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Three complementary approaches for managing physical and psychological symptoms related to chemotherapy-induced peripheral neuropathy were evaluated against an education-only control arm. This study included 26 participants who were randomly assigned to weekly, hour-long sessions of yoga, Reiki, meditation, or an educational control experience for 6 weeks. Each participant completed pre-post measures of neurotoxicity, quality of life, psychological distress, and mindfulness. Descriptive analysis of the data indicated that all experimental group participants demonstrated improved within-group scores on quality of life and neurotoxicity outcomes following intervention; however, the improvements were not statistically significant. Neurotoxicity worsened significantly in the control group, but there were no pre-post changes with respect to quality of life, psychological distress, or mindfulness. Effect sizes were large with respect to meditation and mindfulness and with Reiki and psychological distress. Moderate effect sizes with respect to yoga and neurotoxicity and quality of life offer promise for all 3 interventions in managing chemotherapy-induced peripheral neuropathy. KeywordsReiki, yoga, meditation, complementary and alternative medicine, neuropathy Chemotherapy-induced peripheral neuropathy is a side effect that occurs with many of the most common chemotherapeutic agents used to treat cancer. 1,2 It is the result of damage caused to the peripheral nervous system by chemotherapy and can affect sensory, motor, and autonomic neurons. 3,4 Chemotherapyinduced peripheral neuropathy can produce sensory symptoms that range from bothersome to disabling tingling, burning, numbness, loss of balance, pain, and loss of motor function that can include weakness in muscles in the upper and lower extremities. 5 Although the actual prevalence of chemotherapy-induced peripheral neuropathy is unknown, it is generally estimated at 30% to 40% in patients who have received the classes of chemotherapeutic agents used to treat breast, colon, and lung cancers, and lymphomas. 1,6-8 Typically, symptoms of chemotherapy-induced peripheral neuropathy are considered along with other pain symptoms and treated with opioids and analgesics. 9 However, these options yield limited results. With few alternatives for attenuating the symptoms of unremitting chemotherapy-induced peripheral neuropathy, people living with them have few options other than to endure them.Massage, yoga, and other complementary and alternative medical modalities have proven successful with pain and quality-of-life issues related to cancer and its treatment. [10][11][12][13] Given the limited effectiveness of allopathic intervention, the purpose of this pilot study was to determine the feasibility of using 3 complementary interventions in relieving the physical and emotional symptoms associated with chemotherapyinduced peripheral neuropathy while increasing capacity for mindfulness or self-focused attention. Of specific interest in this proposed study are 1 putative energy...

Cerebral metabolism during vegetative state and after recovery to consciousness One way to approach the study of consciousness is to explore lesional cases in which impairment of consciousness is the prominent clinical sign. Vegetative state is such a condition wherein awareness is abolished whereas arousal persists. It can be diagnosed clinically soon after a brain injury and may be reversible (as in the following case report) or progress to a persistent vegetative state or death. The distinction between vegetative state and persistent vegetative state is that the second is defined as a vegetative state that has continued or endured for at least 1 month. 1 We present a patient who developed a vegetative state after carbon monoxide poisoning and in whom we had the opportunity to measure brain glucose metabolism distribution during the vegetative state and after recovery to consciousness. Using [18 F]fluorodeoxyglucose (FDG) PET and statistical parametric mapping (SPM) we compared both patient's sets to a normal control population. Our findings oVer an insight into the neural correlates of "awareness", pointing to a critical role for posterior associative cortices in consciousness.A 40 year old right handed woman attempted suicide through CO intoxication and was found unconscious. She was treated with hyperbaric oxygen but evolved to a vegetative state diagnosed according to the following criteria: 1 (1) spontaneous eye opening without evidence of awareness of the environment; (2) no evidence of reproducible voluntary behavioural responses to any stimuli; (3) no evidence of language comprehension or expression; (4) intermittent wakefulness and behaviourally assessed sleepwake cycles; (5) normal cardiorespiratory function and blood pressure control; (6) preserved pupillary, oculocephalic, corneal, and vestibulo-ocular reflexes. Brain MRI performed 14 days after admission was normal. Electroencephalography showed a 6 Hz basal activity with more pronounced slowing on the left parietal regions. Auditory evoked potentials were normal. Somaesthetic evoked potentials of the median nerve showed normal latency and amplitude of P14 and N20 potentials without any late cortical components. After remaining in a vegetative state for 19 days the patient regained consciousness. Her sequelae consisted of a bilateral spastic paresis of upper and lower limbs. Neuropsychological testing 1 month after admission showed an attention deficit with moderate impairment of short term memory. One year after the accident she showed a spastic gait with altered fine motor function, most prominent on the right, a slurred speech, and minor short term memory disturbances. FDG-PET was performed during the vegetative state (day 15 after admission) and after recovery to consciousness (day 37).The control population consisted of 48 drug free, healthy volunteers, aged from 18 to 76 years (mean: 42 (SD 21) years).The study was approved by the ethics committee of the University of Liège. Informed consent was obtained by the husband of the patient and ...

High rates of unprotected sexual behaviors and the exchange of sex for crack have been reported among female crack cocaine users. This subpopulation of drug users is at significant risk for contracting and transmitting HIV and AIDS. To date, there has been no research comparing crack- and opioid-abusing women, particularly regarding their involvement in high-risk behaviors and other key background indicators for different subgroups of drug-abusing women. Sixty-one crack-abusing African-American women who recently entered an intensive outpatient treatment program were compared to 64 matched women whose primary drug of abuse was heroin. The opioid subgroup represented both those who were involved in methadone maintenance and those who were out of treatment. Higher rates of high-risk sexual behaviors were reported by the crack subgroup, including prostitution, number of sexual partners, and infrequency of condom use. As expected, i.v. drug use and high-risk behaviors associated with needle use were much higher among the opioid subgroup. Other significant differences were found between the two groups across key indicators. Individuals in the crack subgroup were younger, cared for more children, were less employable, were less likely to be married, and had more extensive lifetime substance abuse. Quantitative and qualitative background and clinical data are also presented. The nature of crack versus heroin abuse is also discussed, particularly in relation to high-risk sexual behaviors. Finally, the impact of the findings on developing appropriate treatment interventions for both groups is addressed.