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Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Bridging the goal intention–action gap in rehabilitation: a study of if-then implementation intentions in neurorehabilitation

Abstract Purpose : To test the feasibility and acceptability of an implementation intention strategy ( if-then plans ) increasingly used in health psychology to bridge the goal intention – action gap in rehabilitation with people with neurological conditions who are experiencing difficulties with mobility . Methods : Twenty people with multiple sclerosis ( MS ) and stroke , r and omised to an experimental and control group , set up to three mobility related goals with a physiotherapist . The experimental group also formulated if-then plans for every goal . Data collection : Focus groups and interviews with participants and therapists ; Patient Activation Measure ( PAM ) , 10-m walk test , Rivermead Mobility Index , self-efficacy , subjective health status , quality of life . Results : Qualitative data highlighted one main theme : Rehabilitation in context , encapsulating the usefulness of the if-then strategy in thinking about the patient in the context of complexity , the usefulness of home-based rehabilitation , and the perceived need for a few more sessions . Changes in walking speed were in the expected direction for both groups ; PAM scores improved over 3 months in both groups . Conclusion : If-then plans were feasible and acceptable in bridging the goal intention – action gap in rehabilitation with people with MS and stroke , who are experiencing difficulties with mobility . This approach can now be adapted and trialled further in a definitive study . Implication s for Rehabilitation Goal planning in rehabilitation necessitates specific strategies that help people engage in goal -related tasks . If-then plans aim to support people to deal more effectively with self-regulatory problems that might undermine goal striving and have been found to be effective in health promotion and health behaviour change . This feasibility study with people with a stroke and multiple sclerosis has demonstrated that if-then plans are feasible and acceptable to patients and physiotherapists in supporting goal -directed behaviour

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Pilot randomized trial of progressive resistance exercise augmented by neuromuscular electrical stimulation for people with multiple sclerosis who use walking aids.

OBJECTIVE To investigate the feasibility and preliminary outcomes of a home progressive resistance training ( PRT ) program augmented by neuromuscular electrical stimulation ( NMES ) . DESIGN R and omized controlled pilot trial . SETTING Participant homes . PARTICIPANTS People with multiple sclerosis ( MS ) ( N=37 ) who use a walking aid . INTERVENTIONS A 12-week home PRT program or the same program augmented by NMES . MAIN OUTCOME MEASURES Strength using h and -held dynamometry ; repeated sit to st and test ; Berg Balance Scale ; timed Up & Go test ; 12-Item Multiple Sclerosis Walking Scale ; Multiple Sclerosis Impact Scale-29 , version 2 ; and Modified Fatigue Impact Scale ( MFIS ) . The NMES group also completed a device usability question naire . RESULTS Only change in MFIS score was significantly greater in the NMES group than the PRT group ( P=.012 ) . The NMES group improved significantly in quadriceps endurance ( median of change , 8.5 ; P=.043 ) , balance ( median of change , 3.5 ; P=.001 ) , physical impact of MS ( median of change , -8.3 ; P=.001 ) , and impact of fatigue ( median of change , -17 ; P=.001 ) . Participants rated the device as highly usable . CONCLUSIONS This pilot study suggests that a home PRT program with NMES is feasible , and the neuromuscular electrical stimulation device is usable by this population . Only reduction in impact of fatigue was greater in the NMES than the PRT group

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Exercise for multiple sclerosis: a single-blind randomized trial comparing three exercise intensities

Background : The most effective exercise dose has yet to be established for multiple sclerosis ( MS ) . Objective : The aim of this study was to investigate the effect of different exercise intensities in people with MS . Methods : We completed a r and omized comparator study of three cycling exercise intensities , with blinded assessment , was carried out in Oxford . Sixty-one adults with MS who fulfilled inclusion criteria were r and omized at entry into the study , using a computer-generated list held by an exercise professional , into either : continuous ( at 45 % peak power , n = 20 ) , intermittent ( 30 sec on , 30 sec off at 90 % peak power , n = 21 ) or combined ( 10 min intermittent at 90 % peak power then 10 min continuous at 45 % peak power , n = 20 ) exercise for 20 min twice a week for 12 weeks in a leisure facility . Groups were assessed at : baseline , halfway ( 6 weeks ) , end intervention ( 12 weeks ) and follow-up ( 24 weeks ) . Primary outcome measure was 2 min walk . Results : Fifty-five participants were included in the analysis ( n = continuous 20 , intermittent 18 , combined 17 ) . No differences were found between groups . After 6 weeks , considering all participants , 2 min walk distance increased by 6.96 ± 2.56 m ( 95 % CI : 1.81 to 12.10 , effect size ( es ) : 0.25 , p < 0.01 ) . The continuous group increased by 4.71 ± 4.24 m ( 95 % CI : −3.80 to 13.22 , es : 0.06 ) , intermittent by 12.94 ± 4.71 m ( 95 % CI : 3.97 to 21.92 , es : 0.28 ) and combined by 3.22 ± 4.60 m ( 95 % CI : −6.01 to 12.46 , es : 0.04 ) . Two minute walk did not significantly change between further assessment s. Between 6 and 12 weeks there was a drop in attendance that seemed to be associated with the intermittent and combined groups ; these groups also had a greater number of adverse events ( leg pain during cycling most common ) and dropouts ( n = continuous 1 , intermittent 5 , combined 10 ) . Considering all participants , 6 weeks of cycling exercise produced benefits in mobility that were maintained with further sessions . Conclusion : While no differences were found between groups , greater benefit may be associated with higher-intensity exercise , but this may be less well tolerated . CONSORT - trial registration number ( IS RCT N89009719

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Progressive resistance training did not improve walking but can improve muscle performance, quality of life and fatigue in adults with multiple sclerosis: a randomized controlled trial

Background : Few high- quality trials have examined the effects of progressive resistance training ( PRT ) on people with multiple sclerosis ( MS ) . Objective : To determine the effectiveness of PRT for people with MS , focusing on improving the gait deficits common in this population . Methods : Using a single blind r and omized controlled trial , people with relapsing – remitting MS were r and omly allocated to either a PRT program targeting the lower limb muscles twice a week for 10 weeks ( n = 36 ) , or usual care plus an attention and social program conducted once a week for 10 weeks ( n = 35 ) . Outcomes were recorded at baseline , week 10 and week 22 . Results : Participants attended 92 % of training sessions , with no serious adverse events . At 10 weeks , no differences were detected in walking performance . However , compared with the comparison group PRT demonstrated increased leg press strength ( 16.8 % , SD 4.5 ) , increased reverse leg press strength ( 29.8 % , SD 12.7 ) , and increased muscle endurance of the reverse leg press ( 38.7 % , SD 32.8 ) . Improvements in favor of PRT were also found for physical fatigue ( Mean difference −3.9 units , 95%CI −6.6 to −1.3 ) , and the physical health domain of quality of life ( Mean difference 1.5 units , 95%CI 0.1 to 2.9 ) . At week 22 almost no between-group differences remained . Conclusion : PRT is a relatively safe intervention that can have short-term effects on reducing physical fatigue , increasing muscle endurance and can lead to small improvements in muscle strength and quality of life in people with relapsing – remitting MS . However , no improvements in walking performance were observed and benefits do not appear to persist if training is completely stopped

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Randomized controlled pilot study of customized pamphlets to promote physical activity and symptom self-management in women with multiple sclerosis

Objective : Investigate the feasibility and potential efficacy of a customized print-based intervention to promote physical activity and symptom self-management in women with multiple sclerosis . Design : A r and omly allocated two-group repeated measures design , with a delayed-treatment contact group serving as the control . Participants were r and omized to receive the intervention immediately ( n = 14 ) or receive it at week 12 ( n = 16 ) . Outcome measures were administered at weeks 1 , 12 , and 24 . Setting : Community-based in metropolitan area . Subjects : Thirty women with multiple sclerosis . Intervention : Prescribing a home-exercise program and following up with customized pamphlets , which are matched to participants ’ stage of readiness to change physical activity behavior and physical activity barriers ( e.g. encouraging self-management of symptoms ) . Main Measures : Physical Activity and Disability Survey-revised , Godin Leisure-Time Exercise Question naire , SF-12 , Symptoms of Multiple Sclerosis Scale , and 6-minute walk test . Results : Intent-to-treat analyses using mixed multivariate analysis of variance ( MANOVA ) were conducted on ( 1 ) physical activity levels and ( 2 ) health and function outcomes . The mixed MANOVAs for physical activity levels and health and function outcomes indicated significant improvements in the immediate group compared with the delayed group ( i.e. condition by time interaction was significant , Wilks ’ λ = 0.59 , F2 , 27 = 9.31 , P = 0.001 and Wilks ’ λ = 0.70 , F4 , 25 = 2.72 , P = 0.052 , respectively ) . The intervention had moderate to large effect sizes in improving physical activity levels ( d = 0.63 to 0.89 ) , perceptions of physical function ( d = 0.63 ) , and 6-minute walk test ( d=0.86 ) . Conclusion : This pilot study indicates that a customized print-based intervention shows promise in improving physical activity levels and health and function in women with multiple sclerosis

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Treadmill training for individuals with multiple sclerosis: a pilot randomised trial

This pilot study investigated whether 4 weeks of aerobic treadmill training in individuals with multiple sclerosis ( MS ) improved mobility and reduced fatigue . Individuals with MS were recruited to this prospect i ve , r and omised controlled trial . Individuals were assessed at baseline , week 7 and 12 with a 10 metre timed walk , a 2 minute walk , the Rivermead Mobility Index , and the Fatigue Severity Scale . After a pre- assessment familiarisation session and a baseline assessment , individuals were r and omly allocated to an initial intervention or delayed intervention group . Treadmill training consisted of 4 weeks of supervised aerobic exercise delivered weeks 3–6 in the immediate group and 8–11 in the delayed group . Of the initial 19 recruits , 16 individuals completed the study . There was a significant difference in walking endurance between the delayed and immediate groups at baseline ( p<0.05 ) . On re assessment in week 7 , decreases in 10 metre walk time were found in both groups , which was significant in the immediate group ( p<0.05 ) . The 2 minute walk distance significantly increased in both groups ( p<0.05 ) . In the training group , reassessed at week 12 after training ceased , there was a return towards baseline scores . No significant changes in fatigue scores were found . This study showed that in individuals with MS , aerobic treadmill training is feasible and well tolerated . Walking speed and endurance increased following training with no increase in reported fatigue . Detraining occurred in the period following training . A larger r and omised clinical trial is warranted

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Motivational interviewing may improve exercise experience for people with multiple sclerosis: A small randomized trial.

People with multiple sclerosis ( MS ) are likely to benefit from regular exercise , but physical inactivity is more common among people with MS than among the general population . This small r and omized study evaluated whether motivational interviewing ( MI ) affects adherence to and personal experience in an exercise program . Inactive people with MS participating in an eight-week exercise program were r and omized to either three brief MI ( n = 7 ) or three health coaching ( n = 6 ) sessions . Session attendance for both conditions was high , and MI fidelity was rigorously and reliably measured using the Motivational Interviewing Treatment Integrity Scales . The feasibility of using this approach was demonstrated with a small sample . Large effects favoring the MI condition were found for physical exertion , affect during exercise , and fatigue , but no effects were found for adherence to the exercise program . Treatment integrity measures of MI were correlated with outcomes in expected directions . Although this study demonstrated the feasibility of this MI approach , the large effect sizes found should be viewed with substantial skepticism and replicated in sufficiently powered studies using objective measures of exercise adherence

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Results of a feasibility randomised controlled study of the guidelines for exercise in multiple sclerosis project.

There is increasing recognition that exercise is an efficacious strategy for managing many consequences of multiple sclerosis ( MS ) , yet persons with MS are not engaging in sufficient exercise for accruing health benefits . Poor exercise uptake might be associated with the design of previous research . We conducted a r and omised controlled trial ( RCT ) for examining the feasibility of a 4-month home-based , exercise-training program design ed based on recent physical activity guidelines for MS and supplemented by behavioural strategies for compliance . Feasibility was assessed in the domains of process ( e.g. , recruitment ) , re source ( e.g. , monetary costs ) , management ( e.g. , personnel time requirements ) and scientific outcomes ( e.g. , treatment effect ) . We recruited persons with mild-to-moderate MS who were r and omised into an intervention or wait-list control condition . Intervention participants received a pedometer , elastic resistance b and s , DVD , training manual , calendars , log-book , video coaching calls and newsletters . Participants in both conditions completed home-based assessment s before and after the 4-month period . Ninety-nine persons with MS were assessed for eligibility , and 57 were r and omised . Fifty-one persons completed the study ( 90 % ) . Total costs of the study were US $ 5331.03 . Personnel time to conduct the study totaled 263h . Participants in the intervention group complied fully with 71 % of all exercise sessions . There was a moderate increase in self-reported exercise behaviour of the intervention participants as measured by the Godin Leisure-Time Exercise Question naire ( d≥0.5 ) . The results support the feasibility and acceptability of a home-based exercise intervention based on physical activity guidelines and supplemented with behavioural strategies for adults with mild-to-moderate MS

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Pilates for people with multiple sclerosis who use a wheelchair: feasibility, efficacy and participant experiences

Abstract Purpose : This mixed methods study aim ed to explore the feasibility , efficacy and the participants ’ experiences of a Pilates programme for people with Multiple Sclerosis ( pwMS ) who use a wheelchair . Method : Fifteen pwMS took part in the 12-week Pilates programme . At baseline and after 6 and 12 weeks of the programme , sitting stability , measured as maximum progression of the Centre of Pressure when leaning sideways ( COPmax ) , posture , pain on a Visual Analogue Scale , function , fatigue and the impact of MS ( MSIS29 ) were assessed . Ten participants took part in two focus groups within six weeks of the completion of the programme . Results : Significant improvements at the 12-week assessment were found in COPmax ( p = 0.046 ) , sitting posture ( p = 0.004 ) , pain in the shoulders ( p = 0.005 ) and back ( p = 0.005 ) and MSIS29 ( p = 0.006 ) . The majority of participants described various physical , functional , psychological and social benefits from participation that reflected increased confidence in activities of daily living . Enjoyment of the classes was expressed by all , and most wished to continue participation . Conclusions : Pilates appears to be efficacious in improving sitting stability and posture and decreasing pain and was also well tolerated by wheelchair users with MS . Further mixed methods studies are warranted . Implication s for Rehabilitation Group-based core stability exercise or Pilates for people with MS who use wheelchair is a feasible and safe way of exercising for this patient group . Pilates exercises for people moderately to severely affected by MS result ed in a decrease in back and shoulder pain and improvement in sitting balance . Future appropriately powered r and omised controlled studies into Pilates for people with MS reliant on wheelchair are warranted

Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) . Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .

Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) . There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing . We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Changes in pain and pressure pain sensitivity after manual treatment of active trigger points in patients with unilateral shoulder impingement: a case series.

The aim of this case series was to investigate changes in pain and pressure pain sensitivity after manual treatment of active trigger points ( TrPs ) in the shoulder muscles in individuals with unilateral shoulder impingement . Twelve patients ( 7 men , 5 women , age : 25 ± 9 years ) diagnosed with unilateral shoulder impingement attended 4 sessions for 2 weeks ( 2 sessions/week ) . They received TrP pressure release and neuromuscular interventions over each active TrP that was found . The outcome measures were pain during arm elevation ( visual analogue scale , VAS ) and pressure pain thresholds ( PPT ) over levator scapulae , supraspinatus infraspinatus , pectoralis major , and tibialis anterior muscles . Pain was captured pre-intervention and at a 1-month follow-up , whereas PPT were assessed pre- and post-treatment , and at a 1-month follow-up . Patients experienced a significant ( P < 0.001 ) reduction in pain after treatment ( mean ± SD : 1.3 ± 0.5 ) with a large effect size ( d > 1 ) . In addition , patients also experienced a significant increase in PPT immediate after the treatment ( P < 0.05 ) and one month after discharge ( P < 0.01 ) , with effect sizes ranging from moderate ( d = 0.4 ) to large ( d > 1).A significant negative association ( r(s ) = -0.525 ; P = 0.049 ) between the increase in PPT over the supraspinatus muscle and the decrease in pain was found : the greater the decrease in pain , the greater the increase in PPT . This case series has shown that manual treatment of active muscle TrPs can help to reduce shoulder pain and pressure sensitivity in shoulder impingement . Current findings suggest that active TrPs in the shoulder musculature may contribute directly to shoulder complaint and sensitization in patients with shoulder impingement syndrome , although future r and omized controlled trials are required

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Test-retest reliability of myofascial trigger point detection in patients with rotator cuff tendonitis

Objectives : To investigate the test-retest reliability of the following clinical diagnostic characteristics of myofascial trigger points : taut b and , spot tenderness , jump sign , pain recognition , referred pain and local twitch responses ( LTRs ) . Design : Test-retest reliability study . Setting : This study was undertaken in an outpatient physiotherapy department . Subjects : Fifty-eight patients ( 31 males and 27 females ) with rotator cuff tendonitis were recruited into this study . Intervention : Rotator cuff muscles were assessed by an expert for the presence or absence of the main clinical diagnostic characteristics of trigger point assessment . The process was then repeated three days later by the same expert . Main measures : Outcomes included the presence or absence of : a taut b and , spot tenderness , jump sign , pain recognition , referred pain and LTRs . Results : Kappa values between testing situations for the taut b and , spot tenderness , jump sign and pain recognition were 1 . Kappa scores for referred pain ranged between 0.79 and 0.88 and for the local twitch response between 0.75 and 1 depending on the muscles under investigation . Conclusions : The presence or absence of the taut b and , spot tenderness , jump sign and pain recognition was highly reliable between sessions . Referred pain and local twitch response reliability varied depending on the muscle being studied

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Active myofascial trigger points might be more frequent in patients with cervical radiculopathy.

BACKGROUND Myofascial trigger points ( MTrPs ) are commonly observed in the neck , parascapular region , and upper back muscles of patients with cervical pathology . AIM To assess the frequency of latent and active myofascial trigger point ( aMTrP ) in the neck and upper back muscles in patients with cervical radiculopathy and healthy subjects . DESIGN Controlled clinical trials . SETTING Out patients and controls . POPULATION Two hundred and forty four patients and 122 controls METHODS The patients clinical ly diagnosed as cervical radiculopathy with positive Spurling 's test and confirmed by MRI , were enrolled in this study . All subjects were examined for active and latent MTrP. In patients with cervical radiculopathy , an aMTrP was distinguished from a latent one when the referred pain elicited by exploration of the MTrP is recognized as familiar . RESULTS The patients comprised of 128 female ( 52.5 % ) and 116 male ( 47.5 % ) patients . Mean age was 44.58(20 - 65 years ) . In 125 ( 51.2 % ) of patients with cervical radiculopathy were found an aMTrP at least one muscle from upper trapezius , multifidus , splenius capitis , levator scapulae , rhomboid major , minor and deep paraspinal muscles . Number and distribution of MTrPs in patients with 244 cervical radiculopathy and in healthy controls . aMTrPs were detected most common in levator scapula ( 16.3 % ) , splenius capitis ( 14.7 % ) , rhomboid minor ( 14.3 % ) , upper part of trapezius ( 13.5 % ) , rhomboid major ( 10.2 % ) and multifidus ( 8.6 % ) muscles . Patients with cervical radiculopathy showed latent MTrP in levator scapula ( 27 % ) , splenius capitis ( 16.8 % ) , rhomboid minor ( 24.6 % ) , upper part of trapezius ( 33.2 % ) , rhomboid major ( 9 % ) and multifidus ( 8.2 % ) muscles . There was significant difference in terms of distribution of active and latent MTrPs in patients with cervical radiculopathy ( P=0.019 ) . Number of latent MTrPs in upper trapezius muscles in patients with cervical radiculopathy was more than the expected distribution . None of the subjects of control group had aMTrP. However , healthy controls showed latent MTrP in levator scapula ( 33.6 % ) , splenius capitis ( 16.4 % ) , rhomboid minor ( 21.3 % ) , upper part of trapezius ( 40.2 % ) , rhomboid major ( 6.5 % ) and multifidus ( 17.2 % ) muscles . There was no significant difference in terms of distribution of latent MTrPs between cervical radiculopathy and control groups ( P=0.249 ) . The frequency of aMTrP was found to be significantly higher in CDH with median localization as compared to posterolateral herniations ( P=0.041 ) . After conservative treatment for two weeks , number of patients with active MTrP in cervical radiculopathy were decreased about 50 % . CONCLUSION Cervical root compression would be considered as the starting or maintaining factor of aMTrP. CLINICAL REHABILITATION IMPACT The treatment of cervical radiculopathy might be facilitated the improving in aMTrPs located in aforementioned muscles

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions.

OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Inclusion of trigger point dry needling in a multimodal physical therapy program for postoperative shoulder pain: a randomized clinical trial.

OBJECTIVE The purpose of this study was to evaluate the effects of including 1 session of trigger point dry needling ( TrP-DN ) into a multimodal physiotherapy treatment on pain and function in postoperative shoulder pain . METHODS Twenty patients ( 5 male ; 15 female ; age , 58 ± 12 years ) with postoperative shoulder pain after either open reduction and internal fixation with Proximal Humeral Internal Locking System plate plate or rotator cuff tear repair were r and omly divided into 2 groups : physiotherapy group ( n = 10 ) who received best evidence physical therapy interventions and a physical therapy plus TrP-DN group ( n = 10 ) who received the same intervention plus a single session of TrP-DN targeted at active TrPs . The Constant-Murley score was used to determine pain , activities of daily living , range of motion , and strength , which was captured at baseline and 1 week after by an assessor blinded to group assignment . RESULTS Analysis of variance showed that subjects receiving TrP-DN plus physical therapy exhibited greater improvement in the Constant-Murley total score ( P < .001 ) and also activities of daily living ( P < .001 ) and strength ( P = .019 ) subscales than those receiving physical therapy alone . Between-group effect sizes were large in favor of the TrP-DN group ( 0.97 < SMD < 1.45 ) . Both groups experienced similar improvements in pain ( P < .001 ) and range of motion ( P < .001 ) . CONCLUSIONS Our results suggest that including a single session of TrP-DN in the first week of a multimodal physical therapy approach may assist with faster increases in function in individuals with postoperative shoulder pain

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Upper cervical mobility, posture and myofascial trigger points in subjects with episodic migraine: Case-control study.

OBJECTIVES To evaluate the association between episodic migraines and the prevalence of myofascial trigger points ( MTrPs ) in the sternocleidomastoid and upper trapezius , forward head posture ( FHP ) , neck range of motion ( ROM ) and cervical facet joint stiffness . METHODS 20 physiotherapy students with episodic migraines and 20 age- and sex matched healthy controls were included in this observational case-control study . Demographics and headache status were evaluated through question naires . Active neck ROM , presence of MTrPs , and cervical facet joint mobility were assessed by physical examination . FHP was measured using a lateral digital photograph taken in a sitting position . RESULTS No significant differences were found in neck ROM measurements and FHP between the migraine and control groups . Significant differences were found in the prevalence of cervical facet joints stiffness in Occiput-C1 ( χ(2 ) = 4.444 , p = 0.035 ) and C1-C2 ( χ(2 ) = 10.157 , p = 0.001 ) , but not in other segments . Significant differences were found in the prevalence of active and latent MTrPs between the migraine and control subjects in the right trapezius ( χ(2 ) = 11.649 , p = 0.003 ) and right sternocleidomastoid ( χ(2 ) = 8.485 , p = 0.014 ) . CONCLUSIONS Our findings support the hypothesis that the prevalence of MTrPs in neck muscles and hypomobility in the upper cervical facet joints are associated with migraines

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment . The pathophysiological mechanisms of shoulder pain are poorly understood . Furthermore , there is little evidence supporting the effectiveness of current treatment protocol s. Although myofascial trigger points ( MTrPs ) are rarely mentioned in relation to shoulder pain , they may present an alternative underlying mechanism , which would provide new treatment targets through MTrP inactivation . While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain , the percentage of patients who actually have MTrPs remains unclear . The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain . Methods An observational study was conducted . Subjects were recruited from patients participating in a controlled trial study ing the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain . Sociodemographic and patient-reported symptom scores , including the Disabilities of the Arm , Shoulder , and H and ( DASH ) Question naire , and Visual Analogue Scales for Pain were compared with other studies . To test for differences in age , gender distribution , and education level between the current study population and the population s from Dutch shoulder studies , the one sample T-test was used . One observer examined all subjects ( n = 72 ) for the presence of MTrPs . Frequency distributions , means , medians , st and ard deviations , and 95 % confidence intervals were calculated for descriptive purpose s. The Spearman 's rank-order correlation ( ρ ) was used to test for association between variables . Results MTrPs were identified in all subjects . The median number of muscles with MTrPs per subject was 6 ( active MTrPs ) and 4 ( latent MTrPs ) . Active MTrPs were most prevalent in the infraspinatus ( 77 % ) and the upper trapezius muscles ( 58 % ) , whereas latent MTrPs were most prevalent in the teres major ( 49 % ) and anterior deltoid muscles ( 38 % ) . The number of muscles with active MTrPs was only moderately correlated with the DASH score . Conclusion The prevalence of muscles containing active and latent MTrPs in a sample of patients with chronic non-traumatic shoulder pain was high

Findings revealed that active and latent MTrPs were prevalent throughout all disorders , however , latent MTrPs did not consistently have a higher prevalence compared to healthy controls . Conclusions We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders .

Background Neck and shoulder disorders may be linked to the presence of myofascial trigger points ( MTrPs ) . These disorders can significantly impact a person ’s activities of daily living and ability to work . MTrPs can be involved with pain sensitization , contributing to acute or chronic neck and shoulder musculoskeletal disorders . The aim of this review was to synthesis e evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Resistant starch lowers postprandial glucose and leptin in overweight adults consuming a moderate-to-high-fat diet: a randomized-controlled trial

Background High-amylose maize resistant starch type 2 ( HAM-RS2 ) stimulates gut-derived satiety peptides and reduces adiposity in animals . Human studies have not supported these findings despite improvements in glucose homeostasis and insulin sensitivity after HAM-RS2 intake which can lower adiposity-related disease risk . The primary objective of this study was to evaluate the impact of HAM-RS2 consumption on blood glucose homeostasis in overweight , healthy adults . We also examined changes in biomarkers of satiety ( glucagon-like peptide-1 [ GLP-1 ] , peptide YY [ PYY ] , and leptin ) and body composition determined by anthropometrics and dual-energy x-ray absorptiometry , dietary intake , and subjective satiety measured by a visual analogue scale following HAM-RS2 consumption . Methods Using a r and omized-controlled , parallel-arm , double-blind design , 18 overweight , healthy adults consumed either muffins enriched with 30 g HAM-RS2 ( n = 11 ) or 0 g HAM-RS2 ( control ; n = 7 ) daily for 6 weeks . The HAM-RS2 and control muffins were similar in total calories and available carbohydrate . Results At baseline , total PYY concentrations were significantly higher 120 min following the consumption of study muffins in the HAM-RS2 group than control group ( P = 0.043 ) . Within the HAM-RS2 group , the area under the curve ( AUC ) glucose ( P = 0.028 ) , AUC leptin ( P = 0.022 ) , and postpr and ial 120-min leptin ( P = 0.028 ) decreased independent of changes in body composition or overall energy intake at the end of 6 weeks . Fasting total PYY increased ( P = 0.033 ) in the HAM-RS2 group , but changes in insulin or total GLP-1 were not observed . Mean overall change in subjective satiety score did not correlate with mean AUC biomarker changes suggesting the satiety peptides did not elicit a satiation response or change in overall total caloric intake . The metabolic response from HAM-RS2 occurred despite the habitual intake of a moderate-to-high-fat diet ( mean range 34.5 % to 39.4 % of total calories ) . Conclusion Consuming 30 g HAM-RS2 daily for 6 weeks can improve glucose homeostasis , lower leptin concentrations , and increase fasting PYY in healthy overweight adults without impacting body composition and may aid in the prevention of chronic disease . However , between-group differences in biomarkers were not observed and future research is warranted before specific recommendations can be made . Trial registration None

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

[Effects of resistant starch on insulin resistance of type 2 diabetes mellitus patients].

OBJECTIVE To observe the effects of resistant starch ( RS ) on insulin resistance ( IR ) in type 2 diabetes mellitus patients . METHODS All 40 patients with type 2 diabetes mellitus were r and omly divided into two groups : Group A and Group B. Cross- design of two stages ( I , II ) was used during observation . Group A received RS 30 g/d as an intervention group for ahead of 4 weeks ( I stage ) , while group B as a control group . Group B was given RS in late 4 weeks ( II stage ) , while Group A as served control group . Blood was taken the first day and on the latest day in each stage . Fasting blood glucose ( FBG ) , post blood glucose ( PBG ) , fructosamine ( FMN ) , total cholesterol ( TC ) , triglyceridemic ( TG ) , insulin sensitive index ( ISI ) , and body mass index ( BMI ) were measured , respectively . RESULTS As Compared with the control group , ISI was higher and FBG , PBG , TC , TG , FMN and BMI were significantly lower in intervention group ( P < 0.05 ) . CONCLUSION RS should be effective in improving IR of type 2 diabetes mellitus patients

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Efficacy of increased resistant starch consumption in human type 2 diabetes

Resistant starch ( RS ) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome , but its effects on human type 2 diabetes ( T2DM ) are unknown . This study aim ed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postpr and ial metabolites and body fat in T2DM . Seventeen individuals with well-controlled T2DM ( HbA1c 46.6±2 mmol/mol ) consumed , in a r and om order , either 40 g of type 2 RS ( HAM-RS2 ) or a placebo , daily for 12 weeks with a 12-week washout period in between . At the end of each intervention period , participants attended for three metabolic investigations : a two-step euglycemic – hyperinsulinemic clamp combined with an infusion of [ 6,6 - 2H2 ] glucose , a meal tolerance test ( MTT ) with arterio-venous sampling across the forearm , and whole-body imaging . HAM-RS2 result ed in significantly lower postpr and ial glucose concentrations ( P=0.045 ) and a trend for greater glucose uptake across the forearm muscle ( P=0.077 ) ; however , there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity , or on HbA1c . Fasting non-esterified fatty acid ( NEFA ) concentrations were significantly lower ( P=0.004 ) and NEFA suppression was greater during the clamp with HAM-RS2 ( P=0.001 ) . Fasting triglyceride ( TG ) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 ( P=0.039 and P=0.027 respectively ) . Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption ( P=0.049 ) , postpr and ial GLP1 excursions during the MTT were significantly greater ( P=0.009 ) . HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM , but demonstrated beneficial effects on meal h and ling , possibly due to higher postpr and ial GLP1

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Increased gut hormones and insulin sensitivity index following a 3-d intervention with a barley kernel-based product: a randomised cross-over study in healthy middle-aged subjects.

Certain purified indigestible carbohydrates such as inulin have been shown to stimulate gut-derived hormones involved in glycaemic regulation and appetite regulation , and to counteract systemic inflammation through a gut microbiota-mediated mechanism . Less is known about the properties of indigestible carbohydrates intrinsic to food . The aim of this study was to investigate the possibility to affect release of endogenous gut hormones and ameliorate appetite control and glycaemic control by ingestion of a whole-grain cereal food product rich in NSP and resistant starch in healthy humans . In all , twenty middle-aged subjects were provided with a barley kernel-based bread ( BB ) or a reference white wheat bread during 3 consecutive days , respectively , in a r and omised cross-over design study . At a st and ardised breakfast the following day ( day 4 ) , blood was collected for the analysis of blood ( b ) glucose regulation , gastrointestinal hormones , markers of inflammation and markers of colonic fermentation ; 3 d of intervention with BB increased gut hormones in plasma ( p ) the next morning at fasting ( p-glucagon-like peptide-1 ; 56 % ) and postpr and ially ( p-glucagon-like peptide-2 ; 13 % and p-peptide YY ; 18 % ) . Breath H₂ excretion and fasting serum ( s ) SCFA concentrations were increased ( 363 and 18 % , respectively ) , and b-glucose ( 22 % ) and s-insulin responses ( 17 % ) were decreased after BB intervention . Insulin sensitivity index ( ISI(composite ) ) was also improved ( 25 % ) after BB . In conclusion , 3 d of intervention with BB increased systemic levels of gut hormones involved in appetite regulation , metabolic control and maintenance of gut barrier function , as well as improved markers of glucose homoeostasis in middle-aged subjects , altogether relevant for the prevention of obesity and the metabolic syndrome

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Resistant dextrin, as a prebiotic, improves insulin resistance and inflammation in women with type 2 diabetes: a randomised controlled clinical trial.

Improvement of insulin resistance and inflammation is a basic strategy in the management of type 2 diabetes . There is limited evidence that prebiotics improve insulin resistance and inflammation . However , the ameliorating effect of resistant dextrin , as a prebiotic , on insulin resistance and inflammation in patients with type 2 diabetes has not been investigated so far . Therefore , the present study aim ed to examine the effects of resistant dextrin on insulin resistance and inflammation in type 2 diabetic patients . In a r and omised controlled clinical trial , fifty-five women with type 2 diabetes were assigned to two groups : the intervention group ( n 30 ) and the control group ( n 25 ) . The intervention group received a daily supplement of 10 g resistant dextrin and the control group received a similar amount of maltodextrin as placebo for 8 weeks . Fasting plasma glucose ( FPG ) , HbA1c , insulin , high-sensitivity C-reactive protein ( hs-CRP ) , IL-6 , TNF-α , malondialdehyde ( MDA ) and serum endotoxin concentrations were measured before and after the intervention . Data were analysed using SPSS ( version 13 ) . Paired and unpaired t tests and ANCOVA were used to compare quantitative variables after the intervention . Patients supplemented with resistant dextrin exhibited a significant decrease in fasting insulin ( 20.1 pmol/l , 22.8 % ) , homeostasis model assessment of insulin resistance ( 1.3 , 24.9 % ) , quantitative insulin sensitivity check index ( 0.2 , 7.2 % ) , IL-6 ( 1.4 pg/ml , 28.4 % ) , TNF-α ( 5.4 pg/ml , 18.8 % ) , MDA ( 1.2 nmol/ml , 25.6 % ) and endotoxin ( 6.2 endotoxin units/ml , 17.8 % ) concentrations than those supplemented with maltodextrin ( P < 0.05 ) . Decreases in FPG ( 0.05 mmol/l , 0.6 % ) , HbA1c ( 0.5 % , 9.6 % ) and hs-CRP ( 2.7 ng/ml , 35.1 % ) concentrations in the resistant dextrin group were not significant when compared with the maltodextrin group . In conclusion , resistant dextrin supplementation can modulate inflammation and improve insulin resistance in women with type 2 diabetes

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Resistant Starch Bagels Reduce Fasting and Postprandial Insulin in Adults at Risk of Type 2 Diabetes.

BACKGROUND Type 2 diabetes ( T2D ) incidence continues to rise . Although increasing dietary fiber intake is an established strategy for improved glycemic control , most adults consume insufficient amounts . Fiber-enhanced functional foods can increase fiber intake , and there is particular interest in resistant starch ( RS ) as a high-fiber ingredient . Studies show that high-amylose maize resistant starch , type 2 ( HAM-RS2 ) improves acute and chronic glycemic responses , but more studies are needed in individuals at high risk of T2D with RS delivered in commonly consumed foods . OBJECTIVE The objective of this study was to examine the chronic effects of consuming bagels high in HAM-RS2 on fasting and postpr and ial glycemic markers in adults at increased risk of T2D . METHODS With the use of a r and omized , double-blind crossover design , 24 men and women with a mean ± SE age of 55.3 ± 1.59 y and body mass index ( in kg/m2 ) of 30.2 ± 0.57 consumed 1 bagel containing 25 g HAM-RS2/d or 1 control wheat bagel/d for 56 d each , separated by a 4-wk washout . Fasting and postpr and ial oral-glucose-tolerance test ( OGTT ) glucose and insulin were measured on study days 1 and 57 of each bagel treatment . RESULTS The RS bagel treatment result ed in significantly lower fasting ( 22.1 % , P = 0.04 ) , 2-h ( 23.3 % , P < 0.008 ) , and 3-h ( 18.9 % , P = 0.05 ) insulin incremental areas under the curve and fasting insulin resistance ( homeostasis model assessment of insulin resistance ; 23.1 % , P = 0.04 ) than did the control bagel treatment . Fasting and postpr and ial OGTT glucose concentrations did not differ between the RS and control bagel treatments on study days 1 or 57 . CONCLUSIONS These data suggest that consumption of a high-HAM-RS2 bagel improves glycemic efficiency by reducing the amount of insulin required to manage postpr and ial glucose while improving fasting insulin sensitivity in adults at increased risk of T2D . This research provides support for a feasible dietary strategy for T2D risk reduction . This trial was registered at clinical trials.gov as NCT02129946

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The Therapeutic Potential of Resistant Starch in Modulation of Insulin Resistance, Endotoxemia, Oxidative Stress and Antioxidant Biomarkers in Women with Type 2 Diabetes: A Randomized Controlled Clinical Trial

Aims : This trial aims to determine the effects of resistant starch ( RS ) subtype 2 ( RS2 ) on glycemic status , metabolic endotoxemia and markers of oxidative stress . Methods : A r and omized , controlled , parallel-group clinical trial group of 56 females with type 2 diabetes mellitus ( T2DM ) was divided to 2 groups . The intervention group ( n = 28 ) and control group ( n = 28 ) received 10 g/day RS2 or placebo for 8 weeks , respectively . Fasting blood sample s were taken to determine glycemic status , endotoxin , high sensitivity C-reactive protein ( hs-CRP ) , malondialdehyde ( MDA ) , total antioxidant capacity ( TAC ) , antioxidant enzymes concentrations as well as uric acid at baseline and after the intervention . Results : After 8 weeks , RS2 caused a significant decrease in the levels of MDA ( -34.10 % ) , glycosylated hemoglobin ( -9.40 % ) , insulin ( -29.36 % ) , homeostasis model of insulin resistance ( -32.85 % ) and endotoxin ( -25.00 % ) , a significant increase in TAC ( 18.10 % ) and glutathione peroxidase ( 11.60 % ) as compared with control . No significant changes were observed in fasting plasma glucose , quantitative insulin sensitivity check index , hs-CRP , superoxide dismutase , catalase and uric acid in the RS2 group as compared with the control group . Conclusion : Supplementation with RS2 may be improved glycemic status , endotoxemia and markers of oxidative stress in patients with T2DM

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Dietary treatment with rice containing resistant starch improves markers of endothelial function with reduction of postprandial blood glucose and oxidative stress in patients with prediabetes or newly diagnosed type 2 diabetes.

OBJECTIVE We aim ed to evaluate whether 4-week of dietary treatment with rice containing resistant starch reduces blood glucose and oxidative stress as well as improves endothelial function . METHODS Patients with impaired fasting glucose ( IFG ) , impaired glucose tolerance ( IGT ) or newly diagnosed type 2 diabetes ( n = 90 ) were r and omly assigned to either a group ingesting rice containing 6.51 g resistant starch daily or a control rice group for 4-weeks . We assessed fasting and postpr and ial levels of glucose and insulin , oxidative stress markers and endothelial function using reactive hyperemia peripheral arterial tonometry ( RH-PAT ) . RESULTS The diet containing rice with resistant starch reduced fasting insulin and insulin resistance , postpr and ial glucose ( P = 0.010 ) and insulin levels at 30 min , and glucose and insulin areas under the response curve after the st and ard meal . Rice with resistant starch also decreased urinary 8-epi-PGF(2α ) and plasma malondialdehyde ( MDA ) and increased the RH-PAT index ( P < 0.001 ) and total nitric oxide ( NO ) . Postpr and ial changes in glucose at 60 and 120 min and areas under the glucose response curve , MDA , RH-PAT , and total NO of the test group differed significantly from those in the control even after adjusting for baseline values . Overall , changes in the RH-PAT index correlated positively with changes in total NO ( r = 0.336 , P = 0.003 ) and superoxide dismutase activity ( r = 0.381 , P = 0.001 ) and negatively with changes in MDA ( r = -0.358 , P = 0.002 ) and 8-epi-PGF(2α ) . CONCLUSIONS In patients with IFG , IGT or newly diagnosed type 2 diabetes , 4-weeks of dietary treatment with rice containing resistant starch was associated with improved endothelial function with reduction of postpr and ial glucose and oxidative stress compared with control

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Prior short-term consumption of resistant starch enhances postprandial insulin sensitivity in healthy subjects

Aims /hypothesisDiets rich in insoluble-fibre are linked to a reduced risk of both diabetes and cardiovascular disease ; however , the mechanism of action remains unclear . The aim of this study was to assess whether acute changes in the insoluble-fibre ( resistant starch ) content of the diet would have effects on postpr and ial carbohydrate and lipid h and ling . Methods Ten healthy subjects consumed two identical , low-residue diets on separate occasions for 24 h ( 33 % fat ; < 2 g dietary fibre ) . Of the diets one was supplemented with 60 g resistant starch ( Novelose 260 ) . On the following morning a fibre-free meal tolerance test ( MTT ) was carried out ( 59 g carbohydrate ; 21 g fat ; 2.1 kJ ) and postpr and ial insulin sensitivity ( SIORAL ) assessed using a minimal model approach . Results Prior resistant starch consumption led to lower postpr and ial plasma glucose ( p=0.037 ) and insulin ( p=0.038 ) with a higher insulin sensitivity(44±7.5 vs 26±3.5 × 10−4 dl kg−1 min−1 per µUml−1 ; p=0.028 ) and C-peptide-to-insulin molar ratio ( 18.7±6.5 vs 9.7±0.69 ; p=0.017 ) . There was no effect of resistant starch consumption on plasma triacylglycerol although non-esterified fatty acid and 3-hydroxybutyrate levels were suppressed 5 h after the meal tolerance test . Conclusion Prior acute consumption of a high-dose of resistant starch enhanced carbohydrate h and ling in the postpr and ial period the following day potentially due to the increased rate of colonic fermentation

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Is there any place for resistant starch, as alimentary prebiotic, for patients with type 2 diabetes?

OBJECTIVE The aim of the present study was to determine effects of Resistant Starch ( RS2 ) on metabolic parameters and inflammation in women with type 2 diabetes ( T2DM ) . METHODS In this r and omized controlled clinical trial , 60 females with T2DM were divided into intervention ( n = 28 ) and placebo groups ( n = 32 ) . They received 10 g/d RS2 or placebo for 8 weeks , respectively . Fasting blood sugar ( FBS ) , glycated hemoglobin ( HbA1c ) , lipid profile , high-sensitive C-reactive protein ( hs-CRP ) , interleukin-6 ( IL-6 ) and tumor necrosis factor-alpha ( TNF-α ) were measured at baseline and at the end of the trial . Paired t test , unpaired t-test and ANCOVA were used to compare the quantitative variables . The data were analyzed using SPSS software version 13.0 . RESULTS RS2 decreased HbA1c ( -0.3 % , -3.6 % ) , TNF-α ( -3.4 pg/mL , -18.9 % ) , triglyceride ( -33.4 mg/dL , -15.4 % ) , and it increased HDL-c ( + 9.4 mg/dL , + 24.6 % ) significantly compared with the placebo group ( p < 0.05 ) . Changes in FBS , total cholesterol , low-density lipoprotein , hs-CRP and IL-6 were not significant in the RS2 group compared with the control group . RS2 can improve glycemic status , inflammatory markers and lipid profile in women with T2DM . CONCLUSIONS Although findings of the present study indicated positive effects of RS2 on inflammation and metabolic parameters , more studies are needed to confirm efficacy of RS2 as an adjunct therapy in diabetes

The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation . There was no significant difference between RS and non-RS supplements in patients with simple obesity . Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity

Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen . Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity . RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial . Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Iron supplementation improves endurance after training in iron-depleted, nonanemic women.

Our objective was to investigate the effects of iron depletion on adaptation to aerobic exercise , assessed by time to complete a 15-km cycle ergometer test . Forty-two iron-depleted ( serum ferritin < 16 microg/l ) , nonanemic ( Hb > 12 g/dl ) women ( 18 - 33 yr old ) received 100 mg of ferrous sulfate ( S ) or placebo ( P ) per day for 6 wk in a r and omized , double-blind trial . Subjects trained for 30 min/day , 5 days/wk at 75 - 85 % of maximum heart rate for the final 4 wk of the study . There were no group differences in baseline iron status or in 15-km time . Iron supplementation increased serum ferritin and decreased transferrin receptors in the S compared with the P group . The S and P groups decreased 15-km time and respiratory exchange ratio and increased work rate during the 15-km time trial after training . The decrease in 15-km time was greater in the S than in the P group ( P = 0.04 ) and could be partially attributed to increases in serum ferritin and Hb . These results indicate that iron deficiency without anemia impairs favorable adaptation to aerobic exercise

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Marginal iron deficiency without anemia impairs aerobic adaptation among previously untrained women.

BACKGROUND Iron deficiency without anemia has been shown to reduce both muscle-tissue oxidative capacity and endurance in animals . However , the consequences of iron deficiency in humans remain unclear . OBJECTIVE We investigated the effects of iron supplementation on adaptation to aerobic training among marginally iron-depleted women . We hypothesized that iron supplementation for 6 wk would significantly improve iron status and maximal oxygen uptake ( VO(2)max ) after 4 wk of concurrent aerobic training . DESIGN Forty-one untrained , iron-depleted , nonanemic women were r and omly assigned to receive either 50 mg FeSO(4 ) or a placebo twice daily for 6 wk in a double-blind trial . All subjects trained on cycle ergometers 5 d/wk for 4 wk , beginning on week 3 of the study . RESULTS Six weeks of iron supplementation significantly improved serum ferritin and serum transferrin receptor ( sTfR ) concentrations and transferrin saturation without affecting hemoglobin concentrations or hematocrit . Average VO(2)max and maximal respiratory exchange ratio improved in both the placebo and iron groups after training ; however , the iron group experienced significantly greater improvements in VO(2)max . Both iron-status and fitness outcomes were analyzed after stratifying by baseline sTfR concentration ( > and < or = 8.0 mg/L ) , which showed that the previously observed treatment effects were due to iron-status and fitness improvements among subjects with poor baseline iron status . CONCLUSIONS Our findings strongly suggest that iron deficiency without anemia but with elevated sTfR status impairs aerobic adaptation among previously untrained women and that this can be corrected with iron supplementation

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Tissue iron deficiency without anemia impairs adaptation in endurance capacity after aerobic training in previously untrained women.

BACKGROUND We previously showed that iron supplementation significantly improves iron status and maximal work capacity in previously untrained , marginally iron-deficient women with a baseline serum transferrin receptor concentration > 8.0 mg/L. However , the effect of transferrin receptor status on adaptation in endurance capacity after aerobic training in these subjects has not been fully explored . OBJECTIVE Our objective was to examine the effect of baseline serum transferrin receptor status on adaptations in endurance capacity . DESIGN Forty-one untrained , iron-depleted , nonanemic women were r and omly assigned to receive either 100 mg FeSO(4 ) or a placebo for 6 wk in a double-blind trial . All subjects trained on cycle ergometers 5 d/wk for the last 4 wk of the study . Endurance capacity was assessed at baseline and after treatment by using a 15-km time trial conducted on a cycle ergometer . RESULTS Significant treatment effects were observed for time to complete the 15-km time trial , work rate , and percentage of maximal oxygen uptake in subjects with a baseline serum transferrin receptor concentration > 8.0 mg/L. No significant treatment effects were observed in subjects with a normal baseline transferrin receptor concentration . CONCLUSIONS Our findings suggest that , in the presence of overt tissue iron deficiency , iron deficiency without anemia impairs adaptation in endurance capacity after aerobic training in previously untrained women . This impairment can be corrected with iron supplementation

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Functional consequences of iron supplementation in iron-deficient female cotton mill workers in Beijing, China.

Eighty iron-deficient , nonpregnant female workers were r and omly assigned to ferrous sulphate ( 60 or 120 mg Fe/d ) or placebo treatment for 12 wk . Energy expenditure was estimated during 3 d by heart rate ( HR ) recording . Production efficiency ( PE ) was calculated as the ratio of productivity to energy expenditure . In the iron-treated group mean hemoglobin ( Hb ) increased from 114 to 127 g/L ( P < 0.001 ) , mean serum ferritin increased from 9.7 to 30.0 micrograms/L ( P < 0.001 ) , and mean free erythrocyte protoporphyrin decreased from 1.01 to 0.49 mumol/L ( P < 0.001 ) . Mean HR at work decreased from 95.5 to 91.1 beats/min ( P < 0.001 ) , which was inversely correlated with the change in Hb ( r = -0.60 , P < 0.001 ) . PE increased significantly in the iron-treated group ( P < 0.001 ) and its change paralleled the change in Hb ( r = 0.58 , P < 0.001 ) . The results show that iron supplementation enabled these women to do the same work at a lower energy cost

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Iron depletion without anemia and physical performance in young women.

Studies in laboratory animals found that iron deficiency without anemia decreased oxidative capacity and increased reliance on carbohydrate as the substrate for energy , thereby causing impaired endurance . The purpose of this cross-sectional study was to investigate the relation between iron deficiency without anemia and physical performance in healthy active women aged 19 - 36 y. Iron-status assessment included determination of hemoglobin , hematocrit , transferrin saturation , and serum ferritin values . Dietary iron intake was assessed by frequency question naires and physical activity level was estimated by frequency question naires and 2-wk records . Fifteen women with normal iron status and 15 women with iron depletion ( serum ferritin < 12 micrograms/L ) were chosen r and omly from a group of 69 nonanemic women and given physical-performance tests , including determinations of maximum oxygen consumption ( VO2max ) , ventilatory threshold , and delta-efficiency . There were no significant differences between the two groups in body size , body composition , physical activity level , dietary iron intake , delta-efficiency , or ventilatory threshold . Compared with the iron-depleted group , the iron-sufficient group had significantly higher hemoglobin , transferrin saturation , and serum ferritin values and a significantly greater tendency to use iron supplements . When physical activity level and fat-free mass were controlled for , the iron-depleted group had a significantly lower VO2max . The difference in VO2max was significantly associated with serum ferritin concentration ; hemoglobin value was not a significant confounder . Therefore , reduction of VO2max in nonanemic women with iron depletion was likely caused by factors related to reduced body iron storage but was unrelated to decreased oxygen-transport capacity of the blood

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Iron supplementation improves progressive fatigue resistance during dynamic knee extensor exercise in iron-depleted, nonanemic women.

BACKGROUND Tissue iron depletion may negatively affect endurance performance and muscle fatigability . OBJECTIVE We investigated tissue-level iron depletion and progressive fatigue of the quadriceps during dynamic knee-extension exercise in young women . DESIGN Twenty iron-depleted ( serum ferritin < 20 micro g/L ) , nonanemic ( hemoglobin > 110 g/L ) women ( macro x + /- SEM age : 29.1 + /- 1.2 y ) received iron ( iron group ) or placebo ( placebo group ) for 6 wk in a r and omized , double-blind trial ( n = 10 per group ) . A protocol integrating 2 - 3-s maximal voluntary static contractions ( MVCs ) with dynamic knee extensions was used to assess fatigue . RESULTS No significant differences between the groups in baseline iron status , MVC at rest , or MVC at the end of the protocol were observed . After treatment , serum iron and transferrin saturation increased significantly in the iron group ( P = 0.02 and P = 0.03 , respectively ) . Serum transferrin receptor concentrations increased significantly in the placebo group ( P < 0.01 ) but not in the iron group . After treatment , the rate of decrease in MVC was attenuated in the iron group but not in the placebo group ( P = 0.01 ) . In the iron group , MVC at the sixth minute of the fatigue protocol and MVC at the end of the protocol were approximately 15 % ( P = 0.04 ) and approximately 27 % higher ( P < 0.01 ) , respectively , after treatment . These improvements were not related to changes in iron-status indexes or tissue iron stores , although power was low ( < 0.50 ) to detect these relations . CONCLUSIONS Iron supplementation was associated with a significant improvement in muscle fatigability . Interpretation regarding the direct role of tissue iron status is limited by the study 's low power to detect relations between tissue iron improvement and decreased muscle fatigue

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Iron status in exercising women: the effect of oral iron therapy vs increased consumption of muscle foods.

Forty-seven previously sedentary women participating in a 12-wk moderate aerobic-exercise program were r and omly assigned to one of four dietary groups : 50-mg/d iron supplement and a low food-iron diet ( 50 FE + EX ) , 10-mg/d iron supplement and a low food-iron diet ( 10 FE + EX ) , placebo and unrestricted diet ( P + EX ) , and meat supplement and high food-iron diet ( M + EX ) . A sedentary control group ( n = 13 ) received no dietary interventions . Hematocrit , total iron-binding capacity , and hemoglobin , serum iron , serum ferritin , and serum albumin concentrations were measured every 4 wk . Hemoglobin values decreased at the end of 4 wk in all exercising groups compared with the control group . Iron status in the 50 FE + EX and M + EX groups improved after week 4 as indicated by an increase in serum ferritin , serum iron , and hemoglobin concentrations , and a decline in total iron-binding capacity . Thus , short-term , moderate aerobic exercise result ed in compromised iron status that was offset to varying degrees by ingesting iron or meat supplements . However , meat supplements were more effective in protecting hemoglobin and ferritin status than were iron supplements

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Clinical evaluation of iron treatment efficiency among non-anemic but iron-deficient female blood donors: a randomized controlled trial

Background Iron deficiency without anemia is related to adverse symptoms that can be relieved by supplementation . Since a blood donation can induce such an iron deficiency , we investigated the clinical impact of iron treatment after a blood donation . Methods One week after donation , we r and omly assigned 154 female donors with iron deficiency without anemia , aged below 50 years , to a four-week oral treatment of ferrous sulfate versus a placebo . The main outcome was the change in the level of fatigue before and after the intervention . Aerobic capacity , mood disorder , quality of life , compliance and adverse events were also evaluated . Hemoglobin and ferritin were used as biological markers . Results The effect of the treatment from baseline to four weeks of iron treatment was an increase in hemoglobin and ferritin levels to 5.2 g/L ( P < 0.01 ) and 14.8 ng/mL ( P < 0.01 ) , respectively . No significant clinical effect was observed for fatigue ( -0.15 points , 95 % confidence interval -0.9 points to 0.6 points , P = 0.697 ) or for other outcomes . Compliance and interruption for side effects was similar in both groups . Additionally , blood donation did not induce overt symptoms of fatigue in spite of the significant biological changes it produces . Conclusions These data are valuable as they enable us to conclude that donors with iron deficiency without anemia after a blood donation would not clinical ly benefit from iron supplementation . Trial Registration Clinical Trials.gov :

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Effects of iron repletion on blood volume and performance capacity in young athletes.

PURPOSE The purpose of this study was to find out whether iron repletion leads to an increase in red blood cell volume ( RBV ) and performance capacity in iron-deficient nonanemic athletes . METHODS 40 young elite athletes ( 13 - 25 yr ) with low serum ferritin ( < 20 microg . L-1 ) and normal hemoglobin ( males > 13.5 g.dL-1 , females > 11.7 g.dL-1 ) were r and omly assigned to 12-wk treatment with either twice a day ferrous iron ( equivalent to 2 x 100 mg elemental iron ) or with placebo using a double blind method . Before and after treatment , hematological measures and parameters of iron status were determined in venous blood . RBV , blood volume ( BV ) , and plasma volume ( PV ) were measured by CO rebreathing . For determination of the aerobic and anaerobic capacity ( maximal accumulated oxygen deficit , MAOD ) , the athletes performed an incremental as well as a highly intensive treadmill test . RESULTS After 12 wk , ferritin levels were within the normal range in the iron-treated group ( IG ) with a significant ( P < 0.001 ) mean increase by 20 microg . L-1 opposed to a slight nonsignificant decrease in the placebo group ( PG ) . RBV did not change significantly in either group nor did any of the hematological measures . However , only in IG there were significant increases in VO2max and in O2 consumption in the MAOD test . MAOD and maximal capillary lactate concentration remained unchanged in both treatment groups . CONCLUSIONS The results indicate that in young elite athletes with low serum ferritin and normal hemoglobin concentration iron supplementation leads to an increase in maximal aerobic performance capacity without an augmentation of RBV

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Improvement in iron deficiency anemia through therapy with ferric ammonium citrate and vitamin C and the effects of aerobic exercise.

In 781 female college students , there were 41 cases of iron deficiency anemia , 209 of latent iron deficiency , 3 of other anemias , and 528 normal cases . Fifty-four volunteers recruited from the iron deficiency anemia and severe latent iron deficiency groups were r and omly divided into 4 study groups . Groups I and III received 500 mg of vitamin C daily , and groups II and IV received ferric ammonium citrate ( FeAC ; equivalent to 6 mg iron ) in addition to vitamin C for 9 weeks . Groups I and II were loaded by aerobic exercise at 50 % VO2 max . Significant differences between groups were noted in serum ferritin ( SF ) in III/IV , hematocrit ( Ht ) in II/III and III/IV , and reticulocytes ( RET ) in I/II , I/IV , and III/IV . Hemoglobin ( Hb ) and other iron-related blood indices tended to normalize in groups II and IV when compared with the pre-values . VO2 max was elevated in groups I and II regardless of iron treatment , but was augmented more in group II than group

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Effect of iron supplementation on endurance capacity in iron-depleted female runners.

The purpose of this investigation was to examine the effects of oral iron supplementation on endurance performance in initially iron-depleted , nonanemic female distance runners . Eighteen iron-depleted ( serum ferritin less than 20 ng.ml-1 , hemoglobin greater than or equal to 12 g.dl-1 ) women ( 22 - 39 yr ) performed a VO2max test and an endurance run to exhaustion . Subjects were pair-matched on the basis of endurance time and then r and omly assigned to an iron supplement or a placebo group . Following supplementation , the iron group had a significantly higher ( P = 0.03 ) mean serum ferritin concentration ( 23.4 vs 15.7 ng.ml-1 ) and lower ( P = 0.04 ) mean total iron-binding capacity than the placebo group . Both groups increased their time to exhaustion ( 25.5 % and 22.2 % for the iron and placebo groups , respectively ) but were not significantly different ( P = 0.72 ) from each other . There were also no differences ( P greater than 0.05 ) between the groups with respect to lactate concentrations and physiological measures taken during the two exercise tests . The results of this study suggest that 8 wk of oral iron supplementation improves iron status in iron-depleted female distance runners , but does not enhance endurance capacity

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Iron repletion decreases maximal exercise lactate concentrations in female athletes with minimal iron-deficiency anemia.

We studied the effect of 2 weeks of iron therapy on exercise performance and exercise-induced lactate production in trained women athletes : six control subjects with normal parameters of iron status and nine with mild iron-deficiency anemia defined by low Fe/TIBC , ferritin , and minimally decreased Hgb values . Iron therapy improved the abnormal measures of iron status and low Hgb in the second group to normal . Exercise performance in a progressive work-exercise protocol on a bicycle ergometer to exhaustion was unchanged after iron therapy in both groups ; however , blood lactate levels at maximum exercise in the iron-deficient group decreased significantly from 10.3 + /- 0.6 mmol/L before therapy to 8.42 + /- 0.7 after therapy ( p less than 0.03 ) . The control subjects did not significantly alter lactate levels after maximal exercise on iron compared to placebo : 8.3 + /- 0.8 mmol/L vs. 8.5 + /- 0.7 . Although there was not a significant difference in maximum exercise performance after iron therapy , these data support animal experiments implying that iron may play a role in oxidative metabolism and that minimal decreases in Hgb may impair arterial oxygen content enough to affect aerobic metabolism . In addition , these findings may have important implication s for competitive women athletes in whom mild iron deficiency may go unnoticed

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Iron supplementation maintains ventilatory threshold and improves energetic efficiency in iron-deficient nonanemic athletes

Objective : To determine the effect of iron supplementation on iron status and endurance capacity . Design : R and omized , double-blind iron supplementation . Setting : University of Missouri-Columbia and surrounding community . Subjects : Twenty iron-deficient ( serum ferritin , sFer<16 μg/l ; serum transferrin receptor , sTfR>8.0 mg/l ; or sTfR/log sFer index > 4.5 ) , nonanemic ( hemoglobin , Hb>120 g/l , women ; > 130 g/l , men ) men and women ( 18–41 years ) were recruited via fliers and newspaper advertisements ; 20 of 31 eligible subjects participated . Interventions : A 30 mg measure of elemental iron as ferrous sulfate or placebo daily for 6 weeks . Results : Dietary iron intake and physical activity did not differ between groups before or after supplementation . Iron supplementation significantly increased sFer compared to placebo ( P=0.01 ) , but did not affect Hb or hematocrit . Iron supplementation prevented the decline in ventilatory threshold ( VT ) observed in the placebo group from pre- to post-supplementation ( P=0.01 ) ; this effect was greater in individuals with lower sFer before intervention ( P<0.05 ) . Changes in sFer from pre- to post-treatment were positively correlated with changes in VT ( P=0.03 ) , independent of supplementation . The iron group significantly increased gross energetic efficiency during the submaximal test ( P=0.04 ) . Changes in sFer were negatively correlated with changes in average respiratory exchange ratio during the submaximal test ( P<0.05 ) . Conclusions : Iron supplementation significantly improves iron status and endurance capacity in iron-deficient , nonanemic trained male and female subjects . Sponsorship : Missouri University Alumni Association , by the Elizabeth Hegarty Foundation and by the Department of Nutritional Sciences

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Effect of an iron supplement on body iron status and aerobic capacity of young training women

Summary Serum iron deficiency has a high incidence in female athletes . We investigated the effects of a daily oral iron supplement , ( 160 mg ) administered during an intensive 7-week physical training programme , on body iron status , and the maximal aerobic capacity ( VO2max ) of 13 women ( group A ) compared to 15 who took a placebo ( group B ) . The subjects were 19 years old . Blood sample s were obtained before training began and on days 1 , 7 , 21 and 42 of training . They were analysed for packed cell volume ( PVC ) and for haemoglobin ( Hb ) , 2,3-diphosphoglycerate ( 2,3-DPG ) , haptoglobin , iron and ferritin concentrations . TheVO2max was measured on days 0 , 21 and 42 of training . Following 21 days of training Hb , PCV and ferritin were significantly higher ( P⩽0.01 ) in group A compared to group B. Over the training period Hb rose by 9.3 % and 2.4 % in groups A and B , respectively . At the end of training 66 % of group B exhibited ferritin concentrations below 10 ng·ml−1 , while none of group A had such low values . MeanVO2max of group A had increased by 7.5 % following 21 days of training ( P⩽0.01 ) and by 15.3 % after 42 days . No appreciable increase inVO2max had occurred in group B by day 21 ( significantly lower thanVO2max of group A;P⩽0.05 ) , however by day 42 it had increased by 14.3 % ( P⩽0.05 ) . In both groups 2,3-DPG·g Hb−1 had increased significantly ( P⩽0.005 ) by day 7 ( 22 % ) and remained at that level for an additional 35 days . We concluded that a daily oral iron supplement given to young women during intensive training improved several haematological variables and their body iron status . This improvement was associated with an increasedVO2max only during the early stages of their training ( day 21 ) compared with the placebo group

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Response of serum transferrin receptor to iron supplementation in iron-depleted, nonanemic women.

Serum transferrin receptor ( sTfR ) concentration has been recognized recently as a reliable indicator of functional iron deficiency , but its response to iron supplementation has not been investigated in marginally iron-deficient women . In this r and omized , double-blinded trial , 37 female subjects aged 19 - 35 y with iron depletion without anemia ( hemoglobin > 120 g/L and serum ferritin < 16 microg/L ) received an iron supplement or placebo for 8 wk . Iron status was measured before treatment , after 4 wk of treatment , and posttreatment ( ie , after 8 wk of treatment ) . Iron supplementation of these iron-depleted , nonanemic women result ed in a progressive and significant decrease in sTfR and a significant increase in serum ferritin , and prevented a fall in hemoglobin . The responsiveness of sTfR to iron treatment indicated that sTfR is a sensitive indicator of marginal iron deficiency in iron-depleted , nonanemic women , even when their body iron stores were being replenished

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Effects of iron repletion on VO2max, endurance, and blood lactate in women.

To determine the effects of an 8-wk dietary iron supplementation ( 100 mg.d-1 ) on low plasma ferritin concentration ( < 20 ng.ml-1 ) and endurance , 20 active women ( 19 - 35 yr ) were studied while performing a VO2max test and an endurance test ( 80 % VO2max ) on a cycle ergometer . Subjects were r and omly placed in an iron supplement ( IG ) or a placebo group ( PG ) using a double-blind method . After treatment in the IG , ferritin levels were higher ( 22.5 + /- 3.4 vs 14.3 + /- 2.2 ng.ml-1 ; P < 0.05 ) , Hb increased ( 12.8 + /- 0.4 to 14.1 + /- 0.2 g.dl-1 ; P < 0.05 ) , and TIBC decreased ( 366.2 + /- 24.8 to 293.8 + /- 14.0 micrograms.dl-1 ; P < 0.05 ) . Also after treatment the IG 's VO2max was significantly greater ( P < 0.05 ) than the PG value and their postendurance blood lactate decreased ( 5.03 + /- 0.44 to 3.85 + /- 0.6 mM.l-1 ; P < 0.05 ) . Endurance time to exhaustion increased 38 % ( 37.28 + /- 5.03 to 51.4 + /- 7.45 min ) following iron treatment ; however , this change was not statistically significant . The results suggest that this level of iron supplementation can reverse mild anemia , increase VO2max , and reduce blood lactate concentration after submaximal exercise

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Iron supplementation and running performance in female cross-country runners.

The purpose of this study was to determine the effects of two weeks of high dosage iron supplementation on various blood iron indices and metabolic parameters in non-anemic , iron-depleted competitive female cross-country runners . The subjects were highly trained members of the Colorado State University cross-country team and were completing 40 to 50 miles of training weekly . A pretest , post-test single-blind crossover design was employed . Upon collection of baseline exercise blood and metabolic data , five subjects were r and omly assigned to iron supplementation ( 650 mg ferrous sulfate ; 130 mg elemental iron ) and five subjects to placebo treatment . At two weeks the treatments were reversed . Exercise blood and metabolic data were collected at two-week intervals . Dietary iron intake was assessed using a three-day dietary survey . Dietary analysis revealed deficiencies in vitamin B-6 , iron , magnesium , and zinc according to USRDA st and ards . Baseline blood sample s revealed no deficiencies in iron storage or transport proteins . Two weeks of iron supplementation result ed in no significant increases in blood iron indices . Metabolic parameters related to running performance were also unchanged after iron supplementation . High dosage , short-term iron supplementation appears to have no effect on blood or metabolic parameters in iron-depleted but non-anemic female cross-country runners

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Hepcidin is the major predictor of erythrocyte iron incorporation in anemic African children

Iron supplementation strategies in the developing world remain controversial because of fears of exacerbating prevalent infectious diseases . Underst and ing the conditions in which iron will be absorbed and incorporated into erythrocytes is therefore important . We studied Gambian children with either postmalarial or nonmalarial anemia , who were given oral iron supplements daily for 30 days . Supplements administered on days 1 and 15 contained the stable iron isotopes 57Fe and 58Fe , respectively , and erythrocyte incorporation was measured in blood sample s drawn 14 days later . We investigated how the iron-regulatory hormone hepcidin and other inflammatory/iron-related indices , all measured on the day of isotope administration , correlated with erythrocyte iron incorporation . In univariate analyses , hepcidin , ferritin , C-reactive protein , and soluble transferrin receptor ( sTfR ) strongly predicted incorporation of 57Fe given on day 1 , while hepcidin , ferritin , and sTfR/log ferritin correlated with 58Fe incorporation . In a final multivariate model , the most consistent predictor of erythrocyte isotope incorporation was hepcidin . We conclude that under conditions of competing signals ( anemia , iron deficiency , and infection ) , hepcidin powerfully controls use of dietary iron . We suggest that low-cost point-of-care hepcidin assays would aid iron supplementation programs in the developing world

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Effects of iron supplementation in female athletes with low serum ferritin concentration.

Low serum ferritin concentrations are commonly found in female athletes . By study ing the effects of an 8-week iron or placebo supplementation in 31 female athletes ( aged 17 - 31 years ) , with an initial serum ferritin concentration less than or equal to 25 micrograms/l and blood hemoglobin 120 g/l , we investigated whether low serum ferritin values hinder aerobic performance . Serum ferritin concentration increased from 14 ( 25th and 75th percentile : 11 , 21 ) to 26 ( 18 , 36 ) micrograms/l in the iron-supplemented group , but remained at a low 11 ( 9 , 17 ) micrograms/l in the placebo group ( group difference after supplementation : p = 0.001 ) . Before supplementation , blood hemoglobin concentration was not different in the two groups . After supplementation , however , the concentration in the iron group was 139 ( 135 , 144 ) g/l and 128 ( 126 , 134 ) g/l in the placebo group ( group difference : p = 0.001 ) . Iron supplementation did not affect blood lactate concentration or VO2max during an incremental ergometer test . Hence , aerobic performance was not impaired in nonanemic female athletes with serum ferritin 25 micrograms/l

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

The effect of iron therapy on the exercise capacity of nonanemic iron-deficient adolescent runners.

Iron-deficiency anemia impairs exercise capacity , but whether nonanemic iron depletion decreases endurance performance is unclear . In 14 iron-deficient ( serum ferritin level , less than 20 micrograms/L [ less than 20 ng/L])nonanemic runners , hematologic and treadmill running values were followed up during a competitive season . Following a four-week control period , runners were treated for one month in a double-blind protocol with ferrous sulfate ( 975 mg/d ) or placebo . During treatment , the mean ferritin level rose from 8.7 to 26.6 micrograms/L ( 8.7 to 26.6 ng/mL ) in those patients taking iron and fell from 10.6 to 8.6 micrograms/L ( 10.7 to 8.6 ng/mL ) in the placebo group . Treadmill endurance times improved significantly in the iron-treated runners compared with controls . Endurance time declined in all seven controls ( range , 0.07 to 1.30 minutes ) , while six of seven iron-treated subjects improved their performance ( range , 0.03 to 1.92 minutes ) . No significant differences in maximal or submaximal oxygen consumption , ventilation , or heart rate were observed between the groups except for a 4 % increase in maximum oxygen consumption during placebo treatment . These data indicate that nonanemic iron deficiency impairs exercise performance but does not influence gas exchange or cardiac measures

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Randomized, double-blind, placebo-controlled trial of iron supplementation in female soldiers during military training: effects on iron status, physical performance, and mood.

BACKGROUND Decrements in iron status have been reported in female soldiers during military training . Diminished iron status adversely affects physical and cognitive performance . OBJECTIVE We wanted to determine whether iron supplementation could prevent decrements in iron status and improve measures of physical performance and cognitive status in female soldiers during basic combat training ( BCT ) . DESIGN In this 8-wk r and omized , double-blind , placebo-controlled trial , soldier volunteers ( n = 219 ) were provided with capsules containing either 100 mg ferrous sulfate or a placebo . Iron status indicator assays were performed pre- and post-BCT . Two-mile running time was assessed post-BCT ; mood was assessed by using the Profile of Mood States question naire pre- and post-BCT . RESULTS The BCT course affected iron status : red blood cell distribution width and soluble transferrin receptor were elevated ( P < 0.05 ) , and serum ferritin was lowered ( P < 0.05 ) post-BCT . Iron supplementation attenuated the decrement in iron status ; group-by-time interactions ( P < 0.01 ) were observed for serum ferritin and soluble transferrin receptor . Iron supplementation result ed in improved ( P < 0.05 ) vigor scores on the Profile of Mood States post-BCT and in faster running time ( P < 0.05 ) in volunteers reporting to BCT with iron deficiency anemia . CONCLUSIONS Iron status is affected by BCT , and iron supplementation attenuates the decrement in indicators of iron status in female soldiers . Furthermore , iron supplementation may prove to be beneficial for mood and physical performance during the training period . Future efforts should identify and treat female soldiers or athletes who begin training regimens with iron deficiency or iron deficiency anemia

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

The effects of hemoglobin supplements on maximal oxygen uptake in females.

There was no significant change in the maximal oxygen uptake for either the experimental or the control group from the pre-test to the post-test . Five blood chemistry measures were unable to predict the post-maximal oxygen uptake scores using the procedure of stepwise regression . An examination of the blood chemistry profiles indicated that sports anemia did not occur . The factorial breakdown was unable to produce any significant insight into the changes in hemoglobin concentration and oxygen consumption . Heme-iron supplementation was unable to override the regulatory system of the body and allow the hemoglobin level to become elevated

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

The effects of prelatent/latent iron deficiency on physical work capacity.

In order to examine the effects of mild iron deficiency on physical work capacity , 40 prelatent iron-deficient female endurance runners were studied before and after 8 wk of supplementation with either oral iron ( 320 mg ferrous sulfate ) or a matching placebo . Subjects underwent the following physical work capacity tests : the Wingate cycle ergometer test , the anaerobic speed test , the ventilatory threshold , VO2max , and maximal treadmill velocity during the VO2max test . Muscle biopsy sample s pre- and post-treatment were obtained from 17 of the subjects , and these were assayed for citrate synthase and cytoplasmic alpha-glycerophosphate dehydrogenase activity . Subjects were r and omly assigned to one of the treatment groups , and a double-blind method of administration of the supplements was used . The differences in improvement scores between the two groups on the work capacity and enzyme activity variables were statistically nonsignificant ( P greater than 0.05 ) . Serum ferritin values rose from a mean of 12.4 + /- 4.5 to 37.7 + /- 19.7 ng.ml-1 for the experimental group and from 12.2 + /- 4.3 to 17.2 + /- 8.9 ng.ml-1 for the controls ( P = 0.0025 ) , whereas hemoglobin levels remained fairly constant for both groups ( P = 0.6 ) . Eight weeks of iron supplementation to prelatent/latent iron-deficient , physically active females did not significantly enhance work capacity . Within the limitations of this study , the presence of a serum ferritin below 20 ng.ml-1 does not pose a significant h and icap to physical work capacity

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Worker productivity and the nutritional status of Kenyan road construction laborers.

The effects of energy supplementation ( group I received 200 kcal/day and group II received 1000/kcal day ) were examined on road workers in Kenya . Anthropometric , dietary , worker productivity , clinical hematology , and parasitology data were collected from 224 workers of both sexes or , sub sample s of these workers at base-line , midpoint , and final measurement periods . Sixty-seven percent of the work force was less than 85 % of weight for height . Females tended to be better nourished than males . Multiple regression analysis showed that increases in arm circumference and Hb levels were associated with significant productivity gains of about 4 % . At the midpoint , group II males gained 1.10 kg ( p less than 0.0003 ) while group I males showed no change . Weight loss during the latter part of the study result ed in no significant final weight change for males . " Successful " supplementation was weakly associated with a productivity increase for group II workers of 12.5 % ( p less than 0.10 )

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

Effects of long-term moderate exercise on iron status in young women.

The impact of long-term ( 6-month ) moderate exercise on the iron status of previously sedentary women was determined by r and omly assigning 62 college-age women into one of the following four groups : 1 ) 50 mg.d-1 iron supplement , low iron diet ( N = 16 ) ; 2 ) Placebo , free choice diet ( N = 13 ) ; 3 ) Meat supplement to achieve 15 mg.d-1 iron intake ( N = 13 ) ; and 4 ) Control , free choice diet ( N = 20 ) . All groups except the Control group exercised 3 d.wk-1 at 60%-75 % of their heart rate reserve . VO2max was measured at baseline and week 24 . Blood was sample d at baseline and every 4 wk thereafter for 24 wk to measure iron status and to eluci date the causes for alterations in iron status . Subjects had depleted iron stores throughout the study as indicated by their serum ferritin levels ( < 15 ng.ml-1 ) . Serum iron , total iron binding capacity and transferrin saturation were not compromised with exercise . Mean hemoglobin level in the Placebo/Ex group was significantly ( P < 0.05 ) lower than the 50 Fe/Ex and the Meat/Ex groups by week 24 . However , changes in serum albumin , haptoglobin , and erythropoietin data from the study can not explain these changes

Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA , providing a rationale to prevent and treat iron deficiency in this group .

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance , but findings from r and omized trials on the effects of iron are equivocal . Iron deficiency and anemia are especially common in women of reproductive age ( WRA ) . Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines . Therefore , we performed a systematic review and meta- analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

Follow-up of Yoga of Awareness for Fibromyalgia: Results at 3 Months and Replication in the Wait-list Group

Objectives : Published preliminary findings from a r and omized-controlled trial suggest that an 8-week Yoga of Awareness intervention may be effective for improving symptoms , functional deficits , and coping abilities in fibromyalgia . The primary aims of this study were to evaluate the same intervention ’s posttreatment effects in a wait-list group and to test the intervention ’s effects at 3-month follow-up in the immediate treatment group . Methods : Unpaired t tests were used to compare data from a per protocol sample of 21 women in the immediate treatment group who had completed treatment and 18 women in the wait-list group who had completed treatment . Within-group paired t tests were performed to compare posttreatment data with 3-month follow-up data in the immediate treatment group . The primary outcome measure was the Fibromyalgia Impact Question naire Revised ( FIQR ) . Multilevel r and om-effects models were also used to examine associations between yoga practice rates and outcomes . Results : Posttreatment results in the wait-list group largely mirrored results seen at posttreatment in the immediate treatment group , with the FIQR Total Score improving by 31.9 % across the 2 groups . Follow-up results showed that patients sustained most of their posttreatment gains , with the FIQR Total Score remaining 21.9 % improved at 3 months . Yoga practice rates were good , and more practice was associated with more benefit for a variety of outcomes . Discussion : These findings indicate that the benefits of Yoga of Awareness in fibromyalgia are replicable and can be maintained

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

Self-report Mindfulness as a Mediator of Psychological Well-being in a Stress Reduction Intervention for Cancer Patients—A Randomized Study

Background There is increasing recognition of mindfulness and mindfulness training as a way to decrease stress and increase psychological functioning . Purpose The aims of this study were to examine the effects of mindfulness stress reduction training on perceived stress and psychological well-being and to examine if changes in mindfulness mediate intervention effects on these outcomes . Methods Seventy women and one man with a previous cancer diagnosis ( mean age 51.8 years , st and ard deviation = 9.86 ) were r and omized into an intervention group or a wait-list control group . The intervention consisted of an 8-week mindfulness training course . Results Compared to participants in the control group , participants in the mindfulness training group had significantly decreased perceived stress and posttraumatic avoidance symptoms and increased positive states of mind . Those who participated in the intervention reported a significant increase in scores on the five-facet mindfulness question naire ( FFMQ ) when compared to controls . The increase in FFMQ score mediated the effects of the intervention on perceived stress , posttraumatic avoidance symptoms , and positive states of mind . Conclusions This study indicates that the improvements in psychological well-being result ing from mindfulness stress reduction training can potentially be explained by increased levels of mindfulness as measured with the FFMQ . The importance of these findings for future research in the field of mindfulness is discussed

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

Mindfulness Training as an Intervention for Fibromyalgia: Evidence of Postintervention and 3-Year Follow-Up Benefits in Well-Being

Background : Mindfulness-based stress reduction ( MBSR ) proposes a systematic program for reduction of suffering associated with a wide range of medical conditions . Studies suggest improvements in general aspects of well-being , including quality of life ( QoL ) , coping and positive affect , as well as decreased anxiety and depression . Methods : A quasi-experimental study examined effects of an 8-week MBSR intervention among 58 female patients with fibromyalgia ( mean , 52 ± 8 years ) who underwent MBSR or an active social support procedure . Participants were assigned to groups by date of entry , and 6 subjects dropped out during the study . Self-report measures were vali date d German inventories and included the following scales : visual analog pain , pain perception , coping with pain , a symptom checklist and QoL. Pre- and postintervention measurements were made . Additionally , a 3-year follow-up was carried out on a subgroup of 26 participants . Results : Pre- to postintervention analyses indicated MBSR to provide significantly greater benefits than the control intervention on most dimensions , including visual analog pain , QoL subscales , coping with pain , anxiety , depression and somatic complaints ( Cohen d effect size , 0.40–1.10 ) . Three-year follow-up analyses of MBSR participants indicated sustained benefits for these same measures ( effect size , 0.50–0.65 ) . Conclusions : Based upon a quasi-r and omized trial and long-term observational follow-up , results indicate mindfulness intervention to be of potential long-term benefit for female fibromyalgia patients

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

Treating fibromyalgia with mindfulness-based stress reduction: Results from a 3-armed randomized controlled trial

& NA ; Mindfulness‐based stress reduction ( MBSR ) is a structured 8‐week group program teaching mindfulness meditation and mindful yoga exercises . MBSR aims to help participants develop nonjudgmental awareness of moment‐to‐moment experience . Fibromyalgia is a clinical syndrome with chronic pain , fatigue , and insomnia as major symptoms . Efficacy of MBSR for enhanced well‐being of fibromyalgia patients was investigated in a 3‐armed trial , which was a follow‐up to an earlier quasi‐r and omized investigation . A total of 177 female patients were r and omized to one of the following : ( 1 ) MBSR , ( 2 ) an active control procedure controlling for nonspecific effects of MBSR , or ( 3 ) a wait list . The major outcome was health‐related quality of life ( HRQoL ) 2 months post‐treatment . Secondary outcomes were disorder‐specific quality of life , depression , pain , anxiety , somatic complaints , and a proposed index of mindfulness . Of the patients , 82 % completed the study . There were no significant differences between groups on primary outcome , but patients overall improved in HRQoL at short‐term follow‐up ( P = 0.004 ) . Post hoc analyses showed that only MBSR manifested a significant pre‐to‐post‐intervention improvement in HRQoL ( P = 0.02 ) . Furthermore , multivariate analysis of secondary measures indicated modest benefits for MBSR patients . MBSR yielded significant pre‐to‐post‐intervention improvements in 6 of 8 secondary outcome variables , the active control in 3 , and the wait list in 2 . In conclusion , primary outcome analyses did not support the efficacy of MBSR in fibromyalgia , although patients in the MBSR arm appeared to benefit most . Effect sizes were small compared to the earlier , quasi‐r and omized investigation . Several method ological aspects are discussed , e.g. , patient burden , treatment preference and motivation , that may provide explanations for differences . In a 3‐armed r and omized controlled trial in female patients suffering from fibromyalgia , patients benefited modestly from a mindfulness‐based stress reduction intervention

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

A cohort-controlled trial of the addition of customized foot orthotics to standard care in fibromyalgia

Customized foot orthotics are widely prescribed for patients with chronic , non-specific low back pain and lower limb pain , but there are few trials demonstrating effectiveness , and none for fibromyalgia . A total of 67consecutive patients presenting with chronic , widespread pain , who met the 1990 American College of Rheumatology criteria for fibromyalgia , were included in the study . A total of 32 subjects were prescribed a spinal exercise therapy program along with analgesics . These subjects formed the Control group . A second group , comprised of 35 subjects , received the same therapy , along with customized foot orthotics ( Orthotics group ) . All subjects completed the Revised Fibromyalgia Impact Question naire ( FIQR ) at the initiation of the study and at 8 weeks follow-up . The number of subjects using any type of prescription analgesic or other medication for chronic pain at baseline and at 8 weeks was also recorded . A total of 30 subjects in the Control group and 33 in the Orthotics group completed the study . All subjects completed the baseline and 8-week FIQR . The two groups were well matched in terms of age ( 45.3 ± 11.5 years in the Orthotics group vs. 47.2 ± 8.7 years in the cohort Control ) , medication use , duration of pain ( 6.5 ± 4.3 years in the Orthotics group vs. 6.2 ± 3.4 years in the cohort Control group ) , as well as baseline FIQR scores ( 55.2 ± 11.0 in the Orthotics group vs. 56.3 ± 12.2 in the cohort Control group ) . At 8 weeks , the Orthotics group had a greater reduction in the FIQR score than the cohort Control group ( reduction of 9.9 ± 5.9 vs. 4.3 ± 4.4 , respectively ) , and this was mainly due to changes in the ‘ function ’ domain of the FIQR ( reduction of 19.6 ± 9.4 in the Orthotics group vs. 8.1 ± 4.3 in the cohort Control group ) . As part of a complex intervention , in a cohort-controlled trial of primary care patients with fibromyalgia , the addition of custom-made foot orthotics to usual care appears to improve functioning in the short term

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms.

OBJECTIVES To examine the effects of a challenge with monosodium glutamate ( MSG ) as compared to placebo on the symptoms of fibromyalgia ( FM ) , in participants who initially experienced > 30 % remission of symptoms on an excitotoxin elimination diet . METHODS Fifty-seven FM patients who also had irritable bowel syndrome ( IBS ) were placed on a 4-week diet that excluded dietary additive excitotoxins including MSG and aspartame . Thirty-seven people completed the diet and 84 % of those reported that > 30 % of their symptoms resolved , thus making them eligible to proceed to challenges . Subjects who improved on the diet were then r and omised to a 2-week double-blind placebo-controlled crossover challenge with MSG or placebo for 3 consecutive days each week . The primary outcome measure was total symptom score . Secondary outcome measures included visual analogue pain scales ( VAS for FM and IBS ) , an IBS Quality of Life Question naire ( IBS QOL ) and the Fibromyalgia Impact Question naire-Revised ( FIQR ) . Repeated measures ANOVA was used to analyse crossover challenge results . RESULTS The MSG challenge , as compared to placebo , result ed in a significant return of symptoms ( total symptom score , p<0.02 ) ; a worsening of fibromyalgia severity as determined by the FIQR ( p<0.03 ) ; decreased quality of life in regards to IBS symptoms ( IBS QOL , p<0.05 ) ; and a non-significant trend toward worsening FM pain based on visual analogue scale ( VAS , p<0.07 ) . CONCLUSIONS These findings suggest that dietary glutamate may be contributing to FM symptoms in some patients . Future research on the role of dietary excitotoxins in FM is warranted

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

The efficacy of mindfulness meditation plus Qigong movement therapy in the treatment of fibromyalgia: a randomized controlled trial.

OBJECTIVE To test the short and longterm benefits of an 8 week mind-body intervention that combined training in mindfulness meditation with Qigong movement therapy for individuals with fibromyalgia syndrome ( FM ) . METHODS A total of 128 individuals with FM were r and omly assigned to the mind-body training program or an education support group that served as the control . Outcome measures were pain , disability ( Fibromyalgia Impact Question naire ) , depression , myalgic score ( number and severity of tender points ) , 6 minute walk time , and coping strategies , which were assessed at baseline and at 8 , 16 , and 24 weeks . RESULTS Both groups registered statistically significant improvements across time for the Fibromyalgia Impact Question naire , Total Myalgic Score , Pain , and Depression , and no improvement in the number of feet traversed in the 6 minute walk . However , there was no difference in either the rate or magnitude of these changes between the mind-body training group and the education control group . Salutary changes occurring by the eighth week ( which corresponded to the end of the mind-body and education control group sessions ) were largely maintained by both groups throughout the 6 month followup period . CONCLUSION While both groups showed improvement on a number of outcome variables , there was no evidence that the multimodal mind-body intervention for FM was superior to education and support as a treatment option . Additional r and omized controlled trials are needed before interventions of this kind can be recommended for treatment of FM

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

Clinical and Economic Characteristics of Patients With Fibromyalgia Syndrome

Objectives Fibromyalgia syndrome ( FMS ) is a chronic disorder defined by widespread muscle pain and multiple tender points . The objectives of this study were to estimate prevalence of comorbidities , healthcare re sources utilization , and costs associated with FMS . Methods A retrospective cohort study was conducted using data from the Quebec provincial health plans ( RAMQ ) for a r and om sample of patients with diagnoses of FMS and a control cohort of patients without FMS , matched for age and gender . Prevalence of comorbidities was estimated . Healthcare re sources consumed by FMS and non-FMS patients were identified in terms of visits to physicians , physician 's interventions , pain-related medications , nonpain-related medications , and hospitalizations . Results A total of 16,010 patients with 2 diagnoses of FMS were identified , and control patients were r and omly selected with a ratio of 1:1 . Incidence of most comorbidities was significantly higher in the FMS group and the chronic disease score ( 3.8 vs. 2.8 ; ANOVA P < 0.001 ) . The proportion of patients with at least 1 comorbidity was 87.4 % in the FMS group and 60.1 % in the control group ( χ2P<0.001 ) . The annual number of visits to physician and physician 's interventions was 25.1 for FMS and 14.8 for non-FMS patients . The amount paid by the RAMQ was significantly higher for patients with FMS ( $ 4065 ) compared with patients without FMS ( $ 2766 ) ( ANOVA P<0.001 ) . Discussion Results of this analysis of the RAMQ data base illustrate the high prevalence of comorbidities among patients with a diagnosis of FMS and strongly indicate that the economic burden of FMS is substantial

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: results of a randomized clinical trial.

OBJECTIVE Depressive symptoms are common among patients with fibromyalgia , and behavioral intervention has been recommended as a major treatment component for this illness . The objective of this study was to test the effects of the Mindfulness-Based Stress Reduction ( MBSR ) intervention on depressive symptoms in patients with fibromyalgia . METHODS This r and omized controlled trial examined effects of the 8-week MBSR intervention on depressive symptoms in 91 women with fibromyalgia who were r and omly assigned to treatment ( n = 51 ) or a waiting-list control group ( n = 40 ) . Eligible patients were at least 18 years old , willing to participate in a weekly group , and able to provide physician verification of a fibromyalgia diagnosis . Of 166 eligible participants who responded to local television news publicizing , 49 did not appear for a scheduled intake , 24 enrolled but did not provide baseline data , and 2 were excluded due to severe mental illness , leaving 91 participants . The sample averaged 48 years of age and had 14.7 years of education . The typical participant was white , married , and employed . Patients r and omly assigned to treatment received MBSR . Eight weekly 2.5-hour sessions were led by a licensed clinical psychologist with mindfulness training . Somatic and cognitive symptoms of depression were assessed using the Beck Depression Inventory administered at baseline , immediately postprogram , and at followup 2 months after the conclusion of the intervention . RESULTS Change in depressive symptoms was assessed using slopes analyses of intervention effects over time . Depressive symptoms improved significantly in treatment versus control participants over the 3 assessment s. CONCLUSION This meditation-based intervention alleviated depressive symptoms among patients with fibromyalgia

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up.

OBJECTIVE To conduct a feasibility and efficacy trial of mindfulness therapy in somatization disorder and functional somatic syndromes such as fibromyalgia , irritable bowel syndrome , and chronic fatigue syndrome , defined as bodily distress syndrome ( BDS ) . METHODS We r and omized 119 patients to either mindfulness therapy ( mindfulness-based stress reduction and some cognitive behavioral therapy elements for BDS ) or to enhanced treatment as usual ( 2-hour specialist medical care and brief cognitive behavioral therapy for BDS ) . The primary outcome measure was change in physical health ( SF-36 Physical Component Summary ) from baseline to 15-month follow-up . RESULTS The study is negative as we could not demonstrate a different development over time for the two groups ( F(3,2674)=1.51 , P=.21 ) . However , in the mindfulness therapy group , improvement was obtained toward the end of treatment and it remained present at the 15-month follow-up , whereas the enhanced treatment as usual group achieved no significant change until 15-month follow-up . The change scores averaged half a st and ard deviation which amounts to a clinical ly significant change , 29 % changed more than 1 st and ard deviation . Significant between-group differences were observed at treatment cessation . CONCLUSION Mindfulness therapy is a feasible and acceptable treatment . The study showed that mindfulness therapy was comparable to enhanced treatment as usual in improving quality of life and symptoms . Nevertheless , considering the more rapid improvement following mindfulness , mindfulness therapy may be a potentially useful intervention in BDS patients . Clinical ly important changes that seem to be comparable to a CBT treatment approach were obtained . Further research is needed to replicate or even exp and these findings

No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales . Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions . Baseline values for the observe subscale of the FFMQ were unexpectedly high .

CONTEXT AND OBJECTIVE A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia . A recent systematic review and meta- analysis of six trials indicated improvement in depressive symptoms and quality of life , calling for increased rigor and use of st and ardized measures in future trials . The purpose of the study was to examine the relationship between mindfulness [ as measured by the Five Facet Mindfulness Question naire ( FFMQ ) ] and fibromyalgia impact [ as measured by the Revised Fibromyalgia Impact Question naire ( FIQR ) ] .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Mediators of Methylphenidate Effects on Math Performance in Children with Attention-Deficit Hyperactivity Disorder

Objective : Stimulant medications , such as methylpheni date ( MPH ) , improve the academic performance of children with attention-deficit hyperactivity disorder ( ADHD ) . However , the mechanism by which MPH exerts an effect on academic performance is unclear . We examined MPH effects on math performance and investigated possible mediation of MPH effects by changes in time on-task , inhibitory control , selective attention , and reaction time variability . Methods : Children with ADHD aged 7 to 11 years ( N = 93 ) completed a timed math worksheet ( with problems tailored to each individual 's level of proficiency ) and 2 neuropsychological tasks ( Go/No-Go and Child Attention Network Test ) at baseline , then participated in a 4-week , r and omized , controlled , titration trial of MPH . Children were then r and omly assigned to their optimal MPH dose or placebo for 1 week ( administered double-blind ) and repeated the math and neuropsychological tasks ( posttest ) . Baseline and posttest videorecordings of children performing the math task were coded to assess time on-task . Results : Children taking MPH completed 23 more math problems at posttest compared to baseline , whereas the placebo group completed 24 fewer problems on posttest versus baseline , but the effects on math accuracy ( percent correct ) did not differ . Path analyses revealed that only change in time on-task was a significant mediator of MPH 's improvements in math productivity . Conclusions : MPH-derived math productivity improvements may be explained in part by increased time spent on-task , rather than improvements in neurocognitive parameters , such as inhibitory control , selective attention , or reaction time variability

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Once-a-day Concerta methylphenidate versus three-times-daily methylphenidate in laboratory and natural settings.

OBJECTIVE Methylpheni date ( MPH ) , the most commonly prescribed drug for attention-deficit/hyperactivity disorder ( ADHD ) , has a short half-life , which necessitates multiple daily doses . The need for multiple doses produces problems with medication administration during school and after-school hours , and therefore with compliance . Previous long-acting stimulants and preparations have shown effects equivalent to twice-daily dosing of MPH . This study tests the efficacy and duration of action , in natural and laboratory setting s , of an extended-release MPH preparation design ed to last 12 hours and therefore be equivalent to 3-times-daily dosing . METHODS Sixty-eight children with ADHD , 6 to 12 years old , participated in a within-subject , double-blind comparison of placebo , immediate-release ( IR ) MPH 3 times a day ( tid ) , and Concerta , a once-daily MPH formulation . Three dosing levels of medication were used : 5 mg IR MPH tid/18 mg Concerta once a day ( qd ) ; 10 mg IR MPH tid/36 mg Concerta qd ; and 15 mg IR MPH tid/54 mg Concerta qd . All children were currently medicated with MPH at enrollment , and each child 's dose level was based on that child 's MPH dosing before the study . The doses of Concerta were selected to be comparable to the daily doses of MPH that each child received . To achieve the ascending rate of MPH delivery determined by initial investigations to provide the necessary continuous coverage , Concerta doses were 20 % higher on a daily basis than a comparable tid regimen of IR MPH . Children received each medication condition for 7 days . The investigation was conducted in the context of a background clinical behavioral intervention in both the natural environment and the laboratory setting . Parents received behavioral parent training and teachers were taught to establish a school-home daily report card ( DRC ) . A DRC is a list of individual target behaviors that represent a child 's most salient areas of impairment . Teachers set daily goals for each child 's impairment targets , and parents provided rewards at home for goal attainment . Each weekday , teachers completed the DRC , and it was used as a dependent measure of individualized medication response . Teachers and parents also completed weekly st and ardized ratings of behavior and treatment effectiveness . To evaluate the time course of medication effects , children spent 12 hours in a laboratory setting on Saturdays and medication effects were measured using procedures and methods adapted from our summer treatment program . Measures of classroom behavior and academic productivity/accuracy were taken in a laboratory classroom setting during which children completed independent math and reading worksheets . Measures of social behavior were taken in structured , small-group board game setting s and unstructured recess setting s. Measures included behavior frequency counts , academic problems completed and accuracy , independent observations , teacher and counselor ratings , and individualized behavioral target goals . Reports of adverse events , sleep quality , and appetite were collected . RESULTS On virtually all measures in all setting s , both drug conditions were significantly different from placebo , and the 2 drugs were not different from each other . In children 's regular school setting s , both medications improved behavior as measured by teacher ratings and individualized target behaviors ( the DRC ) ; these effects were seen into the evening as measured by parent ratings . In the laboratory setting , effects of Concerta were equivalent to tid MPH and lasted at least through 12 hours after dosing . Concerta was significantly superior to tid MPH on 2 parent rating scores , and when asked , more parents preferred Concerta than preferred tid IR MPH or placebo . Side effects on children 's sleep and appetite were similar for the 2 preparations . In the lab setting , both medications improved productivity and accuracy on arithmetic seatwork assignments , disruptive and on-task behavior , and classroom rule following . Both medications improved children 's rule following and negative behavior in small group board games , as well as in unstructured recess setting s. Individual target behaviors also showed significant improvement with medication across domains in the laboratory setting . Children 's behavior across setting s deteriorated across the laboratory day , and the primary effect of medication was to prevent this deterioration as the day wore on . Results support the use of background behavioral treatment in clinical trials of stimulant medication , and illustrate the utility of a measure of individualized daily target goals ( ie , the DRC ) as an objective measure of medication response in both the laboratory and natural school setting s. CONCLUSION This investigation clearly supports the efficacy of the Concerta long-acting formulation of MPH for parents who desire to have medication benefits for their child throughout the day and early evening . ( ABSTRACT TRUNCATED

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Relative efficacy of long-acting stimulants on children with attention deficit-hyperactivity disorder: a comparison of standard methylphenidate, sustained-release methylphenidate, sustained-release dextroamphetamine, and pemoline.

Twenty-two children with attention deficit-hyperactivity disorder underwent a double-blind , placebo-controlled , crossover evaluation of the efficacy of st and ard methylpheni date twice a day and comparable doses every morning of a sustained-release preparation of methylpheni date ( SR-20 Ritalin ) , a sustained-release form of dextroamphetamine ( Dexedrine Spansule ) , and pemoline . The children were participating in a summer treatment program in which they engaged in recreational and classroom activities . Dependent measures include evaluations of social behavior during group recreational activities , classroom performance , and performance on a continuous performance task . Results revealed generally equivalent and beneficial effects of all four medications . Dexedrine Spansule and pemoline tended to produce the most consistent effects and were recommended for 10 of the 15 children who were responders to medication . The continuous performance task results showed that all four medications had an effect within 2 hours of ingestion , and the effects lasted for 9 hours . The implication s of these results for the use of long-acting stimulant medication in children with attention deficit-hyperactivity disorder are discussed

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

A comparison of once-daily extended-release methylphenidate formulations in children with attention-deficit/hyperactivity disorder in the laboratory school (the Comacs Study).

OBJECTIVE The objective of this study was to evaluate differences in the pharmacodynamic ( PD ) profile of 2 second-generation extended-release ( ER ) formulations of methylpheni date ( MPH ) : Meta date CD ( MCD ; methylpheni date HCl , US Pharmacopeia ) extended-release capsules , CII , and Concerta ( CON ; methylpheni date HCl ) extended-release tablets , CII . Little empirical information exists to help the clinician compare the PD effects of the available ER formulations on attention and behavior . Previous studies have shown that the near-equal doses of MCD and CON provide equivalent , total exposure to MPH as measured by area under the plasma concentration time curve , yet their pharmacokinetic ( PK ) plasma concentration versus time profiles are different . We previously offered a theoretical PK/PD account of the similarities and differences among available ER formulations based on the hypothesis that all formulations produce effects related to MPH delivered by 2 processes : 1 ) an initial bolus dose of immediate-release ( IR ) MPH that is expected to achieve peak plasma concentration in the early morning and have rapid onset of efficacy within 2 hours of dosing , which for the MCD capsule is delivered by 30 % of the total daily dose as uncoated beads and for the CON tablet is delivered by an overcoat of 22 % of the total daily dose ; and 2 ) an extended , controlled delivery of ER MPH that is expected to achieve peak plasma concentrations in the afternoon to maintain efficacy for a programmed period of time after the peak of the initial bolus , which for the MCD capsule is delivered by polymer-coated beads and for the CON tablet by an osmotic-release oral system . According to this PK/PD model , clinical superiority is expected at any point in time for the formulation with the highest MPH plasma concentration . METHODS This was a multisite , double-blind , double-dummy , 3-way crossover study of 2 active treatments ( MCD and CON ) and placebo ( PLA ) . Children with confirmed diagnoses of attention-deficit/hyperactivity disorder were stratified to receive bioequivalent doses of MCD and CON that were considered to be low ( 20 mg of MCD and 18 mg of CON ) , medium ( 40 mg of MCD and 36 mg of CON ) , or high ( 60 mg of MCD and 54 mg of CON ) , and in a r and omized order each of the study treatments was administered once daily in the morning for 1 week . On the seventh day of each treatment week , children attended a laboratory school , where surrogate measures of response were obtained by using teacher ratings of attention and deportment and a record of permanent product of performance on a 10-minute math test at each of the 7 classroom sessions spread across the day at 1.5-hour intervals . Safety was assessed by patient reports of adverse events , parent ratings on a stimulant side-effects scale , and measurement of vital signs . RESULTS The analyses of variance revealed large , statistically significant main effects for the within-subject factor of treatment for all 3 outcome measures ( deportment , attention , and permanent product ) . The interactions of treatment x session were also highly significant for all 3 outcome measures . Inspection of the PD profiles for the treatment x session interactions suggested 4 patterns of efficacy across the day : 1 ) PLA > MCD approximately CON ( PLA superiority ) immediately after dosing ; 2 ) MCD > CON > PLA during the morning ( MCD superiority ) ; 3 ) MCD approximately CON > PLA during the afternoon ( PD equivalence of MCD and CON ) ; and 4 ) CON > MCD approximately PLA in the early evening ( CON superiority ) . The effect of site was significant , because some study centers had low and some high scores for behavior in the lab classroom , but both the low- and high-scoring sites showed similar PD patterns across the day . The interaction of dose x treatment was not significant , indicating that the pattern of treatment effects was consistent across each dose level . There were no statistically significant overall differences among the 3 treatments for the frequency of treatment-emergent adverse events , ratings of side effects , or vital signs . Two additional PK/PD questions were addressed : 1 . The a priori hypothesis called for a comparison of the average of sessions ( removing session as a factor ) during a time period that corresponds to the length of a typical school day ( from 1.5 through 7.5 hours after dosing ) . For the planned contrast of the 2 treatment conditions ( MCD versus CON ) , the difference was significant , confirming the a priori hypothesis of superiority of near-equal daily doses of MCD over CON for this predefined postdosing period . 2 . In the design of the study , the dose factor represented the total daily dose , consisting of 2 components : the initial bolus doses of IR MPH , which differ for the near-equal total daily doses of MCD and CON , and the reservoir doses of ER MPH , which were the same for the 2 formulations . To evaluate the moderating effects of the bolus component of dose on outcome , average effect size ( ES ) was calculated for the efficacy outcomes at the time of expected peak PK concentration times of the initial bolus component for each formulation at the 3 dose levels . The correlation ( r ) of ES with IR MPH bolus dose was significant for each of the 3 outcome measures ( r approximately .9 ) , indicating that the magnitude of effects in the early morning may be attributed to the dose administered by the IR MPH bolus of each formulation . For the 2 dose conditions with equal 12-mg IR MPH boluses ( MCD 40 and CON 54 ) , the ESs were large and indistinguishable ( eg , deportment ES approximately 0.75 for both ) . CONCLUSIONS Once-daily doses of MCD and CON produced statistically significantly different PD effects on surrogate measures of behavior and performance among children with attention-deficit/hyperactivity disorder in the laboratory school setting . As predicted by the PK/PD model , superiority at any point in time was achieved by the formulation with the highest expected plasma MPH concentration

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Effects of OROS Methylphenidate on Academic, Behavioral, and Cognitive Tasks in Children 9 to 12 Years of Age With Attention-Deficit/Hyperactivity Disorder

Objective . To assess effects of OROS methylpheni date on cognitive and academic tasks in 9 to 12 year olds with attention-deficit/hyperactivity disorder ( ADHD ) . Methods . A double-blind , within-subject , crossover design was used to compare OROS methylpheni date with placebo in a laboratory classroom setting on several cognitive and academic tasks for 68 children who met r and omization criteria . Results . Performance on the following measures was significantly better when children received individually optimized OROS methylpheni date than placebo : math fluency and accuracy measured by the Permanent Product Math Test , ADHD symptoms observed in the laboratory setting , computerized indices of attention and impulsivity as measured by the Test of Variables of Attention ( TOVA ) , and visual — spatial working memory ( Finger Windows Backwards ) . Study medication was well tolerated ; adverse events were generally consistent with previous reports . Conclusions . OROS methylpheni date improves performance on measures of attention and vigilance , behavior , and working memory in a laboratory school setting in 9 to 12 year olds with ADHD

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD.

BACKGROUND Previous studies have demonstrated the short-term efficacy of pharmacotherapy and behavior therapy for attention-deficit/hyperactivity disorder ( ADHD ) , but no longer-term ( i.e. , > 4 months ) investigations have compared these 2 treatments or their combination . METHODS A group of 579 children with ADHD Combined Type , aged 7 to 9.9 years , were assigned to 14 months of medication management ( titration followed by monthly visits ) ; intensive behavioral treatment ( parent , school , and child components , with therapist involvement gradually reduced over time ) ; the two combined ; or st and ard community care ( treatments by community providers ) . Outcomes were assessed in multiple domains before and during treatment and at treatment end point ( with the combined treatment and medication management groups continuing medication at all assessment points ) . Data were analyzed through intent-to-treat r and om-effects regression procedures . RESULTS All 4 groups showed sizable reductions in symptoms over time , with significant differences among them in degrees of change . For most ADHD symptoms , children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care . Combined and medication management treatments did not differ significantly on any direct comparisons , but in several instances ( oppositional/aggressive symptoms , internalizing symptoms , teacher-rated social skills , parent-child relations , and reading achievement ) combined treatment proved superior to intensive behavioral treatment and /or community care while medication management did not . Study medication strategies were superior to community care treatments , despite the fact that two thirds of community-treated subjects received medication during the study period . CONCLUSIONS For ADHD symptoms , our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication . Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms , but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Reliability and validity of the SKAMP rating scale in a laboratory school setting.

In children with attention deficit hyperactivity disorder ( ADHD ) , the effects of methylpheni date were investigated in a pharmacodynamic comparison of placebo and the st and ard b.i.d . administration of methylpheni date . In each of these conditions , teachers completed ratings in classroom setting s at times chosen to coincide with expected " peaks " and " troughs " of serum concentrations in the b.i.d . condition . Analyses of variance ( ANOVAs ) revealed the expected differences between the two conditions in the laboratory classroom setting using st and ard rating scales ( Conners and the IOWA Conners ) and a new rating scale ( the SKAMP ) , which specifically measures the classroom manifestation of ADHD . The psychometric properties of the SKAMP were evaluated by calculating test-retest reliability and by calculating correlations with the st and ard rating scales to establish concurrent validity

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Stimulant Medication and Reading Performance

The study examined the sustained effects of methylpheni date on reading performance in a sample of 42 boys , ages 8 to 11 , with attention deficit-hyperactivity disorder ( ADHD ) . Two subgroups were formed based on the presence or absence of co-occurring conduct disorders . Subjects were selected on the basis of their positive response to methylpheni date as determined in a series of original medication trials ( Forness , Cantwell , Swanson , Hanna , & Youpa , 1991 ) . For the purpose of this study , subjects were placed on their optimal dose of medication for a 6-week period and then tested on measures of oral reading and reading comprehension equivalent to those used in the original trials , retested after a week without medication ( placebo ) , then tested again the following week after return to medication . Only the subgroup with conduct disorders responded , and this response was limited to reading comprehension improvement in only those subjects who also demonstrated improvement in oral reading on original trials . No response differences were found between subjects with or without learning disabilities

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

A dose-response analysis of the effects of methylphenidate on the peer interactions and simulated classroom performance of ADD children with and without conduct problems.

To examine the social effects of methylpheni date , groups of 15 attention-deficit disordered boys with ( ADD ) and 15 ADD boys without conduct problems ( ADD/CP ) were paired with normal peers . ADD and ADD/CP children showed a different pattern of responses to methylpheni date . While on task behavior in ADD/CP dyads increased at 0.15 mg/kg doses , increases in ADD dyads were not observed until doses reached 0.50 mg/kg . Although controlling interaction in ADD children decreased at 0.15 mg/kg , the controlling behavior of ADD/CP children did not decline at either dose . Peers of both ADD and ADD/CP children showed reciprocal declines in controlling behavior . In both free play and cooperative task situations , 0.15 mg/kg increased social interaction in ADD boys and decreased social interaction in ADD/CP boys

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

A longitudinal examination of neuropsychological and clinical functioning in boys with attention deficit hyperactivity disorder (ADHD): improvements in executive functioning do not explain clinical improvement.

BACKGROUND Attention deficit hyperactivity disorder ( ADHD ) often , but not always , persists into adulthood . Investigations of the associations between clinical and biological markers of persistence can shed light on causal pathways . It has been proposed that compensatory improvements in executive neuropsychological functioning are associated with clinical improvements . This is the first study to test this hypothesis prospect ively . METHOD The clinical and neuropsychological functioning of 17 boys with ADHD ( mean age 10.45 years at time 1 ; 14.65 years at time 2 ) and 17 typically developing ( TYP ) boys ( mean age 10.39 years at time 1 ; 14.47 years at time 2 ) was tested on two occasions , 4 years apart . This was done using a battery of st and ardized neuropsychological tests that included tasks with high and low executive dem and s. RESULTS Clinical improvements were observed over time . Neuropsychological performance improvements were also evident , with ADHD boys developing with a similar pattern to TYP boys , but with a developmental lag . Whilst there was an association between reduced symptoms and superior performance at retest for one task with a high executive dem and ( spatial working memory ) , this was not seen with two further high executive dem and tasks [ Stockings of Cambridge and intra-dimensional extra-dimensional ( ID/ED ) set shifting ] . Also , there was no association between change in executive functioning and change in symptoms . Baseline performance on the ID/ED set-shifting task predicted better clinical outcome . Only change in performance on the low executive dem and delayed matching-to- sample task predicted better clinical outcome . CONCLUSIONS These data highlight the importance of longitudinal measurements of cognition , symptoms and treatment response over time in children and adolescents with ADHD

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Differential Effects of Stimulant Medication on Reading Performance of Boys With Hyperactivity With and Without Conduct Disorder

Controversy surrounding stimulant medication , particularly its effects on reading performance , continues to obscure the issue of the use of this drug in classroom situations . The present study emphasized careful differential diagnosis , double-blind and placebo approaches , and curriculum-based dependent measures to address these concerns . Methylpheni date was administered to two groups of boys , ages 8 through 11 . The two groups included 27 subjects meeting criteria for attention deficit-hyperactivity disorder but not conduct disorder , known as hyperactive disorder ( HD ) , and 28 subjects meeting criteria for both diagnostic categories , known as hyperactive-aggressive ( HA ) . Only four subjects in each group met a discrepancy criterion for learning disabilities ( LD ) . Methylpheni date was administered to both groups at three levels of dosage , along with baseline and placebo conditions . Dependent measures involved both reading recognition and reading comprehension , equivalent across all conditions . No significant results were found for the group with HD in either reading recognition or comprehension , due largely to unusual placebo reactions . Results were generally in the direction predicted for the group with HA , but only significantly so in reading comprehension , and no dose effect was found on this variable . Implication s for reading as a dependent measure of medication effects are discussed

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Comparative efficacy of once–a–day extended–release methylphenidate, two–times–daily immediate–release methylphenidate, and placebo in a laboratory school setting

Abstract Background Given the dosing limitations of methylpheni date short – acting preparations in treating ADHD , galenics with longer release of the substance were developed mainly to avoid drug intake during school hours . Objectives This investigation was conducted to assess the efficacy and the duration of action of a new extended-release formulation of methylpheni date ( Medikinet ® retard ) as a once – daily treatment for children with attention – deficit hyperactivity disorder ( ADHD ) . Method This was a r and omized , double – blind , crossover multicentre study with three treatment conditions : once – daily extended – release methylpheni date , twice – daily immediate – release methylpheni date and placebo given to 79 children ( 8–14 years old ) with ADHD . Daily assessment s in an analogue classroom setting included blind ratings of attention and deportment and a performance measure ( math test ) obtained 5 times over an 8–hour period . Secondary measures included an ADHD rating scale , based on DSMIV/ ICD–10 separately rated for the morning and the afternoon . Results Both active treatment conditions displayed significant time course effects and were superior to placebo in improving all efficacy measures . Once a day extended – release methylpheni date was not different from the same dose of twice daily immediate – release methylpheni date . Conclusions These data provide support for the benefit of this novel , once-daily methylpheni date preparation in the treatment of ADHD . The longer duration of action of Medikinet Retard has the potential to simplify psychostimulant treatment , thus reducing dose diversion and eliminating the need for in – school administration

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

The Effects of Methylphenidate on Word Decoding Accuracy in Boys With Attention-Deficit/Hyperactivity Disorder

The investigation aim ed to delineate the immediate effect of methylpheni date on decoding in the comorbid condition of attention-deficit/hyperactivity disorder and reading disorder . Boys with attention-deficit/hyperactivity and reading disorders ( n = 25 ) between the ages of 7.9 and 11.7 years , with at least average intelligence and verbal processing abilities participated in a double-blind , acute , r and omized , placebo-controlled crossover trial with a single dose of methylpheni date 0.3 to 0.4 mg/kg with weekly intervals between testing sessions . The test battery included tasks of attention/control functions and reading domain functions . Paired comparisons and first trial group comparison comparing performance under placebo and under methylpheni date were used . Methylpheni date selectively improved strategy /set shift ( P = 0.004 ) and facilitated improvement both in rapid naming ( P = 0.043 ) and word/nonword accuracy ( P = 0.028/P = 0.035 ) . These findings lend support to a possible influence of methylpheni date on cognitive attention functions related to reading skills in the comorbid group

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Sustained release and standard methylphenidate effects on cognitive and social behavior in children with attention deficit disorder.

Two studies were conducted to investigate the relative effects of sustained release methylpheni date ( Ritalin [ SR-20 ] ) and st and ard methylpheni date ( Ritalin , 10 mg , administered twice daily ) . In the first study , 13 boys with attention deficit disorder participating in a summer treatment program went through a double-blind , within-subject trial of each form of methylpheni date and placebo . Measures of social and cognitive behavior were gathered in classroom and play setting s. Although group analyses of the data showed that both drugs were effective and there were few differences between them , st and ard methylpheni date was superior to SR-20 on several important measures of disruptive behavior . Furthermore , analyses of individual responsivity showed clearly that most boys responded more positively to st and ard methylpheni date than to SR-20 . The second study involved a partially overlapping group of nine boys with attention deficit disorder participating in the same summer treatment program . Also double-blind , within-subject , and placebo controlled , this study tracked the time courses of the two forms of methylpheni date . Both were shown to have similar time courses on the Abbreviated Conners Rating Scale and other measures , but SR-20 had a slower onset than did the st and ard drug form on a continuous performance task . Effects of SR-20 were still evident eight hours after ingestion

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Short term effects of methylphenidate on the cognitive, learning and academic performance of children with attention deficit disorder in the laboratory and the classroom.

Sixteen children meeting diagnostic criteria for Attention Deficit Disorder with Hyperactivity ( ADD-H ) were tested on methylpheni date ( 0.3 mg/kg ) and placebo on cognitive , learning , academic and behavioral measures in a double-blind study . Assessment s were carried out in the laboratory and in the children 's regular classrooms . Results indicate methylpheni date -induced improvements on a majority of the measures . Drug-induced changes reflected increased output , accuracy and efficiency and improved learning acquisition . There was also evidence of increased effort and self-correcting behaviours . It is argued that review ers have underestimated the potential of stimulants to improve the performance of ADD-H children on academic , learning and cognitive tasks

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Pharmacokinetics and therapeutic effect of OROS methylphenidate under different breakfast conditions in children with attention-deficit/hyperactivity disorder.

OBJECTIVE To examine the pharmacokinetics ( PKs ) and pharmacodynamics ( PDs ) of OROS methylpheni date ( OROS MPH ) dosed once daily ( QD ) versus an early st and ard regimen ( immediate-release [ IR ] MPH dosed three times daily [ TID ] ) under various breakfast conditions . METHODS This single-center , double-blind , double-dummy , r and omized , crossover study of OROS MPH ( NCT00269815 ) in children aged 6 to 12 years with attention-deficit/hyperactivity disorder evaluated the PKs and PDs of MPH given with different breakfast conditions : OROS MPH administered after a high-fat breakfast , after a normal breakfast , or after fasting and IR MPH administered after a normal breakfast or after fasting in the morning and at two subsequent time points during the day . To maximize information , patients were divided into two groups , each receiving three of the five treatments for 1 day in a three-period , r and omized , crossover design . Patients were assigned to 1 of 3 dosage levels ( OROS MPH 18 , 36 , and 54 mg QD , and an assumed equivalent regimen of IR MPH 5 , 10 , and 15 mg given TID ) based on their pre study established clinical dose of IR MPH . PD measurements included Combined-Attention and Deportment scores on a rating scale of school behavior ( the Swanson , Kotkin , Agler , M-Flynn , and Pelham ) , global assessment s of efficacy , and activity monitor levels during academic seatwork . Serial blood sample s for PK analysis were taken predose , and then every 60 to 90 minutes until 11.5 hours postdose . Vital signs were assessed predose , and then every 1.5 to 2.5 hours until 11.5 hours postdose . RESULTS Of the 32 patients enrolled , 31 completed the study . The PK profiles for MPH after OROS MPH administration were similar under all conditions ( with normal , high-fat breakfast , or fasting ) . No bioequivalence tests of OROS MPH and IR MPH under various breakfast conditions were done because there were so few patients in each dose level of treatment . The two IR MPH conditions ( after normal breakfast and fasting ) were not compared . The drug-to-metabolite ratios ( area under the curve ) for all OROS MPH and IR MPH treatments were similar . OROS MPH and IR MPH provided a similar therapeutic effect , irrespective of breakfast conditions , as demonstrated by the Swanson , Kotkin , Agler , M-Flynn , and Pelham Attention and Deportment measures and global assessment s. No serious adverse events , no deaths , and no clinical ly significant changes in vital signs were reported , except for one patient who was discontinued early because of repeated systolic blood pressure elevations on study day 1 . CONCLUSIONS The results of this study demonstrate that in children with attention-deficit/hyperactivity disorder , administering OROS MPH with or without food produces similar PK and PD profiles

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Methylphenidate in Children With ADHD With or Without Learning Disability

Objective : To explore treatment response to Osmotic Release Oral System ® ( OROS ) methylpheni date in children with ADHD with and without comorbid learning disability ( LD ) . Method : Data were analyzed from two 6-week , double-blind , r and omized , placebo-controlled , crossover studies evaluating individually determined doses of OROS methylpheni date versus placebo in 135 children ( ages 9 to 12 years ) with ADHD with or without an LD in reading , math , or both . The sample was demographically diverse , with 31 % females and more than 40 % minority , predominantly African American and Hispanic . On two laboratory school days , participants received either OROS methylpheni date or placebo and were given a battery of cognitive and behavioral tests . Results : Treatment with OROS methylpheni date led to improvement in ADHD Rating Scale scores for participants with or without comorbid LD . Both groups performed better during treatment with OROS methylpheni date than placebo on measures of cognitive skills ( i.e. , Test of Variables of Attention , Finger Windows Backwards ) , academically related tasks ( i.e. , Dynamic Indicators of Basic Early Literacy Skills , Test of H and writing Skills – Revised , Permanent Product Math Test ) , and observed classroom behavior ( i.e. , Swanson , Kotkin , Alger , M-Flynn , and Pelham Scale ) . Conclusion : In children with ADHD with or without comorbid LD , behavior and performance improved during treatment with OROS methylpheni date

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Methylphenidate and children with attention deficit disorder. Dose effects on classroom academic and social behavior.

The short-term , dose-response effects of methylpheni date hydrochloride were evaluated on academic and social classroom measures in 29 children with attention deficit disorder . In a double-blind , cross-over design with order r and omized , children received a placebo for two weeks and three doses of methylpheni date hydrochloride ( 0.15 mg/kg , 0.3 mg/kg , and 0.6 mg/kg ) for one week each . Dependent measures included the output and accuracy of performance in grade -appropriate reading comprehension workbooks and arithmetic problems , spelling word acquisition , and observations of disruptive and on-task behavior . Beneficial drug effects and linear dose-response curves on all dependent measures were found . The results suggest that beneficial methylpheni date effects on classroom behavior may be accompanied by enhanced academic achievement in some hyperactive children

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Comparative effects of methylphenidate on ADD girls and ADD boys.

The effects of 0.3 mg/kg methylpheni date were compared for 12 ADD boys and 12 ADD girls participating in a summer treatment program for children with behavior and /or learning problems . Previous investigations have suggested that ADD girls may differ from ADD boys in some important respects . No information exists regarding whether the effects of the most common treatment for these children , methylpheni date , has comparable effects on boys and girls . The boys and girls were matched for age and IQ . The results revealed equivalent and beneficial effects of methylpheni date for both boys and girls . Methylpheni date therefore would appear to be as useful a treatment for ADD girls as for ADD boys

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Time Course of Treatment Effect of OROS® Methylphenidate in Children With ADHD

Objective : The authors evaluated the time course of the treatment effect of Osmotic-Release Oral System methylpheni date ( OROS ® MPH ) HCl ( Concerta ® , Raritan , NJ ) CII in children with ADHD . Method : Data were combined from two double-blind , r and omized , placebo-controlled , cross-over , analog classroom studies in children ( 9 - 12 years ) with ADHD . Participants received an individualized dose of placebo or OROS ® MPH on two laboratory school days . Permanent Product Math Test and Swanson , Kotkin , Agler , M-Flynn , and Pelham scores were evaluated 0.5 hr before dosing and 1 , 2 , 4 , 10 , 11 , and 12.5 hr post dose . Analysis used a repeated- measures mixed model . Results : Treatment effects were present at all postdose assessment points ( p < .0001 for all comparisons , n = 139 ) . Adverse events were similar to previous reports for OROS ® MPH . Conclusion : A robust treatment effect occurred with OROS ® MPH ; onset was at 1 hr and persisted for at least 12.5 hr after dosing

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Childhood hyperactivity and psychostimulants: a review of extended treatment studies.

ABSTRACT Clinical trials with a treatment duration of at least 3 months were review ed to determine the effect of psychostimulants on the core symptoms of attention-deficit hyperactivity disorder ( ADHD ) and on its commonly associated features . Eighteen studies were identified : 17 were studies of methylpheni date , 1 was a study of dextroamphetamine , and none involved pemoline or slow-release stimulants . Eleven of these studies were r and omized controlled trials , whereas seven employed quasi-experimental design s without r and omization . The results of r and omized controlled trials showed that psychostimulants provided greater benefit than did the nonr and omized trials , suggesting that the efficacy of extended treatment may have been underestimated because more seriously disturbed children were assigned to medication treatment than to control treatments in nonr and omized trials . Evidence from the more definitive r and omized controlled trials indicates that stimulants are more effective in ameliorating the core behavioral symptoms of ADHD ( restlessness , inattentiveness , impulsiveness ) than placebos , nonpharmacological therapies , or no treatment-at least in 3 - 7-month trials . During extended psychostimulant treatment , few children become symptom-free , clinical effects may diminish with time , and improvement dissipates rapidly upon discontinuation of medication . There is minimal evidence that extended stimulant treatment improves cognitive deficits or associated problems such as conduct disturbance , low self-esteem , poor peer relationships , or academic underachievement . The belief that stimulants do not improve the long-term prognosis of children with ADHD may be based on weakly design ed studies that focus on associated rather than core symptoms . A failure to assign patients of similar clinical severity to different treatment conditions may also have contributed to obscuring the efficacy of extended psychostimulant treatments

None of the mediators or moderators tested affected methylpheni date efficacy . Academic improvements were small compared to symptom improvements ; qualitative changes limited to math .

Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD . Previous review s on stimulant-related academic improvements are inconclusive and focus on task engagement . Recent literature suggests outcome -domain-specific medication effects that are larger for productivity than for accuracy . The aims of this study are quantifying methylpheni date effects on academic productivity and accuracy for math , reading , spelling ; exploring the mediating or moderating effects of symptom improvements , demographic- , design - and disorder-related variables .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Population-based cohort study of injuries.

A population -based cohort study was done to estimate the incidence of different types of injuries and to evaluate certain risk factors in an urban slum ; 4333 slum dwellers in Madras city in India were r and omly selected by cluster sampling , of whom 1.7 per cent were lost during the 12 months of follow up . The cumulative injury incidence for 12 months for all injuries was 127 per 1000 persons ( 95 per cent confidence interval 117 - 137 ) ; for males 137 per 1000 and for females 118 per 1000 . Incidence of unintentional injury was 121 per 1000 persons . The incidence for road traffic injury was 16 per 1000 persons , for household injuries 57 per 1000 persons and for injury at place of work 19 per 1000 persons . The relative risk of males to females for traffic injuries was 3.04 and for household injuries was 0.39 . The relative risk of traffic injuries among adult males who reported daily alcohol consumption was 2.26 . The incidence of injury is high in an urban slum and it is a priority health problem . This study has identified groups of people who are at high risk for injuries and who may need specific protective measures

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

The pilot study.

This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

A longitudinal study of the effect of subcutaneous estrogen replacement on bone in young women with Turner's syndrome.

It is desirable that young women with primary ovarian failure achieve normal peak bone mass to reduce the subsequent risk of osteoporosis , and that there are management strategies to replace bone that is already lost . While estrogen ( E2 ) is generally considered to prevent bone loss by suppressing bone resorption , it is now recognized that estrogen also exerts an anabolic effect on the human skeleton . In this study , we tested whether estrogen could increase bone mass in women with primary ovarian failure . We studied the mechanism underlying this by analyzing biochemical markers of bone turnover and iliac crest biopsy specimens obtained before and 3 years after E2 replacement . Twenty-one women with Turner 's syndrome , aged 20 - 40 years , were studied . The T scores of bone mineral density at lumbar spine and proximal femur at baseline were -1.4 and -1.1 , respectively . Hormone replacement was given as subcutaneous E2 implants ( 50 mg every 6 months ) with oral medroxy progesterone . Serum E2 levels increased incrementally from 87.5 pM at baseline to 323 , 506 , 647 , and 713 pM after 6 months and 1 , 2 , and 3 years of hormone replacement therapy ( HRT ) , respectively . The bone mineral density at the lumbar spine and proximal femur increased after 3 years to T scores of -0.2 and -0.4 , respectively . The cancellous bone volume increased significantly from 13.4 % to 18.8 % . There was a decrease in activation frequency , but the active formation period was increased by HRT . There was a significant increase in the wall thickness from 33.4 microm at baseline to 40.9 microm after 3 years of HRT , reflecting an increase in bone formed at individual remodeling units . Although there was an early increase in biochemical markers of bone formation , these declined thereafter . Our results show that estrogen is capable of exerting an anabolic effect in the skeleton of young women with Turner 's syndrome and low bone mass

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Insulin resistance and body composition in Turner syndrome: Effect of sequential change in the route of estrogen administration

The aim of the present study was to examine the impact of sequential change in the route of estrogen administration on body composition and insulin resistance in patients with Turner syndrome ( TS ) using cyclical hormone replacement therapy ( HRT ) with conjugated equine estrogens ( CEE ) plus medroxyprogesterone acetate ( MPA ) . We carried out a self-controlled study of nine non-obese patients with TS , with an average age of 23 ± 4.9 years . Body mass index ( BMI ) , waist-to-hip ratio ( WHR ) , fasting glycemia , insulin tolerance ( glucose disappearance constant during an insulin tolerance test , kITT ) and body composition ( dual-energy X-ray absorptiometry ) were studied after 1 year 's use of CEE plus MPA and repeated after 1 year 's use of 17β-estradiol gel with the same schedule of MPA administration . We did not observe any difference between the oral and percutaneous HRT with regard to BMI , WHR and insulin tolerance ( kITT : 4.9 ± 1.5 vs. 5.3 ± 1.5%/min , p = 0.8 ) . During administration of the 17β-estradiol gel a tendency to increased total lean mass ( p = 0.054 ) was observed . We conclude that sequential change in the route of estrogen administration in TS patients using cyclical HRT with CEE and MPA does not affect insulin resistance , although use of percutaneous 17β-estradiol gel seems to exert favorable changes in body composition

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Health-related quality of life of young adults with Turner syndrome following a long-term randomized controlled trial of recombinant human growth hormone

Background There are limited long-term r and omized controlled trials of growth hormone ( GH ) supplementation to adult height and few published reports of the health-related quality of life ( HRQOL ) following treatment . The present follow-up study of young adults from a long-term controlled trial of GH treatment in patients with Turner syndrome ( TS ) yielded data to examine whether GH supplementation result ed in a higher HRQOL ( either due to taller stature or from the knowledge that active treatment and not placebo had been received ) or alternatively a lower HRQOL ( due to medicalization from years of injections ) . Methods The original trial r and omized 154 Canadian girls with TS aged 7 - 13 years from 13 centres to receive either long-term GH injections at the pharmacologic dose of 0.3 mg/kg/week or to receive no injections ; estrogen prescription for induction of puberty was st and ardized . Patients were eligible for the follow-up study if they were at least 16 years old at the time of follow-up . The instrument used to study HRQOL was the SF-36 , summarized into physical and mental component scales ( PCS and MCS ) ; higher scores indicate better HRQOL . Results Thirty-four of the 48 eligible participants ( 71 % ) consented to participate ; data were missing for one patient . Both groups ( GH and no treatment ) had normal HRQOL at this post-treatment assessment . The GH group had a ( mean ± SD ) PCS score of 56 ± 5 ; the untreated group 58 ± 4 ; mean score for 16 - 24 year old females in the general population 53.5 ± 6.9 . The GH group had a mean MCS score of 52 ± 6 ; the untreated group 49 ± 13 ; mean score for 16 - 24 year old females in the general population 49.6 ± 9.8 . Secondary analyses showed no relationship between HRQOL and height . Conclusions We found no benefit or adverse effect on HRQOL either from receiving or not receiving growth hormone injections in a long-term r and omized controlled trial , confirming larger observational studies . We suggest that it remains ethically acceptable as well as necessary to maintain a long-term untreated control group to estimate the effects of pharmacological agents to manipulate adult height . Young adult women with TS have normal HRQOL suggesting that they adjust well to their challenges in life . Trial Registration Clinical Trials.gov Identifier NCT00191113

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Decreased bone mass despite long-term estrogen replacement therapy in young women with Turner's syndrome and previously normal bone density.

OBJECTIVE To determine whether young women with Turner 's syndrome who had normal bone mineral density ( BMD ) before the induction of puberty maintain normal BMD in young adulthood . DESIGN Controlled clinical study . SETTING A private hospital clinical research setting . PATIENTS Young women with Turner 's syndrome in Tanner stage V of puberty with previously normal BMD . INTERVENTIONS Oral conjugated estrogens and progesterone acetate were administered continuously for a mean ( + /-SD ) of 4.1+/-1.0 years . Bone mineral densities and blood sample s were evaluated . MAIN OUTCOME MEASURE(S ) The BMD of the lumbar spine and the femoral neck was determined during young adulthood . The change in BMD over the previous 6 years also was evaluated . Serum concentrations of the carboxy-terminal propeptide of type 1 collagen and of the carboxy-terminal cross-linked telopeptide of type 1 collagen were measured . RESULT ( S ) The BMD of the lumbar spine was reduced significantly in our patients . There was no change in the BMD of the femoral neck or lumbar spine over a period of 6.1 years . Concentrations of the carboxy-terminal propeptide of type 1 collagen were decreased , whereas concentrations of the carboxy-terminal cross-linked telopeptide of type 1 collagen were increased . CONCLUSION ( S ) Young women with Turner 's syndrome do not attain normal peak bone mass even when estrogen replacement therapy is begun in adolescence . Their low BMD seems to be due to decreased bone formation and increased bone resorption

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

A randomized trial of transdermal and oral estrogen therapy in adolescent girls with hypogonadism

Background Adolescent females with ovarian failure require estrogen therapy for induction of puberty and other important physiologic effects . Currently , health care providers have varying practice s without evidence -based st and ards , thus investigating potential differences between oral and transdermal preparations is essential . The purpose of this study was to compare the differential effects of treatment with oral conjugated equine estrogen ( OCEE ) , oral 17β estradiol ( OBE ) , or transdermal 17β estradiol ( TBE ) on biochemical profiles and feminization in girls with ovarian failure . Study design 20 prepubertal adolescent females with ovarian failure , ages 12–18 years , were r and omized to OCEE ( n = 8) , OBE ( n = 7 ) , or TBE ( n = 5 ) for 24 months . Estrogen replacement was initiated at a low dose ( 0.15 mg OCEE , 0.25 mg OBE , or 0.0125 mg TBE ) and doubled every 6 months to a maximum dose of 0.625 mg/d OCEE , 1 mg/d OBE , or 0.05 mg/d TBE . At 18 months , micronized progesterone was added to induce menstrual cycles . Biochemical markers including sex hormones , inflammatory markers , liver enzymes , coagulation factors , and lipids were obtained at baseline and 6 month intervals . Differences in levels of treatment parameters between the groups were evaluated with one-way analysis of variance ( ANOVA ) . The effect of progesterone on biochemical markers was evaluated with the paired t-test . Results Mean ( ±SE ) estradiol levels at maximum estrogen dose ( 18 months ) were higher in the TBE group ( 53 ± 19 pg/mL ) compared to OCEE ( 14 ± 5 pg/mL ) and OBE ( 12 ± 5 pg/mL ) ( p ≤ 0.01 ) . The TBE and OBE groups had more effective feminization ( 100 % Tanner 3 breast stage at 18 months ) . There were no statistical differences in other biochemical markers between treatment groups at 18 months or after the introduction of progesterone . Conclusions Treatment with transdermal 17β estradiol result ed in higher estradiol levels and more effective feminization compared to oral conjugated equine estrogen but did not result in an otherwise different biochemical profile in this limited number of heterogeneous patients . OBE and TBE provide safe and effective alternatives to OCEE to induce puberty in girls , but larger prospect i ve r and omized trials are required . Trial registration Clinical Trials Identifier : NCT01023178

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Comparison of Transdermal and Oral Estrogen Therapy in Girls with Turner's Syndrome

Eight girls with Turner 's syndrome were given low dose oral ethinyl estradiol or transdermal 17 beta-estradiol in order to compare the effect of the route of administration on selected markers of hepatic metabolism , and various hormonal concentrations . Oral estrogen was given at a dose of 100 ng/kg/day and transdermal estrogen via adhesive skin patch at 0.0125 mg/kg/day . The subjects received one form of estradiol for one month , and after a one month washout period , received the other form . Both oral and transdermal estradiol caused a significant decrease in FSH while only transdermal result ed in a significant decrease in LH . Oral estradiol , though not transdermal estradiol , increased serum high density lipoprotein , thyroxine binding protein and growth hormone binding protein . Urinary growth hormone excretion increased after both forms of therapy , while insulin-like growth factor-I and insulin-like growth factor binding protein-3 remained unchanged . Thus , in girls with Turner 's syndrome , estrogen replacement by the transdermal route may have less deleterious effect on hepatic metabolism than oral estrogen

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Androgen replacement therapy in Turner syndrome: a pilot study.

CONTEXT Women with Turner syndrome ( TS ) have reduced levels of and rogens due to ovarian failure . HYPOTHESES Morbidity associated with TS , such as bone fragility , metabolic changes , obesity , neurocognitive profile , and sexual problems may partly relate to and rogen insufficiency and improve on and rogen replacement therapy ( ART ) . OBJECTIVES The objective of the study was to determine the effect of and rogens on morbidity in TS . DESIGN Fourteen TS women ( aged 17 - 27 yr ) participated in a r and omized , double-blind , placebo-controlled crossover pilot . The study was conducted in a hospital outpatient clinic between December 2001 and July 2004 . INTERVENTION TS patients were on estrogen/progestin replacement therapy . Subjects received oral 1.5 mg methyl testosterone ( ART ) or placebo for 1 yr and the alternative for another year . MAIN OUTCOME MEASURES The study compared body composition as a primary outcome , and physiology , biochemistry , visceral fat , cognition , and quality of life ( QOL ) as secondary outcomes . RESULTS ART as compared with placebo reduced total cholesterol , triglycerides , and high-density lipoprotein cholesterol . It improved bone mineral density , increased lean body mass , and decreased fat mass . ART improved attention , reaction time , and verbal memory and had no effect on executive functions and spatial cognition . Patients reported improved QOL , including general health , coping with stress , and sexual desire . CONCLUSIONS And rogen insufficiency plays a role in TS-impaired body composition , neurocognition , and QOL , and these aspects improve with ART , which was safe and effective when given for 1 yr

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Choosing an oestrogen replacement therapy in young adult women with Turner syndrome*

OBJECTIVE Hormone replacement therapy ( HRT ) is prescribed to most patients with Turner syndrome ( TS ) although its use in adult TS patients has not been scientifically evaluated . The present study was performed to compare the short‐term effects in adult women with Turner syndrome of low‐dose oral conjugated oestrogen ( 0·625 mg , CE ) with relatively high dose ethinyl oestradiol ( 30 µg , EE2 ) ; both combined with an oral progestin

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Growth hormone and 17 beta-oestradiol treatment of Turner girls--2-year results.

Girls with Turner syndrome are mainly characterized by growth retardation and gonadal insufficiency . In order to evaluate the effect of growth hormone ( GH ) and /or low dose 17 beta-oestradiol ( E2 ) on growth and pubertal development , 39 Turner girls with a chronological age ( CA ) of 7.6 - 18.1 years were divided into three groups depending on pretreatment bone age ( BA ) . They were treated with either GH 0.1 IE/kg per day ( n = 13 , BA 7.1 - 10.2 ) , peroral E2 0.01 mg/kg per day ( n = 8 , BA 8.5 - 12.7 ) or both ( n = 18 , BA 10.5 - 15.3 ) . In the 2nd year the E2 group also received GH , while the E2 dose was reduced 30 % . In the 1st year height velocity ( HV ) expressed as st and ard deviation scores ( SDS ) increased in all groups ( mean ) : from -0.4 to 3.3 ( P < 0.01 ) in the GH group , -0.5 to 2.7 ( P < 0.01 ) in the E2 group , and -0.8 to 4.6 ( P < 0.001 ) in the GH+E2 group . A possible synergistic effect from combination therapy was seen , as HV increase was higher in group 3 than groups 1 and 2 ( P < 0.05 ) . In the 2nd year HV was unchanged in groups 1 and 2 , while a clear decrease was seen in the GH+E2 group ( P < 0.001 ) . In the 1st year BA progression in the E2 group was rapid ( 1.9 BA/CA year ) and higher than in the other groups ( P < 0.05 ) . In the 2nd year progression slowed down -- particularly in the E2 group ( 0.7 BA/CA year , P = 0.07 ) . ( ABSTRACT TRUNCATED AT 250 WORDS

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Nonoptimal Lipids Commonly Present in Young Adults and Coronary Calcium Later in Life: The CARDIA (Coronary Artery Risk Development in Young Adults) Study

BACKGROUND Dyslipidemia causes coronary heart disease in middle-aged and elderly adults , but the consequences of lipid exposure during young adulthood are unclear . OBJECTIVE To assess whether nonoptimal lipid levels during young adulthood cause atherosclerotic changes that persist into middle age . DESIGN Prospect i ve cohort study . SETTING 4 cities in the United States . PARTICIPANTS 3258 participants from the 5115 black and white men and women recruited at age 18 to 30 years in 1985 to 1986 for the CARDIA ( Coronary Artery Risk Development in Young Adults ) study . MEASUREMENTS Low-density lipoprotein ( LDL ) and high-density lipoprotein ( HDL ) cholesterol , triglycerides , and coronary calcium . Time-averaged cumulative exposures to lipids between age 20 and 35 years were estimated by using repeated serum lipid measurements over 20 years in the CARDIA study ; these measurements were then related to coronary calcium scores assessed later in life ( 45 years [ SD , 4 ] ) . RESULTS 2824 participants ( 87 % ) had nonoptimal levels of LDL cholesterol ( > or=2.59 mmol/L [ > or=100 mg/dL ] ) , HDL cholesterol ( < 1.55 mmol/L [ < 60 mg/dL ] ) , or triglycerides ( > or=1.70 mmol/L [ > or=150 mg/dL ] ) during young adulthood . Coronary calcium prevalence 2 decades later was 8 % in participants who maintained optimal LDL levels ( < 1.81 mmol/L [ < 70 mg/dL ] ) , and 44 % in participants with LDL cholesterol levels of 4.14 mmol/L ( 160 mg/dL ) or greater ( P < 0.001 ) . The association was similar across race and sex and strongly grade d , with odds ratios for coronary calcium of 1.5 ( 95 % CI , 0.7 to 3.3 ) for LDL cholesterol levels of 1.81 to 2.56 mmol/L ( 70 to 99 mg/dL ) , 2.4 ( CI , 1.1 to 5.3 ) for levels of 2.59 to 3.34 mmol/L ( 100 to 129 mg/dL ) , 3.3 ( CI , 1.3 to 7.8 ) for levels of 3.37 to 4.12 mmol/L ( 130 to 159 mg/dL ) , and 5.6 ( CI , 2.0 to 16 ) for levels of 4.14 mmol/L ( 160 mg/dL ) or greater , compared with levels less than 1.81 mmol/L ( < 70 mg/dL ) , after adjustment for lipid exposure after age 35 years and other coronary risk factors . Both LDL and HDL cholesterol levels were independently associated with coronary calcium after participants who were receiving lipid-lowering medications or had clinical ly abnormal lipid levels were excluded . LIMITATION Coronary calcium , although a strong predictor of future coronary heart disease , is not a clinical outcome . CONCLUSION Nonoptimal levels of LDL and HDL cholesterol during young adulthood are independently associated with coronary atherosclerosis 2 decades later . PRIMARY FUNDING SOURCE National Heart , Lung , and Blood Institute

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Estrogen Deficiency in Adolescents and Young Adults: Impact on Bone Mineral Content and Effects of Estrogen Replacement Therapy

Because the long-term effects of estrogen replacement in adolescents with ovarian failure and hypothalamic amenorrhea have not been previously studied , we conducted a 2-year study of 35 patients to determine factors contributing to baseline bone density measures ( bone density , bone mineral content , and bone width ) and the response to estrogen therapy . Estrogen-deficient patients were often profoundly osteopenic by single-photon absorptiometry of the radius and dual-photon absorptiometry of the spine , despite estrogen replacement . Variables that were significant predictors of better initial single-photon absorptiometry measurements included increased age , increased body mass index , spontaneous pubertal development , lack of radiation therapy , and lower serum osteocalcin . Patients treated with estrogen/progestin had stable cortical bone mineral content and bone density at the distal one-third of the radius , a slight improvement in bone density at the distal one-tenth of the radius , and an encouraging , but marginal , improvement in the z score ( st and ard deviation from the mean ) of bone mineral content at the distal onetenth . The z scores for cortical bone width and bone density decreased , suggesting a possible relative worsening over time . In untreated estrogen-deficient girls , bone mineral content and bone density decreased ( but not significantly ) ; the z score of cortical bone width showed a significant decrease . Using dual-photon absorptiometry , a history of radiation therapy was found to be a predictor of lower bone density compared with age-matched controls . Estrogen/ progestin therapy did not result in changes in serum levels of lipids and antithrombin HI , weight , or blood pressure . This study suggests that because most adolescent/young adult patients with estrogen deficiency may not achieve normal bone density with current therapy , earlier and more aggressive intervention may be necessary

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

[The effect of primary lack of estrogens and the influence of the age at the beginning of estrogen therapy on bone mineral density in patients with Turner's syndrome].

Lumbar spine bone mineral density ( BMD ) values were measured in women with Turner 's syndrome ( TS ) and the influence of primary ovarian failure as well as the age at the start of estroprogestins ( EP ) therapy were considered . EP treatment with 2 mg of estradiol ( E2 ) and BMD monitoring were started in 72 and finally continued for 5 years in 34 patients with TS , aged 12 - 38 years , previously not treated with growth hormone or anabolic steroids . The mean total BMD gain ( deltaBMD ) was 20 % and the most significant increase was observed after the first ( 7.5 % ) and the second ( 6.6 % ) year of the therapy . Before the start and during EP treatment E2 levels were evaluated : they increased from 9.2pg/ml to the values observed in the controls ( C ) but positive correlation with BMD was not observed . Analysis of TS patients in age brackets ( < 15 years , 15 - 20 years , 21 - 25 years , > 25 years ) showed that only in the group that started EP treatment before the age of 15 every year significant deltaBMD was observed . The group that started EP therapy after the age of 20 did n't achieve significant deltaBMD . Patients wit TS had significantly higher levels of bone metabolism markers ( Ntx and BALP ) than the controls and in both groups negative correlation with age was found . On the basis of the results the conclusion was made that in hypoestrogenic women , not exclusively TS , the age when estrogen therapy is started may determine the effects in relation to bone mass . The administered E2 doses may also be important

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Mortality ratios, life expectancy, and causes of death in patients with Turner's syndrome.

In a prospect i ve study of 156 female patients with Turner 's syndrome who had survived infancy and been followed up for an average of 17 years there were 15 deaths . The expected mortality was 3.6 . Sixteen of the patients had a congenital heart anomaly and five of the deaths occurred in this group . The 10 deaths in the remaining 140 were three times as many as expected . The reduction in life expectation was 12.5 years at age 1 year , 11 years at age 20 , and 10 years at age 40 . Deaths were due to a broad spectrum of diseases . In the sample as a whole there were eight deaths from diseases of the circulatory system . This number is significantly greater than expected , but four were due to congenital heart disease . When patients with congenital heart disease were omitted from the sample the mortality from circulatory disorders was not significantly increased . Within the category of circulatory disorders there were three deaths from dissection of the aorta , a number which is greatly in excess of the expected . Two of these patients had no previous evidence of heart disease

Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration . Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions . The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol .

Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency . Hence , long-term estrogen replacement therapy is the cornerstone treatment . The estimates of its effect and optimal use , however , remain uncertain . We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .

Several factors were found to be associated with disability at follow-up for at least two different pain symptoms . However , owing to insufficient studies , no generic risk factors for sick leave were identified . Conclusions Multiple site pain , high pain severity , older age , baseline disability and longer pain duration were identified as potential prognostic factors for disability across pain sites . There was limited evidence that anxiety and depression were associated with disability in patients with subacute pain , indicating that these factors may not play as large a role as expected in developing disability due to a pain condition .

Objective This systematic review aims to identify generic prognostic factors for disability and sick leave in subacute pain patients .

Epidemiology of chronic non-malignant pain in Denmark

& NA ; A series of health surveys are conducted every sixth to seventh year in Denmark . In the most recent survey of 2000 , a national r and om sample ( > 16 years ) was drawn from the Danish Central Personal Register . Out of the original sample 12,333 ( 74 % ) were interviewed and of these 10,066 returned a completed question naire ( SF‐36 ) . The present study includes only those who both took part in the interview and the postal question naire . Cancer patients were excluded . Persons suffering from chronic pain ( PG ) were identified through the question ‘ Do you have chronic/long lasting pain lasting 6 months or more ’ ? An overall chronic pain prevalence of 19 % was found −16 % for men and 21 % for women . Prevalence of chronic pain increased with increasing age . Persons ≥67 years had 3.9 higher odds of suffering from chronic pain than persons in the age group 16–24 years . Compared with married persons , divorced or separated persons had 1.5 higher odds of chronic pain . Odds for chronic pain were 1.9 higher among those with an education of less than 10 years compared with individuals with an education of 13 years or more . During a 14‐day period reporters of chronic pain had an average of 0.8 days ( range 0–10 ) lost due to illness compared with an average of 0.4 days ( range 0–10 ) for the control group ( CG ) ( Odds Ratio ( OR ) ) 2.0 ) . Persons with a job which required high physical strain were more likely to report chronic pain compared with those with a sedentary job ( OR 2.2 ) . The odds of quitting one 's job because of ill health were seven times higher among people belonging to the PG . A strong association between chronic pain and poor self‐rated health was also demonstrated . The PG had twice as many contacts with various health professionals compared with the CG , and the health care system was , on average , utilised 25 % more ( overall contacts ) by the PG than by the general population . Among the persons in the PG , 33 % were not satisfied with the examinations carried out in connection with their pain condition and 40 % were not satisfied with the treatment offered . Nearly 130,000 adults , corresponding to 3 % of the Danish population , use opioids on a regular basis . Opioids are used by 12 % of the PG

Several factors were found to be associated with disability at follow-up for at least two different pain symptoms . However , owing to insufficient studies , no generic risk factors for sick leave were identified . Conclusions Multiple site pain , high pain severity , older age , baseline disability and longer pain duration were identified as potential prognostic factors for disability across pain sites . There was limited evidence that anxiety and depression were associated with disability in patients with subacute pain , indicating that these factors may not play as large a role as expected in developing disability due to a pain condition .

Objective This systematic review aims to identify generic prognostic factors for disability and sick leave in subacute pain patients .

Several factors were found to be associated with disability at follow-up for at least two different pain symptoms . However , owing to insufficient studies , no generic risk factors for sick leave were identified . Conclusions Multiple site pain , high pain severity , older age , baseline disability and longer pain duration were identified as potential prognostic factors for disability across pain sites . There was limited evidence that anxiety and depression were associated with disability in patients with subacute pain , indicating that these factors may not play as large a role as expected in developing disability due to a pain condition .

Objective This systematic review aims to identify generic prognostic factors for disability and sick leave in subacute pain patients .

Increasing value and reducing waste in research design, conduct, and analysis

Correctable weaknesses in the design , conduct , and analysis of biomedical and public health research studies can produce misleading results and waste valuable re sources . Small effects can be difficult to distinguish from bias introduced by study design and analyses . An absence of detailed written protocol s and poor documentation of research is common . Information obtained might not be useful or important , and statistical precision or power is often too low or used in a misleading way . Insufficient consideration might be given to both previous and continuing studies . Arbitrary choice of analyses and an overemphasis on r and om extremes might affect the reported findings . Several problems relate to the research workforce , including failure to involve experienced statisticians and method ologists , failure to train clinical research ers and laboratory scientists in research methods and design , and the involvement of stakeholders with conflicts of interest . Inadequate emphasis is placed on recording of research decisions and on reproducibility of research . Finally , reward systems incentivise quantity more than quality , and novelty more than reliability . We propose potential solutions for these problems , including improvements in protocol s and documentation , consideration of evidence from studies in progress , st and ardisation of research efforts , optimisation and training of an experienced and non-conflicted scientific workforce , and reconsideration of scientific reward systems

Several factors were found to be associated with disability at follow-up for at least two different pain symptoms . However , owing to insufficient studies , no generic risk factors for sick leave were identified . Conclusions Multiple site pain , high pain severity , older age , baseline disability and longer pain duration were identified as potential prognostic factors for disability across pain sites . There was limited evidence that anxiety and depression were associated with disability in patients with subacute pain , indicating that these factors may not play as large a role as expected in developing disability due to a pain condition .

Objective This systematic review aims to identify generic prognostic factors for disability and sick leave in subacute pain patients .

Several factors were found to be associated with disability at follow-up for at least two different pain symptoms . However , owing to insufficient studies , no generic risk factors for sick leave were identified . Conclusions Multiple site pain , high pain severity , older age , baseline disability and longer pain duration were identified as potential prognostic factors for disability across pain sites . There was limited evidence that anxiety and depression were associated with disability in patients with subacute pain , indicating that these factors may not play as large a role as expected in developing disability due to a pain condition .

Objective This systematic review aims to identify generic prognostic factors for disability and sick leave in subacute pain patients .

Do psychological factors predict outcome in both low-back pain and shoulder pain?

Background and Objective : Psychological factors are assumed to predict persistent or recurrent musculoskeletal pain . The influence of psychological factors in patients with low-back pain ( LBP ) or shoulder pain was explored to study whether there is similarity regarding the factors that predict persisting pain and disability . Methods : Patients presenting in primary care with a new episode of shoulder pain or non-specific (sub)acute low back pain ( LBP ) were enrolled in a prospect i ve study . In both patient groups , pain catastrophising , distress , somatisation and fear-avoidance beliefs were measured at baseline . Primary outcome measures at 3 months were ( 1 ) persistent symptoms , and ( 2 ) < 30 % reduction in functional disability . Multivariate logistic regression analysis was used to study the associations between psychological factors and outcome . Results : A total of 587 patients with shoulder pain and 171 patients with LBP were enrolled in the study . In patients with shoulder pain , most associations of psychological factors with outcome were weak and not significant . Only in patients with longer symptom duration at baseline ( ⩾3 months ) were higher scores on catastrophising significantly associated with persistent symptoms ( p = 0.04 ) . In patients with LBP , psychological factors were more strongly associated with poor outcome , although most associations were not significant . Conclusion : Psychological factors , with the exception of fear-avoidance beliefs , are more strongly associated with persistent pain and disability in patients with LBP than in those with shoulder pain . This seems to indicate that in a primary care population the influence of psychological factors on outcome may vary across patients with different types of pain

Several factors were found to be associated with disability at follow-up for at least two different pain symptoms . However , owing to insufficient studies , no generic risk factors for sick leave were identified . Conclusions Multiple site pain , high pain severity , older age , baseline disability and longer pain duration were identified as potential prognostic factors for disability across pain sites . There was limited evidence that anxiety and depression were associated with disability in patients with subacute pain , indicating that these factors may not play as large a role as expected in developing disability due to a pain condition .

Objective This systematic review aims to identify generic prognostic factors for disability and sick leave in subacute pain patients .