Continuous low-level topical heat in the treatment of dysmenorrhea.

OBJECTIVE: To compare the efficacy of topically applied heat for menstrual pain with oral ibuprofen and placebo treatment. METHODS: We conducted a randomized placebo and active controlled (double dummy), parallel study using an abdominal patch (heated or unheated) for approximately 12 consecutive hours per day and oral medication (placebo or ibuprofen 400 mg) three times daily, approximately 6 hours apart for 2 consecutive days. Pain relief and pain intensity were recorded at 17 time points. There was at least 85% power to detect a true one-unit difference in the 2-day pain relief treatment means for comparisons with the unheated patch plus oral placebo group using a one-tailed test at the.05 level of significance, based on an observed within-group standard deviation of 1.147. RESULTS: Eighty-four patients were enrolled and 81 completed the study protocol. Over the 2 days of treatment, the heated patch plus placebo tablet group (mean 3.27, P <.001), the unheated patch plus ibuprofen group (mean 3.07, P =.001), and the combination heated patch plus ibuprofen group (mean 3.55, P <.001) had significantly greater pain relief than the unheated patch plus placebo group (mean 1.95). Greater pain relief was not observed for the combination heated patch plus ibuprofen group compared with the unheated patch plus ibuprofen group (P =.096); however, the time to noticeable pain relief was statistically significantly shorter for the heated patch plus ibuprofen group (median 1.5 hours) compared with the unheated patch plus ibuprofen group (median 2.79 hours, P =.01). CONCLUSION: Continuous low-level topical heat therapy was as effective as ibuprofen for the treatment of dysmenorrhea.

Effect of topical heat on electromyographic power density spectrum in subjects with myofascial pain and normal controls: a pilot study.

OBJECTIVE: To investigate the influence of superficial heat on the fatigue cascade of the upper trapezius muscle in subjects with myofascial pain and matched normal controls. DESIGN: In a prospective randomized block crossover pilot study, eight female subjects, ages 20-35 yr, with upper trapezius muscle trigger points and eight matched female control subjects without pain were studied. Subjects performed six 100-sec shoulder shrug contractions to fatigue, with subjects randomly chosen to receive heat during the first three or last three trials. The initial median frequency and the slope of the median frequency decline were calculated from the data. RESULTS: In the subjects with pain, the slope of the median frequency was elevated in ambient room temperature as compared with controls. There was no difference in slope of the median frequency under heated conditions. Heat application in controls before fatiguing exercise caused an increase in initial median frequency, whereas exercise before heat treatment resulted in a significantly lower initial median frequency. Subjects with myofascial pain had no significant change in initial median frequency. CONCLUSIONS: Heat seems to have a positive effect on muscle function in normal individuals when applied before exercise. Subjects with myofascial pain respond differently to exercise and heat challenge, which suggests a difference in their muscle physiology.

Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials.

BACKGROUND: Soluble fibers, including those from psyllium husk, have been shown to augment the cholesterol-lowering effects of a low-fat diet in persons with hypercholesterolemia. As evidence of this, the US Food and Drug Administration recently authorized the use of health claims on food products containing soluble fiber from psyllium that state that they are associated with a decreased risk of coronary heart disease. OBJECTIVE: This meta-analysis was conducted to more precisely define the hypolipidemic effects and safety of psyllium when used adjunctive to a low-fat diet in men and women with hypercholesterolemia. DESIGN: The 8 studies in the meta-analysis included a total of 384 and 272 subjects receiving psyllium or cellulose placebo, respectively. All studies evaluated the hypocholesterolemic effects of 10.2 g psyllium/d adjunctive to a low-fat diet for >/=8 wk in individuals with mild-to-moderate hypercholesterolemia after a low-fat diet lead-in phase lasting >/=8 wk. The safety and adverse events associated with psyllium consumption were summarized from pooled data of 19 clinical studies ranging from 6 wk to 6 mo in duration. RESULTS: Consumption of 10.2 g psyllium/d lowered serum total cholesterol by 4% (P < 0.0001), LDL cholesterol by 7% (P < 0.0001), and the ratio of apolipoprotein (apo) B to apo A-I by 6% (P < 0.05) relative to placebo in subjects already consuming a low-fat diet, with no effect on serum HDL or triacylglycerol concentrations. CONCLUSIONS: Psyllium supplementation significantly lowered serum total and LDL-cholesterol concentrations in subjects consuming a low-fat diet. Psyllium is well tolerated and safe when used adjunctive to a low-fat diet in individuals with mild-to-moderate hypercholesterolemia.

Diminution of T cells with gamma delta receptor in the peripheral blood of allergic asthmatic individuals.

BACKGROUND: T cells are shown to regulate allergy and asthma. They are heterogeneous by virtue of surface receptor subtypes (alpha beta and gamma delta receptors), however, their pathophysiological roles in asthma are unclear. OBJECTIVE AND METHODS: The present study employed flow cytometric analysis to compare the size of T-cell subsets and eosinophils present in the peripheral blood of healthy, allergic and allergic asthmatic individuals. RESULTS: Current results demonstrated that the percentages of gamma delta T cells declined from 4.1% in healthy to 3.2% in the allergic subjects and to a significantly lower (P = 0.01) 2.4% in allergic asthmatics. The absolute numbers of circulating gamma delta T cells also were diminished in a similar fashion such that healthy individuals had a significantly higher mean cell count (91.8 x 10(3)/mL) than did allergic asthmatics (47.8 x 10(3)/mL) (P = 0.0266). In contrast, alpha beta T cells were comparable in the healthy, allergic, and allergic asthmatic populations (65.3%, 65.8% and 69.4%, respectively); the differences were not statistically significant. On a populational basis, the proportion of individuals having both gamma delta T cells < or = 4.1% and eosinophils > or = 2.1% was the lowest in the healthy population (30.8%), but was elevated in the allergic group (85.7%) as well as in the allergic asthmatic group (86.6%). However, on an individual basis, those who had reduced gamma delta T cells did not have consistently higher eosinophil counts or IgE level. CONCLUSION: It was concluded that no significant correlation existed between the levels between gamma delta T cells and eosinophils or between gamma delta T cells and IgE present in the peripheral blood. This report, for the first time, documents that allergic asthmatics have reduced gamma delta T cells with reciprocally elevated eosinophil numbers in their peripheral circulation. However, it does not indicate that the reduction of gamma delta T cells directly correlates with the predominance of eosinophils of IgE levels in the diseased populations. The pathophysiological role of gamma delta T cells in allergic diseases awaits further exploration.