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1.
Terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome: a randomized,placebo controlled trial 总被引:13,自引:0,他引:13
Cheah PY Liong ML Yuen KH Teh CL Khor T Yang JR Yap HW Krieger JN 《The Journal of urology》2003,169(2):592-596
PURPOSE: We evaluate terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome. MATERIALS AND METHODS: The study included 100, 20 to-50-year-old subjects who met the consensus criteria for chronic prostatitis/chronic pelvic pain syndrome and had not received previous alpha-blockers. Subjects were randomized to receive terazosin with dose escalation from 1 to 5 mg. daily or placebo for 14 weeks. The primary criterion for response was scoring 2 or less ("delighted-to-mostly satisfied") on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) quality of life item. The secondary criterion for response was greater than 50% reduction in NIH-CPSI pain score at 14 weeks. Other outcomes included total and NIH-CPSI domain scores, International Prostate Symptom Score, peak urinary flow rate, post-void residual urine and adverse effects. RESULTS: Using the primary criterion 24 of 43 evaluable subjects (56%) responded in the terazosin group compared to 14 of 43 (36%) in the placebo group (p = 0.03). Using the secondary criterion 26 of 43 subjects (60%) responded in the terazosin group compared to 16 of 43 (37%) in the placebo group (p = 0.03). The terazosin group had greater reductions (p <0.05) in NIH-CPSI total score, individual domain scores and International Prostate Symptom Score than the placebo group. There was no difference in peak urinary flow rate or post-void residual. In the terazosin group 18 patients (42%) had side effects compared to 9 (21%) in the placebo group (p = 0.04). CONCLUSIONS: Terazosin proved superior to placebo for patients with chronic prostatitis/chronic pelvic pain syndrome who had not received alpha-blockers previously. 相似文献
2.
Yupadee Fusakul Thanyaporn Aranyavalai Phongphitch Saensri Satit Thiengwittayaporn 《Lasers in medical science》2014,29(3):1279-1287
The efficacy of low-level laser therapy (LLLT) was evaluated in a total of 66 patients with mild to moderate carpal tunnel syndrome (CTS) with a double-blinded randomized controlled study. The patients were randomly assigned into two groups. Group I received 15 sessions of a gallium-aluminum-arsenide laser treatment at a dosage of 18 J per session over the carpal tunnel area with neutral wrist splint. Group II received placebo laser therapy with neutral wrist splint. The patients were evaluated with the following parameters: (1) clinical parameters which consisted of visual analog scale, symptom severity scale, functional status scale, and pinch strength and grip strength before the treatment and at 5- and 12-week follow-ups and (2) electroneurophysiological parameters from nerve conduction study which were evaluated before the treatment and at 12-week follow-up. Fifty nine patients (112 hands: unilateral CTS?=?6 hands and bilateral CTS?=?106 hands) completed the study. Both groups I and II had n?=?56 hands. Improvements were significantly more pronounced in the LLLT-treated group than the placebo group especially for grip strength at 5- and 12-week follow-ups. At 12-week follow-up, distal motor latency of the median nerve was significantly improved in the LLLT group than the placebo group (p?<?0.05). LLLT therapy, as an alternative for a conservative treatment, is effective for treating mild to moderate CTS patients. It can improve hand grip strength and electroneurophysiological parameter with a carry-over effect up to 3 months after treatment for grip strength of the affected hands. 相似文献
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Juan Alfonso Andrade Ortega Encarnación Cerón Fernández Rosario García Llorent Marisa Ribeiro González Alberto Damián Delgado Martínez 《The spine journal》2014,14(8):1712-1721
Background contextAlthough the use of deep heat therapy is widespread, there is scant literature available on its effectiveness in treating back or neck pain.PurposeThe purpose of this study was to determine the efficacy of microwave diathermy to treat nonspecific chronic neck pain.DesignThe study was designed as a double-blind, randomized controlled trial.Patient sampleThe patient sample consisted of 149 patients with nonspecific chronic neck pain in a hospital of the Andalusian Public Health Care System, SpainOutcome measuresThe study outcome measures are as follows: at baseline, pain intensity (using a visual analogue scale), disability (Neck Disability Index), and health-related quality of life (36-item short form health survey [SF-36]); at 3 weeks, baseline measures and patients' perceived overall outcome and satisfaction with the treatment; and at 6 months, 3–week measures, therapeutic co-interventions, and adherence to exercises.MethodsPatients were allocated randomly to three groups. The first group received continuous microwave diathermy, the second group was administered pulsed microwaves, and the third group (the control group) received unplugged microwaves. All three groups received the same general treatment: range of motion, isometric exercises, and transcutaneous electrical nerve stimulation.ResultsThe three groups had reduced pain and disability, and improvement was seen in some dimensions of the SF-36. However, there were no differences found in any of the parameters measured among the three therapeutic groups.ConclusionsMicrowave diathermy does not provide additional benefit to a treatment regimen of chronic neck pain that already involves other treatment approaches. 相似文献
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Ebba Kihlstedt Pasquier Ellen Andersson 《Surgery for obesity and related diseases》2018,14(3):386-392
Background
Pulmonary recruitment maneuver (PRM) at the end of laparoscopic gynecologic surgery has been shown to reduce postoperative pain. This prospective, randomized, controlled clinical trial aimed to investigate postoperative pain (primary endpoint) and nausea when performing a ventilator-piloted PRM at the end of laparoscopic bariatric surgery.Settings
A secondary-level public hospital in Sweden.Methods
After giving written consent, patients undergoing elective laparoscopic bariatric surgery were randomized to receive routine exsufflation (control group) or a ventilator-piloted PRM to remove residual carbon dioxide from the abdomen at the end of surgery. Pain and nausea intensities were recorded at 4, 12, 24, 36, and 48 hours after surgery using a questionnaire with numeric rating scales. Postoperative consumption of analgesics and antiemetics was also evaluated.Results
There were 150 randomly assigned patients recruited, 79 to PRM intervention and 71 controls. Pain intensity was significantly lower in the PRM group than in the control group 24 hours postoperatively (numeric rating scale 2 [1–3] versus 3 [2–5]; P = .002). Pain during the first 24 hours did not increase in the PRM group as it did in the control group (P = .045). Opioid requirements were significantly lower in the PRM group than in the control group (5.0 mg [2–10] versus 9.0 mg [5–15]; P = .025). The PRM did not affect incidence or intensity of nausea and vomiting.Conclusions
A ventilator-piloted PRM reduced postoperative pain intensity and opioid requirement after laparoscopic bariatric surgery. The heterogeneity of the study population and the large number of hospital staff involved indicate good generalizability of the results. 相似文献5.
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Daniel Germano Maciel Marianne Trajano da Silva José Antônio Rodrigues João Batista Viana Neto Ingrid Martins de França Ana Beatriz Medeiros Melo Therence Yves Pereira Barros da Silva Wouber Hérickson de Brito Vieira 《Lasers in medical science》2018,33(9):1949-1959
This study aims to investigate the effects of low-level laser therapy (LLLT) combined to a functional exercise program on treatment of FM. A double-blind and placebo-controlled randomized clinical trial composed of 22 women divided into two groups: placebo group (functional exercise program associated with placebo phototherapy n?=?11) and laser group (same exercise program associated with active phototherapy; n?=?11). Each session lasted from 40 to 60 min and was performed three times a week for 8 weeks. Phototherapy (808 nm, 100 mW, 4 J, and 142.85 J/cm2 per point) was bilaterally applied to different points of the quadriceps (8), hamstrings (6), and triceps sural muscles (3) immediately after each exercise session. Pre- and post-intervention evaluations regarding pain (sites, intensity, and threshold), functional performance (balance, functional tests), muscle performance (flexibility and isokinetic variables), depression, and quality of life were conducted. A reduction in pain and improvement in functional and muscular performance, depression, and quality of life were observed in both groups (p?<?0.05); however, with no significant differences between them (p?>?0.05). In conclusion, the benefic effects of functional exercise were not improved by combination with LLLT. 相似文献
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Treatment of chronic prostatitis/chronic pelvic pain syndrome with tamsulosin: a randomized double blind trial 总被引:6,自引:0,他引:6
PURPOSE: We compared the efficacy of tamsulosin with placebo for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). MATERIALS AND METHODS: In a double blind phase II trial, 58 patients 55 years old or younger with moderate to severe CP/CPPS were randomized to receive 0.4 mg tamsulosin or placebo for 6 weeks. Patients were assessed on days -14 and -1 during a 2-week washout, and on days 15 and 45. The primary end point was the change from baseline in total National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score on day 45. Secondary end points were the change from baseline in total NIH-CPSI score on day 15 and the change from baseline in pain, urinary symptoms and quality of life/impact domains of the NIH-CPSI on days 15 and 45. Analyses of responders were performed post hoc. RESULTS: On day 45 the treatment effect (difference between treatment groups in change from baseline) was -3.6 (p = 0.04) in favor of tamsulosin. The overall effect of tamsulosin was a function of the baseline total NIH-CPSI score. Treatment effect increased significantly as the baseline score increased (for total NIH-CPSI p <0.01). Tamsulosin efficacy was superior to placebo at the 75th percentile of baseline score for the total NIH-CPSI score (-8.3, p <0.01), the pain domain (-2.9, p = 0.02), the urinary symptoms domain (-2.3, p <0.01) and the impact/quality of life domain (-2.1, p = 0.02). The efficacy of tamsulosin increased with time (no significant treatment difference at 15 days) and tamsulosin was well tolerated. CONCLUSIONS: Tamsulosin was superior to placebo in providing symptomatic relief in men with CP/CPPS, particularly in those with more severe symptoms. 相似文献
8.
Mark J. Hancock Christopher G. Maher Jane Latimer Robert D. Herbert James H. McAuley 《European spine journal》2008,17(7):936-943
A clinical prediction rule to identify patients most likely to respond to spinal manipulation has been published and widely
cited but requires further testing for external validity. We performed a pre-planned secondary analysis of a randomised controlled
trial investigating the efficacy of spinal manipulative therapy in 239 patients presenting to general practice clinics for
acute, non-specific, low back pain. Patients were randomised to receive spinal manipulative therapy or placebo 2 to 3 times
per week for up to 4 weeks. All patients received general practitioner care (advice and paracetamol). Outcomes were pain and
disability measured at 1, 2, 4 and 12 weeks. Status on the clinical prediction rule was measured at baseline. The clinical
prediction rule performed no better than chance in identifying patients with acute, non-specific low back pain most likely
to respond to spinal manipulative therapy (pain P = 0.805, disability P = 0.600). At 1-week follow-up, the mean difference in effect of spinal manipulative therapy compared to placebo in patients
who were rule positive rather than rule negative was 0.3 points less on a 10-point pain scale (95% CI −0.8 to 1.4). The clinical
prediction rule proposed by Childs et al. did not generalise to patients presenting to primary care with acute low back pain
who received a course of spinal manipulative therapy.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. 相似文献
9.
Sureeporn Uthaikhup Jenjira Assapun Kanokwan Watcharasaksilp Gwendolen Jull 《The spine journal》2017,17(1):46-55
Background Context
A previous study demonstrated that in seniors, the presence of cervical musculoskeletal impairment was not specific to cervicogenic headache but was present in various recurrent headache types. Physiotherapy treatment is indicated in those seniors diagnosed with cervicogenic headache but could also be adjunct treatment for those with cervical musculoskeletal signs who are suspected of having transitional headaches.Purpose
This study aimed to determine the effectiveness of a physiotherapy program for seniors with recurrent headaches associated with neck pain and cervical musculoskeletal dysfunction, irrespective of the headache classification.Study Design
This is a prospective, stratified, randomized controlled trial with blinded outcome assessment.Patient Sample
Sixty-five participants with recurrent headache, aged 50–75 years, were randomly assigned to either a physiotherapy (n=33) or a usual care group (n=32).Outcome Measures
The primary outcome was headache frequency. Secondary outcomes were headache intensity and duration, neck pain and disability, cervical range of motion, quality of life, participant satisfaction, and medication intake.Methods
Participants in the physiotherapy group received 14 treatment sessions. Participants in the usual care group continued with their usual care. Outcome measures were recorded at baseline, 11 weeks, 6 months, and 9 months. This study was funded by a government research fund of $6,850. No conflict of interest is declared.Results
There was no loss to follow-up for the primary outcome measure. Compared with usual care, participants receiving physiotherapy reported significant reductions in headache frequency immediately after treatment (mean difference ?1.6 days, 95% confidence interval [CI] ?2.5 to ?0.6), at 6-month follow-up (?1.7 days, 95% CI ?2.6 to ?0.8), and at 9-month follow-up (?2.4 days, 95% CI ?3.2 to ?1.5), and significant improvements in all secondary outcomes immediately posttreatment and at 6- and 9-month follow-ups, (p<.05 for all). No adverse events were reported.Conclusions
Physiotherapy treatment provided benefits over usual care for seniors with recurrent headache associated with neck pain and dysfunction. 相似文献10.
Efficacy of low level laser therapy in myofascial pain syndrome: an algometric and thermographic evaluation 总被引:4,自引:0,他引:4
BACKGROUND AND OBJECTIVES: The efficacy of low level laser therapy (LLLT) in myofascial pain syndrome (MPS) seems controversial. Our aim was to clarify the effect of LLLT in MPS by using algometry and thermography. STUDY DESIGN/MATERIALS AND METHODS: Sixty-two patients with MPS having an active trigger point in the neck or upper back region were randomly divided into two equal groups according to therapy applied (group 1: LLLT + stretching exercises, group 2: stretching exercises alone). The outcome measures were pain measured with visual analogue scale (VAS), algometry on the trigger point, algometric difference, thermographic difference, and thermal asymmetry. Comparison was made within and between the groups pre- and post-therapeutically and 3 weeks after therapy. RESULTS: Mean pain values decreased more significantly in group 1 from baseline to 3 weeks follow up (7.54-3.06) while these values were 7.03-5.19 in group 2 (P < 0.05). Group comparisons revealed significant favorable differences in group 1 patients in terms of all other parameters at the first and the second evaluation post therapeutically (P < 0.05). CONCLUSIONS: LLLT seemed to be beneficial for pain in MPS by using algometry and thermography. 相似文献
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《The Foot》2020
BackgroundThis study aimed at estimating the extent to which a combination therapy of extracorporeal shockwave therapy (ESWT) with usual care (exercise and orthotic support) improve functional ability in the patient with plantar fasciitis when compared to usual care alone.MethodsParticipants with plantar fasciitis were randomly allocated into two groups: ESWT (n = 23), and control (n = 21). All participants received home exercise program with orthotic support. In addition, ESWT group received 2000 shock waves with 0.02 mJ/mm2 for three sessions. Functional outcomes were measured by function subscale of American orthopedic foot and ankle society (AOFAS-F) score and 12 minutes walking test including walking speed, cadence. The scores were recorded at baseline, third week and third month after the treatment. Analysis was performed using repeated measures ANOVA, and an intention to treat approach using multiple imputations.ResultsResults showed that there was a significant improvement in AOFAS-F total score and walking speed over three months in both groups (p < 0.001, p = 0.04 respectively); improvements in AOFAS-F were particularly in activity limitation (p = 0.001), walking distance (p = 0.02) and walking surface (p = 0.02). Groups were comparable with each other for both walking speed and AOFAS-F in any assessment time (p > 0.05). However, groups performed differently in cadence where there was an increase in cadence in ESWT group whereas a decline in control at the third month (p = 0.07).ConclusionThe results revealed that ESWT did not have an additive benefit over usual care to improve foot function and walking performance in patient with plantar fasciitis over three months post-treatment. 相似文献
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Background Laparoscopic strategies for managing intraabdominal pathologies offer significant benefits compared with conventional approaches.
Of interest are reports of decreased postoperative pain, resulting in shorter hospitalization and earlier return to normal
activity. However, many patients still require strong analgesia postoperatively. This study analyzed the use of intraoperatively
delivered aerosolized intraperitoneal bupivacaine and its ability to reduce postoperative pain.
Methods For this study, 80 patients undergoing laparoscopic cholecystectomy were recruited and divided randomly into four groups:
control (n = 20), aerosolized bupivacaine (n = 20), aerosolized normal saline (n = 20), and local bupivacaine in the bladder bed (n = 20). All the patients had standard preoperative, intraoperative, and postoperative care. Pain scores were recorded by the
nursing staff in recovery, then 6, 12, and 24 h postoperatively using a standard 0 to 10 pain scoring scale. In addition,
opiate consumption and oral analgesia were recorded.
Results Aerosolized bupivacaine significantly reduced postoperative pain in comparison with all other treatments (p < 0.05). Injection of bupivacaine into the gallbladder bed did not result in a significant difference from the control condition.
Conclusion Aerosolized intraperitoneal local anesthetic is an effective method for controlling postoperative pain. It significantly helped
to reduce opiate use and contributed to rapid mobilization, leading to short hospitalization and possible reduction in treatment
cost. 相似文献
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ObjectiveThe objective of this study was to verify the effects of resisted and proprioceptive exercises program for the treatment of patients diagnosed with patellofemoral pain syndrome (PFPS).Design methodRandomized Controlled Trial – level of evidence, II.MethodsSixty female patients, clinically diagnosed with PFPS, were allocated into two experimental groups. The exercise group (ExG) underwent 6 weeks of a resisted and proprioceptive exercises for the trunk muscles, abductors and lateral hip rotators and knee extensors. The Guidance Group (GG) received educational, cognitive and behavioral guidance on healthcare. Before and after the program implementation period, all participants were evaluated in relation to the injured limb for pain assessment, subjective functionality, maximum isometric strength and 2D biomechanical analysis.ResultsAfter a six-week follow-up, ExG showed significant improvement in the Numerical Pain Rating Scale, Anterior Knee Pain Scale and Knee Outcome Survey- Activities of Daily Living Scale when compared to the control group (p ≤ 0,05). The ExG also proved superior for increased muscle strength of knee extensors, hip abductors, decreased dynamic knee valgus and pelvic drop in relation to GG (p ≤ 0.05). However, when we consider the strength of the hip lateral rotator muscles there was no difference between the two interventions (p > 0.05).ConclusionResisted and proprioceptive exercises yielded superior results to those of a treatment focused on educational, cognitive and behavioral guidance in improving pain and lower limb function for women with PFPS. 相似文献
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Chondros P Nikolidakis D Christodoulides N Rössler R Gutknecht N Sculean A 《Lasers in medical science》2009,24(5):681-688
Recent preclinical and clinical data have suggested the potential benefit of photodynamic therapy (PDT) in the treatment of
periodontitis. However, currently, there are very limited data from controlled clinical trials evaluating the effect of PDT
in the treatment of periodontitis. The aim of the present study was to evaluate the clinical and microbiological effects of
the adjunctive use of PDT in non-surgical periodontal treatment in patients receiving supportive periodontal therapy. Twenty-four
patients receiving regularly supportive periodontal therapy were randomly treated with either subgingival scaling and root
planing followed by a single episode of PDT (test) or subgingival scaling and root planing alone (control). The following
parameters were evaluated at baseline and at 3 months and 6 months after therapy: full mouth plaque score (FMPS), full mouth
bleeding score (FMBS), bleeding on probing (BOP) at experimental sites, probing pocket depth (PPD), gingival recession (REC),
and clinical attachment level (CAL). Primary outcome variables were changes in PPD and CAL. Microbiological evaluation of Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythensis (T.f.), Treponema denticola (T.d.), Peptostreptococcus micros (P.m.), Fusobacterium nucleatum (F.n.), Campylobacter rectus (C.r.), Eubacterium nodatum (E.n.), Eikenella corrodens (E.c.), and Capnocytophaga species (C.s.) was also performed at baseline and at 3 months and 6 months after therapy, using a commercially available polymerase chain
reaction test. No differences in any of the investigated parameters were observed at baseline between the two groups. At 3 months
and 6 months after treatment, there were no statistically significant differences between the groups in terms of PPD, CAL
and FMPS. At 3 months and 6 months, a statistically significantly higher improvement of BOP was found in the test group. At
3 months after therapy, the microbiological analysis showed a statistically significant reduction of F.n. and E.n. in the test group. At 6 months, statistically significantly higher numbers of E.c. and C.s. were detected in the test group. The additional application of a single episode of PDT to scaling and root planing failed
to result in an additional improvement in terms of PPD reduction and CAL gain, but it resulted in significantly higher reduction
of bleeding scores than following scaling and root planing alone. 相似文献