Objective: To evaluate the effectiveness of aromatherapy in reducing neuropathic pain and improving the quality of life in affected patients. Design: A systematic review and meta-analysis were conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Methods: Four eligible studies were selected, comprising a total of 160 patients with neuropathic pain. The intervention group received aromatherapy, while the control group received standard care. Standardized mean differences (SMD) were calculated to assess the effectiveness of the intervention. Results: The aromatherapy group showed a significant reduction in pain scores, with an SMD of -1.69 (95% confidence interval: -2.04 to -1.34). In addition to pain relief, aromatherapy was also effective in alleviating associated symptoms such as fatigue and numbness. Conclusion: Aromatherapy is an effective non-pharmacological intervention for reducing neuropathic pain and its associated symptoms, as well as improving the quality of life. It should be considered as a complementary treatment for patients with neuropathic pain.

PURPOSE: Peripheral artery disease (PAD) is a form of arteriosclerosis that occurs in the extremities and involves ischemia. Previous studies have reported that patients with periodontitis are at high risk for PAD. However, the relationship between these 2 diseases has not yet been fully elucidated. In this cross-sectional study, we investigated this relationship by comparing patients with PAD to those with arrhythmia (ARR) as a control group. METHODS: A large-scale survey was conducted of patients with cardiovascular disease who visited Tokyo Medical and Dental University Hospital. We investigated their oral condition and dental clinical measurements, including probing pocket depth, bleeding on probing, clinical attachment level, and number of missing teeth; we also collected salivary and subgingival plaque samples and peripheral blood samples. All patients with PAD were extracted from the whole population (n = 25), and a matching number of patients with ARR were extracted (n = 25). Simultaneously, ARR patients were matched to PAD patients in terms of age, gender, prevalence of diabetes, hypertension, dyslipidemia, obesity, and the smoking rate (n = 25 in both groups). Real-time polymerase chain reaction was performed to measure the bacterial counts, while the enzyme-linked immunosorbent assay method was used to measure anti-bacterial antibody titers and proinflammatory cytokine levels in serum. RESULTS: PAD patients had more missing teeth (18.4±2.0) and higher serum levels of C-reactive protein (1.57±0.85 mg/dL) and tumor necrosis factor-alpha (70.3±5.7 pg/mL) than ARR patients (12.0±1.7, 0.38±0.21 mg/dL, and 39.3±4.5 pg/mL, respectively). Meanwhile, no statistically significant differences were found in other dental clinical measurements, bacterial antibody titers, or bacterial counts between the 2 groups. CONCLUSIONS: Our findings suggested that PAD patients had poorer oral and periodontal state with enhanced systemic inflammation.
Arrhythmias, Cardiac ; Arteriosclerosis ; Bacterial Load ; C-Reactive Protein ; Cardiovascular Diseases ; Cross-Sectional Studies ; Dyslipidemias ; Enzyme-Linked Immunosorbent Assay ; Extremities ; Hemorrhage ; Humans ; Hypertension ; Inflammation ; Ischemia ; Methods ; Obesity ; Periodontitis ; Peripheral Arterial Disease ; Prevalence ; Real-Time Polymerase Chain Reaction ; Smoke ; Smoking ; Tooth ; Tumor Necrosis Factor-alpha

STUDY DESIGN: Retrospective study. PURPOSE: To obtain information useful in establishing treatment guidelines by evaluating baseline clinical features and treatment outcomes of patients with spinal cord astrocytoma (SCA). OVERVIEW OF LITERATURE: The optimal management of SCA remains controversial, and there are no standard guidelines. METHODS: The study included 20 patients with low-grade and 13 with high-grade SCA surgically treated between 1989 and 2014. Patients were classified according to the extent of surgical resection. Survival was assessed using Kaplan-Meier plots and compared between groups by log-rank tests. Neurological status was defined by the modified McCormick scale and compared between groups by Mann-Whitney U tests. RESULTS: Surgical resection was performed for 19 of 20 low-grade (95%) and 10 of 13 high-grade (76.9%) SCA patients. Only nine patients (27.3%) underwent gross total resection, all of whom had low-grade SCA. Of all patients, 51.5% showed deteriorated neurological status compared to preoperative baseline. Median overall survival was significantly longer for low-grade SCA than that (91 months, 78% at 5 years vs. 15 months, 31% at 5 years; p=0.007). Low-grade SCA patients benefited from more aggressive resection, whereas high-grade SCA patients did not. Multivariate analysis revealed histology status (hazard ratio [HR], 0.30; 95% confidence interval [CI], 0.09-0.98; p<0.05) and postoperative neurological status (HR, 0.12; CI, 0.02-0.95; p<0.05) as independent predictors of longer overall survival. Adjuvant radiotherapy had no significant impact on survival rate. However, a trend for increased survival was observed with radiation cordotomy (RCT) in high-grade SCA patients. CONCLUSIONS: Aggressive resection for low-grade and RCT may prolong survival. Preservation of neurological status is an important treatment goal. Given the low incidence of SCA, establishing strong collaborative, interdisciplinary, and multi-institutional study groups is necessary to define optimal treatments.
Astrocytoma* ; Cordotomy ; Humans ; Incidence ; Multivariate Analysis ; Prognosis* ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Spinal Cord* ; Survival Rate

STUDY DESIGN: A retrospective study. PURPOSE: The purpose of this study was to obtain useful information for establishing the guidelines for treating high-grade spinal cord gliomas. OVERVIEW OF LITERATURE: The optimal management of high-grade spinal cord gliomas remains controversial. We report the outcomes of the surgical management of 14 high-grade spinal glioma. METHODS: We analyzed the outcomes of 14 patients with high-grade spinal cord gliomas who were surgically treated between 1989 and 2012. Survival was charted with the Kaplan-Meier plots and comparisons were made with the log-rank test. RESULTS: None of the patients with high-grade spinal cord gliomas underwent total resection. Subtotal resection was performed in two patients, partial resection was performed in nine patients, and open biopsy was performed in three patients. All patients underwent postoperative radiotherapy and six patients further underwent radiation cordotomy. The median survival time for patients with high-grade spinal cord gliomas was 15 months, with a 5-year survival rate of 22.2%. The median survival time for patients with World Health Organization grade III tumors was 25.5 months, whereas the median survival time for patients with glioblastoma multiforme was 12.5 months. Both univariate and multivariate Cox proportional hazards models demonstrated a significant effect only in the group that did not include cervical cord lesion as a factor associated with survival (p=0.04 and 0.03). CONCLUSIONS: The surgical outcome of patients diagnosed with high-grade spinal cord gliomas remains poor. Notably, only the model which excluded cervical cord lesions as a factor significantly predicted survival.
Biopsy ; Cordotomy ; Glioblastoma ; Glioma* ; Humans ; Proportional Hazards Models ; Radiotherapy ; Retrospective Studies ; Spinal Cord* ; Survival Rate ; World Health Organization

PORPOSE: This study aimed to investigate the relation between cardiorespiratory fitness(CRF) and physical activity, especially vigorous physical activity, in Japanese middle-aged and elderly men.METHODS: Eighty-five men aged 30-69 years participated in this study. CRF was assessed by measuring the maximal oxygen uptake based on weight (VO₂max/wt) in an incremental test on a bicycle ergometer. METs·h/week was measured as the parameter of physical activity by using accelerometers. We defined the amount of physical activity higher than 3 METs as “Physical activity ; PA”in this study. Then, PA was divided into “Moderate physical activity ; MPA”(higher than 3 METs and below 6 METs)and “Vigorous physical activity ; VPA”(higher than 6 METs).RESULTS : CRF was positively correlated with PA(r=0.318, P<0.01), MPA(r=0.230, P<0.05), and VPA(r=0.301, P<0.01) and negatively correlated with age(r=-0.607, P<0.001), BMI(r=-0.369, P<0.01), and waist circumference(WC)(r=-0.486, P<0.001). After adjusting for age and WC, the multiple regression analysis revealed that PA was positively correlated with CRF(P<0.01). VPA was positively correlated with CRF(P<0.05) after adjusting for age, WC, and MPA. MPA was not correlated with CRF in the case of adjusting for age and WC.CONCLUSION : This study suggested that physical activity higher than 3 METs was positively associated with cardiorespiratory fitness independently of age and waist circumference, and particularly vigorous physical activity may contribute to increased cardiorespiratory fitness in middle-aged and elderly men. Thus physically active life with maintenance of adequate waist circumference may help to prevent age-related decline in cardiorespiratory fitness.

PORPOSE: This study aimed to compare the prevalence of metabolic syndrome (MS) risk factors and its components in different levels of aerobic fitness established by “Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006)” in Japanese middle-aged and elderly people.METHOD: Men (n=102) and women (n=133), aged 30-69yrs, participated in this study. The prevalence of MS risk factors was evaluated as the number of MS risk factors, according to the diagnostic criterion for Japanese-specific MS. Aerobic fitness was quantified as maximal oxygen uptake (VO₂max). Subjects were classified into the three groups by aerobic fitness level based on “Reference values” and “Reference range” established in EPAR2006; 1) High fitness group (H); VO₂max (mL/kg/min) is higher than “Reference values”, 2) Medium fitness group (M); VO₂max is below “Reference values” but within “Reference range”, 3) Low fitness group (L); VO₂max is lower than “Reference range”.RESULTS: In men, M and L groups showed significantly higher frequency of risk factors for MS than H group (H: 1.09±0.98, M: 1.81±1.07, L: 2.27±0.70, P＜0.01). In women, L group showed significantly higher frequency of risk factors for MS than H and M groups (H: 0.57±0.80, M: 0.81±1.01, L: 1.53±1.07, P＜0.01).CONCLUSION: These results suggest that higher MS risk appears when the VO₂max is lower than “Reference values” in men, and below “Reference range” in women, and that particularly, men with low aerobic fitness have higher MS risk.