Analysis of the Risk Factors for Mechanical Allodynia in Herpetic Neuralgia: A Retrospective Cross-Sectional Study.

Purpose: Mechanical allodynia is reportedly common during herpetic neuralgia. The purpose of this study was to establish a risk prediction model to predict the individual risk of allodynia in herpetic neuralgia. Methods: Three hundred and eighty-six patients with trunk herpetic neuralgia were divided into two regions, T2-5 and T6-11. The causality between allodynia and other factors was analyzed by a binary logistic regression model. Results: 42.2% of subjects had allodynia, 137 suffered from dynamic allodynia, and 110 with dynamic allodynia experienced local sweating. The following 5 items as predictors determined this model: local sweating (Odd Ratio = 27.57, P<0.001), lesion location (Odd Ratio=2.46, P =0.017), pain intensity (Odd Ratio=1.38, P =0.020), pain duration (Odd Ratio=0.94, P =0.006), and local scars (Odd Ratio=0.07, P<0.001). The presence and development of allodynia are associated with local sweating. The positive proportion of the Iodine-starch test between the T2-5 (50.0%) with the T6-11 (23.7%) had a statistically significant difference (χ2=5.36, P=0.021). 29.5% of patients at the T2-6 had obvious sweating, which was different from only sticky feelings at the T6-11 (70.5%, χ2=10.88, P=0.001). 19.2% of patients with residual scars and allodynia was significantly lower than 48.5% of patients without allodynia (χ2=15.28, P<0.001). Conclusion: This analysis suggests that local sweating is a concomitant symptom in dynamic allodynia, which imply the sympathetic nerves innervating the sweat glands of the skin were also involved during herpetic neuralgia. This may assist in the evaluation of dynamic allodynia and prove the role of sympathetic nerve intervention for herpetic neuralgia.

Low Trend for VZV-Associated Disease Patients to Visit Neurologists.

Background: Herpes zoster (HZ) is a skin disease that can also cause virus-infectious peripheral neuropathies. Despite this, there is limited information on patient preferences for seeking medical attention for HZ and zoster-associated pain (ZAP). Our study aimed to evaluate how frequently patients with ZAP choose to visit neurologists for their symptoms. Methods: This study conducted a retrospective review of electronic health records in three general hospitals from January 2017 to June 2022. Using association rule mining, the study analyzed referral behaviors. Results: We identified 33,633 patients with 111,488 outpatient visits over 5.5 years. The study found that the majority of patients (74.77-91.22%) visited dermatologists during their first outpatient visit, while only a small percentage (0.86-1.47%) preferred to consult a neurologist. The proportion of patients referred to a specialist during their medical visit varied significantly between different specialties within the same hospital (p <0.05) and even within the same specialty (p<0.05). There was a weak association (Lift:1.00-1.17) of referral behaviors between dermatology and neurology. Across the three hospitals, the average number of visits to a neurologist for ZAP was 1.42-2.49, with an average electronic health record duration of 11-15 days per patient. After consulting with a neurologist, some patients were referred to other specialists. Conclusion: It was observed that patients with HZ and ZAP tended to visit a variety of specialists, with only a small number seeking the assistance of neurologists. However, from the perspective of neuroprotection, it is the duty of neurologists to provide more means.

Role of metabolic equivalent between calcium intake and vertebral fractures: a cross-sectional study of NHANES 2013-2014.

BACKGROUND: This study was to analyze the association of calcium intake and metabolic equivalent (MET) with vertebral fractures, and to explore the role of MET between calcium intake and vertebral fractures. METHOD: This cross-sectional study used data from the National Health and Nutrition Examination Surveys (NHANES) 2013-2014. The study involved individuals aged ≥ 50 years old with complete information on vertebral fracture, calcium intake, and physical activity. Vertebral fracture assessment is obtained using dual-energy x-ray absorptiometry to perform a lateral scan of the thoracolumbar spine. Calcium intake included total nutrient intake and total dietary supplements. The total MET is the sum of the METs for each activity (Vigorous/ moderate work-related activities, walking or bicycling for transportation and vigorous/ moderate recreational activities). Univariate and multivariate logistic regression analyses were utilized to investigate the effect of calcium intake, MET, and their combined effect on vertebral fracture. RESULTS: A total of 766 participants were included in the analysis, and 54 participants had vertebral fractures. The median calcium intake and MET were 8.43 mcg and 280.00, respectively. Multivariate results showed that neither calcium intake nor MET as continuous or categorical variables was significantly associated with vertebral fractures. MET < 160 and calcium intake ≥ 670 mg group was associated with the decreased risks of vertebral fracture [odds ratio (OR) = 0.47, 95% confidence interval (CI): 0.26-0.83, P = 0.032] after adjusting for age, race, energy, total femur bone mineral density (BMD), and femoral neck BMD. In the group of MET < 160, increased calcium intake was associated with a reduced risk of vertebral fracture, with a decreased OR value. In the group of MET ≥ 160, increased calcium intake was associated with an increased risk of vertebral fracture, with an increased OR value. CONCLUSION: The combination of MET < 160 and calcium intake ≥ 670 mg was associated with decreased risks of vertebral fractures. There may be an interaction between calcium intake and MET on vertebral fracture risk.

The Healing Effects of Piano Practice-Induced Hand Muscle Injury.

Background: The muscles related to piano practice are mainly concentrated in the fingers and upper limbs, and the muscles related to other parts of the body are weak. Compared with other sports injuries, the injuries caused by piano practice are mainly chronic injuries caused by long-term strain of the upper limbs, and acute injuries rarely occur. The purpose of this study was to analyze the therapeutic effect of hand muscle injury caused by piano practice. Method: A total of 60 patients with hand muscle injury caused by piano practice admitted to our hospital from January 2019 to June 2020 were selected. According to the number random grouping method, they were randomly divided into two groups. There were 30 patients in the observation group, including 20 males and 10 females, aged 24-53 (39.51 ± 7.01) years old, and the course of disease was 1-5 (3.24 ± 1.62) months. In the control group, there were 30 patients, including 18 males and 12 females, aged 24-56 (39.62 ± 7.17) years old, and the course of disease was 1.5-5 (3.14 ± 1.71) months. If the observation group experienced excessive pain, the group took ibuprofen sustained-release capsules. On weekdays, exercise your fingers 2-3 times per day. After the intervention, the wrist joint function score of the observation group was higher than that before the intervention. Results: Before treatment, there was no significant difference in pain level scores between the two groups (P > 0.05). After treatment, the limb pain score in the observation group was lower than that in the control group. The effective rate of hand tendon rehabilitation in the observation group was 93.33%. The effective rate of hand tendon rehabilitation in the control group was 70.00%. The comparison results showed that there was statistical significance (P < 0.05). The score of the observation group was significantly higher than that of the control group, with statistically significant differences (P < 0.05). Conclusion: Piano workouts can cause hand muscle difficulties, which can be alleviated by daily finger gymnastics. Daily finger exercises are simple and not limited by time and place. Piano practitioners can use the spare time of daily training and performance to exercise for a long time, so as to prevent or recover finger muscle damage caused by piano practice. It has the potential to help pianists avoid hand muscle injuries when practicing while also allowing music to reach its full potential.