Sex and Age Characteristics in Acute or Chronic Myocarditis A Descriptive, Multicenter Cohort Study.

BACKGROUND: Understanding the clinical features of myocarditis in various age groups is required to identify age-specific disease patterns. OBJECTIVES: The objective of this study was to examine differences in sex distribution and clinical outcomes in patients with myocarditis of various ages. METHODS: Patients with acute or chronic myocarditis in 3 centers in Berlin, Germany from 2005 to 2021 and in the United States (National Inpatient Sample) from 2010 to 2019 were included. Age groups examined included "prepubescent" (below 11 years for females and below 13 years for males), adolescents (11 [female] or 13 [male] to 18 years), young adults (18-35 years), "middle-aged adults" (35-54 years), and older adults (age >54 years). In patients admitted to the hospital, hospital mortality, length of stay, and medical complication rates were examined. RESULTS: Overall, 6,023 cases in Berlin and 9,079 cases in the U.S. cohort were included. In both cohorts, there were differences in sex distribution among the 5 age categories, and differences in the distribution were most notable in adolescents (69.3% males vs 30.7% females) and in young adults (73.8% males vs 26.3% females). Prepubescent and older adults had the highest rates of in-hospital mortality, hospital length of stay, and medical complications. In the Berlin cohort, prepubescent patients had higher levels of leukocytes (P < 0.001), antistreptolysin antibody (P < 0.001), and NT-proBNP (P < 0.001) when compared to young adults. CONCLUSIONS: In this study, we found that sex differences in myocarditis and clinical features of myocarditis were age-dependent.

Mortality and healthcare resource utilisation after cardiac arrest in the United States - A 10-year nationwide analysis prior to the COVID-19 pandemic.

AIM: Understanding the public health burden of cardiac arrest (CA) is important to inform healthcare policies, particularly during healthcare crises such as the COVID-19 pandemic. This study aimed to analyse outcomes of in-hospital mortality and healthcare resource utilisation in adult patients with CA in the United States over the last decade prior to the COVID-19 pandemic. METHODS: The United States (US) National Inpatient Sample was utilised to identify hospitalised adult patients with CA between 2010 and 2019. Logistic and Poisson regression models were used to analyse outcomes by adjusting for 47 confounders. RESULTS: 248,754 adult patients with CA (without "Do Not Resuscitate"-orders) were included in this study, out of which 57.5% were male. In-hospital mortality was high with 51.2% but improved significantly from 58.3% in 2010 to 46.4% in 2019 (P < 0.001). Particularly, elderly patients, non-white patients and patients requiring complex therapy had a higher mortality rate. Although the average hospital LOS decreased by 11%, hospital expenses have increased by 13% between 2010 and 2019 (each P < 0.001), presumably due to more frequent use of mechanical circulatory support (MCS, e.g. ECMO from 2.6% to 8.7% or Impella® micro-axial flow pump from 1.8% to 14.2%). Strong disparities existed among patient age groups and ethnicities across the US. Of note, the number of young adults with CA and opioid-induced CA has almost doubled within the study period. CONCLUSION: Over the last ten years prior to the COVID-19 pandemic, CA-related survival has incrementally improved with shorter hospitalisations and increased medical expenses, while strong disparities existed among different age groups and ethnicities. National standards for CA surveillance should be considered to identify trends and differences in CA treatment to allow for standardised medical care.

Safety and Healthcare Resource Utilization in Patients Undergoing Left Atrial Appendage Closure-A Nationwide Analysis.

Percutaneous left atrial appendage closure (LAAC) has emerged as a non-pharmacological alternative for stroke prevention in patients with atrial fibrillation (AF) not suitable for anticoagulation therapy. Real-world data on peri-procedural outcomes are limited. The aim of this study was to analyze outcomes of peri-procedural safety and healthcare resource utilization in 11,240 adult patients undergoing LAAC in the United States between 2016 and 2019. Primary outcomes (safety) were in-hospital ischemic stroke or systemic embolism (SE), pericardial effusion (PE), major bleeding, device embolization and mortality. Secondary outcomes (resource utilization) were adverse discharge disposition, hospital length of stay (LOS) and costs. Logistic and Poisson regression models were used to analyze outcomes by adjusting for 10 confounders. SE decreased by 97% between 2016 and 2019 [95% Confidence Interval (CI) 0-0.24] (p = 0.003), while a trend to lower numbers of other peri-procedural complications was determined. In-hospital mortality (0.14%) remained stable. Hospital LOS decreased by 17% (0.78-0.87, p < 0.001) and adverse discharge rate by 41% (95% CI 0.41-0.86, p = 0.005) between 2016 and 2019, while hospital costs did not significantly change (p = 0.2). Female patients had a higher risk of PE (OR 2.86 [95% CI 2.41-6.39]) and SE (OR 5.0 [95% CI 1.28-43.6]) while multi-morbid patients had higher risks of major bleeding (p < 0.001) and mortality (p = 0.031), longer hospital LOS (p < 0.001) and increased treatment costs (p = 0.073). Significant differences in all outcomes were observed between male and female patients across US regions. In conclusion, LAAC has become a safer and more efficient procedure. Significant sex differences existed across US regions. Careful considerations should be taken when performing LAAC in female and comorbid patients.

Anterior eye parameters and lens thickness measured by an intraoperative OCT and a swept-source OCT: comparison of hyperopic, emmetropic and myopic eyes.

PURPOSE: To evaluate if anterior chamber depth (ACD) and lens thickness (LT) measured by two different devices are affected by different eye lengths. METHODS: ACD and LT of 251 eyes (44 hyperopic, 60 myopic, 147 emmetropic) of 173 patients received with an iOCT-guided femtosecond laser-assisted lens surgery (FLACS) and the IOL Master 700 were compared. RESULTS: ACD measured with the IOL Master 700 was -0.026 ± 0.125 mm smaller (p = 0.001) than that with the iOCT for all eye-groups (hyperopic: p = 0.601, emmetropic: p = 0.003; myopic: p = 0.094). However, differences in all groups were not clinically relevant. LT measurements (all eyes: -0.0642 ± 0.0504 mm) shows a statistically significant difference in all evaluated groups (p < 0.001). Only myopic eyes showed a clinically relevant difference in LT. CONCLUSION: The two devices show no clinically relevant differences in the eye-length groups (myopic, emmetropic, and hyperopic) for all ACD measurements. LT data shows a clinically relevant difference only for the group of myopic eyes.

Left-ventricular unloading in extracorporeal cardiopulmonary resuscitation due to acute myocardial infarction - A multicenter study.

BACKGROUND: Guidelines advocate the use of extracorporeal cardio-pulmonary resuscitation with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in selected patients with cardiac arrest. Effects of concomitant left-ventricular (LV) unloading with Impella® (ECMELLA) remain unclear. This is the first study to investigate whether treatment with ECMELLA was associated with improved outcomes in patients with refractory cardiac arrest caused by acute myocardial infarction (AMI). METHODS: This study was approved by the local ethical committee. Patients treated with ECMELLA at three centers between 2016 and 2021 were propensity score (PS)-matched to patients receiving VA-ECMO based on age, electrocardiogram rhythm, cardiac arrest location and Survival After Veno-Arterial ECMO (SAVE) score. Cox proportional-hazard and Poisson regression models were used to analyse 30-day mortality rate (primary outcome), hospital and intensive care unit (ICU) length of stay (LOS) (secondary outcomes). Sensitivity analyses on patient demographics and cardiac arrest parameters were performed. RESULTS: 95 adult patients were included in this study, out of whom 34 pairs of patients were PS-matched. ECMELLA treatment was associated with decreased 30-day mortality risk (Hazard Ratio [HR] 0.53 [95% Confidence Interval (CI) 0.31-0.91], P = 0.021), prolonged hospital (Incidence Rate Ratio (IRR) 1.71 [95% CI 1.50-1.95], P < 0.001) and ICU LOS (IRR 1.81 [95% CI 1.57-2.08], P < 0.001). LV ejection fraction significantly improved until ICU discharge in the ECMELLA group. Especially patients with prolonged low-flow time and high initial lactate benefited from additional LV unloading. CONCLUSIONS: LV unloading with Impella® concomitant to VA-ECMO therapy in patients with therapy-refractory cardiac arrest due to AMI was associated with improved patient outcomes.

Encountering Ostomies in Acute Care: Peristomal Skin Changes.

ABSTRACT: Up to 80% of individuals with an ostomy experience a peristomal skin complication, which can result in significant healthcare issues. All clinicians working with patients with stomas need to be aware of the signs and symptoms of peristomal skin complications and basic strategies to address the most common cause of skin complications: leakage of stool or other effluent onto the skin. Use of an evidence-based, standardized instrument to guide peristomal assessment and selection of appropriate interventions can improve patient outcomes and increase meaningful collaboration between all members of the healthcare team. This case study addresses dilemmas of care during a non-ostomy-related hospitalization.

Intraoperative OCT vs Scheimpflug and swept-source OCT measurements for anterior eye parameters.

PURPOSE: To compare agreement of anterior segment parameter measurements using an intraoperative optical coherence tomography (iOCT) of a femtosecond laser (LenSx) during interface docking to the eye with preoperative Scheimpflug tomography (Pentacam AXL) and swept-source optical coherence tomography (SS-OCT) (IOLMaster 700). SETTING: Department of Ophthalmology, Goethe University, Frankfurt, Germany. DESIGN: Retrospective study. METHODS: Anterior segment measurements were performed in mydriasis prior to surgery using Scheimpflug tomography and SS-OCT. Postoperatively, iOCT images were analyzed using a modification of the FIJI image-processing program. Outcome measures included external anterior chamber depth (ACD), central corneal thickness (CCT), and central lens thickness (LT). RESULTS: 95 eyes of 66 patients who underwent planned OCT guided femtosecond laser-assisted lens surgery were included. The ACD measured with the iOCT was -0.011 ± 0.126 mm smaller (P = .389) than that with the SS-OCT and -0.059 ± 0.185 mm than with the Scheimpflug tomography (P = .003). The SS-OCT measured a -0.047 ± 0.146 mm smaller ACD than the Scheimpflug tomography (P = .002). The measurements of CCT using the iOCT and the Scheimpflug tomography (-0.705 ± 20.837 µm, P = .742) and the LT measurements using SS-OCT and iOCT (-0.050 ± 0.089 mm, P < .001) showed no clinically relevant difference. Only the ACD between the iOCT and the Scheimpflug tomography showed a clinically relevant difference. CONCLUSIONS: The comparison of the anterior segment parameters of iOCT with SS-OCT showed no clinically relevant differences regarding the ACD and the LT. However, Scheimpflug tomography vs iOCT measured a small clinically relevant difference for ACD. The iOCT showed no clinically relevant differences in anterior segment parameters compared with the SS-OCT. A small clinically relevant difference for ACD was found in comparison with that of a Scheimpflug device.

C-reactive Protein Levels in Plasma and Chronic Venous Ulcer Exudate of Persons Who Inject Drugs: A Pilot Study.

BACKGROUND: Persons who inject drugs (PWID) in the groin, legs, and/or feet are at high risk for chronic venous ulcers (CVUs). The plasma C-reactive protein (CRP) level is a marker of systemic inflammation. OBJECTIVE: This pilot study examined CRP levels in plasma and CVU exudate of PWID. The aims were to (1) compare levels of CRP in plasma and exudate; (2) examine if the CRP level in exudate changed over 4 weeks with wound treatment; and (3) examine the relationship of the exudate CRP level with CVU area, CVU age, number of CVUs, and number of comorbidities. MATERIALS AND METHODS: Persons who inject drugs seeking wound care were enrolled in this Institutional Review Board approved prospective, longitudinal, descriptive study. A blood sample was collected on the first visit (week 1); the plasma was then separated. Wound exudate was collected on swabs during the first visit (week 1) and 4 weeks later (week 4). All samples were stored at -80° C. Samples were eluted from swabs using mass spectrometry grade water then aliquoted for CRP analysis. RESULTS: The participants of the study included 14 PWID (mean age, 62.14 ± 4.52 years; mean number of comorbidities, 5.71 ± 1.90; and mean number of ulcers 2.07 ± 1.07 that were present for a mean of 7.96 ± 11.91 years without healing). C-reactive protein level in plasma was a mean of 6.47 ± 8.56 mg/L, with lower levels found in wound exudate but highly correlated (rho = .925). Exudate CRP levels decreased from week 1 to week 4, and the 2 were highly correlated (rho = .895). Exudate CRP level week 1 was not significantly related to wound area, wound age, number of ulcers, or number of comorbidities. CONCLUSIONS: Plasma and exudate CRP levels were highly correlated. Exudate CRP levels decreased across time. Future large-scale wound healing studies should examine CRP levels over a longer duration and as they correlate to wound healing.

Development of the middle-range theory of wound itch.

The problem of itch occurring with chronic wounds has been recognised, but is often ignored in practice. This paper describes the process of how the 'theory of wound itch' was formulated from Levine's conservation model. Concepts and propositions from the conceptual model were used to develop the theory. The theory will provide a basis for nursing research and practice.

Evaluating the Manitoba Infant Feeding Database: a Canadian infant feeding surveillance system.

OBJECTIVE: The Manitoba Infant Feeding Database (MIFD) is being piloted as a surveillance system leveraging infant vaccination visits as a point of contact to collect infant feeding data during the first year of life. The objective of this study was to assess data quality and acceptability of the MIFD as a sustainable population-based surveillance system. METHODS: Internal completeness and internal validity were measured to assess data quality. Internal completeness was defined as the number of completed data fields out of the total number of data fields. Internal validity was defined as the proportion of translation errors from one level of the system, the paper questionnaire, to the next, the electronic database. A survey assessed staff's acceptance of data collection and submission processes. RESULTS: A total of 947 records were reviewed. Data were 98.5% complete. Discrepancies were noted in 13.5% of data. The survey response rate was 78.4%. Nearly all respondents reported that the MIFD data collection tool was easy to use (96.6% agreed or strongly agreed). Whereas some challenges were identified, the majority were willing to continue with the MIFD data collection tool and process (93.1%). CONCLUSION: Results from this evaluation suggest that the MIFD data collection process worked well; however, data validation will require human resources. The MIFD approach provides a sustainable mechanism for collecting data on infant feeding for surveillance and research purposes.

Descriptors for Itch Related to Chronic Wounds.

INTRODUCTION: Wound-related itch can be a source of great discomfort for patients with chronic wounds. Although itch is common among patients with chronic wounds, it is an understudied phenomenon. A greater understanding of itch is needed in order for clinicians to more effectively manage it. OBJECTIVE: The purpose of this study is to identify descriptors for wound-related itch based on patient responses. METHODS: Data from structured interviews of patients with chronic wounds were analyzed. Those patients who described wound-related itch were asked to rate how much various descriptors matched their itch on a scale of 0 (not at all) to 4 (to a great extent). Analysis included descriptive statistics and principal components factor analysis. RESULTS: Fifty-six of 199 (28%) patients with wound-related itch rated descriptors, and 5 categories of descriptors were identified. A concise set of 15 descriptors of itch related to chronic wounds was defined from this. CONCLUSIONS: This list of descriptors for wound-related itch can be tested further for clinical use and for research purposes when wound-related itch is being explored.

Protocol for establishing an infant feeding database linkable with population-based administrative data: a prospective cohort study in Manitoba, Canada.

INTRODUCTION: Breast feeding is associated with many health benefits for mothers and infants. But despite extensive public health efforts to promote breast feeding, many mothers do not achieve their own breastfeeding goals; and, inequities in breastfeeding rates persist between high and low-income mother-infant dyads. Developing targeted programme to support breastfeeding dyads and reduce inequities between mothers of different socioeconomic status are a priority for public health practitioners and health policy decision-makers; however, many jurisdictions lack the timely and comprehensive population-level data on infant-feeding practices required to monitor trends in breastfeeding initiation and duration. This protocol describes the establishment of a population-based infant-feeding database in the Canadian province of Manitoba, providing opportunities to develop and evaluate breastfeeding support programme. METHODS AND ANALYSIS: Routinely collected administrative health data on mothers' infant-feeding practices will be captured during regular vaccination visits using the Teleform fax tool, which converts handwritten information to an electronic format. The infant-feeding data will be linked to the Manitoba Population Research Data Repository, a comprehensive collection of population-based information spanning health, education and social services domains. The linkage will allow us to answer research questions about infant-feeding practices and to evaluate how effective current initiatives promoting breast feeding are. ETHICS AND DISSEMINATION: Approvals have been granted by the Health Research Ethics Board at the University of Manitoba. Our integrative knowledge translation approach will involve disseminating findings through government and community briefings, presenting at academic conferences and publishing in scientific journals.

The effect of brumation on memory retention.

Long-term torpor is an adaptive strategy that allows animals to survive harsh winter conditions. However, the impact that prolonged torpor has on cognitive function is poorly understood. Hibernation causes reduced synaptic activity and experiments with mammals reveal that this can have adverse effects on memories formed prior to hibernation. The impact of brumation, the winter dormancy that is observed in ectotherms, on memory remains unknown. The aim of this study was to examine whether an amphibian, the fire salamander (Salamandra salamandra), was able to retain learned spatial information after a period of brumation. Twelve fire salamanders were trained to make a simple spatial discrimination using a T-maze. All subjects learned the initial task. Upon reaching criterion, half of the subjects were placed into brumation for 100 days while the other half served as controls and were maintained under normal conditions. A post-brumation memory retention test revealed that animals from both conditions retained the learned response. Control tests showed that they solved the task using learned information and not olfactory cues. This finding contrasts with much of the mammalian research and suggests that the processes involved in prolonged torpor may have a fundamentally different impact on memory in mammals and amphibians.

Describing Art - An Interdisciplinary Approach to the Effects of Speaking on Gaze Movements during the Beholding of Paintings.

Ever since the Renaissance speaking about paintings has been a fundamental approach for beholders, especially experts. However, it is unclear whether and how speaking about art modifies the way we look at it and this was not yet empirically tested. The present study investigated to the best of our knowledge for the first time in what way speaking modifies the patterns of fixations and gaze movements while looking at paintings. Ninety nine university students looked at four paintings selected to cover different art historical typologies for periods of 15 minutes each while gaze movement data were recorded. After 10 minutes, the participants of the experimental group were asked open questions about the painting. Speaking dramatically reduced the duration of fixations and painting area covered by fixations while at the same time increasing the frequencies of fixations, gaze length and the amount of repeated transitions between fixation clusters. These results suggest that the production of texts as well-organised sequences of information, structures the gazes of art beholders by making them quicker, more focused and better connected.

A 6-year retrospective review of pediatric firearm injuries: do patients < 14 years of age differ from those 15-18 years of age?

BACKGROUND: Pediatric firearm injuries are an increasing source of morbidity. Firearm injuries in adolescents are common but not well studied in younger children. The aims were to describe the epidemiology of firearm injuries in patients 0 year to 18 years old, with a case study of patients 14 years or younger for determining shooting characteristics and epidemiologic trends. METHODS: Part 1 obtained data from hospital trauma registry. Inclusion criteria were patients 0 year to 18 years of age presenting from 2005 to 2010 with firearm injury and registry inclusion. Demographic and injury data were extracted. Part 2 included a retrospective review of patients 14 years or younger including hospital and emergency medical services records. Data from the group 0 year to 14 years included shooting and treatment details. Categorical variables were described using counts and percentages. Differences between the groups were assessed using odds ratios (ORs), along with 95%confidence intervals (CIs), extracted from logistic regression models. RESULTS: Registry query resulted in 456 patients (0-18 years), including 78 patients who are 14 years or younger. In the group of 0 to 18 years, 86% were male; 83% were black in the group of 15 to 18 years and 64% in the group 0 to 14 years. Overall death rate was 7%. Patients in the group of 15 years to 18 years were twice more likely (23% vs. 11%) to arrive via car or walk-in compared with the patients in the group of 0 year to 14 years (OR, 2.32;95% CI, 1.07-5.03). Patients in the group of 0 year to 14 years were almost four times more likely to be shot at home compared with those who are 15 years to 18 years (OR, 3.76; 95% CI, 2.29-6.19). Patients in the group of 5 years to 9 years were six times more likely to have multiple injury sites compared with those who are 10 years to 14 years (OR, 6.26; 95% CI, 1.26-31.09). Only 13% had documented child protective services notification. CONCLUSION: Results from this study suggest that firearm injuries differ in younger patients compared with adolescents. The younger subset was more likely to be shot at home versus public settings. Hospital and emergency medical services records lacked important shooting details often found in crime scene reports, which are necessary for the development of effective crime and prevention strategies.

Touchscreen performance and knowledge transfer in the red-footed tortoise (Chelonoidis carbonaria).

In recent years red-footed tortoises have been shown to be proficient in a number of spatial cognition tasks that involve movement of the animal through space (e.g., the radial maze). The present study investigated the ability of the tortoise to learn a spatial task in which the response required was simply to touch a stimulus presented in a given position on a touchscreen. We also investigated the relation between this task and performance in a different spatial task (an arena, in which whole-body movement was required). Four red-footed tortoises learned to operate the touchscreen apparatus, and two learned the simple spatial discrimination. The side-preference trained with the touchscreen was maintained when behaviour was tested in a physical arena. When the contingencies in the arena were then reversed, the tortoises learned the reversal but in a subsequent test did not transfer it to the touchscreen. Rather they chose the side that had been rewarded originally on the touchscreen. The results show that red-footed tortoises are able to operate a touchscreen and can successfully solve a spatial two-choice task in this apparatus. There was some indication that the preference established with the touchscreen could transfer to an arena, but with subsequent training in the arena independent patterns of choice were established that could be evoked according to the test context.

More harm than good: antiseizure prophylaxis after traumatic brain injury does not decrease seizure rates but may inhibit functional recovery.

BACKGROUND: The purposes of this study were to examine the current Brain Trauma Foundation recommendation for antiseizure prophylaxis with phenytoin during the first 7 days after traumatic brain injury (TBI) in preventing seizures and to determine if this medication affects functional recovery at discharge. METHODS: The records of adult (age ≥ 18 years) patients with blunt severe TBI who remained in the hospital at least 7 days after injury were retrospectively reviewed from January 2008 to January 2010. Clinical seizure rates during the first 7 days after injury and functional outcome at discharge were compared for the two groups based on antiseizure prophylaxis, no prophylaxis (NP) versus phenytoin prophylaxis (PP). Statistical analysis was performed using χ2. RESULTS: A total of 93 adult patients who met the previously mentioned criteria were identified (43 [46%] NP group vs. 50 [54%] PP group). The two groups were well matched. Contrary to expectation, more seizures occurred in the PP group as compared with the NP group; however, this did not reach significance (PP vs. NP, 2 [4%] vs. 1 [2.3%], p = 1). There was no significant difference in the two groups (PP vs. NP) as far as disposition are concerned, mortality caused by head injury (4 [8%] vs. 3 [7%], p = 1), discharge home (16 [32%] vs. 17 [40%], p = 0.7), and discharge to rehabilitation (30 [60%] vs. 23 [53%], p = 0.9). However, with PP, there was a significantly longer hospital stay (PP vs. NP, 36 vs. 25 days, p = 0.04) and significantly worse functional outcome at discharge based on Glasgow Outcome Scale (GOS) score (PP vs. NP, 2.9 vs. 3.4, p < 0.01) and modified Rankin Scale score (2.3 ± 1.7 vs. 3.1 ± 1.5, p = 0.02). CONCLUSION: PP may not decrease early posttraumatic seizure and may suppress functional outcome after blunt TBI. These results need to be verified with randomized studies before recommending changes in clinical practice and do not apply to penetrating trauma. LEVEL OF EVIDENCE: Therapeutic study, level IV; epidemiologic study, level III.

A cross-sectional study of chronic wound-related pain and itching.

Persons with chronic wounds may experience wound-related itch (pruritus) and pain. A cross-sectional study was conducted to examine the occurrence of itch and pain in chronic wounds and the relationship of the intensity between these factors. Patients in an outpatient wound care center, 18 years and older with an open wound, were recruited consecutively over a 5-month period. The 199 participants (112 [56%] men) had a mean age of 67 years (range 21-98 years); one wound per person was addressed and included venous (31), arterial (23), neuropathic (31), pressure-related (33), traumatic (37), and "other" (41) wounds. Wound-related pain and itch data were obtained using a modified Paul-Pieper Itching Questionnaire and Characteristics of Itch Questionnaire. Responses were hand-recorded and coded without personal identifiers and analyzed using descriptive statistics, and associations among data were assessed using Pearson chi-square, Mantel-Haenszel chi-square, and Cochran-Armitage trend tests. Wound-related itch was significantly associated with participant age (P = 0.011) and employment status (P = 0.003). Wound-related pain was significantly associated only with education level (P = 0.048). Persons with venous wounds had both the largest proportion with wound-related itch (45.2%) and the largest proportion with wound-related pain (61.2%) out of all of the wound types. Persons with diabetic neuropathy had both the smallest proportion with wound-related itch (16.1%) and the smallest proportion with wound-related pain (35.4%) among all of the wound types. Associations between wound type and wound-related itch or pain were not significant. When venous wounds were compared to all other wound types combined, wound-related itch was significantly associated (P = 0.021) with wound type - ie, venous wound type and itch was statistically significant when venous wounds were compared to a combination of all other wound types. Wound-related pain and itch occurred together in 35 participants (17.6%) across all wound types. Pain and itch on the wound were significantly associated (r = .36, P = 0.043), as were pain and itch around the wound (r = .43, P = 0.002). Because pain and itching can occur with chronic wounds and the presence of one factor can affect the other, clinicians need to assess and manage both symptoms in patients with wounds.