Impact of Electroacupuncture Treatment on Quality of Life and Heart Rate Variability in Fibromyalgia Patients.

This study examines the effects of electroacupuncture treatment on health-related quality of life and heart rate variability in women with fibromyalgia. Twenty women with fibromyalgia received a 10-week treatment with electroacupuncture. Primary outcome measures were the Fibromyalgia Impact Questionnaire, the Short Form 36 Health Survey Questionnaire, and heart rate variability. Compared with pretreatment, there was a significant improvement in health-related quality of life; electroacupuncture significantly increases low frequency, low frequency/high frequency, and decreases high frequency, all indicating rise in sympathetic tone. Fibromyalgia patients showed a significant ( P < .05) improvement in pain, fatigue, morning tiredness, stiffness, anxiety, and depression on the Fibromyalgia Impact Questionnaire scores; and physical function, physical role, body pain, general health, and vitality scores on the Short Form 36 Health Survey Questionnaire. These changes mainly in mental status scores could be related to a new autonomic balance with sympathetic predominance at the horary of the study.

Thermal analysis of platelet aggregation assessed by differential scanning calorimetry.

Calorimetry is an analytical method that measures heat flow between a heat source and sample. The sample gains or losses heat based on physical or chemical composition. Differential scanning calorimetry (DSC) compares the results of heating a sample to those for heating a reference material. DSC then measures internal energy or a sample's calorific capacity. The aim of this study was to examine the thermal characteristics of platelet activation. Blood was obtained from human volunteers by venipuncture and collected in 5 ml siliconised and citronated vacutainer tubes. Platelet counts were measured using a hemocytometer. Platelet-rich (PRP) or platelet-poor plasma (PPP) was obtained by centrifugation. Ten microliters of PRP or PPP were placed into aluminum pans for DSC with or without activation by epinephrine (5.0 microM) or CaCl2 (50 microM). To avoid a spontaneous activation of platelets samples were kept frozen, after a 5 min period of stabilization, 5 microl of aggregation-inducing agent was added. Scans were initiated at a -12 degrees C after stabilization, with an increase of a 5 degrees C/min to a maximum of 60 degrees C. The experiments were performed on a TA Differential Scanning Calorimeter (New Castle, DE, USA). The difference in heat evolved between the PRP and PPP during the process of platelet activation was 253 J/g. The difference of heat flow in the activation of PRP versus PPP may correspond to an exothermic process involved in platelet aggregation.

Vascular responses to manual PC6 acupuncture in nonsmokers and smokers assessed by the second derivative of the finger photoplethysmogram waveform.

BACKGROUND: Smoking is reported to increase arterial stiffness. Indices obtained from the second derivative of digital volume pulse (SDDVP) waveform have been proposed to characterize vascular aging and arterial rigidity. PC6 (Neiguan) is a traditional acupoint in each forearm that has been shown to modify cardiovascular functioning. OBJECTIVE: To investigate the acute effects of manual needling with PC6 on SDDVP indices in healthy chronic smoker and nonsmoker subjects. SUBJECTS AND METHODS: Aging index (AI) was defined as (b - c - d - e)/a, B:A was calculated as the ratio of the absolute value for the height of the b wave (B) to that of the a wave (A), and D:A was calculated as the ratio of the absolute value for the height of the d wave (D) to that of the a wave (A). These indices derived of the wave components of SDDVP of healthy nonsmokers (n=40; 28.3+/-3.0 years old) vs. chronic smokers (n=30; 29.9+/-2.9 years old) were compared. The digital volume pulse (DVP) was obtained by measuring infrared light transmission through the finger. Of each subject, a DVP registration 20 minutes long was obtained. PC6 was stimulated unilaterally by manual needling for 5 minutes (1-6 minutes). SDDVP indices were compared in each subject in pre- vs. post-acupuncture periods (30 seconds vs. 18 minutes, respectively). RESULTS: At baseline, we found significant difference in B:A between nonsmokers and smokers. Comparing pre- vs. post-acupuncture periods, B:A and D:A did not show significant differences among nonsmokers, but B:A improved significantly in smokers and AI improved significantly in both nonsmokers and smokers. CONCLUSION: These findings suggest that manual needling with PC6 could revert some of the deleterious effects on vascular functioning produced by chronic cigarette smoking.

Assessment of the vascular effects of PC6 (Neiguan) using the second derivative of the finger photoplethysmogram in healthy and hypertensive subjects.

Indices obtained from the second derivative of the digital volume pulse waveform have been proposed to characterize vascular aging, arterial rigidity, and the effects of vasoactive drugs. The purpose of this study was to assess the effects of manual needling of PC6 on SD(DVP) indices in healthy and untreated hypertensive subjects. AI, B:A, and D:A indices, based on the height of the wave components of SD(DVP), in 40 healthy subjects and 25 untreated hypertensive subjects were compared. DVP was obtained by measuring infrared light transmission through the finger. For each subject, 20-min-long DVP registration was obtained. PC6 was stimulated unilaterally by manual needling for 5 min (1-6 min). In each subject, pre-acupuncture DVP indices were compared to those of during acupuncture (1 vs. 4 min) and post-acupuncture (1 vs. 18 min). In healthy subjects, AI was significantly improved when comparing the pre- to the post-acupuncture values. In hypertensive subjects, the SD(DVP) indices improved significantly as follows: the AI index when the value of pre-acupuncture comparing to that of during acupuncture and post-acupuncture values; B:A and D:A indices when the pre-comparing to post-acupuncture values. There were significant differences between healthy and hypertensive subjects in AI, B:A, and D:A at baseline and in B:A in the during acupuncture period; there were no significant differences at post-acupuncture. These results indicate that manual needling of PC6 produced acute effects on vascular pathophysiology. Moreover, PC6 needling produced changes in SD(DVP) indices related to both large artery stiffness and the reflected wave originating in small arteries.

Sobreprecio y acceso a los medicamentos: el caso de los medicamentos esenciales en México / Overpricing and affordability of drugs: the case of essential drugs in México

Para la Organización Mundial de la Salud (OMS) la accesibilidad y disponibilidad de los medicamentos es un tema central al cual le ha dedicado una gran atención. Si bien la política de medicamentos esenciales ha tenido una acogida favorable por parte de las organizaciones sanitarias, la industria farmacêutica, especialmente sus filiales asentadas en los países menos desarrollados, no ha brindado una respuesta adecuada a los planteamientos de la OMS de proporcionar medicamentos esenciales a precios accesibles. El objetivo es estudiar el precio de los medicamentos esenciales de marca en México en relación al precio de los medicamentos esenciales genéricos disponibles en el mercado internacional. Se estudió una muestra de especialidades farmacéuticas líderes de ventas en su categoría terapéutica y se compararon los precios, por unidades farmacéuticas, de los medicamentos de marca y los medicamentos genéricos a precio internacional. Los resultados muestran que el nivel de precios de los medicamentos esenciales en México es muy elevado. La venta per cápita no se ha reducido, a pesar de la caída del producto interno bruto que se produjo en México a partir del años de 1995. Se discuten las razones de este sobreprecio y se proponen algunas medidas para solucionar este problema.