Background Growing evidence suggests that beta-hydroxy-beta-methylbutyrate (HMB), arginine (Arg), and glutamine (Gln) positively affect wound recovery. This study investigated the effects of long-term administration of HMB/Arg/Gln on pressure ulcer (PU) healing in sedentary older adults admitted to geriatric and rehabilitation care facilities.
Methods This was a pilot retrospective case (standard of care and HMB/Arg/Gln)-control (standard of care alone) clinical study. Outcome measures were relative healing rates and Pressure Ulcer Scale for Healing (PUSH) scores (calculated after 4, 8, 12, 16, and 20 weeks) and time to healing.
Results The study subpopulation was comprised of 14 participants (four males, 28.6%) with the median age of 85.5 years (interquartile range [IQR], 82.0–90.2 years). The control subpopulation was comprised of 31 participants (18 males, 58.1%) with the median age of 84.0 years (IQR, 78.0–90.0 years). At the beginning of follow-up, there were no statistically significant demographic (sex and age) and clinical (main diagnosis, baseline area, and PU perimeter) differences between the groups. During the study period, there were no significant differences in the relative healing rates and PUSH scores between the subpopulations. The median time to complete healing in the study and control populations was 170.0 days (95% confidence interval [CI], 85.7–254.3) and 218.0 days (95% CI, 149.2–286.7) (log-rank, chi-square=3.99; p<0.046), respectively.
Conclusion More than 20 weeks of HMB/Arg/Gln supplementation had a positive effect on difficult PU healing in older adults with multiple comorbidities.
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Background Poor sleep quality is associated with psychoactive substance abuse/addiction/withdrawal. Auricular acupuncture (AA) is a nonpharmacological method used for the treatment of sleep disturbances. This study aimed to examine the quality of sleep before and after AA in participants with mental and behavioral disorders due to prior multiple drug use in the therapeutic community.
Methods This was a consecutive case series of 27 participants (25 male [92.6%]). The median age was 35.0 years (interquartile range [IQR], 29.0–37.2 years), methadone/buprenorphine were not used, and the participants were treated with AA (median number of treatments, 15.0 [IQR, 12.0–18.0]) during a median period of 51.0 days (IQR, 49.0–51.0 days) according to the National Acupuncture Detoxification Association (NADA)-Acudetox protocol. Sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI), a self-rated questionnaire that assesses sleep quality and disturbances over a 1-month interval.
Results The global PSQI score dropped (indicating better sleep quality) by a median of 3.0 points (IQR, 0.0–8.0 points) after treatment. In the multivariate logistic regression analysis, with an increase in global PSQI score during AA by 1 point, there was a 0.73-fold reduction in the risk of poor sleep quality post-AA (adjusted odds ratio, 0.73; 95% confidence interval, 0.52–1.01; p<0.055; Nagelkerke's R2=0.66).
Conclusion The results revealed a positive effect of AA (by the NADA-Acudetox protocol) on sleep quality (as measured by PSQI) among participants in a treatment center with mental and behavioral disorders due to multiple drug use.
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