ABSTRACT
INTRODUCTION: This study seeks to determine if modified Battlefield Acupuncture is more effective at relieving acute extremity pain, reducing medication use, and improving quality of life than placebo acupuncture or standard care after lower extremity surgery. METHODS: We conducted a multi-site 3-arm randomized, double-blind controlled trial of standard care alone versus standard care + placebo auricular acupuncture with semi-permanent needles versus standard care + modified battlefield acupuncture with semi-permanent needles for lower extremity surgery at two Air Force hospitals. Subjects reported pain level immediately after acupuncture, 24, 48, 168, and 720 hours later to a blinded research associate. Additionally, subjects completed a PIQ-6 30 days post-operatively, and opioid use was tracked for 30 days post-operatively. RESULTS: Two hundred thiry-three subjects >18 years old (92 females and 141 males) with a mean age of 44.5 years were randomized with 81 randomized to modified BFA, 74 randomized to placebo acupuncture, and 78 randomized to standard care. Overall pain levels were unchanged at each time point between groups. Outcomes showed unchanged pain, opioid and quality of life between groups. CONCLUSION: The use of modified battlefield acupuncture protocol does not change pain opioid use or quality of life in those with lower extremity surgery.
Subject(s)
Acupuncture Therapy/standards , Orthopedic Procedures/methods , Pain Management/standards , Quality of Life/psychology , Acupuncture Therapy/methods , Adult , Double-Blind Method , Female , Humans , Male , Middle Aged , Orthopedic Procedures/psychology , Orthopedic Procedures/standards , Pain Management/methods , Pain Measurement/methods , Psychometrics/instrumentation , Psychometrics/methodsABSTRACT
OBJECTIVE: To ensure that cinnamon extract does not cause electrocardiographic (ECG) effects in patients with prediabetes. DESIGN: A subgroup analysis was carried out on data from 103 prediabetic patients participating in the "Effect of Lifestyle Intervention Plus Water-Soluble Cinnamon Extract on Lowering Blood Glucose in Prediabetics" trial. The trial was a randomized, double-blind, placebo-controlled trial comparing cinnamon extract versus placebo in prediabetic adults who committed to participate in a standard-of-care, aggressive lifestyle therapy program. SETTING: Family Medicine Residency, Mike O'Callaghan Military Medical Center; Family Medicine Residency, David Grant Medical Center, Travis AFB; Wilford Hall Ambulatory Surgical Center, Family Medicine Residency; Eglin AFB, Family Medicine residency; Offutt AFB, Family Medicine Residency. MAIN OUTCOME MEASURES: QTc interval, QT interval, PR interval, QRS duration and heart rate from ECGs at baseline, 3 months, and 6 months. RESULTS: Analysis of the ECGs showed no time-matched intra-group differences in any of the ECG parameters (QTc interval, QT interval, PR interval, QRS duration and heart rate; all p-values >0.05). CONCLUSIONS: Use of cinnamon extract in prediabetic patients does not affect electrocardiographic measures.
Subject(s)
Cinnamomum zeylanicum/chemistry , Electrocardiography/drug effects , Plant Extracts/pharmacology , Adult , Female , Humans , Male , Middle Aged , Plant Extracts/adverse effects , Plant Extracts/chemistry , SolubilityABSTRACT
We present a report of cinnamon bark powder 1000 mg daily associated with edema that resolved after stopping the supplement in an adult male. Thiazolidinediones (TZDs) cause fluid retention in those with diabetes or prediabetes. Some medications in this class have been implicated in increased cardiac deaths from this side effect. While medications are effective for diabetes, many people have turned to natural remedies to treat their diabetes instead of conventional pharmaceuticals. Cinnamon is a common agent used, and it has received extensive lay press attention. Chemically, cinnamon bark powder activates peroxisome proliferated activated receptors similar to TZDs. It is reasonable to hypothesize that cinnamon bark powder can cause edema. This case demonstrates that cinnamon bark powder may have a similar side effect profile. Physicians should be aware that consumption of cinnamon bark powder could cause fluid retention and possibly worsen congestive heart failure.
Subject(s)
Cinnamomum zeylanicum , Diabetes Mellitus, Type 2/therapy , Edema/etiology , Plant Preparations/adverse effects , Humans , Hypoglycemic Agents/adverse effects , Male , Middle Aged , Phytotherapy , Thiazolidinediones/adverse effectsSubject(s)
Acclimatization/physiology , Arabidopsis/physiology , Hot Temperature , Plant Leaves/physiology , Plant Transpiration/physiology , Arabidopsis/anatomy & histology , Arabidopsis/growth & development , Plant Leaves/anatomy & histology , Plant Leaves/growth & development , Plant Stems/anatomy & histology , Plant Stems/growth & development , Plant Stems/physiologyABSTRACT
Thirty adult patients who received intravenous colistin (5.1 ± 2.4 mg/kg/day) were reviewed to evaluate dosing with respect to nephrotoxicity, which occurred in 10 (33%) patients within the first 5 days of treatment. Excessive colistin dosing was frequent (47%), often (71%) resulted from the use of actual body weight in obese patients, and was associated with higher rates of nephrotoxicity (80% versus 30%, P = 0.019).
