Therapeutic Actions Relaxation Therapy

NCBI pubmed

The effects of mindfulness and relaxation training for insomnia (MRTI) on postmenopausal women: a pilot study.

The effects of mindfulness and relaxation training for insomnia (MRTI) on postmenopausal women: a pilot study. Menopause. 2018 May 21;: Authors: Garcia MC, Kozasa EH, Tufik S, Mello LEAM, Hachul H Abstract OBJECTIVE: The aim of the study was to evaluate the effects of mindfulness and relaxation training for insomnia on insomnia and quality of life in postmenopausal women. METHODS: Thirty postmenopausal women aged 50 to 65 years, who were not using hormone therapy, and had a diagnosis of insomnia and an apnea-hypopnea index of less than 15, were randomly assigned to two groups: a mindfulness intervention group and a control group. They were assessed before the intervention, and 8 weeks after its completion using questionnaires assessing sleep quality (Pittsburgh Sleep Quality Index), insomnia (Insomnia Severity Index), quality of life in menopause (Menopause-Specific Quality of Life), menopausal symptoms (Kupperman Menopausal Index), and level of attention (Mindfulness Awareness Attention Scale). They were also assessed through ambulatory polysomnography. This is a pilot study and is limited by its small sample size. RESULTS: The results of the questionnaires showed significant differences in the group that received mindfulness training compared with the control group, namely, improvements in sleep quality, a reduction in the severity of insomnia, a better quality of life, improved attention levels, and a reduction in menopausal and vasomotor symptoms. Polysomnography results showed no differences between the groups. CONCLUSIONS: Eight weeks mindfulness meditation training improved sleep quality, quality of life, attention levels, and reduced vasomotor symptoms in postmenopausal women with insomnia. PMID: 29787483 [PubMed - as supplied by publisher]

Evolution of Echocardiographic Measures of Cardiac Disease From CKD to ESRD and Risk of All-Cause Mortality: Findings From the CRIC Study.

Related Articles Evolution of Echocardiographic Measures of Cardiac Disease From CKD to ESRD and Risk of All-Cause Mortality: Findings From the CRIC Study. Am J Kidney Dis. 2018 May 18;: Authors: Bansal N, Roy J, Chen HY, Deo R, Dobre M, Fischer MJ, Foster E, Go AS, He J, Keane MG, Kusek JW, Mohler E, Navaneethan SD, Rahman M, Hsu CY, CRIC Study Investigators Abstract RATIONALE & OBJECTIVE: Abnormal cardiac structure and function are common in chronic kidney disease (CKD) and end-stage renal disease (ESRD) and linked with mortality and heart failure. We examined changes in echocardiographic measures during the transition from CKD to ESRD and their associations with post-ESRD mortality. STUDY DESIGN: Prospective study. SETTING & PARTICIPANTS: We studied 417 participants with CKD in the Chronic Renal Insufficiency Cohort (CRIC) who had research echocardiograms during CKD and ESRD. PREDICTOR: We measured change in left ventricular mass index, left ventricular ejection fraction (LVEF), diastolic relaxation (normal, mildly abnormal, and moderately/severely abnormal), left ventricular end-systolic (LVESV), end-diastolic (LVEDV) volume, and left atrial volume from CKD to ESRD. OUTCOMES: All-cause mortality after dialysis therapy initiation. ANALYTICAL APPROACH: Cox proportional hazard models were used to test the association of change in each echocardiographic measure with postdialysis mortality. RESULTS: Over a mean of 2.9 years between pre- and postdialysis echocardiograms, there was worsening of mean LVEF (52.5% to 48.6%; P<0.001) and LVESV (18.6 to 20.2mL/m2.7; P<0.001). During this time, there was improvement in left ventricular mass index (60.4 to 58.4g/m2.7; P=0.005) and diastolic relaxation (11.11% to 4.94% with moderately/severely abnormal; P=0.02). Changes in left atrial volume (4.09 to 4.15mL/m2; P=0.08) or LVEDV (38.6 to 38.4mL/m2.7; P=0.8) were not significant. Worsening from CKD to ESRD of LVEF (adjusted HR for every 1% decline in LVEF, 1.03; 95% CI, 1.00-1.06) and LVESV (adjusted HR for every 1mL/m2.7 increase, 1.04; 95% CI, 1.02-1.07) were independently associated with greater risk for postdialysis mortality. LIMITATIONS: Some missing or technically inadequate echocardiograms. CONCLUSIONS: In a longitudinal study of patients with CKD who subsequently initiated dialysis therapy, LVEF and LVESV worsened and were significantly associated with greater risk for postdialysis mortality. There may be opportunities for intervention during this transition period to improve outcomes. PMID: 29784617 [PubMed - as supplied by publisher]

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative.

Related Articles Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative. Skeletal Radiol. 2018 Jan;47(1):93-106 Authors: Hofmann FC, Neumann J, Heilmeier U, Joseph GB, Nevitt MC, McCulloch CE, Link TM Abstract OBJECTIVE: To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). MATERIALS AND METHODS: We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. RESULTS: Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). CONCLUSION: A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. PMID: 28852821 [PubMed - indexed for MEDLINE]

Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review.

Related Articles Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review. Syst Rev. 2017 Jul 17;6(1):144 Authors: Clough BA, March S, Chan RJ, Casey LM, Phillips R, Ireland MJ Abstract BACKGROUND: Occupational stress and burnout are highly prevalent among medical doctors and can have adverse effects on patient, doctor, and organisational outcomes. The purpose of the current study was to review and evaluate evidence on psychosocial interventions aimed at reducing occupational stress and burnout among medical doctors. METHOD: A systematic review was conducted for original research articles reporting on psychosocial interventions targeting occupational stress or burnout among medical doctors, published in the English language, and with data collected at a minimum of two time points. Searches were conducted across five electronic databases, as well as by manual search of Google Scholar. Data was extracted relating to study characteristics and outcomes, quality and rigour, as well as modes of delivery and engagement. Studies were appraised using the Strength of Recommendation Taxonomy (SORT) and Critical Appraisal Skills Programme (CASP). RESULTS: Twenty-three articles were reviewed, which reported on interventions utilising cognitive-behavioural, relaxation, and supportive discussion strategies. Only 12 studies allowed estimation of pre- to post-intervention effects. Cognitive behavioural interventions demonstrated the strongest evidence, particularly for reducing stress. Some evidence was identified to support the efficacy of relaxation-based approaches, but no such evidence was found for the efficacy of discussion-based interventions, such as Balint groups. There was a lack of quality among reviewed studies, with no studies receiving a quality rating of 1, and the overall body of evidence being rated as level B, according to the SORT. Effect sizes were not pooled due to a lack of quality among the study sample. CONCLUSION: This review found that despite increased scientific attention, the quality of research examining the benefits of psychosocial/behavioural interventions for occupational stress and burnout in medical doctors remains low. Despite this, interventions focused on cognitive and behavioural principles appear to show promise in reducing doctor stress and burnout. Limitations of the current review include a lack of risk of bias assessment or pooling of analyses. Recommendations for improving the quality of research in this area, as well as implications of the current body of evidence are discussed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016032595. PMID: 28716112 [PubMed - indexed for MEDLINE]

Current treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser.

Related Articles Current treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser. J Cosmet Dermatol. 2017 Sep;16(3):303-318 Authors: Gold MH, Goldberg DJ, Nestor MS Abstract The treatment of acne, especially severe acne, remains a challenge to dermatologists. Therapies include retinoids, antibiotics, hormones, lights, lasers, and various combinations of these modalities. Acne is currently considered a chronic rather than an adolescent condition. The appropriate treatment depends on the patient and the severity of disease. The purpose of this study was to review current therapies for acne of all severities and to introduce the 650-μs 1064-nm laser for the treatment of acne. PMID: 28703382 [PubMed - indexed for MEDLINE]

Mapping the illness trajectories of insomnia: a biographical disruption?

Related Articles Mapping the illness trajectories of insomnia: a biographical disruption? Sociol Health Illn. 2017 Jun;39(5):659-679 Authors: Cheung JMY, Saini B, Bartlett DJ, Laba TL, Mason PH Abstract The insomnia illness experience can be conceptualised as a form of biographical disruption. Using a critical interpretive phenomenological lens 51 in-depth semi-structured interviews were conducted with patients from specialist sleep and psychology clinics (n = 22) and the general community (n = 29). Patients' narratives revealed key phases of their illness trajectories as they recognise, rethink and respond to insomnia. Their biographical events served as reference points for both patient groups to make sense of their illness experiences as they transitioned from a perceived state of sleeplessness to clinical insomnia. The innate biological process of sleep at night and the sleep-dependent daytime psychosocial function exerted a negative bi-directional effect, creating a continuous circuit of disruption. Coping mechanisms were inspired by the participants' immediate social environment and centred on sociocultural motifs of relaxation and alertness to break the 'circuit'. Access to specialist clinic services appeared to be contingent on the richness of resources in one's social network and surrounding environment rather than the clinical severity of the disease alone. Treatment that can simultaneously target the night time and daytime consequences of insomnia resonates closely with participants' depiction of insomnia as both a physiological and a psychosocial phenomenon. PMID: 27928829 [PubMed - indexed for MEDLINE]

Tert-butylhydroquinone lowers blood pressure in AngII-induced hypertension in mice via proteasome-PTEN-Akt-eNOS pathway.

Related Articles Tert-butylhydroquinone lowers blood pressure in AngII-induced hypertension in mice via proteasome-PTEN-Akt-eNOS pathway. Sci Rep. 2016 07 20;6:29589 Authors: Xu BC, Long HB, Luo KQ Abstract Tert-butylhydroquinone (tBHQ), as an antioxidant, has been widely used for many years to prevent oxidization of food products. The aim of this study was to investigate whether tBHQ activates endothelial nitric oxide synthase (eNOS) to prevent endothelial dysfunction and lower blood pressure. The role of Akt in tBHQ-induced eNOS phosphorylation was examined in human umbilical vein endothelial cells (HUVEC) or in mice. tBHQ treatment of HUVEC increased both Akt-Ser473 phosphorylation, accompanied with increased eNOS-Ser1177 phosphorylation and NO release. Mechanically, pharmacologic or genetic inhibition of Akt abolished tBHQ-enhanced NO release and eNOS phosphorylation in HUVEC. Gain-function of PTEN or inhibition of 26S proteasome abolished tBHQ-enhanced Akt phosphorylation in HUVEC. Ex vivo analysis indicated that tBHQ improved Ach-induced endothelium-dependent relaxation in LPC-treated mice aortic arteries, which were abolished by inhibition of Akt or eNOS. In animal study, administration of tBHQ significantly increased eNOS-Ser1177 phosphorylation and acetylcholine-induced vasorelaxation, and lowered AngII-induced hypertension in wildtype mice, but not in mice deficient of Akt or eNOS. In conclusion, tBHQ via proteasome-dependent degradation of PTEN increases Akt phosphorylation, resulting in upregulation of eNOS-derived NO production and consequent improvement of endothelial function in vivo. In this way, tBHQ lowers blood pressure in hypertensive mice. PMID: 27435826 [PubMed - indexed for MEDLINE]