Workers whose occupational physician is allocated to the intervention group will receive the collaborative occupational health care intervention. Occupational physicians allocated to the care as usual group will give conventional sickness guidance. Follow-up assessments will be done at 3, 6, 9, and 12 months after baseline. The primary outcome is duration until RTW. The secondary outcome is severity of symptoms of CMD. An economic evaluation will be performed as part of this trial.

Conclusion: It is hypothesized that collaborative occupational health care intervention will be more (cost)-effective than care as usual.

This intervention is Nocodazole nmr innovative in its combination of a decision aid by email sent to the occupational physician and an E-health module aimed at RTW for the sick-listed worker.”
“Mono- and digalactosyldiacylglycerol (MGDG and DGDG, respectively) constitute the bulk of membrane lipids in plant chloroplasts. Mutant analyses in Arabidopsis have shown that these galactolipids are essential for chloroplast biogenesis and photoautotrophic growth. Moreover,

VX-661 cost these non-phosphorous lipids are proposed to participate in low-phosphate (Pi) adaptations. Under Pi-limited conditions, a drastic accumulation of DGDG occurs concomitantly with a large reduction in membrane phospholipids, suggesting that plants substitute DGDG for phospholipids during Pi starvation. Previously, we reported that among the three MGDG synthase genes (MGD1, MGD2 and MGD3), the type-B MGD2 and MGD3 are upregulated in parallel with DGDG synthase genes during Pi starvation. Here, we describe the identification and characterization of T-DNA insertional mutants of Arabidopsis type-B MGD genes. Under Pi-starved conditions, the mgd3-1 mutant showed a drastic reduction

in DGDG accumulation, selleck products particularly in the root, indicating that MGD3 is the main isoform responsible for DGDG biosynthesis in Pi-starved roots. Moreover, in the roots of mgd2 mgd3 plants, Pi stress-induced accumulation of DGDG was almost fully abolished, showing that type-B MGD enzymes are essential for membrane lipid remodeling in Pi-starved roots. Reductions in fresh weight, root growth and photosynthetic performance were also observed in these mutants under Pi-starved conditions. These results demonstrate that Pi stress-induced membrane lipid remodeling is important in plant growth during Pi starvation. The widespread distribution of type-B MGD genes in land plants suggests that membrane lipid remodeling mediated by type-B MGD enzymes is a potent adaptation to Pi deficiency for land plants.”
“To examine the health-related quality of life (HRQoL) and factors associated with HRQoL in Chinese patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) using two generic preference-based HRQoL instruments, EQ-5D (plus EQ-VAS) and SF-6D, with the results compared with general population.

The PCBs 138, 153, and 180 were the most abundant PCBs congeners found in the fin whales samples. Males had significant higher concentrations of Sigma OC, Sigma DDTs and Sigma PCBs than females (P < 0.05), although the p,p’-DDE/Sigma DDTs ratios were similar between the sexes. Although the OC concentrations found in this population were generally below the levels that would be expected to cause deleterious health effects, the maximum values observed (2700 ng g(-1) lw) in some animals were higher than those

associated with reproductive effects in whales. Given the small population size and highly isolated characteristics Crenolanib of Gulf of California fin whales, health effects in individuals could readily translate into population-level effects.

Future research on this topic will be necessary to better understand the role that these compounds may have on the health of this population. (C) 2009 Wiley Periodicals, Inc. Environ Toxicol 25: 381-390, 2010.”
“Aim: Evidence suggests that orexin regulates food consumption, glucose metabolism and insulin secretion. Orexin may have a role in the pathogenesis of type II diabetes mellitus, however its role in gestational diabetes mellitus is not known. We aimed to assess maternal serum and cord blood orexin-A (OXA) concentrations in pregnant women selleck products with gestational SNS-032 solubility dmso diabetes mellitus (GDM). Material and Methods: Thirty-five pregnant women with GDM and 35 gestational-age-matched healthy pregnant

subjects participated in the study. Maternal serum and cord blood OXA levels were measured with enzyme immunoassay at the time of birth. The correlations between maternal serum and cord blood OXA levels, anthropometric and metabolic parameters were also assessed. Results: The mean maternal and cord serum OXA (1.16 +/- 0.37 and 1.35 +/- 0.20 ng/mL, respectively) in the GDM group were significantly different from those of the controls (1.58 +/- 0.59 and 1.25 +/- 0.21 ng/mL, respectively). The mean maternal fasting-glucose-to-OXA ratio was significantly higher in the GDM group. In the GDM group, the mean maternal serum OXA levels were similar in the insulin (n = 24) and diet (n = 11) treated cases, respectively (1.13 +/- 0.36 ng/mL and 1.21 +/- 0.41 ng/mL). Maternal serum OXA levels positively correlated with fetal serum OXA and maternal glucose levels. OXA concentrations in maternal serum were negatively correlated with the fasting glucose, fasting insulin and homeostasis model assessment insulin resistance index. Conclusions: Maternal serum OXA levels decrease, and fetal serum OXA levels increase in women with GDM.

5% DSS mixed with normal chow. In the second group, the mice were fed 3.5% DSS plus 6.0 or 9.0% (weight/weight) cellobiose mixed with normal chow. The development of colitis was assessed on day 21. Mucosal cytokine expression was analyzed by RT-PCR. Body weight loss was significantly attenuated in the 9.0% cellobiose-fed DSS mice as compared to the DSS mice. Colonic weight/length ratio, a maker of tissue edema, was significantly higher in the DSS mice than in the 9.0% cellobiose-fed DSS mice. The disease activity index and histological colitis

score were also significantly higher in the DSS mice than in the 9.0% cellobiose-fed DSS mice. Mucosal mRNA expression for IL-10, TNF-alpha, IL-17 and IP-10 were markedly reduced in the 9.0% cellobiose-fed DSS mice. In conclusion, a preventive effect of cellobiose against DSS colitis suggests its clinical use for inflammatory AG-014699 datasheet bowel diseases patients.”
“The effect of bovine viral diarrhoea virus (BVDV) infection on early pregnant cows between 10 and 24 days after virus inoculation at day 26 of pregnancy was determined. Four cows were inoculated intravenously with either BVDV (treated, n=3) or growth medium (control, n = 1). The treated cows were euthanized on either day 10, 17 or 24 post-infection and the control cow was euthanized on day 24 post-infection. The level of serum 2-5A synthetase increased in all of the three treated cows. Progesterone

levels decreased GSK3235025 to below 1.0 ng/ml between 10 and 22 days after inoculation in two of the three treated cows and the embryos/foetuses of two cows died. Therefore, BVDV may be a cause of early embryonic or feotal loss in early pregnant cows and serum 2-5A synthetase may be useful as an indicator of viral infection in cows. (C) 2012 Elsevier Ltd. All rights reserved.”
“Background: Radiofrequency

ablation is an effective treatment for atrial fibrillation (AF). With improved safety, the therapy has been offered to increasingly older populations. Arrhythmia mechanisms, medical comorbidities, and safety may vary in the very elderly population.

Methods: Patients presenting AC220 clinical trial for AF ablation were divided into two groups [>= 80 years (n = 35), < 80 years (n = 717)]. AF ablation consisted of pulmonary vein antral isolation with or without additional linear lesions. A successful outcome was defined as no further AF and off all antiarrhythmic medications > 3 months following 1 + ablation procedures.

Results: The type of AF was similar in both groups (paroxysmal: 46% in the older group vs 54% in the younger, P = 0.33). Older patients were more likely to have a higher CHADS2 score, coronary artery disease, and less likely to have had a prior ablation. The hospital stay on average was longer in the older cohort (2.9 +/- 7.7 vs 2.1 +/- 1.1 days, P = 0.001). There was no increased risk of peri-procedural complications. One-year survival free of AF or flutter was 78% in those >80 and 75% in those younger (P = 0.78).

Areca quid chewing is associated with the high incidence of oral squamous cell carcinomas (OSCCs) in Taiwan. The aim of this study Selleck LDK378 was to compare heat shock protein 27 (HSP27) expression in OSCCs and the normal oral tissues. Methods: Forty-eight OSCCs from areca quid chewers and ten normal oral tissue biopsy samples without areca quid chewing were analyzed by immunohistochemistry for HSP27. The normal human oral keratinocytes (HOKs)

were challenged with arecoline, the major alkaloid of areca nut, by Western blot for HSP27. Furthermore, epigallocatechin-3 gallate (EGCG), glutathione precursor N-acetyl-l-cysteine (NAC), cyclooxygenase-2 inhibitor NS-398, HSP inhibitor quercetin, extracellular signal-regulated protein kinase (ERK) inhibitor PD98059, and p38 inhibitor SB203580 were added to find the possible regulatory mechanisms. Results: Heat shock protein 27 exhibited higher expression in OSCCs than normal specimens (P < 0.05). Arecoline was found to elevate HSP27 expression in a dose- and time-dependent manner (P < 0.05). The additions of pharmacological agents were found to inhibit arecoline-induced HSP27 expression (P < 0.05). Conclusions: Heat shock protein 27 expression is significantly elevated in areca quid chewing-associated OSCCs. Arecoline-induced HSP27 expression was downregulated by EGCG, NS398, NAC, quercetin, PD98059,

and SB203580.”
“This study evaluated the clinical usefulness of the newly developed Two-Step Thickened Water Test (TTWT) in identifying patients with poststroke dysphagia Selleckchem AC220 at risk of aspiration Volasertib ic50 of paste food. The study subjects were 110 poststroke patients (mean age, 73 +/- 10 years). The TTWT comprises a bedside pretest (tongue protrusion, vocalization, voluntary cough, and dry swallow) and a direct swallowing test using 4 mL of thickened water. Fiberoptic endoscopic evaluation

of swallowing determined the subject’s ability to swallow the paste food. Based on the test results and endoscopic evaluation, we calculated the TTWT’s sensitivity and specificity in identifying paste food aspiration. We also calculated these values when normal water was used instead of thickened water in a direct swallowing test. The prevalence of dysphagia for paste food was 41% in our study group. The sensitivity and specificity of the TTWT in identifying dysphagia for paste food was 93% and 88%, respectively. The specificity decreased to 78.5% when normal water was used, with no decrease in sensitivity. The test was completed in less than 10 minutes, with no adverse events in any subject. Our data suggest that the TTWT might be a useful assessment tool for evaluating the risk of paste food aspiration in patients with poststroke dysphagia.”
“The reaction of 5,6-dialkyl-2-halopyridine-3,4-dicarbonitriles with alcoholic ammonia under elevated pressure gave 5,6-dialkyl-2-aminopyridine-3,4-dicarbonitriles as a result of nucleophilic replacement of the halogen atom by amino group.

HPLC-DAD was used to analyse phenolic acids. Sensory analysis was performed by trained panellists. After a screening step, CAT-1, UFLA FW 15 and S. bayanus CBS 1505 were previously selected based on their fermentative characteristics and profile of the metabolites identified. The beverage produced with CAT-1 showed the highest volatile fatty acid concentration (1542.6 mu g/L), whereas the beverage produced with UFLA FIN 15 showed the highest concentration of acetates (2211.1 mu g/L) and total volatile compounds (5835 mu g/L). For volatile sulphur compounds. 566.5 mu g/L were found in the beverage produced with

S. bayanus CBS 1505. The lowest concentration selleck of volatile sulphur compounds (151.9 mu g/L) was found for the beverage produced with UFLA FW 15. In the sensory analysis, the beverage produced

with UFLA FW 15 was characterised by the descriptors raspberry, cherry, sweet, strawberry, floral and violet. In conclusion, strain UFLA FW 15 was the yeast that produced a raspberry wine with a good chemical and sensory quality. (C) 2010 Elsevier Ltd. All rights reserved.”
“Background: Activation of caspase-14 occurs during terminal differentiation of keratinocytes and may play a role in filaggrin degradation. Therefore, down-regulation selleck chemicals llc of caspase-14 may lead to impaired barrier function. Objective: To compare the levels of active and total caspase-14 in healthy subjects in various age groups and in patients with atopic dermatitis (AD), using two enzyme-linked immunoassay (ELISA) systems.

Methods: We established four clones of monoclonal antibodies to caspase-14 and used clone 3 as the immobilizing antibody. A cleavage site-directed antibody, h14D146 [14] was used for specific quantification of active caspase-14 in extracts of tape-stripped corneocytes. Total caspase-14 was measured with a commercial antibody, H-99.

Results: The amount of caspase-14

remained constant (ca. 0.1% of extractable proteins) in healthy males from their twenties to their fifties. Caspase-14 was mostly in active form (71-94%) in these extracts. In contrast, caspase-14 level and active caspase-14 ratio were significantly decreased in females in their fifties and sixties. Contents of free amino acids were decreased in females in their sixties, GM6001 mw and transepidermal water loss was increased in females in their forties and sixties. In patients with AD, active caspase-14 was markedly down-regulated compared to age-matched controls in both lesional (7.5%) and non-lesional skin (10.6%). Staining of active caspase-14 was considerably weaker in non-lesional skin and was hardly detectable in lesional skin with parakeratosis.

Conclusion: Our new ELISA systems are effective tools to quantify activation of caspase-14. Our results indicate a role of caspase-14 in epidermal barrier function. (C) 2010 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

5 years. The BGJ398 supplier mean calculated EuroSCORE was 28.3 7.9%. The mean AVA was 0.61 0.19 cm2. The MPG was 48 16 mmHg. The surgical technical success achieved 100%. There was no reported moderate to severe postoperative paravalvular aortic regurgitation, permanent complete atrioventricular block, major access site complication, or embolic stroke. Chronic renal

failure, which necessitated permanent hemodialysis, developed in 10% of the patients. One acute myocardial infarction and one case of pneumonia developed postoperatively. The AVA was increased by 251%, whereas the MPG was decreased by 80% at the 3 month followup. The 30-day mortality rate was 10%. The all-cause 1-year mortality rate was 20%.

Conclusion: This new technique and device requires greater caution and needs more practice to accumulate sufficient experience. The studied patients were very fragile, due to old age and multiple comorbidities. Our results are similar to findings of multicenter trials. With careful patient screening and selection, TAVI can be a promising treatment for high-risk severe AS GS-7977 research buy patients. Copyright (C) 2013 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.”
“Objectives: Endovascular aneurysm repair (EVAR) is an established method of aortic aneurysm repair, in favourable anatomical configurations. It does however expose patients to radiation. The study aim was to determine if the aneurysm

neck morphology influenced radiation exposure.

Patients and methods: All elective and emergency EVAR patients were identified. Elective patients had a bifurcated stent-graft deployed, while emergency patients were repaired with an aorto-uni-iliac stent-graft and fem-fem crossover bypass. Proximal and distal aortic neck diameters, neck length, neck angles and sac diameter were recorded, with the radiation dose, screening time and contrast volume. The two subgroups of elective

and emergency patients were compared and correlation between anatomical and radiological parameters calculated by using Pearson’s correlation coefficient.

Results: 320 (270 male) elective patients and 64 (55 male) emergency patients from October 1998 to October 2008 Apoptosis Compound Library solubility dmso underwent EVAR. The mean proximal (p = 0.004) and distal (p = 0.01) neck diameters were smaller and mean sac diameter (p < 0.0001) was greater in emergencies. No difference between groups existed in the neck length (p = 0.36) and suprarenal diameter (p = 0.30), sagittal (p = 0.05) and coronal (p = 0.62) neck angles. The screening time (p = 0.053) and contrast volume (p = 0.04) were lower, with a slightly higher radiation dose (p = 0.12) in emergencies. There was no definite correlation between the seven anatomical and three radiological parameters.

Conclusion: While radiation exposure is different in emergency patients, this is thought due to surgical technique rather than the aneurysm neck morphology. (C) 2010 European Society for Vascular Surgery.

The high risk of CRC in IBD patients probably results from chronic inflammation. In most cases, neoplastic lesions arise within the inflamed gastrointestinal mucosa during the process of re-epithelization, which is a healing response to ulceration. The recently discovered Th17

lymphocytes, which demonstrate strong pro-inflammatory capabilities, might link the two diseases. Th17 lymphocytes produce a number of pro-inflammatory cytokines, such as interleukin (IL)-17A, IL-17F, IL-21, IL-22 and tumor necrosis factor (TNF)-a, and play a key role Selleck Nocodazole in mucosal defense against various pathogens. Numerous observations suggest that Th17 lymphocytes are involved in pathogenesis of different autoimmune diseases and pathologic inflammatory states. Mounting evidence suggests that Th17 cells contribute to the pathogenesis of IBD and CRC. However, their precise role in both diseases is unknown.”
“Background: Genomics research check details is becoming increasingly globally connected and collaborative, contesting traditional ethical and legal boundaries between global and local research practice. As well, global data-driven genomics research holds great promise for health discoveries. Yet, paradoxically, current research ethics review

systems around the world challenge potential improvements BVD-523 ic50 in human health from such research and thus undermine respect for research participants. Case reports illustrate that the current system is costly, fragmented, inefficient, inadequate, and inconsistent. There is an urgent need to improve the governance system of ethics review to enable secure and seamless genomic and clinical data sharing across jurisdictions.

Discussion: Building on the international privacy ‘safe harbor’ model that was developed following the adoption of the European Privacy

Directive, we propose an international infrastructure. The goal is to create a streamlined and harmonized ethics governance system for international, data-driven genomics research projects. The proposed ‘Safe Harbor Framework for International Ethics Equivalency’ would consist in part of an agency supporting an International Federation for Ethics Review (IFER), formed by a voluntary agreement among countries, granting agencies, philanthropies, institutions, and healthcare, patient advocacy, and research organizations. IFER would be both a central ethics review body and also a forum for review and follow-up of policies concerning ethics norms for international genomics research projects. It would be built on five principle elements: (1) registration; (2) compliance review; (3) recognition; (4) monitoring and enforcement; and (5) public participation.

“
“The purpose of this presentation was to share the Japanese experiences with IGRA. Based on a 2002 clinical P5091 clinical trial trial of QuantiFERON(R)-TB Gold (stimulants: ESAT-6, CEP-10), a cut-off of 0.35 IU/ml was fixed, and 0.1 to 0.35 IU/ml is the ‘gray’ zone. Japan had a universal BCG vaccination and re-vaccination policy until 2006. As a consequence, the TST has very poor specificity in Japan and many low-risk people test positive to TST. The TST policy in Japan is to measure erythema rather than induration. Contact investigations

in adults are largely limited to case finding with chest X-ray screening. In Japan, contacts who are <30 years of age undergo TST. Those contacts that show an erythema diameter >30 mm are indicated for chemoprophylaxis. There is very poor evidence of diagnostic utility for TST in Japan. Four contact studies in Japan have shown the value of the QFT vs. TST, and there is an overall emerging large body of evidence showing that QFT performs better than TST. With the OFT test, BCG vaccination is no longer an issue, and targeting INH prophylaxis is now possible based on the positive QFT results. Also, the use of QFT results in significant savings in contact screening. In the Japanese experience, overall

QFT responses did significantly decline after the treatment of LTBI, despite the rate of reversion in QFT being low. And most of them stay Sapanisertib mouse positive for a long time even after 18 months of treatment. These results suggest that TB control needs more effective ways to treat LTBI. New

drugs (perhaps RMP for 3 or 4 months) or better regimens (i.e., 9 or 12 months of INH instead of 6 months) would have a large impact on TB control. Low QFT reversion rates do suggest that QFT would not be useful as a marker to evaluate the success of treatment for LTBI if the success of chemotherapy is defined as reversion in the QFT test. However, the finding that OFT responses significantly decline after the treatment of LTBI suggests the possibility that this decline could be used as a marker of the susceptibility of the infective M. tuberculosis strain to the prophylactic drug used.”
“Students in a primary school exposed to PD173074 clinical trial a tuberculosis (TB) patient (a teacher) were investigated using the TST, chest X-ray, and sequential QFT-G tests. The rate of QFT-G positivity in close contacts was 9.8% (4/41) and in casual contacts it was 1.8% (5/272; P = 0.020). The rate of TST positivity at the 5 mm cut-off for close contacts was 52.6% (20/38), and for casual contacts it was 67.2% (180/268; P = 0.078). The rate of TST positivity at the 10 mm cut-off for close contacts was 34.2% (13/38) and for casual contacts it was 28.7% (77/268; P = 0.488). Data suggest that QFT-G has the same performance characteristics in BCG-vaccinated children as it does in adults.

Study Design and Setting: To illustrate the usefulness and applicability of the PR-tool, we applied it to two systematic reviews. Each included RCT was scored on the 10 PRECIS domains on a scale of 1-5. After this scoring, a 10-domain average for each individual trial and for the systematic review a single domain average and an overall average was calculated.

Results: One review was more pragmatic with an average score of 3.7 (range, 2.9-4.6) on our PR-tool, Daporinad in vivo whereas the other review was more explanatory with an average score of 1.9 (range, 1.1-3.3). The results also suggest that the included studies within each systematic review were rather uniform in

their approach, although A-1210477 molecular weight some domains seemed more prone to heterogeneity.

Conclusion: The PR-tool provides

a useful estimate that gives insight by estimating quantitatively how pragmatic each RCT in the review is, which methodological domains are pragmatic or explanatory, and how pragmatic the review is. (C) 2011 Elsevier Inc. All rights reserved.”
“Background: Public access automated external defibrillator (PAD) programs have been shown to be successful in several municipalities. This study sought to determine the usage of and survival rate from a large, urban PAD program in the first 10 years since its implementation.

Methods: This was a prospective, longitudinal, observational study from January 2002-2012 conducted in Los Angeles, California, a city with a population of 3.8 million. An incremental rollout resulted in a current total of 1300 automated external defibrillators (AEDs) in place in city-owned buildings this website and other public places, including all 3 area airports, golf-courses, and public pools. All instances where an AED was applied were included in the study.

Results: There were 59 incidents of cardiac arrest with a public access

AED applied, of which 42 (71%) occurred at an airport. 51 (86%) of the patients were male, with a median age of 64 years (interquartile range, 56.5 to 70 years). A shockable rhythm was detected and shocks were applied in 39 (66%) patients, with 30 (77%) of these patients achieving a return of spontaneous circulation (ROSC). Of those patients who received shock(s) by public access AED, 27 (69%) survived to hospital discharge. The youngest survivors were a 25 year old male and a 34 year old female.

Conclusion: While the majority of PAD cases occurred at an airport, there were also survivors from other public locations. AEDs deployed as part of a large PAD program resulted in a very high survival rate for patients with cardiac arrest. (C) 2012 Elsevier Ireland Ltd. All rights reserved.”
“AimsWe determined whether or not homelessness is associated with cigarette smoking independent of other socio-economic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit.

This study characterised the

functional and structural changes induced by the most commonly used in vivo and in situ models for hypoxia/ischemia-reperfusion in the rat liver. Methods: A range of no-flow, slow-flow and lobar ischemia and reperfusion models were established in the rat liver. Changes following reperfusion were monitored using physiological, biochemical, histological and pharmacological assessments, including bile production, oxygen consumption, lignocaine extraction, enzyme release, and disposition of exogenous markers. Results: Short periods of hepatic ischemia/hypoxia-reperfusion led to minimal changes in liver function whereas long periods of ischemia-reperfusion led to substantial liver injury. The most severe injury was found with the slow flow, reflow model. The formation of cell vacuoles, blebs and focal hepatitis were the most important GSK2399872A liver morphological BAY 73-4506 changes observed as a consequence of ischemia/hypoxia. The major liver histological findings after reperfusion were dispersed apoptosis and local necrosis. Hepatic ischemia/hypoxia-reperfusion was also associated with

significant changes in the hepatic extracellular and intracellular spaces. Discussion: The morphology and function of the liver associated with a range of hepatic ischemia/hypoxia-reperfusion models varies with the duration of the insult and between models. The choice of model is therefore an important consideration in seeking to Pexidartinib research buy resolve any particular hypothesis associated with hepatic ischemia/hypoxia-reperfusion.

(C) 2013 Elsevier Inc. All rights reserved.”
“Introduction.

Pulsed radiofrequency (PRF) current applied to nerve tissue to treat intractable pain has recently been proposed as a less neurodestructive alternative to continuous radiofrequency lesioning. Clinical reports using PRF have shown promise in the treatment of a variety of focal, neuropathic conditions. To date, scant data exist on the use of PRF to treat myofascial and neuromatous pain.

Methods.

All cases in which PRF was used to treat myofascial (trigger point) and neuromatous pain within our practice were evaluated retrospectively for technique, efficacy, and complications. Trigger points were defined as localized, extremely tender areas in skeletal muscle that contained palpable, taut bands of muscle.

Results.

Nine patients were treated over an 18-month period. All patients had longstanding myofascial or neuromatous pain that was refractory to previous medical management, physical therapy, and trigger point injections. Eight out of nine patients experienced 75-100% reduction in their pain following PRF treatment at initial evaluation 4 weeks following treatment. Six out of nine (67%) patients experienced 6 months to greater than 1 year of pain relief.