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JPEN J Parenter Enteral Nutr 2021 Apr 21. Epub 2021 Apr 21.

Gazi University School of Medicine, Department of Pediatric Metabolism and Nutrition, Ankara, Turkey.

Background: Ketogenic diet (KD) is a low carbohydrate, high fat diet used  as a non-pharmacological treatment in many neurological and metabolic disorders effectively for a long time. The effectiveness of the KD  is revealed in mitochondrial disorders mainly in the pyruvate dehydrogenase deficiency.

Conclusion: This is the first case of effectively treated mitochondrial depletion syndrome with parenteral ketogenic diet for lactic acidosis. Read More

Food Funct 2021 Apr 21. Epub 2021 Apr 21.

Department of Food Science and Technology, Faculty of Agricultural Sciences, University of Guilan, Rasht, Iran.

Background/objective: In the current study, we aimed to explore the effects of rice bran oil (RBO) in adjunct to conventional medical therapy on left ventricular ejection fraction (LVEF), cardiometabolic risk factors, and inflammatory mediators in male patients with coronary artery disease (CAD).

Subjects/methods: The present randomized controlled trial included 40 men diagnosed with CAD (mean age = 55.76 years) who were randomly allocated into two groups to receive either 30 grams per day of RBO (intervention group) or sunflower oil (control group) plus a standard diet for eight weeks. Read More

Jpn J Nurs Sci 2021 Apr 20:e12421. Epub 2021 Apr 20.

Afşin City Hospital, Kahramanmaraş, Turkey.

Introduction: In addition to pharmacological methods, non-pharmacological methods can also be used for reducing pain and increasing comfort during invasive procedures in newborn babies. This study was conducted to determine the effect on pain level and comfort of foot massages given by mothers to newborns before heel lancing.

Methods: This is a double-blind randomized controlled experimental study. Read More

Neurotherapeutics 2021 Apr 20. Epub 2021 Apr 20.

Mayo Center for Sleep Medicine, 200 First Street SW, Rochester, MN, 55905, USA.

Restless legs syndrome (RLS) is characterized by an uncomfortable urge to move the legs while at rest, relief upon movement or getting up to walk, and worsened symptom severity at night. RLS may be primary (idiopathic) or secondary to pregnancy or a variety of systemic disorders, especially iron deficiency, and chronic renal insufficiency. Genetic predisposition with a family history is common. Read More

Digit Signal Process 2021 Apr 15:103058. Epub 2021 Apr 15.

Adana Alparslan Turkes Science and Technology University, Adana, Turkey.

Insights about the dominant dynamics, coupled structures and the unknown uncertainties of the pandemic diseases play an important role in determining the future characteristics of the pandemic diseases. To enhance the prediction capabilities of the models, properties of the unknown uncertainties in the pandemic disease, which can be utterly random, or function of the system dynamics, or it can be correlated with an unknown function, should be determined. The known structures and amount of the uncertainties can also help the state authorities to improve the policies based on the recognized source of the uncertainties. Read More

Open Heart 2021 Apr;8(1)

NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK.

Objective: Most current cardiovascular disease (CVD) risk stratification tools are for people without CVD, but very few are for prevalent CVD. In this study, we developed and validated a CVD severity score in people with coronary heart disease (CHD) and evaluated the association between severity and adverse outcomes.

Methods: Primary and secondary care data for 213 088 people with CHD in 398 practices in England between 2007 and 2017 were used. Read More

Rev Port Cardiol 2021 Apr 17. Epub 2021 Apr 17.

Departamento de Cardiologia de Intervenção do Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal.

Refractory angina is defined as persistent angina (≥3 months) despite optimal medical and interventional therapies. It is increasing in frequency, due to the success of current medical and interventional therapies in improving the prognosis of coronary artery disease. Long-term mortality is similar to that of patients with asymptomatic stable disease, but it affects patients' quality of life, and has a significant impact on health care resources. Read More

Public Health 2021 Apr 16;194:109-115. Epub 2021 Apr 16.

St John of God Health Care, Perth, Western Australia, Australia. Electronic address:

Objective: The evaluation of real-world, hospital-based, arts programmes is important for quality assurance, to increase knowledge of successful practice and awareness of effective arts-health collaborations. The objective of this study was to describe the Music for Wellness programme and evaluation at St John of God Frankston Rehabilitation Hospital, Australia.

Study Design: An impact evaluation and quasi-experimental pre-post study was conducted. Read More

Sleep Med 2021 Apr 3;82:37-42. Epub 2021 Apr 3.

Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States.

Osteoarthritis is commonly comorbid with insomnia in older adults. While cognitivebehavioral therapy for insomnia is the recommended first-line treatment for insomnia, alternative efficacious non-pharmacological options are needed. This study examined sleep and pain in 30 community-dwelling older adults with comorbid insomnia and osteoarthritis pain randomized to two weeks of 30 min of bedtime active (n = 15, mean age 66. Read More

J Asthma 2021 Apr 20:1-6. Epub 2021 Apr 20.

Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada.

Introduction: Asthma guided self-management enhances patients' control of their condition under the guidance of the treating physician. The aim of the present study was to understand how physicians perceive, endorse, uptake, and support asthma guided self-management.

Methods: We conducted a secondary supplementary analysis of data originally collected as part of a multicenter collective case study in which physicians treating patients with asthma were interviewed. Read More

Pain Ther 2021 Apr 19. Epub 2021 Apr 19.

Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Via Vanvitelli, 32, 20133, Milan, Italy.

Osteoarthritis (OA) is a leading cause of disability among older adults worldwide. Treatment aims are to alleviate inflammatory pain and improve physical function through non-pharmacological and pharmacological interventions. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line therapy. Read More

Int J Community Based Nurs Midwifery 2021 Apr;9(2):152-158

Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Diabetes is the most common endocrine disorder. Non-pharmacological methods can be used for treatment of these patients. The present study aimed to investigate the effect of acupressure point on fasting blood glucose and glycosylated levels of diabetic patients. Read More

BMJ Open 2021 Apr 19;11(4):e043776. Epub 2021 Apr 19.

Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway.

Purpose: Around 15%-30% of adolescents and young adults (AYAs) experience persistent or chronic pain. The purpose of this study was to synthesise evidence from qualitative primary studies on how AYAs in a non-clinical population experience living with persistent pain.

Method: A qualitative metasynthesis guided by Sandelowski and Barroso's guidelines was used. Read More

Trials 2021 Apr 19;22(1):289. Epub 2021 Apr 19.

Department of Surgery, V-th Surgical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.

Background: Pain after surgery is normal, and treatments, including both pharmacological and psychological components, are fundamental for proper postoperative care. While several trials have investigated the analgesic effect of traditional non-pharmacological treatments, such as cognitive behavior therapies, the newer ways of delivering psychological interventions for pain after surgery are scarcely investigated. The aim of this randomized controlled trial (RCT) is to determine if delivering the psychological content through virtual reality (VR) along with the standard pharmacological treatment return better pain relief outcomes than standard care in adult patients following surgery. Read More

Cochrane Database Syst Rev 2021 Apr 19;4:CD009951. Epub 2021 Apr 19.

School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Australia.

Background: Gestational diabetes mellitus (GDM) is associated with a range of adverse pregnancy outcomes for mother and infant. The prevention of GDM using lifestyle interventions has proven difficult. The gut microbiome (the composite of bacteria present in the intestines) influences host inflammatory pathways, glucose and lipid metabolism and, in other settings, alteration of the gut microbiome has been shown to impact on these host responses. Read More

Transl Perioper Pain Med 2020 14;7(1):145-151. Epub 2019 Oct 14.

Department of Anesthesiology, Drexel University College of Medicine, Reading Hospital/Tower Health System, 420 S 5th Avenue, West Reading, PA 19611, USA.

Hiccup is an involuntary contraction of the diaphragm and intercostal muscles resulting in sudden inspiration and closure of the glottis. The presence of hiccup in the perioperative period can be a challenging problem. Sudden movements of the patient from hiccups can interfere preoperative diagnostic procedures, intraoperative hiccup may delay the beginning of surgery, interfere with the surgical process, and affect intraoperative monitoring, and postoperative hiccup may affect would healing and hemodynamic stability. Read More

Front Cell Dev Biol 2021 1;9:636506. Epub 2021 Apr 1.

Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

As neurons are highly energy-demanding cell, increasing evidence suggests that mitochondria play a large role in several age-related neurodegenerative diseases. Synaptic damage and mitochondrial dysfunction have been associated with early events in the pathogenesis of major neurodegenerative diseases, including Parkinson's disease, atypical parkinsonisms, and Huntington disease. Disruption of mitochondrial structure and dynamic is linked to increased levels of reactive oxygen species production, abnormal intracellular calcium levels, and reduced mitochondrial ATP production. Read More

Expert Opin Pharmacother 2021 Apr 19. Epub 2021 Apr 19.

Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States.

: Testosterone deficiency (TD) is defined as low serum testosterone associated with symptoms and signs. There is an increasing prevalence of TD in recent decades, especially in males aged 15-39. Many of these men will require long-term testosterone therapy (TT). Read More

Aten Primaria 2021 Apr 14;53(7):102053. Epub 2021 Apr 14.

Residencia Reyes de Aragón/Orpea, Zaragoza, España. Electronic address:

Objective: To provide evidence about the efficacy of a community health intervention through a cognitive stimulation program at long term in older people with mild cognitive impairment.

Design: Randomized controlled trial (CONSORT group norms).

Location: San José Norte-Centro Primary Care Center and La Caridad Foundation (Zaragoza, Spain). Read More

Res Social Adm Pharm 2021 Apr 12. Epub 2021 Apr 12.

University of Sherbrooke, Canada; Research Center on Aging of CIUSSS de L'Estrie-CHUS, Canada. Electronic address:

Background: Antipsychotics are often used for the first-line management of behavioral and psychological symptoms of dementia despite their limited efficacy and the risk of serious adverse drug events, compounded with disregard for guidelines recommending prioritizing non-pharmacological interventions. Some innovative interventions promote the deprescription of antipsychotics in long term care (LTC) settings.

Objective: The objective of this article is to present the conditions leading to the scale-up of an innovative program on the appropriate use of antipsychotics in LTC centers. Read More

Rev Chil Pediatr 2020 Dec 13;91(6):961-967. Epub 2020 Dec 13.

Hospital de Niños Roberto del Río, Universidad de Chile, Santiago, Chile.

Stridor is an abnormal respiratory sound caused by obstruction or collapse of the laryngotracheal airway, either acutely or chronically. There are different causes, both congenital and acquired, that can produce shortness of breath which may be severe and potentially life-threatening. The clini cal diagnosis must be complemented with an endoscopic airway assessment and sometimes with imaging, to try to determine the areas involved and possible associated malformations. Read More

PLoS One 2021 16;16(4):e0248740. Epub 2021 Apr 16.

Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, State University of New York, Albany, NY, United States of America.

Brazil has a cesarean rate of 56% and low use of Intrapartum Evidence-based Practices (IEBP) of 3.4%, reflecting a medically centered and highly interventionist maternal health care model. The Senses of Birth (SoB) is a health education intervention created to promote normal birth, use of EBP, and reduce unnecessary c-sections. Read More

Internist (Berl) 2021 Apr 16. Epub 2021 Apr 16.

Schwerpunkt Akutgeriatrie, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ziemssenstraße 1, 80336, München, Deutschland.

Osteoporosis is nowadays understood as an increased risk of fractures, with bone density measurement by dual-energy X‑ray absorptiometry (DXA) being a useful diagnostic criterion and a potent fracture predictor; however, especially in geriatric patients the result is often falsely negative, so that the diagnosis, indications for treatment and treatment selection should be based on an overall clinical evaluation of the individual situation. Sarcopenia is defined as a geriatric syndrome characterized by a generalized loss of skeletal mass and muscle function. Sarcopenia is associated with an increased likelihood of adverse outcomes including falls, fractures, disability and mortality. Read More

Schizophr Res 2021 Apr 12;231:145-153. Epub 2021 Apr 12.

Department of Biomedicine-Pharmacology and Therapeutics unit, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200 - 319 Porto, Portugal; Department of Psychiatry and Mental Health, University Hospital Center of São João, Alameda Prof. Hernâni Monteiro, 4200 - 319 Porto, Portugal. Electronic address:

Background: Smoking is a significant risk factor for mortality and morbidity among patients with schizophrenia.

Objective: To clarify the effectiveness of multimodal smoking cessation interventions in adult smokers diagnosed with schizophrenia.

Methods: A systematic review was conducted according to PRISMA guidelines. Read More

Pulm Ther 2021 Apr 15. Epub 2021 Apr 15.

Global Medical Affairs, Cipla Ltd, Mumbai, India.

Introduction: There is much recent data from Nepal, Sri Lanka and Malaysia that can help us understand the practice patterns of physicians regarding the diagnosis and management of chronic obstructive pulmonary disease (COPD) in these countries. We conducted this survey to understand the practice patterns of physicians related to the diagnosis and management of COPD in these three countries.

Methods: This questionnaire-based, observational, multicentre, cross-sectional survey was carried out with 438 randomly selected physicians consulting COPD patients. Read More

Cureus 2021 Apr 9;13(4):e14386. Epub 2021 Apr 9.

Oncology Department/Palliative Care, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Jeddah, SAU.

The present study discusses opioid-induced constipation (OIC) in advanced cancer patients, focusing on the OIC definition, pathophysiology, and treatment. OIC is any change from baseline defecation patterns and bowel habits that developed after starting opioid therapy. The condition is characterized by bowel frequency reduction, worsening or development of straining, a sensation of incomplete defecation, or distress associated with bowel habits. Read More

Br J Sports Med 2021 Apr 13. Epub 2021 Apr 13.

Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milano, Lombardia, Italy.

Objective: To assess the effectiveness of interventions for acute and subacute non-specific low back pain (NS-LBP) based on pain and disability outcomes.

Design: A systematic review of the literature with network meta-analysis.

Data Sources: Medline, Embase and CENTRAL databases were searched from inception until 17 October 2020. Read More

Enferm Clin 2021 Apr;31 Suppl 2:S330-S333

Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia. Electronic address:

This study aimed to analyze the relationship between the quality of pain and fatigue in ALL children 1-3 days after chemotherapy. A cross-sectional design with a consecutive sampling technique was used to 44 ALL children in Jakarta aged 7-18 years as the samples. Brief Pain Inventory (BPI) and Allen-Child Oncology Fatigue questionnaire were used to measure quality of pain and fatigue. Read More

J Psychiatr Res 2021 Apr 6;138:107-116. Epub 2021 Apr 6.

Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciuma, SC, Brazil. Electronic address:

This study aimed to evaluate the effects of environmental enrichment (EE) in Wistar rats subjected to maternal deprivation (MD). MD was performed in the first post-natal days (PND) ten for 3 h/day. The groups were: control; deprived without EE; and deprived with EE. Read More