[An evaluation of pain in haemodialysis patients using different validated measurement scales]. / Evaluación del dolor en hemodiálisis mediante diversas escalas de medición validadas.

Pain in haemodialysis is very common, although frequently underdiagnosed. Chronic pain in dialysis has been scarcely evaluated, and intradialytic pain has not been specifically analyzed. Our aim was to compare intradialytic versus chronic pain characteristics in the same group of twenty-seven hemodialyzed patients, to investigate whether there were or not differences between them. Several validated scales were used: a) Analogical Visual Scale, defines pain intensity from 0, no pain, to 10, the worst pain; b) Pain Management Index, that results from subtracting pain level from analgesic use, ranging from - 3 (inadequate) to + 3 (adequate management); c) McGill Pain Questionnaire, which defines three items: pain related qualitative index, number of words chosen, and present pain intensity; and d) Brief Pain Inventory, which analyses influence of pain in patient's life, was only aplicable to evaluate chronic pain. Tests were administered firstly during the dialysis session for evaluating intradialytic pain, and another day out of the session to evaluate chronic pain. Ischemic pain was the most common during the session (37%), whereas muscle-skeletal was more frequent out of the session (77%). Prevalence of pain was higher during the session (92.5% vs 77.7%, p < 0.05). Number of weekly sessions with pain was 1.78 +/- 1.2. Analogical visual score was slightly higher during the session with respect to chronic pain (3.28 +/- 2.22 vs 2.67 +/- 2.13, p = NS). Pain Management Index scores were significantly different (intradialytic: -0.81 +/- 0.76, chronic pain: -0.12 +/- 0.94). McGill test scores were similar in both situations. Only in chronic pain, time on dialysis correlated significantly with analogical visual scores, pain related index and number of words chosen, and parathyroid hormone levels with analogical visual scores and interference to displacement score from Brief Pain Inventory. Farmacological treatment was prescribed in 11% of patients with intradialytic pain (63.1% of responders) compared to 74% for those with chronic pain (53.1% of responders). In conclusion, pain in hemodialysis is very frequent and becomes undertreated. Pain scales used have been shown to be useful in this setting. Several differences appear between intradialytic and chronic pain. Chronic pain is less frequent and intense, better treated, mainly derived from a muscle-skeletal source, and it is related to time on dialysis and to secondary hyperparathyroidism.

Evaluación del dolor en hemodiálisis mediante diversas escalas de medición validadas / No disponible

El dolor es un síntoma muy prevalente en hemodiálisis, pero pasa frecuentemente inadvertido. Los escasos estudios sobre el dolor en diálisis hacen únicamente referencia al dolor crónico. Para conocer las características del dolor intradiálisis y las del dolor crónico fuera de diálisis, se administraron diversas escalas de medición validadas, a un grupo de 27 pacientes en hemodiálisis: la Escala Visual Analógica, el Pain Management Index, el McGill Pain Questionnaire, y el Brief Pain Inventory, primero durante la sesión y posteriormente fuera de la misma. La etiología más frecuente del dolor intradiálisis fue la de tipo isquémico, y la del dolor crónico el musculo esquelético. La prevalencia del dolor intradiálisis fue mayor. El valor medio de la escala visual analógica fue ligeramente superior en el dolor intradiálisis. El valor medio del Pain Management Index fue superior en el dolor crónico. El McGill Pain Questionnaire mostró valores similares en ambas situaciones. Sólo en el dolor crónico el tiempo de permanencia en diálisis se relacionaba con la escala visual, el índice cualitativo total y el número de palabras escogidas, y los niveles de PTHi con la escala visual y la interferencia con el desplazamiento. Recibieron analgesia el 11% de pacientes para el dolor intradiálisis, y el 74% para el dolor crónico. Se concluye que el dolor en diálisis es muy frecuente y su manejo resulta inadecuado, y que las escalas utilizadas se han mostrado útiles para evaluar el dolor en diálisis. Respecto al dolor intradiálisis, el dolor crónico se muestra menos prevalente e intenso, mejor tratado, mayoritariamente de origen musculo esquelético y relacionado con el tiempo en diálisis y el hiperparatiroidismo (AU)

Pain in haemodialysis is very common, although frequently underdiagnosed. Chronic pain in dialysis has been scarcely evaluated, and intradialytic pain has not been specifically analyzed. Our aim was to compare intradialytic versus chronic pain characteristics in the same group of twenty-seven hemodialyzed patients, to investigate whether there were or not differences between them. Several validated scales were used: a) Analogical Visual Scale, defines pain intensity from 0, no pain, to 10,the worst pain; b) Pain Management Index, that results from subtracting pain level from analgesic use, ranging from – 3 (inadequate) to + 3 (adequate management); c) McGill Pain Questionnaire, which defines three items: pain related qualitative index, number of words chosen, and present pain intensity; and d) Brief Pain Inventory, which analyses influence of pain inpatient’s life, was only aplicable to evaluate chronic pain. Tests were administered firstly during the dialysis session for evaluating intradialytic pain, and another day out of the session to evaluate chronic pain. Ischemic pain was the most common during the session (37%), whereas muscle-skeletal was more frequent out of the session (77%). Prevalence of pain was higher during the session (92.5% vs 77.7%, p <0.05). Number of weekly sessions with pain was 1.78 ± 1.2. Analogical visual score was slightly higher during the session with respect to chronic pain (3.28 ± 2.22 vs 2.67 ± 2.13, p = NS). Pain Management Index scores were significantly different (intradialytic: -0.81 ±0.76, chronic pain: -0.12 ± 0.94). McGill test scores were similar in both situations. Only in chronic pain, time on dialysis correlated significantly with analogical visual scores, pain related index and number of words chosen, and parathyroid hormone levels with analogical visual scores and interference to displacement score from Brief Pain Inventory. Farmacological (..) (AU)

Analysis of mandelonitrile lyase and beta-glucosidase from sweet almonds by combined electrophoretic techniques.

Almonds are a rich source of mandelonitrile lyase (oxynitrilase) and beta-glucosidase. The isolation of these two enzymes from sweet almonds requires fractional ammonium sulfate precipitation followed by ion-exchange chromatography on diethylaminoethyl-(DEAE) and carboxymethylcellulose (CMC) columns. In the present investigation different electrophoretic techniques such as sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), isoelectric focusing in immobilized pH gradients (IEF-IPG), and capillary electrophoresis were used to characterize these two enzymes. For the first time, beta-glucosidase and oxynitrilase were separated in an immobilized pH gradient of one pH unit. Capillary zone electrophoresis (CZE) was an excellent tool for analysis of the purity of enzyme preparations, achieving complete separation of various protein constituents in only 15 min. CZE showed a resolving capacity for the separation of enzyme forms comparable to that of isoelectric focusing in an immobilized pH gradient.