Objective-To determine the efficacy of electroacupuncture in patients with fibromyalgia, a syndrome of unknown origin causing diffuse musculoskeletal pain.Design-Three weeks' randomised study with blinded patients and evaluating physician.Setting-University divisions of physical medicine and rehabilitation and rheumatology, Geneva.Patients-70 patients (54 women) referred to the division for fibromyalgia as defined by the American College of Rheumatology.Interventions-Patients were randomised to electroacupuncture (n=36) or a sham procedure (n= 34) by means ofan electronic numbers generator.Main outcome measures-Pain threshold, number of analgesic tablets used, regional pain score, pain recorded on visual analogue scale, sleep quality, morning stiffness, and patient's and evaluating physician's appreciation.Results-Seven of the eight outcome parameters showed a significant improvement in the active treatment group whereas none were improved in the sham treatment group. Differences between the groups were significant for five of the eight outcome measures after treatment.Conclusions-Electroacupuncture is effective in relieving symptoms of fibromyalgia. Its potential in long term management should now be studied.
within normal limits. Kidney and liver function tests were considered to be normal.A tentative diagnosis of serum sickness-like illness due to lamotrigine was made, and intravenous methylprednisolone 1 mg/kg was started and lamotrigine gradually discontinued. On day 7 of methylprednisolone therapy, the rash faded and disappeared, and the fever subsided. After 2 weeks of hospitalization, the patient was discharged while on vigabatrin and valproic acid combination therapy. Twenty days later, he underwent placebo-controlled oral rechallenge at the clinic with a starting dose of 50 mg lamotrigine given in four divided doses. On day 1, he did not have any reaction. On day 2, after 2 h, the cumulative dose of 75 mg was reached, and he developed an increasing urticarial rash with pruritus of face, chest, hands, and legs. However, hypotension, angioedema, and wheezing did not develop. white blood cell count 7470/ml (eosinophils 6%), platelets 239 000/ml, and total IgE antibodies 199 UI/ml (,100 UI/ml). As no lidocaine was used during TURP, a reaction to latex or to anesthesia agents was suspected.In vivo and in vitro tests were performed with the substances associated with the period of anesthesia: vecuronium, propofol, and latex.
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