- 03 May 18It is important to assess the effectiveness and efficiency of water-based training programs in order to prescribe it as an alternative in cardiac rehabilitation for patients who have coronary artery disease (CAD) (1). In these patients, autonomic dysfunction is an important physiological change strongly associated with adverse outcomes, morbidity, and mortality. This study aimed to evaluate the effects of water aerobic exercise training (WAET) on the autonomic modulation of heart rate (HR) and body composition, in the rehabilitation of CAD patients. Twenty-six male subjects with CAD were randomly divided into a training group, submitted to the WAET, and a control group. The WAET consisted of 3 weekly sessions on alternate days, totalling 48 sessions.
- 03 May 18Restless legs syndrome (RLS) is a sensorimotor disorder characterised by an uncomfortable urge to move the legs. This article attempted to synthesise results of non-pharmacological/non-surgical treatment compared to no-treatment controls or alternative treatment for RLS on any relevant outcome (1). The search yielded 442 articles. Eleven trials met inclusion criteria. Repetitive transcranial magnetic stimulation, exercise, compression devices, counterstrain manipulation, infrared therapy, and standard acupuncture were significantly more effective for RLS severity than control conditions. Vibration pads, cryotherapy, and transcranial direct current stimulation were ineffective in reducing RLS severity. Vibration pads, cryotherapy, yoga, compression devices, and acupuncture significantly improved some sleep-related outcomes.
- 03 May 18There have been several studies evaluating the association between vitamin and mineral status and menstrual disturbance (1). In this study, the authors aimed to assess the relationship between the menstrual bleeding pattern and premenstrual syndrome (PMS) symptoms with serum 25-hydroxyvitamin D, and calcium levels in adolescent girls. There was no significant association between the symptoms of PMS, as assessed by the questionnaire and serum vitamin D status, or serum calcium concentrations, apart from the irritability. There appears to be an association between serum calcium, menstrual blood loss and irritability in adolescent girls. The authors conclude that the level of calcium was associated with the level of menstrual blood loss and irritability. However, no significant association was observed between the menstrual bleeding pattern or the PMS symptoms with a vitamin D status. References (1) Bahrami A, et al. J Obstet Gynaecol. 2018; doi: 10.1080/01443615.2018.1434764.
- 03 May 18This article aimed to review all studies examining efficacy, tolerability and the biological mechanisms of action, of nutrient supplementation in first episode psychosis (FEP) (1). A systematic review was conducted. The results included 11 studies. . Six studies examined omega-3 fatty acids, with inconsistent effects on psychiatric symptoms. However, mechanistic studies found significant improvements in hippocampal neuronal health and brain glutathione. Antioxidants "n-acetyl cysteine" and vitamin C also improved oxidative status in FEP, which was associated with reduced psychiatric symptoms. No benefits were found for vitamin E . Finally, one study trialling the amino acid taurine, showed significant improvements in positive symptoms and psychosociall functioning.
- 03 May 18
This article discusses Vitamin D and its effects on athletic performance (1). Vitamin D is important for calcium homeostasis and bone metabolism. It also has important direct effects on skeletal muscle. Unlike authentic vitamins, which cannot be synthesized in the body, vitamin D is produced in the skin using sunlight. Through its nuclear receptor located throughout the body, including skeletal muscle, vitamin D initiates genomic and nongenomic pathways regulating multiple actions, including muscle cell proliferation and growth. In some studies, vitamin D supplementation has been shown to increase muscle strength, particularly in people who are vitamin D deficient. Higher serum levels of vitamin D are associated with reduced injury rates and improved sports performance.
- 20 Apr 18
This study aimed to determine the prevalence of complementary health approaches (CHAs) specifically for acute complaints in patients assessed in a pediatric emergency department (ED) and factors associated with use (1). A cross-sectional survey was offered to patients between the age of 28 days and 18 years assessed at a tertiary pediatric ED. The results showed that of 475 potential participants, 412 (86.7%) participated, of which 369 (89.5%) completed the survey. Overall, 28.7% reported using any CHA for their child to treat the presenting complaint in the prior 72 hours to the ED visit. Gastrointestinal complaints had the highest use of CHA (46.3% of presentations endorsed use). The most common complementary health products used were vitamins and minerals; the most common complementary health practice used was massage.
- 16 Apr 18
The purpose of this review is to outline the currently developed non-vitamin K oral anticoagulant (NOAC) molecular antagonists, their potential clinical roles and future directions (1). The incidence and prevalence of atrial fibrillation (AF) is expected to more than double between 2010 and 2030. Accordingly, the use of NOAC agents for thromboembolic stroke prevention is anticipated to increase. The development of effective and safe antidotes is needed to address the unmet need for rapid anticoagulation reversal. The immediate role for these novel antidotes is for reversal of NOAC activity in life threatening bleeding and urgent surgical intervention. In addition, reversal agents may play an important role in simplifying bridging protocols in the peri-procedural period for catheter ablation of AF and elective surgery.
- 16 Apr 18
Circulatory failure, especially with low systemic vascular resistance (SVR), as observed in septic shock, thyrotoxicosis, and anemia, is a particular pattern that should suggest thiamine (vitamin B1) deficiency. The clinical picture of wet beriberi secondary to thiamine deficiency only demonstrates non-specific clinical manifestations. This article presents a rare case of wet beriberi associated with multiple organ failure (MOF) in a prison patient with years of heavy alcohol consumption (1). The patient started treatment with thiamine (100 mg) by intramuscular injection, together with basic supportive care. The outcomes were that the hemodynamic indices improved within 12 hours after thiamine administration. Echocardiographic examinations revealed right ventricular function improvement within a few days, which were normal within a month.
- 15 Apr 18
Vitamin D has been proposed to have anti-inflammatory properties. This study was a meta-analysis to examine the effects on inflammatory markers (1). Multiple databases were searched and randomized controlled trials were identified for analysis. The results showed that 28 studies were included. Vitamin D lowered C-reactive protein, TNF-alpha, and ESR – all inflammatory markers. This meta-analysis provides level 1 evidence that vitamin D supplementation may reduce chronic low-grade inflammation in patients with type 2 diabetes.
- 04 Apr 18
Recommended fish intake differs substantially from observed fish intake. In Denmark, ∼15% of the population consumes the state-recommended fish intake. How much fish individuals eat varies greatly, and this variation cannot be captured by considering the fish intake of the average population. The objective of this study was to propose specific fish intake levels for individuals that meet the recommendations for eicosapentaenoic acid, docosahexaenoic acid, and vitamin D without violating the permitted intake recommendations for methyl mercury, dioxins, and polychlorinated biphenyls (1). Results showed that individual, personal dietary recommendations were successfully modeled. Modeled fish intake levels were compared to observed fish intakes.
- 25 Mar 18
In this study, the authors evaluated the effectiveness and safety of outpatient balneological treatment consisting of hydrotherapy and peloid therapy in elderly patients with osteoarthritis (1). Hydrotherapy was applied as head-out immersion in a tap water pool at 36-38 °C for 20 min and then peloid therapy was applied as a local peloid pack on the painful region or joint at 42-43 °C for 20 min, on each weekday for 2 weeks. Patients were evaluated before and after the treatment and outcome measurements were pain, patient's global assessment, physician's global assessment, Western Ontario and McMaster Universities index, Lequesne hip index, Waddell index, neck pain and disability scale, and health assessment questionnaire. In total, 235 osteoarthritis patients were included in the analysis. The authors found significant improvements in pain and function scores in generalized, knee, lumbar, cervical and hand osteoarthritis.
- 20 Mar 18
Constant exposure to various stressors are leading to an increase in immunocompromising health conditions (1). In this review, the authors discuss the role of herbal immunomodulators. Synthetic chemotherapeutic agents, which are widely available in the commercial market, may be highly efficacious, but most are immunosuppressive and exert many side effects. Numerous herbs used in ethnoveterinary medicine can be successfully employed as adjuvant rehabilitators to negate the deleterious effects of chemotherapeutics. Globally, many studies have been conducted on these herbs and have revealed unique active constituents that activate the innate immune system through the stimulation of macrophages and lymphocytes, and modulation of the cytokine profile, which leads to a state of alertness with a subsequent reduction in the incidence of infection.
- 15 Mar 18
In this study, the authors reported on the long-term (up to 1 year) outcomes of acupuncture as a primary and independent treatment in patients with insomnia. The patient was evaluated with polysomnography. In this study, the diagnosis of chronic insomnia was based on the International Classification of Sleep Disorders insomnia. The patient had no obvious differential diagnosis. Acupuncture treatment was planned for this patient who refused to take medical treatment with chronic insomnia. So the patient received 1 hour of acupuncture treatment for 12 weeks. Polysomnographic evaluation was performed at baseline and 3 months, and 1 year after acupuncture treatment. He was asked to keep a diary of all his insomnia-related symptoms. All outcome measures substantially improved. Moreover, during the observation period, the patient's sleep quality did not worsen. The authors conclude that acupuncture is a viable therapy for chronic insomnia.
- 10 Mar 18
In this study, the authors evaluated which factors predicated a high patient throughput to add more evidence to the body of naturopathic evidence (1). It was a cross-sectional study sampling 1096 practitioners in Germany. Besides, sociodemographic data and practice characteristics topics like job satisfaction and feeling for the job were evaluated. This was supplemented with an evaluation of patient traits which were perceived as challenging. The results showed that the naturopathic practitioners were very satisfied with their job. Naturopathic practitioners described that 40% of their patients are challenging.
- 05 Mar 18
Based on a growing body of evidence implicating low vitamin D status in the development of cardiovascular disease, the authors hypothesized that in Canadian HIV-positive adults, low vitamin D concentration would be associated with increased subclinical vascular disease progression (1). In this study, they analyzed the association. The results showed mean progression was 0.027 mm/year. Only 13.3% of participants were vitamin D deficient (25(OH)D < 50 nmol/L), whereas 61.7% had a 25(OH)D exceeding the sufficiency threshold (75 nmol/L). The authors conclude that baseline vitamin D was associated with carotid intima-media thickness progression in this relatively vitamin D replete, predominately white and male, Canadian HIV-positive population.
(1) Huff H, et al. Vitamin D and progression of carotid intima-media thickness in HIV-positive Canadians. HIV Med. 2018;19(2):143-151.