The Effect of Auriculotherapy on Nausea, Vomiting, and Anxiety in Patients Undergoing Elective Cesarean Section with Spinal Anesthesia: A Clinical Trial Study.

Background: Nausea, vomiting, and anxiety are common complications during and after spinal anesthesia. Auriculotherapy as a complementary medicine can be useful for reducing nausea, vomiting, or anxiety. This study was performed to evaluate the effects of auriculotherapy on nausea, vomiting, and anxiety in patients undergoing elective Cesarean Section (CS) with spinal anesthesia. Materials and Methods: The present study was a clinical trial study that was performed on 56 pregnant women selected as CS candidates in Ommolbanin Hospital in Mashhad during the years 2016-2017. In the intervention group, 1 h before spinal anesthesia, auricular acupoint stimulation was performed at four points bilaterally, for 20-30 seconds at each point. Evaluations were done by the following questionnaires: State-Trait Anxiety Inventory (STAI), Visual Analog Scale (VAS), and Vomiting Assessment Form. Results: The mean anxiety (SD) before the intervention in the intervention group and the control group was 47.88 (8.67) and 47.84 (10.49), respectively, and 4 h after the intervention, it was 40.23 (10.19) and 42.88 (12.18) in the intervention and control groups, respectively. These results were significant in the intervention group (p = 0.008). 30-40 min before and 4 h after the surgery, the severity of nausea and vomiting was low in both groups and no significant difference was observed between the two groups during the surgery and in the recovery room (p > 0.05). Conclusions: According to the results, auriculotherapy could reduce anxiety in CS patients with spinal analgesia. The results also showed that auriculotherapy reduced the severity of nausea and vomiting, but these changes were not significant.

Computational simulation and modelling of uranium extraction using tributylphosphate through membrane extractor.

Non-disperse solvent extraction is an effective technique for the extraction of metal ions from aqueous solution. In this study, uranium extraction using n-dodecane solvent containing tributylphosphate extractant in a membrane contactor was investigated. A 2D mathematical model was developed for the fluid flow and mass transfer in the hollow fibre membrane extractor. The equations of the created model were solved using the finite element method. The uranium concentration distribution in the extractor at different extractant concentrations as well as feed acidity was studied. The results showed that there is reasonable good agreement between experimental uranium extraction and modelling outputs at different extractant concentrations. Increasing extractant concentration from 5 to 30% led to the enhancement of uranium extraction from 2.60 to 34.13%. Also, there was an increase in the uranium extraction with increasing feed acidity in the range of 1-3 M. Furthermore, based on the radial uranium concentration distribution, it was found that the main mass transfer resistance in the system was microporous membrane section. Finally, it was obtained that the uranium extraction efficiency could be improved significantly by increasing porosity-to-tortuosity ratio. It was concluded that the membrane specification plays the most important role as the dominant mass transfer resistant was in the membrane subdomain.

Delay-Dependent Functional Observer Design for Linear Systems With Unknown Time-Varying State Delays.

Partial state estimation has numerous applications in practice. Nevertheless, designing delay-dependent functional observers (FOs) for systems with unknown time delays is rigorous and still an open dilemma. This paper addresses the problem for linear time-invariant systems with state time-varying delays. The delay is assumed to be bounded in an interval with a bounded derivative. A sliding mode FO structure that is robust against the delay uncertainties is established to this aim. The structure employs an auxiliary delay function that can be defined based on the existing knowledge on the actual delay values. Delay-dependent sufficient conditions for the stability of the observer are obtained using the Lyapunov Krasovskii approach, and are expressed in terms of a linear matrix inequality and two rank conditions. The delay-free observer structure is additionally studied and the necessary and sufficient conditions for its stability are obtained. Two descriptive numerical examples and simulation results demonstrate the design procedure and emphasize the effectiveness of the proposed observer design algorithm.

Abdominal and auricular acupuncture reduces blood pressure in hypertensive patients.

INTRODUCTION: Hypertension is an important risk factor of cardiovascular disease (CVD), which is associated with premature death, myocardial infarction, stroke, peripheral vascular disease, and renal disease. The goal of the present study was to use a randomized controlled clinical trial to explore and compare the effectiveness of abdominal and auricular acupuncture on blood pressure in 440 subjects with and without obesity. METHODS: Four hundred participants were recruited and randomized to one of four groups: cases and controls receiving auricular acupuncture (204 subjects) and cases and controls receiving abdominal electroacupuncture (196 subjects). Blood pressure and anthropometric parameters were measured before and after the intervention period. In order to match the initial diet of the groups, participants were required to follow an isocaloric diet for two weeks before the trial, and a low-calorie diet for 6 weeks during the intervention period. RESULTS: We observed a significant time dependent improvement in the systolic blood pressure measurements in the abdominal intervention group, although this improvement was more pronounce in the first period of study. Of note, in the auricular intervention group, a significant increasing in the level of SBP was detected. Importantly no statistically significant changes were found in the corresponding sham groups. CONCLUSIONS: Our findings demonstrated that abdominal electro-acupuncture for 6 weeks reduced both systolic and diastolic blood pressure and auricular acupuncture had a short-term adverse effect on both SBP and DBP.

Reduced Serum Levels of Zinc and Superoxide Dismutase in Obese Individuals.

The oxidant-stress (OS) has an essential role to play in the pathogenesis and progression of many diseases. OS is the outcome when the level of free-radical-formation is increased or protective-antioxidant-mechanisms are compromised. Its value is expected to increase, although its emerging roles have not been conclusive in different studies. The objective of this study was to explore the level of zinc, copper, and antioxidant in response to obesity-related-stress by measuring superoxide-dismutase (SOD) levels as a key antioxidant-enzyme in 706 individuals with/without obesity. Anthropometric/biochemical parameters including total-cholesterol (TC), fasting-blood-glucose, high-density-lipoprotein (HDL), low-density-lipoprotein, and triglycerides were determined. The activity of SOD was measured followed by the measurement of Cu and Zn levels. Obese subjects had a significantly higher level of body mass index (BMI) and TC, while the level of HDL was lower in the obese group, as compared to the related values in control subjects. The level of Zn was significantly decreased in the obese group, while the level of Cu and Cu/Zn ratio increased. Additionally, we observed that the SOD level was less in obese subjects when compared to that in the non-obese subjects. In addition to the complications of high BMI, low level of Zn and SOD in obesity can be considered a risk factor, resulting in a reduced antioxidant response, supporting the need for identifying a suitable treatment option for this group.

The Effect of Acupressure on Sleep Quality in Menopausal Women: A Randomized Control Trial.

BACKGROUND: One of the common problems in menopausal women is sleep disorder. Traditional Chinese acupressure is a noninvasive and safe technique. Menopausal women can easily learn the technique and a self-care method to manage their sleep disorder. This study was carried out to evaluate the effectiveness of acupressure on sleep quality of postmenopausal women in Mashhad during 2009. METHODS: This double blind, randomized clinical trial was performed on 120 qualified menopausal women at the age of 41-65 years. Their sleep quality was measured according to the Pittsburgh Sleep Quality Index (PSQI). Participants were randomly assigned to an acupressure group (n=37), a sham acupressure group (n=36) and a control group (n=32) by two time randomized method (systematic and simple randomized). These interventions were carried out for four consecutive weeks. The participants in the acupressure and sham acupressure groups learned to carry out the acupressure technique as a self-care at home with simultaneous massage techniques that were to be performed 2 hours before sleep, whereas only conversation was used in the control group. The data were analyzed by the SPSS software version 17. RESULTS: The results indicated significant differences in total PSQI scores among the three groups (P<0.001). Tukey's test revealed that there were significant differences between the acupressure group and the control group (P<0.001), the acupressure group and sham acupressure group (P<0.001), and the sham acupressure and the control group (P<0.001). CONCLUSION: Acupressure can be used as a complementary treatment to relieve sleep disorders in menopausal women; and is offered as an efficient method to manage sleep quality. TRIAL REGISTRATION NUMBER: IRCT2013100614910N1.

Size and deformability based separation of circulating tumor cells from castrate resistant prostate cancer patients using resettable cell traps.

The enumeration and capture of circulating tumor cells (CTCs) are potentially of great clinical value as they offer a non-invasive means to access tumor materials to diagnose disease and monitor treatment efficacy. Conventional immunoenrichment of CTCs may fail to capture cells with low surface antigen expression. Micropore filtration presents a compelling label-free alternative that enriches CTCs using their biophysical rather than biochemical characteristics. However, this strategy is prone to clogging of the filter microstructure, which dramatically reduces the selectivity after processing large numbers of cells. Here, we use the resettable cell trap (RCT) mechanism to separate cells based on their size and deformability using an adjustable aperture that can be periodically cleared to prevent clogging. After separation, the output sample is stained and analyzed using multi-spectral analysis, which provides a more sensitive and unambiguous method to identify CTC biomarkers than traditional immunofluorescence. We tested the RCT device using blood samples obtained from 22 patients with metastatic castrate-resistant prostate cancer while comparing the results with the established CellSearch® system. The RCT mechanism was able to capture ≥5 CTCs in 18/22 (82%) patients with a mean count of 257 in 7.5 ml of whole blood, while the CellSearch system found ≥5 CTCs in 9/22 (41%) patients with a mean count of 25. The ~10× improvement in the CTC capture rate provides significantly more materials for subsequent analysis of these cells such as immunofluorescence, propagation by tissue culture, and genetic profiling.

Auricular or body acupuncture: which one is more effective in reducing abdominal fat mass in Iranian men with obesity: a randomized clinical trial.

BACKGROUND: The prevalence of abdominal obesity is on the rise worldwide. Previous studies have indicated the higher diagnostic value of body fat distribution pattern compared with general body in abdominal obesity assessments. Several non-pharmacological methods have been suggested for obesity management, of which acupuncture has gained a great deal of research interest with promising results. This study aimed to comparatively evaluate the effects of conventional auricular and body electroacupuncture on abdominal fat mass in obese men. METHODS: The volunteers were randomly divided into four groups, including 2 interventions and 2 controls. This study was conducted on 80 obese volunteer men with Body Mass Index (BMI) range of 30-40 kg/m2.The intervention groups including real body electroacupuncture (A), real auricular acupuncture (C) and the control groups containing sham body electroacupuncture (B), and sham auricular acupuncture (D). All groups were in combination with a low-calorie diet for 6 weeks. BMI, Trunk Fat Mass (TFM), Waist Circumference (WC), and Hip Circumference (HC) were measured pre- and post-intervention. RESULTS: In group A, respectively a significant reduction was shown in BMI (P < 0.005), TFM (P < 0.005), WC (P < 0.05, P < 0.005) and HC (P < 0.005) when compared with controls (Groups B and D). Interestingly, group C had significant decreases in BMI (P < 0.005), TFM (P < 0.01, P < 0.005), WC (P < 0.005) and HC (P < 0.001) after comparison with the sham. Likewise, WC (P < 0.05) and HC (P < 0.05) were significantly reduced post- intervention when compared with two treatment groups. CONCLUSIONS: In our study, acupuncture treatment (body or auricular) seemed to have an effect on reducing BMI, TFM, WC and HC. Comparison of the two types of treatment (body and auricular acupuncture) suggests that the two types of acupuncture had similar effects on reducing BMI and TFM, but body electroacupuncture is more effective in reducing WC and auricular in HC. It seems that both auricular and body electro-acupuncture combined with a low-calorie diet are efficient, simple and painless methods to reduce respectively the HC and WC fat in obese men, compared with conventional techniques. TRIAL REGISTRATION: IRCT201201127117N2.

Effects of body electroacupuncture on plasma leptin concentrations in obese and overweight people in Iran: a randomized controlled trial.

BACKGROUND: The prevalence of obesity, a major public health problem, is increasing in many countries, including Iran. Leptin, a peptide hormone that is released from adipocytes, is a major factor in appetite regulation. Levels of plasma leptin increase with increased body fat mass (BFM). Research has found acupuncture to be effective both in weight loss and suppression of appetite. Although a few studies have reported the effect of body and ear acupuncture on leptin levels, researchers have performed few studies on the effect of body electroacupuncture in humans. OBJECTIVE: The research team examined the effects of body electroacupuncture and a low-calorie diet on plasma leptin in obese and overweight individuals with an excess (phlegm-dampness or phlegm-heat) or deficiency (spleen/stomach qi deficiency or primary qi deficiency) pattern according to Chinese medicine. DESIGN: The research team randomly assigned participants to one of two groups, intervention or control. SETTING: This study occurred in the nutritional clinic at Ghaem Hospital in Mashhad, Iran. PARTICIPANTS: Participants were individuals (N = 86) between 18 and 65 years of age with body mass indexes (BMI) between 25 and 45 kg/m2. INTERVENTION: The intervention group (n = 47) received actual electroacupuncture, and the control group (n = 47) received sham acupuncture. Both groups consumed a low-calorie diet for 6 weeks. OUTCOME MEASURES: The research team measured plasma leptin, BFM, body weight (BW), and BMI before and after treatment. RESULTS: For participants in the intervention group with both the excess and the deficiency patterns, the research team found a significant reduction in plasma leptin (24.96%, P = .001) and BFM (8.29%, P = .001). In the control group, the team found a less significant reduction in leptin and BFM. The difference between the two groups was significant for leptin (P = .03) but not for BFM (P = .8). CONCLUSIONS: While body electroacupuncture with a low-calorie diet can reduce plasma leptin concentration, the mechanism will require further clarification.

Effects of auricular acupuncture on anthropometric, lipid profile, inflammatory, and immunologic markers: a randomized controlled trial study.

OBJECTIVES: A randomized controlled clinical trial was performed to examine the effectiveness of auricular acupuncture on body weight loss and its impact on lipid profile, and immunologic and inflammatory markers in obese subjects. METHODS: Participants (n=204) were randomized to therapeutic acupuncture and control groups. Subjects received authentic (cases) or sham (controls) acupuncture for 6 weeks (first period) in combination with a low-calorie diet. In the next 6 weeks (second period), the low-calorie diet was used on its own. Subjects were assessed at the beginning and 6 and 12 weeks later. In addition to anthropometric and lipid parameters, serum anti-heat shock protein (Hsp)-27, 60, 65, 70 and high sensitive C-reactive protein (hs-CRP) levels were assessed. RESULTS: In the first period, anthropometric parameters and hs-CRP changed significantly in both groups, while significant changes in anti-Hsp antibodies were only observed in case subjects. In the second period, which shows the sustainable effects of acupuncture, changes in anthropometric parameters were more prominent in controls, while significant reductions in the group receiving authentic acupuncture were maintained for anti-Hsp antibodies. A comparison between the first and second period in both groups showed that the changes for most of the parameters were more significant in the first period. Comparison between cases and controls showed that authentic acupuncture was more effective in reducing the levels of anthropometric factors and anti-Hsp antibodies but not hs-CRP. CONCLUSIONS: Auricular acupuncture in combination with diet restriction was effective for weight loss and dyslipidemia. Moreover, it was found that it has immunomodulatory but not anti-inflammatory effects on the immune system by regulation of the levels of anti-Hsp antibodies.

Effects of auricular acupressure combined with low-calorie diet on the leptin hormone in obese and overweight Iranian individuals.

BACKGROUND: Human leptin is a peptide hormone that is released from white adipocytes. The absence of leptin or its receptor leads to uncontrolled food intake, leading to obesity. In the present work, the effects of auricular acupressure combined with low-calorie diet on the leptin hormone level were investigated. METHODS: Volunteers (n=86) with body mass indices (BMI) between 25 and 45 kg/m² were randomised into a case (n=43) or a control (n=43) group. Participants in each group received a low-calorie diet for 6 weeks. The case group was treated with auricular acupressure and the control group received a sham procedure. Plasma leptin levels, body fat mass, body weight and BMI were measured before and after treatment. RESULTS: Participants who received auricular acupressure showed significant reductions in their plasma leptin levels (18.57%, p<0.01) as well as in their body fat mass (4%, p<0.05). These changes were not observed in the control group. The reduction in leptin was significantly greater in the acupressure group than the controls. CONCLUSIONS: Auricular acupressure combined with a low-calorie diet significantly reduced plasma levels of leptin. However, the mechanism of this reduction is not clear.

The effects of body acupuncture on obesity: anthropometric parameters, lipid profile, and inflammatory and immunologic markers.

A randomized controlled clinical trial in 196 obese subjects was performed to examine the effectiveness of body acupuncture on body weight loss, lipid profile and immunogenic and inflammatory markers. Subjects received authentic (cases) or sham (controls) acupuncture for 6 weeks in combination with a low-calorie diet. In the following 6 weeks, they received the low-calorie diet alone. Subjects were assessed at the beginning, 6 and 12 weeks later. Heat shock protein (Hsps)-27, 60, 65, 70 antibody titers and high sensitivity C-reactive protein (hs-CRP) levels were also assessed. A significant reduction in measures of adiposity and improvement in lipid profile were observed in both groups, but the levels of anti-Hsp-antibodies decreased in cases only. A reduction in anthropometric and lipid profile in cases were sustained in the second period, however, only changes in lipid profile were observed in the control group. Anti-Hsp-antibodies and hs-CRP levels continued to be reduced in cases but in controls only the reduction in hs-CRP remained. Changes in anthropometric parameters, lipid profile, and anti-Hsp-antibodies were more evident in cases. Body acupuncture in combination with diet restriction was effective in enhancing weight loss and improving dyslipidemia.

Association between indices of body mass and antibody titers to heat-shock protein-27 in healthy subjects.

OBJECTIVES: We have assessed the relationship between indices of adiposity and antibody titers to Hsp-27 in healthy subjects. DESIGN: Two-hundred and fifty subjects were studied, including 50 normal-weight subjects (body-mass-index (BMI) 25 kg/m(2)), 100 overweight subjects (BMI 25 to 30 kg/m(2)) (n=100) and 100 obese subjects (BMI ≥ 30 kg/m(2)). RESULTS: Anti-Hsp27-antibody levels in obese subjects were [0.34 (0.20-0.39) absorbency unit], being significantly higher than overweight and normal-weight groups (P<0.05). Anti-Hsp27-antibody levels in overweight subjects [0.29 (0.15-0.34) absorbency unit] were statistically higher than controls [0.18 (0.10-0.23) absorbency unit] (P<0.05). CONCLUSION: High anti-Hsp-27-antibody levels in obese-subjects without established coronary disease may be related to a heightened state of immunoactivation associated with obesity.

Role of laparoscopic nephrectomy for management of symptomatic nephrogenic hypertension.

OBJECTIVES: To investigate the efficacy of laparoscopic nephrectomy for the management of hypertension associated with a unilateral poorly functioning kidney in adults and the role of some variables in the prediction of its outcome in the management of nephrogenic hypertension. METHODS: We conducted this study on 22 hypertensive patients with a unilateral, minimally functioning kidney. We included patients with a well-functioned contralateral kidney, no renal tumors, no renovascular hypertension, and no diagnosis of end-stage renal disease. All patients had poorly controlled hypertension or preferred to discontinue medical therapy. Their age at the onset of hypertension, gender, age at laparoscopic nephrectomy, and the interval from diagnosis to intervention were evaluated. A complete response was defined as blood pressure normalization without medical treatment. A partial response was defined as a decrease in the medication requirements and/or a 10-mm Hg decrease in diastolic blood pressure after surgery. Measurement of plasma renin activity was not available in our country at the time of the study. RESULTS: After nephrectomy, 12 (54.5%), 2 (9.1%), and 8 (36.4%) patients had a complete, partial, or no response to the surgery, respectively. No significant association was found between the response to laparoscopic nephrectomy and age, gender, and mean blood pressure. Only the hypertension-related signs and symptoms before surgery were significantly associated with the response to laparoscopic nephrectomy (P = 0.01) on both univariate and multivariate analysis. CONCLUSIONS: Nephrectomy seems effective for the management of nephrogenic hypertension in patients who wish to discontinue medical therapy. We suggest paying attention to the preoperative hypertension-related symptoms for the prediction of the response to nephrectomy.