[Effects of acupuncture treatment on natural killer cell activity, pulse rate, and pain reduction for older adults: an uncontrolled, observational study].

[Effects of acupuncture treatment on natural killer cell activity, pulse rate, and pain reduction for older adults: an uncontrolled, observational study].

J Integr Med. 2013 Mar;11(2):101-5

Authors: Mori H, Kuge H, Tanaka TH, Taniwaki E, Hanyu K, Morisawa T

Abstract
OBJECTIVE: The aim of this study was to examine the changes in natural killer (NK) cell activity, pulse rate, and pain intensity among older adults before and after acupuncture treatment.
METHODS: Fifty-six individuals (16 males and 40 females), age 60 to 82 years (mean age 72.4 ± 5.0), who were experiencing pain in the shoulder, low back, or knee, participated in the study. NK cell activity, leukocyte differentiation (granulocytes and lymphocytes), pulse rate, and blood pressure values obtained. Pain intensity was used to analyze NK cell activity, leukocytes (granulocyte counts and granulocyte-to-lymphocyte ratio), and the VAS score in accordance with the location of pain complaints before and after acupuncture treatment.
RESULTS: NK cell activity decreased after acupuncture treatment for pain in the shoulder-pain and knee-pain groups. Further, the lymphocyte and granulocyte counts increased after acupuncture treatment for the shoulder-pain group. Pulse rate decreased for the shoulder-pain, low-back-pain, and knee-pain groups after acupuncture treatment. The VAS score decreased after acupuncture treatment for the shoulder-pain, low-back-pain, and knee-pain groups.
CONCLUSION: This study showed that in older adults, acupuncture treatment decreases pulse rate, relieves pain in the shoulder, low back, and knee, and reduces NK-cell activity.

PMID: 23762897 [PubMed – in process]

Pain and anxiety mediate the relationship between dizziness and falls in older people.

Related Articles

Pain and anxiety mediate the relationship between dizziness and falls in older people.

J Am Geriatr Soc. 2013 Mar;61(3):423-8

Authors: Menant JC, Wong A, Sturnieks DL, Close JC, Delbaere K, Sachdev PS, Brodaty H, Lord SR

Abstract
OBJECTIVES: To identify medical, psychological, and physiological mediators of the relationship between dizziness and falls in older adults.
DESIGN: Secondary analysis of a prospective cohort study.
SETTING: Community.
PARTICIPANTS: Five hundred sixteen community-dwelling adults aged 73 to 92.
MEASUREMENTS: Participants completed questionnaires related to health and psychological well-being and underwent a tilt table blood pressure test, the Physiological Profile Assessment (PPA; vision, reaction time, proprioception, postural sway, and quadriceps strength), and leaning balance tests. Prospective falls data were collected using monthly calendars for 12 months. Participants were categorized into dizzy and nondizzy groups based on self-report of dizziness, vertigo, and light-headedness.
RESULTS: Two hundred seventeen (42%) participants reported vertigo or dizziness (10%), light-headedness (16%), or both (16%). The dizzy participants were significantly more likely to report neck and back pain, past transient ischemic attacks, and feeling dizzy upon upright tilting. They also had poorer balance and less strength and scored higher on measures of depression and anxiety (P < .05). There were no blood pressure measurement-related differences between the groups. Dizziness increased the risk of multiple falls in an unadjusted analysis (relative risk (RR) = 1.55, 95% confidence interval = 1.08-2.23). After controlling for PPA scores, neck and back pain and anxiety were mediators that reduced the RR of the relationship between dizziness and faller status the most (14%) in a modified Poisson regression model.
CONCLUSION: Suffering from neck and back pain and anxiety were mediators of the relationship between dizziness and falls after controlling for poor sensorimotor function and balance. Older people with dizziness might benefit from interventions targeting these mediators such as pain management and cognitive behavioral therapy.

PMID: 23351026 [PubMed – in process]

Use of Bone Morphogenetic Proteins in Spinal Fusion Surgery for Older Adults with Lumbar Stenosis: Trends, Complications, Repeat Surgery, and Charges.

Use of Bone Morphogenetic Proteins in Spinal Fusion Surgery for Older Adults with Lumbar Stenosis: Trends, Complications, Repeat Surgery, and Charges.

Spine (Phila Pa 1976). 2011 Apr 7;

Authors: Deyo RA, Ching A, Matsen L, Martin BI, Kreuter W, Jarvik JG, Angier H, Mirza SK

ABSTRACT: Study Design: Retrospective cohort study of Medicare claims.Objective: Examine trends and patterns in the use of bone morphogenetic proteins (BMP) in surgery for lumbar stenosis; compare complications, reoperation rates, and charges for patients undergoing lumbar fusion with and without BMP.Summary of Background Data: Small randomized trials have demonstrated higher rates of solid fusion with BMP than with allograft bone alone, with few complications, and in some studies, reduced rates of revision surgery. However, complication and reoperation rates from large population-based cohorts in routine care are unavailable.Methods: We identified patients with a primary diagnosis of lumbar stenosis who had fusion surgery in 2003 or 2004 (n = 16,822). We identified factors associated with BMP use; major medical complications during the index hospitalization, rates of rehospitalization within 30 days, and rates of reoperation within 4 years of follow-up (through 2008).Results: Use of BMP increased rapidly, from 5.5% of fusion cases in 2003 to 28.1% of fusion cases in 2008. BMP use was greater among patients with previous surgery and among those having complex fusion procedures (combined anterior and posterior approach, or greater than 2 disc levels). Major medical complications, wound complications, and 30-day rehospitalization rates were nearly identical with or without BMP. Reoperation rates were also very similar,, even after stratifying by previous surgery or surgical complexity, and after adjusting for demographic and clinical features. On average, adjusted hospital charges for operations involving BMP were about $15,000 greater than hospital charges for fusions without BMP, though reimbursement under Medicare’s Diagnosis-Related Group (DRG) system averaged only about $850 greater Significantly fewer patients receiving BMP were discharged to a skilled nursing facility (15.9% vs. 19.0%, p<0.001)Conclusion: In this older population having fusion surgery for lumbar stenosis, uptake of BMP was rapid, and greatest among patients with prior surgery or having complex fusion procedures. BMP appeared safe in the perioperative period, with no increase in major medical complications. Use of BMP was associated with greater hospital charges but fewer nursing home discharges, and was not associated with reduced likelihood of reoperation.

PMID: 21494195 [PubMed – as supplied by publisher]