TrP and paraspinal dry needling is suggested to be a better method than TrP dry needling only for treating myofascial pain syndrome in elderly patients.

IntroductionMyofascial pain syndrome (MPS) is a common cause of musculoskeletal pain characterised by trigger points (MTrPs), that is tender loci in taut bands of skeletal muscle, limited range of motion in joints, referred pain and local twitch responses (LTRs) during mechanical stimulation of the MTrPs. 1 Inactivation of MTrPs is essential in managing MPS and several methods have been recommended. The treatments most commonly used for this purpose are dry needling of the MTrPs, injection treatments with local anaesthetics or saline, sprays, and stretching. 2According to the results of several studies, injection continues to be the most effective choice for treatment. The superiority of local injection or dry needling for the inactivation of MTrPs is controversial, [2][3][4][5][6][7][8] and hollow needles were used for dry needling in these studies. 2;6 Gunn suggests that the 'hollow needle' induces more tissue injury and is more painful than a 'pointed-tip needle '. 9 In this single-blinded randomised trial, we compared the efficacies and adverse events of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome. Method ParticipantsWe obtained retrospective ethical approval from the institutional review board of Inha University Hospital. We selected 40 subjects with chronic MPS of the upper trapezius from volunteers at four communitybased facilities; one further subject proved unable to complete the necessary forms. Subjects were selected on the basis of physical examination and interview, and signed informed consent was obtained. Participants were randomised into two groups by coin-toss: 1) ACU (acupuncture needling) group and 2) TPI (trigger point injection with 0.5% lidocaine) group.Inclusion criteria for the trial were 1) aged more than 60 years old; 2) complaining of chronic shoulder AbstractAim To compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome of elderly patients. Methods Thirty nine participants with myofascial pain syndrome of one or both upper trapezius muscles were randomised to treatment with either acupuncture needling (n=18) or 0.5% lidocaine injection (n=21) at all the trigger points on days 0, 7 and 14, in a single-blinded study. Pain scores, range of neck movement, pressure pain intensity and depression were measured up to four weeks from the first treatment. Results Local twitch responses were elicited at least once in 94.9% of all subjects. Both groups improved, but there was no significant difference in reduction of pain in the two groups at any time point up to one month. Overall, the range of cervical movement improved in both groups, apart from extension in the acupuncture needling group. Changes in depression showed only trends. Conclusion There was no significant difference between acupuncture needling and 0.5% lidocaine injection of trigger points for treating myofascial pain syndrome in elderly patients.

OBJECTIVE To evaluate the association between coffee consumption and the risk of prostate cancer. METHODS We searched PubMed, EMBASE, and the bibliographies of relevant articles in August 2009. Two evaluators independently reviewed and selected articles based on predetermined selection criteria. RESULTS Twelve epidemiological studies (eight case‐control studies and four cohort studies) were included in the final analysis. In a meta‐analysis of all included studies, when compared with the lowest level of coffee consumption, the overall relative risk (RR) of prostate cancer for the highest level of coffee consumption was 1.16 (95% confidence interval [CI] 1.01–1.33). In subgroup meta‐analyses by study design, there was a significant positive (harmful) association between coffee consumption and prostate cancer risk in seven case‐control studies using both crude and adjusted data (RR 1.20, 95% CI 1.02–1.40; and RR 1.21, 95% CI 1.03–1.43, respectively), whereas there was no significant association in four cohort studies using crude or adjusted data (RR 0.97, 95% CI 0.68–1.38; and RR 1.06, 95% CI 0.83–1.35, respectively). CONCLUSION Given that a cohort study gives a higher level of evidence than a case‐control study, there is no evidence to support a harmful effect of coffee consumption on prostate cancer risk. Further prospective cohort studies are required.

A meta-analysis found that pharmacologic therapy for smoking cessation among adolescent smokers did not have a significant effect on abstinence rates at short-term and mid-term follow-up times of <26 weeks, and the RCTs examined found few adverse events. However, the results may have been affected by the limited number of participants in published trials.

Aims: To investigate the effect of vitamin treatment or supplements with purported antioxidant properties on the primary and secondary prevention of skin cancer using a meta-analysis of randomized controlled trials (RCTs). Methods: We searched PubMed, Embase and the Cochrane Library in June 2009. Among 398 articles searched, 11 articles on 10 RCTs were included in the final analysis. Results: In a fixed-effects meta-analysis of all 10 trials, vitamin treatment or supplements with purported antioxidant properties were found to have no preventive effect on skin cancer [relative risk (RR) = 0.98; 95% confidence interval (CI) = 0.94–1.03]. Similar findings were observed in a subgroup meta-analysis of 10 studies on both primary prevention trials (RR = 0.98; 95% CI = 0.93–1.03) and secondary prevention trials (RR = 0.97; 95% CI = 0.83–1.13). Further, subgroup meta-analyses revealed no preventive effect on cancer by type of antioxidant, type of cancer and the methodological quality of the studies. Conclusion: The current meta-analysis of RCTs indicated that there is no clinical evidence to support an overall primary and secondary preventive effect of vitamin treatment or supplements with purported antioxidant properties on skin cancer. The effect of vitamin supplements on skin cancer should not be overemphasized.

falls are a major health problem, and efforts to lower the risk of falling in the community setting are needed, 1 but a fall is also one of the most serious iatrogenic events that an elderly person requiring hospitalization might experience. Approximately 5% to 10% of community-dwelling elderly people who fall sustain a significant injury. 2 It is likely that a greater percentage of falls results in such an injury if the elderly person is acutely ill and unable to protect herself during the fall. Multiple factors, including poor vision, delirium, pharmaceuticals, a hazardous environment, and chronic dementing illness may contribute to a greater risk of falling. 3 One program, the Hospital Elder Life Program, designed to decrease the incidence of delirium in the hospital setting, has been shown to decrease the risk of falls. 4 Notwithstanding such efforts, falls in the hospital setting remain a matter of considerable concern to patients, their families, their physicians, and hospital administrators.To address this, a video monitoring system was put in place at Hackensack University Medical Center on a 33-bed unit that serves the older population almost exclusively. Eight individuals deemed to be at high risk of falling were located in adjoining rooms, and video cameras were directed at their beds. To protect the privacy of the individuals when nursing care was being provided, the monitors were located in such a way that the patient in the bed could not be seen if the curtains were fully drawn.Individuals selected to occupy these beds were aged 70 and older and acutely ill. In addition, they had a diagnosis of delirium or dementia and a history of a fall in the recent past. Initially, a nursing assistant observed all eight beds continuously during the night shift on a single video screen. Each attendant received an educational program targeted to fall prevention. If a patient appeared to be about to fall, the nursing assistant intervened immediately.During the first full year of this program, 72 falls occurred on the 33-bed unit, with more than 50% of them happening at night, but not a single individual in a monitored bed fell at night during the year. Because of its initial success, the monitoring program has been expanded to be in place throughout the 24-hour period. The only fall by a monitored individual during this period occurred when two patients were observed to be ready to fall at the same time, and the assistant was unable to reach the second elder in time.Although no data are available at this time, it seems likely that this video-monitoring program would not only improve outcomes, but would also save money directly, lower legal costs, and improve patient satisfaction. In addition, in the near future, Medicare might not pay for the acute care of an individual who sustains an iatrogenic event, such as a fall-related injury, that occurred during hospitalization.

The smoking status and the number of cigarettes smoked daily are associated with an increased risk for developing IFG or type 2 diabetes in Korean men.

Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.