).Results:No G2019S mutations were found in both patients with sporadic PD and controls.Conclusions:Our results may be explained by the relatively small sample size.

Promoting early dementia diagnosis: a video designed by patients, for patients

2016 ◽  
Vol 29 (5) ◽  
pp. 863-867 ◽  
Author(s):  
Nina Baruch ◽  
Charlotte L. Allan ◽  
Maureen Cundell ◽  
Samuel Clark ◽  
Brian Murray
Keyword(s):  
Early Diagnosis ◽  
Small Sample Size ◽  
Small Sample ◽  
Memory Clinic ◽  
Patient Feedback ◽  
Before And After ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
Advance Decisions ◽  
Level Of Understanding

ABSTRACTEarly diagnosis of dementia allows people to access effective treatment and make advance decisions while they still have capacity. We aimed to encourage people to attend memory clinic, in order to boost rates of diagnosis. We created a patient information video about Oxford Health NHS Foundation Trust Memory Clinics, to inform and empower those awaiting assessment and to promote early diagnosis.Fourteen people (patients, carers, and staff) were approached prior to developing the video to ascertain their views on the themes the video should cover. The video consisted of unscripted interviews with patients, carers, and staff. We surveyed participants and new patients attending memory clinic to get feedback on the video and to assess patients’ level of understanding and confidence about a memory assessment before and after watching the video. The video content was refined based on this feedback and a final version was produced.Patient feedback demonstrated that confidence and understanding increased after watching the video.Although this study is limited by its small sample size and lack of access to those with undiagnosed dementia, feedback suggested that the video empowered and reassured those awaiting assessment and could be used as a tool to reduce barriers to early diagnosis. Patients and carers involved in making the video found it a therapeutic activity in itself.

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