auricular branch of which is concentrated in the area of the acupuncture point, ear stomach. It has also been shown that acupuncturestimulation raises levels of both serotonin and relaxing neurotransmitter endorphins in the body. 2
It has been demonstrated that acupuncture exerts its effect on pain by production of endorphins. The fact that many pain sufferers receive long term relief from pain despite cessation of treatment, indicates that acupuncture may produce a long term rise in natural endorphin production by the body. A similar parallel would assume that acupuncture may well produce a long term adjustment to normal production of serotonin by the body, in those with obesity associated with low serotonin levels. So it is feasible to expect that frequent stimulation of the auricularacupuncturepoints which bring about these changes in body chemistry, would assist in controlling excessive appetite in those with an obesity problem.
It has been reported that acupuncture application is effective in weightloss through its effect in reducing intestinal motility, and metabolism, as well as emotional stress. Increases in neural activity of the ventromedial nuclei of hypothalamus, tone of the smooth muscle of the stomach and levels of the encephalin, beta endorphin, and serotonin in the plasma and brain tissue have been observed with the application of acupuncture (Cabyoglu et al., 2006). acupuncture exerts its effects on weightloss through different mechanisms, such as reducing hunger, affecting lipid and carbohydrate metabolism, affecting activity of glucose-inhibited neurons and modulating feeding behavior (Zhi et al., 2013). Manual acupuncturestimulation produces soreness, fullness and distention. Electro-acupuncture generally produce sting lingandnumbness (Kong et al., 2007). Electrical stimulation of acupuncturepoints was developed as an alternative to manual acupuncturepoints. Electrical stimulation has several advantages. It is less painful than manual stimulation, requires less practitioner time directly spent with the patient and provides better analgesia (Zhou et al., 2011).
Participants of the treatment group will additionally re- ceive unilateral auricular acupressure at four auricularpoints as Hunger, Shen men, Spleen and Stomach with Semen Vaccariae (Wang Bu Liu Xing) embedded within adhesive tape at each treatment session (Fig. 2). Acu- pressure will be self-applied by the subjects with re- peated pressing of the tape with fingertips for 1 minute per point, thrice per day. The embedded tape will be retained in situ for 24 hours, and then the alternate ear will be treated at the next visit. The four points were most frequently used on overweight treatment as sum- marized by a systemic review . Clinically, the ear points Spleen and Stomach are used for regulating gastrointestinal function; Shen men, meaning Spirit gate, is used for calming mental conditions; Hunger is used for suppressing the desire to eat and is reported to be particularly effective on weightloss .
many variables including body points, ear points, standard- ized and individualized point selection, bilateral, unilateral, manual stimulation and electrical stimulation of the points, and a wide range of different controls and different outcome measures. White concluded that half of the trials he reviewed had at least one positive result, lending support to the concept that acupuncture has some benefits in treating drug depen- dence; however, the evidence is inconsistent due to the large number of variables in treatment and outcomes. He suggests that trials of the NADA protocol should be done with truly inactive controls, as looking at just the NADA protocol trials, he found that 80% of the studies with non-needle controls were positive versus 33% that used sham, possibly active, controls. White also posits that looking only at abstinence, attrition, craving, and withdrawal may miss other significant responses to acupuncture.
Of the various complementary and alternative medicine (CAM) available for pain relief, acupuncture has become increasingly accepted as an effective means of pain con- trol, due to its holistic approach and limited side effects [9,10]. Current evidence supports the use of acupuncture for people with CLBP, particularly when provided along- side other conventional therapies [10-13]. Thomas and colleagues  concluded that acupuncture was signifi- cantly more effective in reducing bodily pain and partici- pants' concerns about back pain than usual care for up to 24 months. A recent study has suggested that stimulation of auricular (ear) acupuncturepoints is effective for the treatment of CLBP : this study compared electrical stimulation of auricularpoints with manual stimulation, and found that both groups experienced pain relief. Aside from the above study and the use of auricularacupuncture for pain relief for cervical spine pain [15,16] and after knee and hip surgery [17,18], the evidence for auricularacupuncture is limited and there have been no studies that have examined the adjuvant effect of auricular acupunc- ture to an exercise programme in CLBP. Auricular acu- puncture is relatively easy to administer, promoting pain relief with minimal interruption to the individual's nor- mal daily activities. Needles can stay in situ for up to seven days allowing participants to self-treat at home. It is pro- posed that the addition of AA to a supervised PEP will address the pain relieving expectations of participants, and help to decrease the barriers to exercise that can often limit adherence. The individually tailored approach to exercise is intended to foster the development of active self-management strategies, and functionally-related
Number of days of treatment of the newborn with mor- phine was chosen as the primary outcome because it is a clinical measure of the time required for the newborn to complete withdrawal from opiates. In this unit, morphine is prescribed for the neonate by pediatricians if there is a constellation of symptoms unresponsive to environmental control including: 1) convulsions, 2) inconsolability or cry- ing continuously for 3 hours, 3) persistent tremors or jit- teriness when undisturbed, 4) continuous central nervous system irritability including hyperactive Moro reflex, tre- mors, jitteriness, increased muscle tone and unprovoked muscle jerks, 5) persistent vomiting or projectile vomiting over a 12 hour period, or 6) explosive diarrhea for 2–3 consecutive episodes . Additional clinical signs such as tachycardia, tachypnea, watery stools, fever, or weightloss > 10% may justify use of morphine after consideration of differential diagnoses. Morphine 1 mg/ml is started at a rate of 0.03 mg/kg/dose every 3 hours. The dose is re- viewed daily and titrated based on daily weights and ongoing symptoms.
There is no doubt, as Bruckner (1982) has said in discussing the shortcomings of numerous reports on the treatment of the ‘frozen shoulder’, that ‘it is essential to design prospective trials that will give definite answers, by carefully defining the condi- tion under study (excluding shoulder pain with- out passive limitation of movement), treating patients only in the acute stage (first 6 months) and including a proper control group’. It would also seem reasonable, in view of Camp’s observations, to include in any such trial one group treated with acupuncture. Firstly, however, it is necessary to establish which particular acupuncture technique is most suitable for the alleviation of this type of pain. My reason for saying this is because, in my experi- ence, the pain of frozen shoulder can be aggravated by carrying out superficial dry needling at TrP sites too vigorously. Gentle brief stimulation of nerve endings in the tissues overlying these points is often all that is necessary. This is similar to what Camp (1986) has found, as she states: ‘sometimes attempts at needling trigger points simply produces more pain and a violent reaction to acupuncture. Moving the needle away from the trigger points and treat- ing more peripheral points, results almost in com- plete loss of symptoms in these cases’.
For the acupuncture group, the acupuncture site was cleaned with ethanol and an intradermal needle (3 mm in length, 0.12 mm in diameter; Seirin, Japan) was inserted horizontally to a depth of approximately 1 – 2 mm. Needles were inserted bilaterally. The needles were ﬁ xed with medical tape and left in position for 1 week. All needles were replaced on a weekly basis for a period of 4 weeks. A new ‘ session ’ began immediately after the needle was replaced. For the placebo group, the intradermal needle was ﬁ xed with medical tape but did not pierce the skin. Only the acupuncturist was aware of the group into which each participant had been assigned. The participants all ﬁ rmly believed that they were receiving auricularacupuncturestimulation. At no point were the participants told whether or not they had received auricularacupuncture. The same acu- puncture points were used for all participants, and all received acupuncture treatment once per week for four consecutive weeks (ie, four sessions) at the KOSAI Oriental Healthcare Center.
The natural history of knee osteoarthritis is poorly understood. Osteoarthritis symptoms can vary greatly among patients. Symptoms include joint pain and stiffness, swelling, decreased function, and cracking or grinding noise with joint movement. Pain features are the pain itself, including its intensity, quality, and predictability as well as the pain’s impact on mobility, mood, and sleep. Symptoms usually start gradually in a prolonged history of discomfort associated with exacerbation. Symptoms are often variable in severity and change slowly. Some patients may indicate that pain and functional disability increased over time and have symptoms that may progress from occurring during weight-bearing activities towards symptoms at rest, especially at night. 41
Vagal nerve stimulation using implanted electrodes is used as a treatment option in otherwise therapy- refractory epilepsy and depression . Case reports and small series of patients who received an implanted vagal nerve stimulator for treatment of epilepsy and had comor- bid migraine suggest that VNS may have a preventive ef- fect in migraine [13–16]. A recently developed medical device (NEMOS®, cerbomed, Erlangen, Germany) allows for non-invasive, transcutaneous stimulation of the auricu- lar branch of the vagus nerve (auricular t-VNS) using a special ear electrode. Auricular t-VNS excites thick mye- linated sensory Aβ-fiber afferents in the vagal nerve, acti- vating the nucleus of the solitary tract [17, 18]. Effects on autonomous activity have been demonstrated in healthy subjects where auricular t-VNS increases heart rate vari- ability . Anticonvulsive effects in rodents are similar to those achieved with invasive VNS . Functional imaging during auricular t-VNS has shown a pattern consistent with afferent vagal stimulation [20, 21]. Both invasive VNS and auricular t-VNS reduce pinprick and pressure pain in humans [22, 23]. In addition, a recent observational study has suggested that t-VNS to the right cervical branch of the vagus nerve (cervical t-VNS) may be effective for acute migraine treatment . In the present study, we investi- gated the effect of auricular t-VNS on chronic migraine.
This study found that gender and number of repeated Challenges for both males and females were significantly associated with greater percent weightloss. Males likely lost more weight than females initially due to differences in percentage of muscle mass, hormones, and other physiological characteristics . A systematic review on gender differences in weightloss interventions found that men lose more weight than women, but women are better with weightloss maintenance possibly due to a slower initial weightloss . Because participants were not obligated to return for final weigh-in assessments at the conclusion at each Challenge or to return to re- peated Challenges, those who did return were likely those who found success with prior attempts at weightloss through this program while those who did not re- turn and were lost to follow-up likely did not experience success with The Challenge. Initial weightloss goals for those trying to lose weight often exceed what can rea- sonably be expected and this may cause them not to re- turn to the final weigh-in and may prevent them from participating in additional Challenges if they do not ob- tain the success they think they should obtain . Therefore, those who attended more Challenges may have been able to obtain a greater percent weightloss over time, though the amount of weightloss decreased for each additional Challenge for those who participated in multiple Challenges.
clear that increasing autonomous regulation for exercise may convey multiple benefits for weight control.
Consistent with previous research (Teixeira et al., 2012a), our bivariate
correlational analyses showed that identified regulation was the most strongly associated regulation with MVPA in the intervention condition over all three time points. Identified regulation reflects the importance or value that an individual places on the activity or behaviour (Deci & Ryan, 2002). It has been hypothesized by Edmunds et al. (2006) that participation in a behaviour that is strenuous or difficult would need to be considered important by the participant. Identified regulation has consistently been demonstrated to be the strongest predictor of physical activity behaviour (Wilson, Sabiston, Mack & Blanchard, 2012) including PA intervention studies (Edmunds et al., 2006; Rahman, Thogerson-Ntoumani, Thatcher & Doust, 2011; Wilson et al., 2003). When change scores are considered in the present investigation, an increase in PA was positively associated with an increase in identified regulation in the intervention condition both during the weightloss challenge as well as over the entire length of the investigation. Interestingly, in the control condition, a similar pattern of a moderately correlated cross- sectional positive relationship existed between PA and identified regulation, however, change scores indicate increased PA was only associated with greater importance or value in this group from baseline to Time 1. A possible explanation for the association of identified regulation may be that participation in PA behaviours can require organization and planning and therefore may be undertaken more often by individuals who consider it important as opposed to interesting and enjoyable (Edmunds et al., 2006). This
When is losing weight harmful?
Obviously, not all weightloss is harmful. Anyone, including an athlete, can benefit from losing body fat in certain circumstances. Excessive fat does not enhance an athlete’s performance, even in foot- ball where coaches often seek out heavy players. It can hamper heat acclimatization, speed, endurance, and work efficiency. Weightloss can be beneficial if it involves losing excessive body fat without reducing lean muscle mass or causing signif- icant dehydration. Healthy weightloss requires eating a balanced diet that supplies adequate calories to support growth and daily activity and drinking enough fluid to maintain an appropriate state of hydration.
Mr. H reported relief to almost all of his symptoms more than seven months after ceasing treatment. Data collected during the initial interview compared to follow-up data indicates an improve- ment to the PTSD condition and symptoms. The outcome of this case study suggests that the auricularacupuncture NADA protocol can be an effective long-term therapy for PTSD. The same NADA protocol discussed in this article is currently provided as a free treat- ment for veterans, their families, and their caregivers at the Walter Reed Veterans Administration Hospital in Washington, D.C. 23 In
Inadvertent weight reduction can happen as a result of a deficiently nutritious eating regimen in respect to a man's vitality needs (for the most part called lack of healthy sustenance). Infection forms, changes in digestion, hormonal changes, pharmaceuticals or different medicines, illness or treatment-related dietary changes, or decreased hunger related with a sickness or treatment can likewise cause accidental weightloss. Poor supplement usage can prompt weight reduction, and can be caused by fistulae in the gastrointestinal tract, looseness of the bowels, medicate supplement connection, compound consumption and muscle atrophy.
Please understand the majority of the photos seen in this brochure were taken at three months post-operatively. It takes at least a year for a scar to mature and fade.
LIPOSUC T ION
Destin Plastic Surgery specializes in liposuction (also called body contouring) for weightloss pateints. Liposuction involves the destruction of the fat cell and elimination of the fat cell from the body. The destruction of the fat cell can be in the form of high negative pressure, ultrasonic energy, laser energy, or mechanical energy.
In comparison, our work narrowed the inclusion criteria to studies in which auricularacupuncture was the sole intervention. Then, we chose primary insomnia sufferers with at least one month of sleep problem as target population. Because secondary insomnia patients varied in physical conditions, symptoms and might result in substantial clinical heterogeneity in meta-analyses. Add- itionally, outcomes selected in the meta-analyses were of credible reliability and validity: five from the auricularacupuncture VS sham or placebo method comparison were all continuous variable, measured by PSG, EEG, actigraphic monitoring, PSQI, or Sleep Diary. These are internationally accepted indexes of sleep evaluation [72-74] and particularly the former three are objective sleep parameters; the adverse effects from the auricular acu- puncture VS medications comparison have complemented the assessment from another point of view. Likewise, the GRADE system would help to evaluate each outcome not only statistically but also methodologically by revealing and detailing all defects, which will definitely facilitate a better understanding and improvement for further research.
To earn credits, go to www.cfp.ca and click on the Mainpro link. Key Points Obesity and overweight are more common than “normal” weight in our society. Weight gain averages 0.25 to 0.50 kg per year. Metabolic pathways exist that resist intentional weightloss and that tend to return body mass to the obese state. Weightloss might increase mortality among the healthy obese. Mortality is actually minimized with body mass in the high-normal or overweight range, and the safest body-mass trajectory is weight stabilization with no further gain and optimized physical and metabolic fitness at any size. Initial and continuing weight gain must be avoided through mitigation of the toxic effects of poor diet and low physical activity levels common in our current environment.
course of human immu- nodeficiency virus (HIV) infection is associated with increased mortality and adverse dis- ease outcome. 1-4 Of the various thera- pies being considered for the treatment of HIV-associated weightloss, testos- terone and exercise are attractive be- cause they are relatively inexpensive and safe. There is a high prevalence of low testosterone levels in HIV-infected men. 4-11 Serum testosterone levels are lower in those with weightloss 9 and cor- relate with deficits in muscle mass, 11 low Karnofsky scores, 12 and disease progres- sion. 10,13 Replacement doses of testos- terone augment lean body mass and muscle strength in healthy, hypogo- nadal men. 14-16 These data have led to the hypothesis that testosterone replace- ment might also increase muscle mass and strength in HIV-infected men with low testosterone levels. Some of the stud- ies 17-29 that have examined the effects of