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Abstract Background Migraine is a chronic neurologic disease that can severely affect the patient's quality of life. Although in recent years many randomised studies have been carried out to investigate the effectiveness of acupuncture as a treatment for migraine, it remains a controversial issue. Our aim is to determine whether acupuncture, applied under real conditions of clinical practice in the area of primary healthcare, is more effective than conventional treatment. Methods/Design The design consists of a pragmatic multi-centre, three-armed randomised controlled trial, complemented with an economic evaluation of the results achieved, comparing the effectiveness of verum acupuncture with sham acupuncture, and with a control group receiving normal care only. Patients eligible for inclusion will be those presenting in general practice with migraine and for whom their General Practitioner (GP) is considering referral for acupuncture. Sampling will be by consecutive selection, and by randomised allocation to the three branches of the study, in a centralised way following a 1:1:1 distribution (verum acupuncture; sham acupuncture; conventional treatment). Secondly, one patient in three will be randomly selected from each of the acupuncture (verum or sham) groups for a brain perfusion study (by single photon emission tomography). The treatment with verum acupuncture will consist of 8 treatment sessions, once a week, at points selected individually by the acupuncturist. The sham acupuncture group will receive 8 sessions, one per week, with treatment being applied at non-acupuncture points in the dorsal and lumbar regions, using the minimal puncture technique. The control group will be given conventional treatment, as will the other two groups. Discussion This trial will contribute to available evidence on acupuncture for the treatment of migraine. The primary endpoint is the difference in the number of days with migraine among the three groups, between the baseline period (the 4 weeks prior to the start of treatment) and the period from weeks 9 to 12. As a secondary aspect, we shall record the index of laterality and the percentage of change in the mean count per pixel in each region of interest measured by the brain perfusion tomography, performed on a subsample of the patients within the real and sham acupuncture groups. Trial registration Current Controlled Trials ISRCTN98703707.

Summary: The use of immunochemotherapy has improved the outcome of follicular lymphoma (FL). Recently, complete response at 30 months (CR30) has been suggested as a surrogate for progression‐free survival. This study aimed to analyse the life expectancy of FL patients according to their status at 30 months from the start of treatment in comparison with the sex and age‐matched Spanish general population (relative survival; RS). The training series comprised 263 patients consecutively diagnosed with FL in a 10‐year period who needed therapy and were treated with rituximab‐containing regimens. An independent cohort of 693 FL patients from the Grupo Español de Linfomas y Trasplante Autólogo de Médula Ósea (GELTAMO) group was used for validation. In the training cohort, 188 patients were in CR30, with a 10‐year overall survival (OS) of 53% and 87% for non‐CR30 and CR30 patients, respectively. Ten‐year RS was 73% and 100%, showing no decrease in life expectancy for CR30 patients. Multivariate analysis indicated that the FL International Prognostic Index was the most important variable predicting OS in the CR30 group. The impact of CR30 status on RS was validated in the independent GELTAMO series. In conclusion, FL patients treated with immunochemotherapy who were in CR at 30 months showed similar survival to a sex‐ and age‐matched Spanish general population. [ABSTRACT FROM AUTHOR]

Objective: A directed forgetting paradigm (word method) was used to assess the relationships between the event-related potentials (ERPs) recorded during the study phase and the subsequent forgetting effects.Methods: In the study phase 100 words were presented each followed by either an instruction to remember (R) or to forget (F). Then these 100 words, together with another 100 new words, were presented and subjects had to perform an old/new decision task. The forgetting effect was considered as the difference between the rate of R- and F-words correctly recognised. Based on this difference, the whole sample was divided into two 10-subject groups with high and low forgetting effect.Results: From 300 to 600 msec post-instruction differences in ERPs between R and F instructions were similar in both groups. In contrast, in the 100–300 msec epoch, ERP differences only appeared in the high-effect group and consisted of an enhanced positive activity elicited by F instruction at frontal and prefrontal areas and a larger positivity associated to R instruction at parietal area.Conclusions: The findings suggest that the processing of the word is kept on stand-by until the instruction is provided. Instruction to remember would reactivate this processing, which would mainly involve the parietal area, whereas instruction to forget appears to trigger frontal and prefrontal mechanisms trying to inhibit such processing. [Copyright &y& Elsevier]