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Neuropeptide B Minimizes Nose Epithelial T2R Sour Style Receptor-Stimulated Nitric Oxide Creation.
This report, prepared by a lead researcher, describes 2 independent, but similarly designed, clinical trials that were conducted to investigate the effectiveness, mechanisms, and predictors of electroacupuncture (EA) for treating chronic low-back pain (CLBP). check details Both trials recruited adults (ages 21-65) who had CLBP with an intensity ≥4/10 and a duration ≥6 months. Verum EA or sham EA was administered twice per week for 6-8 weeks. The common outcome between the 2 studies was the patients' responses to the Roland Morris Disability Questionnaire. Using least absolute shrinkage and selection operator (LASSO), the authors were able to predict clinical outcome in the second study by using a prediction model based on data from the first study. This work demonstrated the feasibility of predicting clinical outcomes when using acupuncture for treating CLBP.Background High-symptom burdens, including pain, are associated with high-dose chemotherapy. Objective We conducted a pilot study to evaluate how acupuncture may affect symptom burden and use of pain medication. Design This is a randomized sham acupuncture (SA) controlled trial. Setting An academic cancer center. Patients Patients were with multiple myeloma undergoing autologous hematopoietic stem cell transplantation. Intervention Once daily acupuncture for 5 days after high-dose chemotherapy. Main Outcome Measures M. D. Anderson Symptom Inventory (MDASI), opioid use. Results Compared with SA, true acupuncture reduced nausea, poor appetite, and drowsiness, and use of opioids in opioid-naive patients. Randomizations Yes. Blinding Investigators and study participants were blinded. Conclusion Further study of acupuncture in a larger trial is warranted for its effect on reducing opioid use and symptom burdens during high-dose chemotherapy. Registration NCT01811862.Nascent research is beginning to link reduced opioid prescribing and increased well-being with acupuncture. While pain is the most common reason patients see physicians, acupuncture is often recommended to treat it. Due to lack of a common nomenclature around acupuncture treatment protocols, it can be difficult for clinicians to replicate research findings. This article discusses communication of ideas about how the National Institutes of Health (NIH) could help propagate meaningful research findings to practicing acupuncturists. While communication strategies can increase uptake of acupuncture in primary care and pain practices, the NIH could (1) describe priorities in developing algorithmic acupuncture protocols; (2) require some grant applications to include both clinical and basic science outcomes; (3) develop a "dating service" to match clinical acupuncture researchers and those with the capability and interest to test mechanisms; and (4) initiating fellowships for young investigators that prioritize bringing together the art and science of acupuncture.Background The translation of clinical practice into research presents unique challenges. This is especially the case in evaluating the effect of interventions in the management of chronic conditions such as pain, mental health, substance misuse, and oncology care. Chronic complex conditions might respond to different strategies at different points in time and may require an interdisciplinary approach to treatment. Objectives To define the key barriers to the design, implementation, and evaluation of clinical trials of acupuncture that derive from a unidirectional translational research strategy. Results Critical challenges to the design, implementation, and evaluation of clinical trials of acupuncture center around four areas (1) insufficient early phase research, (2) suboptimal treatment protocols, (3) inadequate research questions, and 4) a narrowed assessment of outcomes. Conclusions By promoting research priorities that reflect the complex nature of chronic illness, we can more clearly articulate research questions that better reflect clinical practice, while evaluating the impact of acupuncture in patient care. Key priorities include phase I research funding opportunities, pragmatic trials that evaluate acupuncture embedded in interprofessional teams, and the inclusion of hypothesis-driven secondary outcomes.Background The Acupuncture Trialists' Collaboration has updated its individual patient data meta-analysis of acupuncture for chronic pain originally published in 2012. The updated meta-analysis, published in 2018, now includes raw trial data from 39 trials and 20,827 patients. The overall effect of acupuncture, and the effect of sham acupuncture controls, was evaluated. Results For 4 conditions, acupuncture has statistically significantly better effects than sham acupuncture (effect sizes 0.16-0.19 [small]). link2 When compared with usual care controls, effect sizes are larger (0.44-0.63 [moderate]). Sham acupuncture has a considerable therapeutic effect; true acupuncture compared with usual care has an effect size of around 0.5, of which 60% is ascribed to nonspecific context effects plus sham, and the remaining 40% to the specific benefit of true acupuncture. Investigators also determined no significant variation in effect related to any acupuncture characteristic; that acupuncture's effect size drops against a high-intensity control; and that only 10%-15% of acupuncture's benefit is lost at 12 months post-treatment. Conclusions Acupuncture is more than a placebo for chronic pain, and both specific and nonspecific effects can be distinguished in a meta-analysis of appropriate size.Objective Epigenetics, including DNA methylation, histone modification, and posttranscriptional regulation of microRNAs, is the study of heritable changes in gene expression that do not include DNA-sequence alterations. Epigenetics has become a new strategy for basic and clinical research on acupuncture in the last decade. The aim of this research update was to summarize the epigenetic mechanisms of angiogenesis induced by acupuncture treatment in ischemic heart diseases. Materials and Methods The current authors' group has been working to illustrate the mechanism of acupuncture from an epigenetics perspective, which has shed new lights on the mechanisms and applications of acupuncture in cardiovascular diseases. This article summarizes the group's new findings in animal models as well as in patients with chronic stable angina. Progress since 2011 in other teams' research in this field is also discussed in this article. Conclusions Acupuncture could regulate histone modifications and could rescue patients who sustain ischemic injuries. This treatment could possibly work through promoting angiogenesis.Introduction Developing a new and innovative acupuncture technique to deal with acute and chronic pain is a considerable undertaking in itself as many barriers must be overcome. Designing the technique and gaining acceptance is even more daunting and challenging across a large system of medical facilities such as the Department of Defense and the Veterans Administration. Such was the case of Battlefield Acupuncture (BFA), a 5-needle placement in each external ear into specific auricular points to treat acute and chronic pain. Discussion This technique geared for military deployment is rapid, safe, and easily reproducible without side effects because it uses a choice acupuncture microsystem, namely the ear. Acquiring acupuncture practical skills is the prerequisite before designing the technique and then taking into consideration, neurophysiology data, and actual clinical experience to finally focus development is demanding. Conclusions The benefits of BFA that was promulgated in a Joint Incentive Fund for $5.4 million resulted in thousands of trained health care providers and eventually many clinical trials to help validate the technique. Process improvement data were beneficial and important for its sustainment. There are 5 steps recommended for overcoming the barriers.The glymphatic system is network of perivascular spaces through which cerebrospinal fluid and interstitial fluid can move through the brain, clearing metabolic waste, such as amyloid beta, lactate and more, from the parenchyma. This cleaning system is regulated by sleep and norepinephrine, with increased levels of norepinephrine during wakefulness inhibiting fluid movement. Norepinephrine is also essential for transition from acute to chronic pain, and sufferers of chronic neuropathic pain frequently present with sleep disruption. These connections among glymphatic clearance, sleep, and pain are very intriguing, and might lead to nonpharmaceutical interventions for pain treatment. This short perspective provides a rationale for the hypothesis that mind-body interventions-such as acupuncture-can reduce norepinephrine and increase glymphatic function, ultimately relieving chronic neuropathic pain.Background Healing is a complicated process that can have several components including the self-healing properties of the body, the nonspecific effects of treatment (e.g., the power of the mind), and the specific effects of an intervention. This article first discusses the brain imaging studies on placebo acupuncture analgesia and the modulation effects of expectancy on real acupuncture in healthy subjects. Then, it introduces some attempts to translate findings from healthy subjects to patient population using power of the mind as a way to enhance acupuncture's treatment effects on chronic pain. After that, a new alternative method which merges acupuncture and imagery, while also drawing on power of the mind, is presented. Finally, the specific effects of acupuncture are discussed. Conclusions Elucidating the mechanism underlying power of the mind would provide new opportunities for boosting the therapeutic effect of acupuncture treatment and furthering the development of new alternative interventions.Objective Acupuncture, as an important part of Traditional Chinese Medicine, has been practiced for thousands of years in China and now all over the world, but the underlying neuroanatomical basis is still poorly understood. This article explores how acupuncture drives autonomic reflexes and why the widely used Streitberger sham-needling control should be revisited. Method This article summarizes modern studies, suggesting that functional connections between somatic tissues and internal organs may be explained via somato-autonomic reflexes. Results Modern studies have revealed a few organizational rules regarding how acupuncture drives distinct somatosensory autonomic pathways, including acupoint selectivity and intensity dependence. Activation of these autonomic pathways modulates various body physiologic functions, such as gastrointestinal motility and systemic inflammation. link3 Meanwhile, extensive anatomical and functional characterization of the somatosensory system raises a question about the widely used Streitberger sham-needling control. Specifically, the skin epidermis and hair follicles contain mechanically sensitive afferents, whose activation by this sham stimulation could modulate pain and the autonomic nervous system. Conclusions A deeper understanding of the underlying neuroanatomical basis of acupuncture is crucial for optimizing stimulation parameters and designing proper sham-controls to demonstrate and improve the efficacy and the safety of using this modality to treat human conditions.
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