Preliminary efficacy of the "SitLess with MS" intervention for changing sedentary behaviour, symptoms, and physical performance in multiple sclerosis.

PURPOSE: People with multiple sclerosis (MS) sit (i.e., are sedentary) more than peers. We examined the preliminary efficacy of an internet-based intervention that focuses on sitting less and moving more for changing sedentary behaviour outcomes, symptoms, QOL, and physical performance in adults with MS. METHODS: Persons with mild-to-moderate disability from MS took part in a 15-week pre-post trial. Outcomes including sedentary behaviour, representative symptoms (e.g., fatigue, pain), QOL and physical performance measures (e.g., walking speed) were measured at three time points: pre-post intervention and at follow-up. An unstructured linear mixed-effects model was used to determine change over time per outcome. RESULTS: Forty-one persons with MS participated (age 50 ± 10.3 years). There were significant reductions in total sedentary time (d = 0.34) and the number of long (≥30 min) bouts of sedentary time (d = 0.39) post-intervention. All symptoms and physical performance measures were significantly improved following the intervention, with effects sizes greatest for fatigue (d = 0.61) and depression (d = 0.79). Changes were maintained during the 7-week follow-up, except for all sedentary behaviour outcomes and sleep quality. Cognition did not change. CONCLUSIONS: This study provides preliminary support for the efficacy of an intervention focused on sitting less and moving more for improving symptoms in adults with MS.IMPLICATIONS FOR REHABILITATIONThis research provides preliminary evidence that an intervention aimed at reducing sedentary behaviour and increasing light intensity activity throughout the day can have an impact.Fatigue, depression and anxiety, symptoms frequently encountered by people with MS, showed the greatest improvement following the intervention.Weekly coaching sessions including discussions about results from activity monitoring provided motivation for participants. TRIAL REGISTRATION: The "SitLess with MS" feasibility study was registered at ClinicalTrials.gov Trial Registration Number: NCT03136744. Date of registration was 2 May 2017. Find at https://clinicaltrials.gov/ct2/show/NCT03136744.

The SitLess With MS Program: Intervention Feasibility and Change in Sedentary Behavior.

OBJECTIVES: This study reports on the feasibility of the SitLess with MS trial, an intervention targeting sedentary behavior in individuals with multiple sclerosis (MS). DESIGN: Single group, pre-post intervention design. SETTING: Community. PARTICIPANTS: Participants (N=41) with mild to moderate disability from MS. INTERVENTION: The intervention was 15 weeks, with a 7-week follow-up, and included 2 stages: SitLess and MoveMore. During the SitLess stage, participants were encouraged to break up prolonged sitting bouts over a 7-week period, whereas the MoveMore stage promoted increased steps per day and interrupting sitting over a 7-week period. The intervention was delivered through weekly one-on-one coaching sessions via telerehabilitation and an accompanying newsletter based on social-cognitive theory. Activity was monitored throughout the program using a Fitbit. MAIN OUTCOME MEASURES: Process (eg, recruitment) and resource and management (eg, personnel requirements) metrics were assessed, along with efficacy outcomes (eg, effect). Progression criteria were set a priori and were related to safety, fatigue, satisfaction, and attrition. Sedentary behavior, measured using the ActivPal, was reported pre- and postintervention, as well as 7 weeks postintervention. Effect sizes (pre to post, pre to 7 weeks post) were calculated for the sedentary behavior outcomes (eg, time sitting, transitions from sitting to standing, number of long sitting bouts). Experiences with the intervention were explored through an online survey. RESULTS: Forty-one participants enrolled, 39 of whom completed the intervention. All participants but 1 were satisfied with the experience. Pre-post intervention effect sizes for change in total sedentary time, number of transitions from sit to stand, and number of long (>30 min) sedentary bouts were 0.34, 0.02, and 0.39 respectively. All a priori progression criteria were met. CONCLUSIONS: The SitLess with MS program, a novel intervention that emphasized and facilitated sitting less and moving more, was feasible and resulted in small changes in sedentary behavior in individuals with MS.

Regenerative potential of endometrial stem cells: a mini review.

Recent findings in stem cell biology have opened a new window in regenerative medicine. The endometrium possesses mesenchymal stem cells (MSCs) called endometrial stem cells (EnSCs) having specific regenerative properties linked to adult stem cells. They contribute in tissue remodeling and engineering and were shown to have immuno-modulating effects. Many clinical trials were undertaken to ascertain the therapeutic potential of EnSCS. In this mini review, we showed that EnSCs are readily available sources of adult stem cells in the uterus that can be highlighted for their renewable multipotent and differentiation properties. This cell population may be a practical solution of choice in reproductive biology, regenerative medicine and autologous stem cell therapy.

A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit.

BACKGROUND: In recent years, there is an increasing tendency to use diced cartilage grafts in rhinoplasty surgery for improving dorsum contour irregularities. This study was designed to compare graft resorption between three techniques of diced cartilage using surgical blade, electrical grinder and grater in rabbit model. METHODS: Thirteen New Zealand rabbits were divided into three groups. Three 2×2 cm cartilage specimens were harvested from one of their ears. In group one, the cartilage was diced by use of No:11 surgical blade to o.5 to 1 mm cube pieces. In group two, an electrical grinder was used and in group three, a grater was applied. The grafts were placed in three subcutaneous pockets in the back of rabbits and after 12 weeks, the implants were removed and their weight and volume were recorded and were evaluated by histological techniques. RESULTS: There was no difference between the three methods in the 3 groups for graft resorption. There was no change in the volume, but the weight showed a decrease in the control group. CONCLUSIONS: As the histological results had no statistically difference between groups, we may recommend use of these two techniques in reconstructive and in aesthetic cases.

Can we add auricular composite graft to our rhinoplasty armamentarium?

BACKGROUND: The ala of the nose, with its particular texture and characteristics, poses both aesthetically and functionally intriguing challenges and is rather problematic regarding choices for reconstructive methods. Both flaps and grafts have been used to restore natural structure of nasal ala. The present study summarizes a ten-year experience of reconstructive surgery using small composite grafts from non-cartilage bearing tissues, and large composite grafts, containing cartilaginous tissue, with a mean follow-up of 4 years and 8 months. METHODS: Cumulatively 56 patients were reported. Some of them required surgery due to previous cosmetic rhinoplasty. In 47 of the cases, a small graft from the non-cartilage bearing junction of ear lobule to helical rim sufficed. Nine patients had rather large defects for which grafts were harvested from the helical root. Donor sites were primarily closed and grafts were implanted in place in a single, rapid session. RESULTS: All small grafts had excellent take. Of 9 large grafts, 5 had excellent take, three had acceptable, and one, in a male smoker, failed to take. During follow-up, no gross deformity or poor scar was detected in either donor or recipient site. CONCLUSIONS: We have demonstrated that using both large and small auricular composite grafts has favorable long term results for reconstruction of alar rim deformities. However, use of small grafts seems more beneficial and applicability of large grafts requires further studies.

A comparison between cetirizine and ondansetron in preventing postoperative nausea and vomiting in adults.

BACKGROUND: Postoperative nausea and vomiting are some of the important and common side effects of anesthesia after surgery occurring in almost 20-30% of patients and is the second factor of a patient's complaint and inconvenience after pain. This study compares the effect of oral cetirizine and ondansetron in the prevention of postoperative nausea and vomiting in adults. MATERIALS AND METHODS: In a blind and prospective study in fall 2010, 300 patients aged 18-65 years who were among ASA I-II in Chamran Orthopedic Hospital were randomly divided into three equal groups receiving cetirizine, ondansetron, and placebo, respectively. General anesthesia was identical. After operation (after 1-2 h in the recovery room, after 2-12 and 12-24 h in the ward), the presence or absence and any nausea or vomiting was recorded. RESULTS: The postoperative nausea and vomiting (PONV) rate after 1-2 h in the recovery room, after 2-12 and 12-24 h in the ward in placebo, and both groups of cetirizine and ondansetron were 50%, 21%, and 11%, respectively while the difference was significant (P value < 0.05). Regarding the number of vomiting, the least was related to ondansetron (especially in the first 2-12 h) but the difference was not significant (P > 0.05). CONCLUSION: The PONV rate in cetirizine and ondansetron groups was less than the placebo group.

Incidence of breast cancer in fars province, southern iran: a hospital-based study.

BACKGROUND: Breast cancer is still considered as one of the most common female cancers worldwide regardless of the countries' level of development. This study determines the incidence of breast cancer in Fars Province, Southern Iran. METHODS: This study used patients' records from Shiraz University of Medical Sciences Cancer Registry Centre, which is a Hospital-Based Registry of Nemazee Hospital. Data were recorded based on International Classification of Diseases for Oncology (ICD-O) and compromised all invasive cancers in ICD-10 categories of C-00 to C-80. The findings were shown as the number of cases by site (ICD-10) and gender, with crude incidence (CRs), age-specific incidence and age-standardized incidence rates (ASRs) per 100,000 persons per year, performed by direct method using the world standard population. RESULTS: The age group of 40-49 years had the highest rate of breast cancer and naturally most cases were post-menopause ones. Most cases were diagnosed in moderate differentiated state with an increasing trend. Early diagnosis of in situ neoplasms has not increased over time in comprised with malignant cases. The number of diagnosed cases has sharply increased after year 2004 especially during post-menopause period. CONCLUSION: As the number of diagnosed cases has increased during post-menopausal period, screening and health programs seem necessary for menopause women.

Prevalence of workplace violence in psychiatric wards, Tehran, Iran.

Workplace violence is still a problem that nurses may be exposed to in clinical wards. A psychiatric ward is among the most probable one confronting this violence. This study determined the workplace violence in psychiatric wards in Tehran, Iran. Nurses working in Razi Psychiatric Center, Tehran, Iran were enrolled using the International Workplace Violence questionnaire. Among 385 nurses of this ward, 200 subjects completed the questionnaire using a simple random sampling method with a response rate of 91.5%. The prevalence of workplace violence was 71% including mental (93.4%) and physical violence (71.6%). Verbal and sexual violence occurred in 19.1 and 5.5% of subjects, respectively. The 62.3% of the nurses did not report violence because they considered it useless (55.3%) or did not believe to be important (42.1%). The 61.2% believed to the necessity of training courses while 72.7% had completed these courses and 59.6% believed to a reporting system. The need to security guard (56.8%), taking security actions in wards (67.8%) and training of staffs (68.9%) were the most important preventive measures reported to be effective for workplace violence. It seems that training courses, establishing rules to prevent workplace violence, reporting systems, compensating losses from violence, increasing the security at workplace, increasing the number of nurses and providing especial guiding protocols against any workplace violence would promote the wards to control the workplace violence against nurses.