OBJECTIVES: This study aims to examine the effect of 20-minute mindful breathing on the rapid reduction of dyspnea at rest in patients with lung cancer, chronic obstructive pulmonary disease, and asthma.
METHODS: We conducted a parallel-group, nonblinded, randomized controlled trial of standard care plus 20-minute mindful breathing vs. standard care alone for patients with moderate to severe dyspnea due to lung disease, named previously, at the respiratory unit of University Malaya Medical Centre in Malaysia, from August 1, 2017, to March 31, 2018.
RESULTS: Sixty-three participants were randomly assigned to standard care plus a 20-minute mindful breathing session (n = 32) or standard care alone (n = 31), with no difference in their demographic and clinical characteristics. There was statistically significant reduction in dyspnea in the mindful breathing group compared with the control group at minute 5 (U = 233.5, n1 = 32, n2 = 31, mean rank1 = 23.28, mean rank2 = 37.72, z = -3.574, P
DATA SOURCES: A PubMed search was completed in Clinical Queries using the key terms "erythema nodosum".
RESULTS: Clinically, erythema nodosum presents with a sudden onset of painful, erythematous, subcutaneous nodules mainly localized to the pretibial areas. Lesions are usually bilateral and symmetrical, ranging from 1 to 5 cm in diameter. Erythema nodosum may be associated with a variety of conditions such as infection, medications, sarcoidosis, pregnancy, inflammatory bowel disease, vaccination, autoimmune disease, malignancy, and miscellaneous causes. The condition is idiopathic in approximately 50% of cases. The diagnosis is mainly clinical with biopsy reserved for atypical cases. To evaluate for the underlying cause, some basic laboratory screening studies are worthwhile in most cases and include a complete blood cell count, erythrocyte sedimentation rate and/or C-reactive protein, throat swab culture, antistreptococcal O titers, and a chest radiograph. Other tests should be individualized, guided by the history and physical examination results. Most cases of erythema nodosum are self-limited and require no treatment. Bed rest and leg elevation are generally recommended to reduce the discomfort. Nonsteroidal anti-inflammatory drugs are the first-line treatment for pain management.
CONCLUSIONS: As erythema nodosum is often a cutaneous manifestation of a systemic disease, a thorough search should be performed to reveal the underlying cause.
Materials and Methods: The compilation of data was based on signalment, case history, duration of clinical signs, anatomical location of the pain, method of diagnosis, type of EBD, treatment, and outcome. The diagnosis of EBD was based on a history of poor performance, clinical examination findings, radiography, and, where applicable, necropsy.
Results: A total of 181 diagnosed cases of EBDs were identified. The age of horses ranged from 5 to 22 years. The EBD cases were more prevalent in male than female horses and predominantly in geldings (60.77%). Thoroughbred, Arab, Polo pony, and Warmblood also recorded the most EBD cases among breeds. The discipline of horses tended to influence the development of EBDs, with patrolling horses recording the highest frequency. Most EBD cases were of the primary type (92.27%), with the main causes being soft-tissue lesions (57.48%), vertebral lesions (18.56%), tack-associated problems (16.77%), and neurological lesions (7.19%). The common treatments employed were administration of nonsteroidal anti-inflammatory agents, 1 to 3-month rest, warm and cold compression therapy, massage therapy, exercise adjustment, as well as correction of ill-saddle fit.
Conclusion: Most EBDs in this study were associated with soft-tissue lesions. Among vertebral lesions, kissing spines were the most common cause of EBDs in horses in Malaysia.