Hasil untuk "Miscellaneous systems and treatments"

Sun Jin Bae, Yeon Soo Kang, Pil Je Park et al.

This study discussed significant improvements in the cervical spine curvature and decreased pain levels after receiving combined Korean medicine treatments, including Chuna therapy, in a patient diagnosed with abnormal cervical spine curvature accompanied with neck, shoulder, and upper back pain. In addition to Chuna therapy, the patient received both inpatient and outpatient treatments between January 11, 2022, and February 26, 2022, including acupuncture, pharmacopuncture, electroacupuncture, herbal medicine, and physiotherapy. The patient’s condition was assessed by measuring the range of motion (ROM) to determine joint mobility, the numerical rating scale (NRS) was used to assess pain levels, and Jackson’s angle on radiography was utilized to assess cervical spine curvature. After treatment, the patient’s pain level decreased from NRS 5 to 1–2, with significant improvements in cervical ROM and Jackson’s angle.

Martohap Parotua Lumbanraja, Kusnandar Anggadiredja, Neng Fisheri Kurniati et al.

Objectives: Dyslipidemia has currently become a major health challenge that still opens for safer and more effective modes of treatment. The plant Pandanus amaryllifolius Roxb. (pandan) has been indicated to contain active ingredients that interfere with the pathological pathway of dyslipidemia. The aim of the study was to test the effects of pandan leaves ethanol extract on lipid and proinflammatory profiles in a rat dyslipidemic model. Methods: Dyslipidemia was induced by administration of high-fat feed for 8 weeks. Treatments (vehicle, the reference drug simvastatin at 1.8 mg/kg, and extract at 200, 300 or 600 mg/kg) were given for 4 weeks following the completion of induction. Results: Significant post-treatment decreases in total cholesterol, low density lipoprotein (LDL), and triglyceride levels in groups receiving all doses of extract and simvastatin were observed. Similar results were also found in regards to proinflammatory cytokines levels. Pandan extracts significantly lowered the concentrations of IL-6, TNF-α, and NFκB p65. Characterization of metabolite contents of the extract confirmed the presence of the previously suggested active alkaloids pandamarilactonine-A and B. Conclusion: Taken together, results of the present study implied the ameliorating effects of pandan leaves ethanol extract in dyslipidemic condition which is potential for opening an avenue in combating this essential component of metabolic disorder.

Armenia Armenia, Elsa Badriyya, Sri Rahmita et al.

Background: Malondialdehyde (MDA) is one of a dominat marker in oxidative stress condition, and when inflammation occurred tumor necrosis factor- α (TNF-α) played a significant influence in the propagation this process. Purified gambier (Uncaria gambier Roxb.) contained 90% catechin which is proven to have antioxidant activity and may prevent unwanted inflammatory responses during diabetic state. Objective: The objective of this research was to assess how purified gambier affected plasma MDA and TNF- α levels in alloxan-induced diabetic rats. Material and methods: In this study, 35 rats were used. Alloxan 120 mg/kg BW intraperitoneal injection was administered to induce diabetes conditions in rats. All animals were divided into 5 groups, diabetic control group treated with vehicle, positive control group treated with glibenclamide dose 0.45 mg/kg BW), and treatment groups treated with purified gambier dose of 2.5; 5 and 10 mg/kg BW. All animals were treated respectively for 14 days. Plasma MDA and TNF- α levels were measured on day 3, and 14. Results: Two-way ANOVA was applied to analyze all of the data, these findings suggested that purified gambier has antioxidant-related anti-inflammation actions. possesses blood sugar-lowering activity (p<0.05). The plasma MDA and TNF- α level of treatment group were significantly reduced (p<0.05) compared to diabetes control group. Conclusion: These results depicted that at doses of 2.5–10 mg/kg BW, purified gambier has antioxidant-associated anti-inflammation effects when given for 14 days on diabetic rat model by reducing plasma levels MDA and TNF-α.

Heba A. Soliman, Amel M. Yousef, Hamada A. Hamada et al.

Abstract Background There are a significant number of female athletes competing at the highest levels of sport. But, women are still largely underrepresented in scientific literature. The female menstrual cycle is characterized by variations in circulating hormone levels, which may have an impact on performance. Aim This study aimed to assess the impact of hormonal changes through different menstrual cycle phases on hand grip strength, pulp pinch strength, three fingers pinch strength, and lateral pinch strength of athletic and non-athletic girls. Methods An observational case control study was conducted on forty post-pubertal girls, their ages ranged from 16 to 22 years old, and their body mass index (BMI) ranged from 18.5 to 25 kg/m2. They were divided into two groups: athletic group of twenty basketball and tennis players recruited from basketball and tennis teams at Mena Garden City Club, 6 October Club, and Shooting Club October and non-athletic group of twenty non-sportive undergraduate students from Faculty of Physical Therapy, Misr University for Science and Technology. Hand grip strength was evaluated by Jamar hand dynamometer, while pulp pinch strength, three fingers pinch strength, and lateral pinch strength were evaluated by Jamar pinch gauge through three different menstrual cycle phases (follicular, ovulatory and luteal phases). Results Statistical analysis demonstrated a significant increase in handgrip strength, pulp pinch strength, three fingers pinch strength, and lateral pinch strength in non-athletic group. Also, there was a significant increase in three fingers pinch strength and lateral pinch strength in athletic group during the ovulatory phase across the menstrual cycle (p < 0.05). But, there was a significant difference across menstrual phases in handgrip strength and pulp pinch strength in athletic group (p > 0.05). Conclusion Hormonal changes during menstrual cycle phases do not alter handgrip strength, pulp pinch strength performance for athletic girls. But, they alter hand grip strength, pulp pinch strength, three fingers, and lateral pinch grip strength performance for non-athletic girls. Trial registration The protocol of the study was registered in clinical trials.gov PRS (Protocol Registration and Result System (registration No. NCT06086262 ), Registered on 17 October 2023). The study received ethical approval from the Institutional Review Board of the Faculty of Physical Therapy at Cairo University prior to its beginning (approval No P.T.REC/012/003358) .

Sejin Kim, Yunna Kim, Seung-Hun Cho

Objectives: Psychiatric symptoms in epilepsy are very common, and the most common symptoms are depression, insomnia, and anxiety. These symptoms not only lower the quality of life of epilepsy patients, but also elevate the risk of epileptic seizures. There are no specific criteria for the available antiepileptic drugs to ameliorate these symptoms in patients with epilepsy, and there is a lack of evidence to support the efficacy and safety of existing drugs. The Shugan Jieyu capsule (SJC) is a traditional herbal medicine composed of Acanthopanax senticosus and Hypericum perforatum and is reported to be effective in relieving psychiatric symptoms. The purpose of this study was to assess the efficacy of SJC as a treatment for psychiatric symptoms in epilepsy patients.Methods : : Electronic databases will be investigated for publications in English, Korean, Japanese, and Chinese. The participants of the study are epilepsy patients with psychiatric symptoms diagnosed using any validated criteria. All types of controls will be compared—placebo, conventional treatments, and no treatment—to groups treated with SJC or modified SJC. We will measure the degree of improvement in psychiatric symptoms and check epileptic symptoms, such as the frequency of seizures. The study selection and data extraction will be performed by two independent reviewers, who will also assess methodological quality using the risk-of-bias tool by Cochrane. We will use Review Manager software (RevMan) to carry out all statistical analyses.Results : : This systematic review and meta-analysis will be performed in accordance with the PRISMA-P statement.Conclusion : : This systematic review is the first study to assess the efficacy and safety of SJC for the treatment of psychiatric symptoms in epilepsy. We expect that this study will provide clinically applicable evidence for patients with epilepsy when selecting drug treatments.

Ye-Seul Lee, Yoon Jae Lee, In-Hyuk Ha

Real world data (RWD) is increasingly used to investigate health outcomes and treatment efficacy in the field of integrative medicine. Due to the fact that the majority of RWDs are not intended for research, their secondary use in research necessitates complex study designs to account for bias and confounding. To conduct a robust analysis of RWD in integrative medicine, a comprehensive study design process that reflects the characteristics of integrative therapies is necessary. In this paper, we present a guide for designing comparative effectiveness RWE research in integrative medicine. We discuss key factors to consider when selecting RWDs for research on integrative medicine. We provide practical steps for developing a research question, formulating the PICOT objectives (population, intervention, comparator, outcome, and time horizon), and selecting and defining covariates with a summary table. Specific study designs are depicted with corresponding diagrams. Finally, data analysis procedures are introduced. We hope this article clarifies the importance of RWE research design and related processes in order to improve the rigor of RWD studies in the field of integrative medicine research.

Mira Lee, Yan Guo, Xilin Chen et al.

Objective: To investigate whether acupotomy could inhibit subchondral bone remodeling in knee osteoarthritis (KOA) rabbits by regulating the activity of osteoblasts and osteoclasts. Methods: KOA rabbits were prepared by immobilization for 6 and 9 weeks by Videman method. Nine groups of rabbits (control, 6 weeks and 9 weeks model, 6 weeks and 9 weeks acupotomy, 6 weeks and 9 weeks electroacupuncture, and 6 weeks and 9 weeks drug groups) received acupotomy, electroacupuncture and risedronate sodium intervention, respectively, for 3 weeks. Results: Acupotomy can inhibit the activity of osteoclasts and osteoblasts in subchondral bone by reducing the proteins expression of cathepsin K (CK) and tartrate-resistant acid phosphatase (TRAP) and decreasing the proteins expression of osteocalcin (OCN) and alkaline phosphatase (ALP), to intercept the abnormal bone resorption and bone formation of subchondral bone in 6-week and 9-week immobilization-induced KOA rabbits. Conclusion: These findings indicated that acupotomy may be more advantageous than risedronate sodium intervention in modulating subchondral bone remodeling in KOA rabbits, especially in 9-week immobilization-induced KOA rabbits.

Julie D. Ries

Abstract Introduction & Background The aging of the population assures increased prevalence of Individuals Living with Dementia (ILwD) and there will be an increased representation of this cohort requiring physical rehabilitation. If physical therapists (PTs) manage these patients as they do their age-matched, cognitively-intact peers, they will likely be unsuccessful. ILwD have unique needs related to interpersonal and pragmatic components of rehabilitation. Therapeutic nihilism (doubting the benefit of therapy) is well-documented in PTs, either because of existing biases about dementia or previous challenges in working with ILwD. Physical rehabilitation eligibility and placement decisions are often made by PTs without special training in dementia, based upon brief exposure to patients in environments not well-designed for their best functioning. This can lead to underestimation of rehabilitation potential and denial of future PT services. PTs who work with ILwD desire more practical knowledge and targeted skills. Those with more education and training have a more positive attitude and outlook related to ILwD. Purpose The purpose of this paper is to introduce a framework for rehabilitation with ILwD equipped with pragmatic ideas to facilitate therapeutic success. The four primary components of the model are: (1) Establish a personal RELATIONSHIP, (2) Use intentional verbal and nonverbal COMMUNICATION, (3) Understand and optimize MOTOR LEARNING capabilities, and (4) Create a safe, purposeful ENVIRONMENT. Specific strategies to help PTs optimize each component are provided with supporting evidence. The model is intended to be dynamic, encouraging PTs to capitalize on the most accessible strategies within their control for a given patient and setting. Implications This framework provides a practical resource for working with ILwD with immediate implications for facilitating therapeutic success. The model is displayed in a schematic that reminds the reader of ideas at a glance within the context of each of the components. If an appreciation for this content was among core competencies required among PTs working with ILwD, perhaps there would be significantly fewer patients written off as “uncooperative” or “unable to participate” in PT.

Isa Slaviero Schulz, Ramona Fernanda Ceriotti Toassi

O cuidado à saúde da gestante envolve o acesso às ações de promoção, prevenção e tratamento no período gestacional. Embora a cobertura de atenção ao pré-natal tenha aumentado no Brasil, inadequações ainda são observadas. Nesse contexto, o conhecimento sobre a autopercepção das condições de saúde e das práticas de cuidado às gestantes apresenta-se como estratégia de qualificação da atenção. Esta pesquisa tem o objetivo compreender a autopercepção das gestantes sobre suas condições de saúde e práticas de cuidados na Atenção Primária à Saúde (APS). Será um estudo de abordagem qualitativa, realizado com gestantes atendidas na APS de município do sul do Brasil. A amostra é intencional definida pelo critério da saturação teórica. Participarão da pesquisa gestantes maiores de 18 anos que tenham realizado no mínimo três consultas pré-natal. Entrevistas individuais semiestruturadas serão realizadas com as gestantes, as quais serão gravadas e posteriormente transcritas. O material textual das entrevistas será interpretado pela análise de conteúdo com o apoio do software ATLAS.ti (Visual Qualitative Data Analysis). Categorias emergentes serão discutidas tendo por base o referencial teórico sobre o tema e guiarão a elaboração de material de caráter educativo-informativo sobre a atenção à saúde da gestante (Boletim Informativo-material didático), que será compartilhado com os profissionais das equipes de APS e com as participantes de pesquisa. A pesquisa foi aprovada por Comitê de Ética em Pesquisa e está na etapa de coleta de dados. Os resultados encontrados têm potencial para qualificar o trabalho das equipes de APS e o cuidado às gestantes. Palavras-chave: Gestantes. Cuidado Pré-Natal. Autopercepção de Saúde.

K. M. Koriem

Strobilus lupuli is the dried strobiles (inflorescences) of Humulus lupulus L. (Cannabaceae). Other names of Strobilus lupuli include European hops, hoblon, hop vine, hopfen, and hops. Humulus lupulus L. is an important plant that contains metabolites used in the brewing and pharmaceutical fields. Strobilus lupuli is cultivated in Europe, Asia, and North America, occurring in the world's temperate areas. The analysis of Strobilus lupuli through chromatography analysis showed the presence of bitter substances and xanthohumol. The bitter substances in the resins are the major constituents of Strobilus lupuli, where these substances represent 15-25% of Strobilus lupuli constituents. Strobilus lupuli is applied as a sedative agent for the treatment of nervous tension and insomnia. Strobilus lupuli is applied in the treatment of dyspepsia and lack of appetite. Strobilus lupuli is applied to treat anemia, bacterial infections, abdominal cramps, dysmenorrhoea, leukorrhoea, dermatitis, diarrhea, migraine, and edema. The pharmacology activity of Strobilus lupuli includes experimental and clinical pharmacology. Experimental pharmacology includes antimicrobial, anti-inflammatory, antioxidant, central nervous system depressant, estrogenic and miscellaneous activities. The oral median lethal dose of ethanol extract of Strobilus lupuli in mice was found to be 500 mg/kg, while the oral median lethal dose of Strobilus lupuli in rats was 2700 mg/kg. No information is available on general precautions or on precautions concerning drug and laboratory test interactions. There is no teratogenic effect in pregnancy, or nursing mothers, or pediatric use of Strobilus lupuli. Strobilus lupuli powder dose = one dose of 0.5 g. Infusion or decoction dose = 0.5 g/ 150 ml water. Strobilus lupuli extract dose = 0.06-0.08g.

K. J. Siddiqi, F. Khan

Objectives: To audit the incidence and nature of post-anesthesia recovery room complications, their treatment and review the role of recovery room in modern anesthetic practice. Methods: 3151 patients who received general or regional anaesthesia were admitted to the recovery room during six months period (August 01, 1995 to January 31, 1996). Information noted on forms by recovery nurse by encircling the pre coded complication. Result: Out of 3151 patients, 2716 patient's data forms could be collected. Therefore results reflect 86% of the patients passing through the recovery. The overall incidence of complications in our population was 36.26%.Complications referable to CNS were 52.29%, the commonest of which was pain[51.26%], agitation (0.18%) and excessive drowsiness (1.01%).The second commonest system was GIT(25.07%) nausea (14.31%) and vomiting (12.18%). The third system was CVS (21.52%), bradycardia (5.48%), tachycardia (7.61%), hypertension (4.26%), hypotension (2.53%) ,myocardial ischaemia (0.81%) myocardia infarction (0.10%) and new arrhythmias (1.41%).The fourth system was Respiratory system (5.58%), hypoventilation (1.42%), bronchospasm (0.81%), and Desaturation (Sp02 < 90%) in (0.1%).0.6% patients had to be re-intubated. Two patients had oliguria. Miscellaneous complications were (9.94%). More than one complication was observed in some patients. The incidence of mortality in our study during this period was 0.10%. Conclusion: Every third patient is susceptible to get some form of complications in the immediate post-anesthesia recovery period. It reflects the importance and need of a specialized designated area called recovery room with qualified staff.

Lynn M. Matrisian, M. Martínez, A. Rosenzweig et al.

Trends in clinical trials for pancreatic cancer between 2011-2020 were tracked in the Pancreatic Cancer Action Network database originally designed to assist in identifying open trials for eligible patients. More than 125 trials specific for pancreatic cancer or including no more than one additional cancer type have been open each year, the majority for patients with a diagnosis of pancreatic adenocarcinoma (PAC). The trends indicate an active and progressive pancreatic cancer research community and include an increasing number of trials for previously treated patients, the emergence of trials for post-adjuvant or maintenance therapy, an increasing number of research-intensive phase 0 trials, increasing seamless phase I/II and II/III trials to improve efficiency, and an increasing number of phase III trials despite historical failures. Trials were analyzed by treatment type and included trials to optimize standard chemotherapy or radiation therapy, trials targeting tumor pathways, the stroma, or the immune system, biomarker-specified trials, and a miscellaneous category of trials testing tumor metabolism, complementary medicine approaches, or alternate energy sources. There was a dramatic increase in immunotherapy trials over this time. Several biomarker-specified trials were initiated, and FDA approval was obtained for biomarker-specified targeted agents, many in a tissue-agnostic setting, indicating an increase in a precision medicine approach to pancreatic cancer treatment. An increasing number of trials tested non-standard approaches, many which progressed to phase III. The trends suggest an encouraging trajectory of pancreatic cancer clinical research.

Aman Wadhwa, Kathryn A. Six, S. Bhatia et al.

Background: The projected 5y survival rates for pediatric hematologic malignancies exceed 85% (SEER statistics, 2017), in large part due to risk-stratified intensive multi-agent therapeutic approaches. However, these regimens result in chemotoxicity, often requiring hospitalization. However, the burden of chemotoxicity-related hospitalizations in children with hematologic malignancies remains understudied. Methods: Using an administrative claims database (Truven Marketscan ®), we describe chemotoxicity-related hospitalizations within the first 12 mo from first claim of chemotherapy in children with hematologic malignancies who were <21y at diagnosis. Eligibility included (i) incident acute lymphoblastic leukemia (ALL; ICD-10-CM code: C91), acute myeloid leukemia (AML; C92), Hodgkin lymphoma (HL; C81) or non-Hodgkin lymphoma (NHL; C83.0, C83.3, C83.5, C83.7, C84.4, C85) diagnosed between 2011 and 2018; and (ii) continued insurance coverage 30d prior to and 365d after cancer diagnosis. Chemotoxicities (identified using ICD-9 and -10 codes) were grouped into organ systems (hematologic, infectious, gastrointestinal, renal, allergic, pulmonary, central nervous system, cardiovascular and miscellaneous). A hospitalization was considered chemotoxicity-related if a toxicity diagnosis was the primary reason for admission (i.e., first billing code) or occurred in the second billing position only if the cancer diagnosis was in the primary billing position. Hospitalizations for chemotherapy administration for primary or relapsed cancer were excluded. Logistic regression was used to examine the following factors for their association with chemotoxicity-related hospitalization: age at cancer diagnosis, sex, year of diagnosis (2011-2014; 2015-2018), insurance (commercial, Medicaid) and primary cancer diagnosis. Results: We identified 897 eligible patients (ALL: n=461, AML: n=79, HL: n=202, NHL: n=155). Median age at diagnosis was 15y (range, 0-21), 52.7% were male, 54.2% were diagnosed between 2011 and 2014, and 70.2% had commercial insurance. Medicaid patients were younger than those with commercial insurance (median age at diagnosis: 12y [range, 0.9-21] vs. 17y [0-21y]), and were less likely to carry a diagnosis of ALL (46% vs. 54%, P<0.001) but more likely to have AML (15% vs. 6%, P<0.001). Over the 4,736 person-months of follow-up, 360 patients (40.1%) had 636 chemotoxicity-related hospitalizations (ALL: 56.9%, AML: 8.9%, HL: 20.9%, NHL: 13.2%); 164 (18.3%) patients had ≥1 chemotoxicity-related hospitalization. Median time to first chemotoxicity-related hospitalization from start of therapy was 37d (interquartile range, 12-78). Chemotoxicity claims included hematologic toxicities (63.6%), infections (22.7%) and gastrointestinal toxicities (6.1%); the figure shows the distribution of claims during these hospitalizations by hematologic malignancy. The average length of stay (LOS) for chemotoxicity-related hospitalization was 6.8±8.7d [5.8±7.8d (HL) to 8.6±12.6d (AML)]. Multivariable logistic regression analysis identified Medicaid insurance (vs. commercial) to be associated with lower odds of chemotoxicity-related hospitalization (odds ratio=0.68, 95% confidence interval 0.56-0.84, P<0.001). Conclusions: Over 40% of children with hematologic malignancies require chemotoxicity-related hospitalizations during the first year of treatment. These data could be used to provide guidance to patients and their families and inform healthcare policy decisions. Figure 1 Figure 1. No relevant conflicts of interest to declare.

Tamer Aboushanab, Saad Baslom

S. Bahadur, Tripti Naurange, Pragya Baghel et al.

The brain targeting drug delivery system is the technique and process to deliver the drug into brain or central nerves system (CNS). The main problem arise during brain targeting in case of several brain related diseases and disorders such as CNS malignancy, brain abscess, multiple sclerosis, schizophrenia etc. selective and limiting permeation nature of barriers i.e. blood brain barrier (BBB) and blood cerebrospinal fluid barrier (BCSF), these two barriers only allow highly lipophilic molecule enters into brain and is one of the greatest clinical impediment of treatment of brain and CNS diseases and disorders. To treated this type of diseases and disorders drugs are targeted into brain and drug must be cross these two barriers they’re by different types of approaches are used to delivered drug molecules. Aim of research. The main aim of this review paper is to compile all the approaches, strategies and techniques used for brain targeted drug delivery in a single paper/ article. Material and method. To prepare this manuscript, various keywords were searched in different engines such as Google, Yahoo and Bing etc. The available information in public domain was collected and classified according to brain drug delivery system. This review deals with approaches and current strategies used to enhance the brain targeted drug delivery system. The approaches for brain targeting – invasive, noninvasive and miscellaneous techniques, by using these approaches enhance the drugs delivery and drugs are easily across BBB and BCSF. Result. The different type of approaches and strategies used to enhance the drug delivery into brain and CNS. All these techniques described in this paper are applied for overcoming the problems that arises during treatment of brain related diseases. This review paper has a list of different types of models (In-vitro and In-vivo) used in study of brain and CNS drug delivery. Conclusions. Drug delivery to brain for treating a various diseases and disorders are very difficult and challenging because the delivery of drug molecules must be pass through the BBB and BCSF. Overcome this difficulties and challenges certain approaches and technique such as invasive, non-invasive, intranasal delivery of drug, ocular delivery of drug and focused ultrasound technique are used to brain targeting. They are help to penetrate the drug molecule through BBB and CSF very easily and enhance the efficacy of treatment. This review article covered current approaches and strategies of brain targeting drug delivery in past five to ten years. These approaches and strategies are used to the brain delivery of drug, proteins, peptides, amino acids, etc.

Hely Shah, J. Surujballi, A. Awan et al.

Juan Fernando Uribe-Arcila, Andrés Delgado-Montoya, Federico Gaviria-Gil

Background: Testicular pain encompasses a vast medical diagnostic field, with numerous organ and system convergence. Acute testicular pain is a medical emergency that requires accurate evaluation and immediate resolution, whereas chronic testicular pain is enigmatic and requires sound knowledge of the mechanisms of testicular pain and the differential diagnosis. Objective: To review the causes of testicular pain and propose a new etiologic classification consisting of 10 subgroups.   Methods: A bibliographic search was carried out utilizing Google and the National Library of Medicine’s PubMed databases to identify original articles and review articles (hard copy or electronic) published on testicular pain, up to March 2020. The search included: MeSH terms: testicular disease (classification, complications, etiology, trauma, microbiology, pathology, pathophysiology, secondary, surgery, treatment) and vasectomy; Non-MeSH terms:  acute and chronic orchialgia, scrotalgia, orchidynia, groin pain, epididymalgia, testalgia, chronic testicular pain, chronic scrotal pain syndrome, testicular pain syndrome, epididymal pain syndrome, and post-vasectomy pain syndrome. The initial search produced 625 articles, of which 143 were included in the present review. Results: To better understand testicular pain etiology, 100 possible diagnoses were divided into ten subgroups: infectious, neoplastic, traumatic, torsional, vascular, immunologic, neurologic, pharmacologic, obstructive, and miscellaneous causes.  Likewise, treatment can be divided into two main groups, according to therapeutic options: pharmacologic and non-pharmacologic, with the latter subdivided into: noninvasive and the increasingly performed invasive (surgical) alternatives. Conclusions: Testicular pain should be understood as a complex pain syndrome of enigmatic origin. Treatment success depends on the correct identification, from hundreds of possibilities, of the cause of pain. Logical grouping of those possibilities could aid in making the accurate etiologic identification.

Da Yoon Oh, Soo Jin Lee, Jae Eun Park et al.

This review aimed to compare the effectiveness of Korean medicine (KM) with Korean-Western integrative medicine (KWIM) at treating Bell’s palsy. A literature search of several databases for relevant randomized controlled trials was performed. Six studies that compared KM with KWIM to treat Bell’s palsy were included in this review. Acupuncture and steroids were the most commonly used treatments in KWIM. A comparison of the effectiveness of KW with KWIM did not produce consistent results. Both KM and KWIM were useful intreating Bell’s palsy. KWIM was more effective than KM when the Western medicine was a steroid and was given in the early stages of treatment. However, these findings are limited due to the low quality and number of included studies. KM and KWIM are both effective in Bell’s palsy, and KWIM is more effective than KM. However, more high-quality randomized controlled trials are required.

Stephen Bhagroo, S. French, Joshua Mathews et al.

Abstract We have developed a fast and accurate in‐house Monte Carlo (MC) secondary monitor unit (MU) check method, based on the EGSnrc system, for independent verification of volumetric modulated arc therapy (VMAT) treatment planning system dose calculations, in accordance with TG‐114 recommendations. For a VMAT treatment plan created for a Varian Trilogy linac, DICOM information was exported from Eclipse. An open‐source platform was used to generate input files for dose calculations using the EGSnrc framework. The full VMAT plan simulation employed 107 histories, and was parallelized to run on a computer cluster. The resulting 3ddose matrices were converted to the DICOM format using CERR and imported into Eclipse. The method was evaluated using 35 clinical VMAT plans of various treatment sites. For each plan, the doses calculated with the MC approach at four three‐dimensional reference points were compared to the corresponding Eclipse calculations, as well as calculations performed using the clinical software package, MUCheck. Each MC arc simulation of 107 particles required 13–25 min of total time, including processing and calculation. The average discrepancies in calculated dose values between the MC method and Eclipse were 2.03% (compared to 3.43% for MUCheck) for prostate cases, 2.45% (3.22% for MUCheck) for head and neck cases, 1.7% (5.51% for MUCheck) for brain cases, and 2.84% (5.64% for MUCheck) for miscellaneous cases. Of 276 comparisons, 201 showed greater agreement between the treatment planning system and MC vs MUCheck. The largest discrepancies between MC and MUCheck were found in regions of high dose gradients and heterogeneous densities. By parallelizing the calculations, point‐dose accuracies of 2‐7%, sufficient for clinical secondary checks, can be achieved in a reasonable amount of time. As computer clusters and/or cloud computing become more widespread, this method will be useful in most clinical setups.

F. Buiarelli, F. Bernardini, G. Simonetti et al.

Background: Caffeine, theophylline, and theobromine are methylxanthines commonly found in coffee, tea, cola, and cocoa. Other sources may be soft drinks or energy drinks. All of them are stimulants of the nervous system and can be used for the treatment of some diseases. The three xanthines produce addiction with typical abstinence symptoms. Among young people, the consumption of energy beverages is increasing, and the growing market causes concern about the caffeine intake. To evaluate intake of methylxanthines, their accurate determination can be helpful. Methods: A simple method for their determination without sample pretreatment was applied to beverages, including coffee, tea, cola, and energy drinks. The separation was achieved by LC with UV detection. The method was validated in terms of linearity, LOD and LOQ, accuracy, and reproducibility. Results: The drinks were directly injected after a filtration, and no matrix effect was demonstrated. The procedure proved to be simple, time saving, accurate, and reproducible and may be recommended for reliable assays in routine work. The investigated samples showed a range of caffeine concentration from 100 to 3050 mg/L. Possible intake of methylxanthines from miscellaneous types of drinks was assessed considering the European Food Safety Authority Opinion on the safety of caffeine consumption. Our results were in good agreement with other authors. Conclusions: A fast and accurate method for the simultaneous determination of three xanthynes in beverages was validated. The selected strategy has proved to be fit-for-purpose by applying it to different nervous system stimulant drinks. Highlights: A simple and time saving procedure was proposed for the separation, detection, and quantitation of three methylxantynes in nervous system stimulant drinks. No sample preparation was needed, and speculation could be made about the possible intake of them from beverages.