The effectiveness of acupuncture versus clonazepam in patients with burning mouth syndrome.

OBJECTIVE: Burning mouth syndrome (BMS) is a chronic oral condition, characterised by burning symptoms, which mainly affects perimenopausal and postmenopausal women. Neuropathy might be the underlying cause of the condition. There are still insufficient data regarding successful therapy. The aim of this study was to compare the effectiveness of acupuncture and clonazepam. METHODS: Forty-two patients with BMS (38 women, 4 men) aged 66.7±12.0 years were randomly divided into two groups. Acupuncture was performed on 20 participants over 4 weeks, 3 times per week, on points ST8, GB2, TE21, SI19, SI18 and LI4 bilaterally as well as GV20 in the midline, each session lasting half an hour. Twenty-two patients took clonazepam once a day (0.5 mg in the morning) for 2 weeks and, after 2 weeks, two tablets (0.5 mg in the morning and in the evening) were taken for the next 2 weeks. Prior to and 1 month after either therapy, participants completed questionnaires: visual analogue scale, Beck Depression Inventory, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale, 36-item Short Form Health Survey (SF-36) and Montreal Cognitive Assessment (MoCA). RESULTS: There were significant improvements in the scores of all outcome measures after treatment with both acupuncture and clonazepam, except for MoCA. There were no significant differences between the two therapeutic regimens regarding the scores of the performed tests. CONCLUSIONS: Acupuncture and clonazepam are similarly effective for patients with BMS.

Quantitative and qualitative evaluation tool in planning stroke treatment strategies: the "Safe implementation of treatments in stroke Monitoring Study (SITS MOST)" registry.

A decade ago, stroke was the first leading cause of morbidity and mortality in Croatia. Nowadays, we record reduction in stroke incidence, as well as stroke consequences-invalidity and mortality. These are due to long-term planned actions in the field of public health as well as actions performed by professional organizations. Today, we can be satisfied with improvement in that field, but there are still things we can improve, at the first place improvement of the emergency medicine network due to Croatian-specific topographical characteristics to reduce onset-to-door time. In this paper, we evaluated results from 11 Croatian hospitals in the period 11/2005-11/2012. To find out about the past and present state in applying thrombolytic therapy in Croatia and to plan further actions in light of new studies and efforts in Europe and in the world, all with the aim of improvement in stroke prevention and acute treatment resulting in reduction of stroke morbidity, mortality and symptomatic intracerebral hemorrhage as well as better functional outcome. Our results have shown that we improved stroke treatment in the last decade, but further actions should be performed to raise public stroke awareness and to improve emergency medicine network as well as in hospital protocols.

Cognitive decline and cerebral vasoreactivity in asymptomatic patients with severe internal carotid artery stenosis.

The aim of the study was to correlate cognitive decline and cerebral vasoreactivity in 150 asymptomatic right-handed patients with severe ≥70% unilateral internal carotid artery (ICA) stenosis and to evaluate the role of intracranial collateral circulation during cognitive testing. Cognitive assessment was performed by means of Montreal Cognitive Assessment (MoCA) and Mini Mental State Exam (MMSE) scales. Cerebrovascular reactivity (CVR) and intracranial collateral circulation were evaluated by means of breath holding index (BHI) and transcranial color Doppler (TCD) sonography. The results were compared with 150 right-handed controls matched for demographic variables and vascular risk factors. Patients with severe unilateral ICA stenosis had MMSE scores within a normal range, but MoCA scores were lower than normal. By examining the side of the observed stenosis, it has been noted that patients with left-sided ICA stenosis had lower MoCA scores in categories of language and episodic memory performance, while patients with right-sided ICA stenosis had lower MoCA scores in a category of visual-spatial skills. All patients had BHI values lower than normal. Subjects with a single intracranial collateral artery recruited had slightly better cognitive results than the patients with two or more collateral arteries activated. Results of the study showed that altered cerebrovascular reactivity and cerebral hypoperfusion might be responsible for the reduction of specific cognitive functions ipsilateral to the ICA stenosis, therefore BHI and MoCA might be useful tools when screening for cognitive decline in asymptomatic patients with severe ICA stenosis.