Background: There is evidence to support both the use of intravenous methylprednisolone (IVMP) in multiple sclerosis (MS) relapse and physiotherapy in the management of MS, but no studies have investigated the combination of steroids and rehabilitation together. Objectives: To evaluate the benefits of IVMP with planned, comprehensive multidisciplinary team (MDT) care compared to IVMP with standard care. Methods: In this randomised controlled trial, patients confirmed to have had a definite MS relapse severe enough to warrant IVMP (1 g daily for three days) were randomised to two groups. The control group was managed according to the standard ward routine; the treatment group received planned coordinated multidisciplinary team assessment and treatment. Baseline assessments, including demographics and Expanded Disability Status Scale (EDSS) were carried out on both groups. The primary outcome measures were Guy's Neurological Disability Scale (GNDS), and Amended Motor Club Assessment (AMCA). The secondary measures were the Barthel Index (BI), Human Activity Profile (HAP), and Short Form Item 36 Health Survey (SF-36). All measures have published data on reliability and validity. Measures were administered at one and three months. Results: Forty subjects, including 27 females, completed data collection. There were no significant differences between the two groups at baseline. Results showed statistically significant differences in GNDS (p = 0.03), AMCA (p = 0.03), HAPM (p < 0.01), HAPA (p = 0.02), and BI (p = 0.02) at three months in favour of planned MDT care. Conclusion: This study indicates that combining steroids with planned MDT care is superior to administering them in a standard neurology or day ward setting. Further research is necessary in order to confirm this finding.
Relatively little is known about the exposure of nail
technicians
to semivolatile organic compounds (SVOCs) in nail salons. We collected
preshift and postshift urine samples and silicone wrist bands (SWBs)
worn on lapels and wrists from 10 female nail technicians in the Boston
area in 2016–17. We analyzed samples for phthalates, phthalate
alternatives, and organophosphate esters (OPEs) or their metabolites.
Postshift urine concentrations were generally higher than preshift
concentrations for SVOC metabolites; the greatest change was for a
metabolite of the phthalate alternative di(2-ethylhexyl) terephthalate
(DEHTP): mono(2-ethyl-5-carboxypentyl) terephthalate (MECPTP) more
than tripled from 11.7 to 36.6 μg/g creatinine. DEHTP biomarkers
were higher in our study participants’ postshift urine compared
to 2015–2016 National Health and Nutrition Examination Survey
females. Urinary MECPTP and another DEHTP metabolite were moderately
correlated (r = 0.37–0.60) with DEHTP on the
SWBs, suggesting occupation as a source of exposure. Our results suggest
that nail technicians are occupationally exposed to certain phthalates,
phthalate alternatives, and OPEs, with metabolites of DEHTP showing
the largest increase across a work day. The detection of several of
these SVOCs on SWBs suggests that they can be used as a tool for examining
potential occupational exposures to SVOCs among nail salon workers.
A double-blind, placebo-controlled study using male subjects (n = 60), was conducted to investigate the efficacy of three different frequencies of combined phototherapy/low-intensity laser therapy (CLILT) in alleviating the signs and symptoms of delayed-onset muscle soreness (DOMS). The study was approved by the University's ethical committee. After screening for relevant pathologies, recent analgesic or steroid drug usage, current pain, diabetes, or current involvement in regular weight-training activities, subjects were randomly allocated to one of five experimental groups: Control, Placebo, or 2.5-Hz, 5-Hz, or 20-Hz CLILT groups (660-950 nm; 31.7 J/cm2; pulsed at the given frequencies for a duration of 12 min; n = 12 all groups). Once baseline measurements were obtained, DOMS was induced in the nondominant arm, which was exercised in a standardized fashion until exhaustion, using repeated eccentric contractions of the elbow flexors. The procedure was repeated twice more to ensure exhaustion was achieved, after which subjects were treated according to group allocation. In the CLILT/placebo groups, the treatment head was applied directly to the affected arm at the level of the musculotendinous junction. Subjects returned on two consecutive days for further treatment and assessment. The range of variables used to assess DOMS included range of movement (universal goniometer), mechanical pain threshold/tenderness (algometer) and pain (visual analogue scale and McGill Pain Questionnaire). Measurements were taken before and after treatment on each day, except for the McGill Pain questionnaire, which was completed at the end of the study. Analysis of results using repeated measures and one-factor analysis of variance with relevant post hoc tests showed significant changes in ranges of movement accompanied by increases in subjective pain and tenderness for all groups over time (p = 0.0001); however, such analysis failed to show any significant differences between groups on any of the days. These results thus provide no convincing evidence for any putative hypoalgesic effect of CLILT upon DOMS at the parameters used here.
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