Hand Osteoarthritis

We will apply Ashi points, Ex-UE9, SI3, and TE5. Sterile needles (0.3mm× 40mm) and SDZ-V EA apparatus will be utilized. Acupuncturists will insert needles perpendicularly into Ashi points for approximately 2-3mm until they pierce into the bone surface; acupuncturists will insert needles horizontally into Baxie points towards the wrist with a depth of 5-10mm; and acupuncturists will insert needles perpendicularly into SI3 and TE5 for approximately 5-10mm. All needles except Ashi points will be manually manipulated to achieve De qi. The needles at Baxie 1 and Baxie 4 will be connected using alligator clips from the EA apparatus. The electrical stimulation will last for 30 minutes with a continuous wave of 10 Hz and a fixed current intensity of 0.5 to 2 mA. All the needles will be retained for 30 minutes. Participants will undergo EA treatment three times per week for a total of 12 sessions in four consecutive weeks. If bilateral hands were affected, both sides will be treated.

Electroacupuncture

The gel will be gently rubbed over the affected joints without excessive joint movement four times per day for 4 weeks and will be asked not to wash hands for one hour after application. Each hand treatment will be used in identical dispensing doses of gel (4 cm strip, approximately 2g, which was judged sufficient for approximately half the surface of each hand (200 cm2)). Dosing times should be distributed evenly over waking hours.If bilateral hands were affected, both sides will be treated.

Topical diclofenac sodium gel

Electroacupuncture vs Topical Diclofenac Sodium Gel for Patients With Hand Osteoarthritis

Electroacupuncture vs Topical Diclofenac Sodium Gel for Patients With Hand Osteoarthritis: Study Protocol for a Randomized Controlled Trial

Pain intensity will be measured using a 0-100 VAS, with 0 indicating no pain and 100 indicating maximal pain.

The AUSCAN index contains a 15-item scale referring to hand pain (5 items), stiffness (1 item), and function (9 items) during the preceding 48 hours, which is valid, reliable and responsive in patients with hand OA. All items are scaled on a 0-100 VAS (0=none to 100= very severe), with higher scores indicating more severe symptoms/function.

The FIHOA is a patient-reported hand function questionnaire, comprising 10 items with a four-point Likert scale, in which 0 represents "possible without difficulty", 1 indicates "possible with slight difficulty", 2 represents "possible with important difficulty" and 3 indicates "impossible"

All finger joints will be reported spontaneously for the presence of pain by the participants, and examined by a trained research nurse for the presence of pain at digital pressure.

All soft swollen finger joints count (0-30) will be assessed by a trained research nurse at each study visit.

Hand grip strength and pinch strength of the fingers of the dominant hand will be tested using a hand dynamometer and a Jamar digital pinch gauge respectively.

The patients will be asked to respond to the question 'Considering all the ways your hand OA affects you, how have you been during the last 48 h?' on a self-administered 0-100 VAS (0, worst possible, to 100, best possible, in 10-point increments)

The OMERACT-OARSI response is defined as an improvement in either pain (0-100 overall finger joints pain) or function (0-36 AUSCAN physical function) with ≥50% (relative) and ≥20/100 (absolute); or if the improvement is ≥20% (relative) and ≥10/100 (absolute) in ≥2 of the following: pain, functioning and patient global assessment of improvement.

The WHOQOL-BREF is a 26-item self-report questionnaire rated on a 5-point Likert-type scale with four domains of QOL: physical (seven items), psychological (six items), social (three items), and environment (eight items), plus 2 items representing the general QOL. The four domain scores are scaled in a positive direction with higher scores indicating a higher quality of life.

The proportion of participants using acetaminophen and the average dosage of acetaminophen used weekly will be calculated and assessed.

At baseline, participants in the EA group will be asked to answer the following question: "What do you expect from EA treatment to improve your hand OA?"

Any adverse events (AEs) during the whole study, whether reported spontaneously by the participants, or observed by the researcher, will be recorded and categorized as acupuncture-related AEs(e.g., fainting, broken needle, localized hematoma, dizziness, or), the side effect of TDG (e.g., skin irritation/itching, reddening, scaly skin), and non-treatment-related AEs. All AEs will be recorded in detail in the case report form.

Individual participant data are available on reasonable request. You can send e-mail to us if you have any question

Liu Zhishun

Principal Investigator

Guang'anmen Hospital of China Academy of Chinese Medical Sciences

Efficacy evaluators and data analysts will be blinded to the group assignments.

Venous Leg Ulcer

The MPS-Ag dressing used in this study has a unique gelling action which helps to remove dead, damaged, and infected tissues from the wound by trapping and removing them later at dressing changes. It is designed to provide intimate contact with the wound for gentle healing. It also contains ionic silver.

Marine polysaccharide dressing

The CMC-Ag dressing used in this study incorporates two technologies to help eliminate the key barriers to healing that are exudate, infection, and bioburden. It can be used on chronic and acute wounds that are infected or at risk of infection with varying exudate levels.

Carboxymethylcellulose dressing

Valley Vascular Surgery Associates

Central Valley Vein and Wound Center

Covenant Hospital

Wake Forest Baptist Health

A Comparative Evaluation of a MPS Dressing and a CMC Dressing on Subjects With Lower Extremity Venous Ulcers

A Comparative Evaluation of a Marine Polysaccharide Dressing and a Carboxymethylcellulose Dressing on Subjects With Lower Extremity Venous Ulcers

The peri-ulcer skin assessment scale will be used to assess the peri-ulcer skin. There are 9 systemically quoted items including oedema, erythema, white atrophy, venous pigmentation, papulovesicular erythema, hyperkeratosis, purpuric patches, telengiectasis, and itching lesions. Each item will be measured for an extension score from 0-4 and as severity score from 0-3. The global score is the extension score multiplied by the severity score. All global scores are added together to encompass a total global score. For all sub-score values, a value of 0 is the lowest value.

The pain score will be evaluated with a numeric rating scale from 0 to 10 with 0 representing no pain and 10 representing pain as bad as it could be.

Medline Industries

Receives cafeteria intervention and behavior intervention

Dietary Modification

Diabetes

Hypertension

Health Behavior

canteen intervention: (a) form and train a canteen improvement team; (b) train canteen staff on healthy cooking; (c) add healthy food and remove unhealthy food; (d) information and communication of canteen changes to employees; (e) monitoring of the interventions.
Behavioral : 16 core classes and 8 maintenance classes

Canteen and Behavior intervention

canteen intervention: (a) form and train a canteen improvement team; (b) train canteen staff on healthy cooking; (c) add healthy food and remove unhealthy food; (d) information and communication of canteen changes to employees; (e) monitoring of the interventions.

Canteen Only

Dhulikhel Hospital

Nepal Pioneer Worksite Intervention Study

Nepal Pioneer Work-site Intervention Study

a composite score based upon improvement in 3 cardio-metabolic risk factors (0-3) [HbA1c decrease ≥0.5%; a systolic blood pressure decrease (SBP) ≥5 mm Hg; and plasma triglycerides decrease ≥10 mg/dl

Intake of whole grains, fruits and vegetables and other healthy labelled items in the canteen from sales data

Glycated haemoglobin, % continuous variable

An average of three measurements, mmHg continuous variable

Archana Shrestha

Postdoctoral Fellow

Harvard School of Public Health

Arm investigates the efficacy of Botulinum Toxin A injection for the treatment of basal thumb joint arthritis

Arm uses the standard of care - Steroid injection - as an active comparator to the experimental injection of Botulinum Toxin A for the treatment of basal thumb joint arthritis

Arm uses plain lidocaine injection to serve as a baseline for evaluating the efficacy of Botulinum toxin as compared to steroid injection for the treatment of basal thumb joint arthritis.

Participants received one of three treatments:
Botulism Toxin Type A: One-time injection of 50 units of Botulinum Toxin A suspended in 2 mL of normal saline, with approximately 1 mL injected or sufficient quantity to fill joint capsule
Lidocaine: Single injection of 1 - 3 mL of 2% Lidocaine
Triamcinolone Acetonide: Single injection of 1 - 3 mL of 40mg/mL Triamcinolone acetonide solution

Arthritis Treatment

Sex: Female, Male

Race and Ethnicity Not Collected

Region of Enrollment

Pain

Range of Motion

Strength

Overall Study

Stephen Colbert

Participants received one of three treatments:
Botulism Toxin Type A: One-time injection of 50 units of Botulinum Toxin A suspended in 2 mL of normal saline, with approximately 1 mL injected or sufficient quantity to fill joint capsule
Lidocaine: Single injection of 1 - 3 mL of 2% Lidocaine
Triamcinolone Acetonide: Single injection of 1 - 3 mL of 40mg/mL Triamcinolone acetonide solution
8 participants were randomized; 2 withdrew voluntarily. Study was terminated due to lack of funds, and unblinding did not occur - it is not known how many participants were placed in each group.

Arthritis Multiple Joint

One-time injection of 50 units of Botulinum Toxin A suspended in 2 mL of normal saline, with approximately 1 mL injected or sufficient quantity to fill joint capsule

Botulinum Toxin Type A

Single injection of 1 - 3 mL of 40mg/mL Triamcinolone acetonide solution

Steroid - Triamcinolone Acetonide

Single injection of 1 - 3 mL of 2% Lidocaine

port-wine stain/obesity

Electroacupuncture vs Topical Diclofenac Sodium Gel for Patients With Hand Osteoarthritis

A Comparative Evaluation of a MPS Dressing and a CMC Dressing on Subjects With Lower Extremity Venous Ulcers

Nepal Pioneer Worksite Intervention Study

Botulism Toxin Injection as a Treatment for Arthritis of the Basal Thumb Joint

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