Atlas of Procedures in Neonatology

This study was embedded in a routine care rehabilitation program delivered at a specialized clinic in Southwest Germany. Participating patients came from many regions in Germany and thus were only available for a three-week treatment and observation period. Considering the frequent long-term chronic course of the CIPN symptoms it cannot be excluded that a longer treatment period might have yielded different results for electroacupuncture or one of the other therapies under study.

Prior studies on acupuncture treatment in peripheral neuropathy have shown that measurable results can only be found after a longer period of treatment up to 10 weeks [ 17 ]. While peripheral neuropathy is a disease with structural damage of the nerves, any stable successful treatment has to induce neuroregeneration. The time of functional recovery varies, ranging usually from 3 to 6 months, depending on the level of the lesion and factors in regeneration [ 37 ].

So effects of treatment naturally take longer than in other indications of acupuncture treatment with functional states like in pain or vegetative imbalance. All participating patients were not treated exclusively by the therapies under study but concomitantly received various medical and psychological interventions, depending on the individual need of each patient.

This included regular participation in sport therapy sessions, psychoeducative groups, art therapies, ergotherapies, relaxation methods, physiotherapies, massages, and lymph drainages. Effects of these interventions may have contributed to a remarkable effect in the placebo group—as well as to all other groups—thus possibly diminishing the estimated group differences.

Positive effects of this program—as delivered in the study center—have already been demonstrated [ 38 ]. Nevertheless further studies are necessary, to evaluate the role of acupuncture in the treatment of CIPN. The use of nerve conduction studies as an objective parameter for the evaluation of treatment effects [ 17 ] as well as recently introduced better outcome measures for the standardization of studies of CIPN will be helpful to improve the quality of future studies [ 39 ]. While contrary to our results other studies with different acupuncture concepts and longer treatment periods showed a positive effect on CIPN, the effect of acupuncture on CIPN remains unclear.

All authors certify that there is no conflict of interests with any financial organization regarding the material discussed in the paper. Ludtke designed the study, M. Guethlin collected the data, R. Ludtke carried out the statistical analyses, M. Ludtke drafted the paper, and all authors participated in the interpretation of the findings, reviewed the paper, and approved the final paper. Europe PMC requires Javascript to function effectively.

Introduction

The snippet could not be located in the article text. This may be because the snippet appears in a figure legend, contains special characters or spans different sections of the article. Evid Based Complement Alternat Med. Published online Aug Jaroslawski , 1 , 4 C. Guethlin , 4 , 5 R. Ludtke , 6 S. Received May 8; Accepted Jul 7.

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Background Chemotherapy-induced peripheral neuropathy CIPN is common and can be dose limiting for several cytotoxic drugs, for example, the antitubulins paclitaxel, docetaxel, ixabepilone, and vincristine , platinum analogs cisplatin, carboplatin, and oxaliplatin , and the proteasome inhibitors bortezomib and thalidomide. Patients The study enrolled male and female adult cancer patients, who were in remission after chemotherapy with taxanes, platinum derivatives, or vinca alkaloids and who presented with symptoms of CIPN.

Treatments Treatment protocols spanned 3 weeks and were as follows.

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Placebo The placebo treatment consisted of 3 lactose capsules per day identical in form, taste, and odour to the VitB capsules. Primary Outcome By means of detailed questionnaires, patients were interviewed before the start of the therapy day 0 , after treatment on day 21, and during follow-up on day 84, about extension and intensity non, mild, moderate, or severe of their CIPN complaints numbness, swelling, tingling, pain, and subjective impairment in everyday life and at work.

Secondary Outcomes Before the start of the study day 0 and after completion of the treatment day 21 , the patients were examined by an independent neurologist. Statistics This trial was planned using a group-sequential adaptive design which allowed for an adaptation i. Results From September to February a total of cancer patients with CIPN were assessed for eligibility and 60 were randomized into one of the four treatment groups Figure 1.

Open in a separate window. Table 1 Basic data no. Table 7 NCI common toxicity criteria sensory item day 21—day 0. Conflict of Interests All authors certify that there is no conflict of interests with any financial organization regarding the material discussed in the paper.

Atlas of Procedures in Neonatology

Diagnosis, management, and evaluation of chemotherapy-induced peripheral neuropathy. Grading of chemotherapy-induced peripheral neuropathy. Interventions for preventing neuropathy caused by cisplatin and related compounds. Cochrane Database of Systematic Reviews. Clinical Pharmacology and Therapeutics. Supportive Care in Cancer. Putting evidence into practice: Clinical Journal of Oncology Nursing. European Journal of Cancer.

Brunelli B, Gorson KC. The use of complementary and alternative medicines by patients with peripheral neuropathy. Journal of the Neurological Sciences. Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: Diabetes Research and Clinical Practice. Two styles of acupuncture for treating painful diabetic neuropathy—a pilot randomised control trial. Effects of acupuncture on diabetic peripheral neuropathies. Quantification of acupuncture effects on peripheral neuropathy of unknown and diabetic cause by nerve conduction studies.

Journal of Acupuncture and Tuina Science. Use of noninvasive electroacupuncture for the treatment of HIV-related peripheral neuropathy: Journal of Alternative and Complementary Medicine. Effect of acupuncture administered in a group setting on pain and subjective peripheral neuropathy in persons with human immunodeficiency virus disease. Acupuncture treatment improves nerve conduction in peripheral neuropathy. European Journal of Neurology. Acupuncture for the relief of cancer-related pain—a systematic review.

European Journal of Pain. Aim To provide a guide for nursing staff on what to prepare for a Rickhams tap and the management of an infant undergoing a tap. To provide a guide for Doctors on how to perform a tap on a ventricular reservoir. Assessment Head circumference prior to procedure Follow Neurosurgery recommendations regarding frequency of reservoir tap based on assessment and recent cranial ultrasound Perform a clinical nursing assessment on the infant: Slowly aspirate over 20 minutes. Remove needle and hold pressure for 2 minutes over insertion site Send CSF samples for microscopy, protein, glucose and culture.

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