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1.
Biol Pharm Bull ; 45(3): 360-363, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-34937813

RESUMO

In this study, we investigated the effects of fosphenytoin (fPHT), a water-soluble prodrug of phenytoin, on the pain responses of a mouse herpes zoster (HZ) pain model. Transdermal herpes simplex virus type 1 (HSV-1) inoculation induced mechanical allodynia and hyperalgesia of the hind paw and spontaneous pain-like behaviors, such as licking the affected skin. Intravenous injection of fPHT (15 and 30 mg/kg) alleviated HSV-1-induced provoked pain (allodynia and hyperalgesia). The suppressive effects of fPHT on provoked pain were weaker than those of diclofenac and pregabalin which were used as positive controls. fPHT, diclofenac, and pregabalin significantly suppressed HSV-1-induced spontaneous pain-like behaviors. Among them, high-dose fPHT (30 mg/kg) showed the strongest suppression. Intravenous fPHT may become a viable option for an acute HZ pain, especially for spontaneous pain.


Assuntos
Herpes Simples , Herpesvirus Humano 1 , Animais , Herpes Simples/tratamento farmacológico , Hiperalgesia/tratamento farmacológico , Camundongos , Dor/tratamento farmacológico , Fenitoína/análogos & derivados , Fenitoína/farmacologia , Fenitoína/uso terapêutico
2.
3.
Laryngorhinootologie ; 101(8): 631, 2022 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-35915898
4.
Eur Rev Med Pharmacol Sci ; 26(14): 5043-5052, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35916800

RESUMO

OBJECTIVE:   Sickle Cell Anemia (SCA), also called the Sickle Cell Disease (SCD), is an inherited hematological disorder characterized by a syndrome of acute anemia and a painful crisis. The sickling hemoglobin, Hgb-S causes viscosity and inflammation of blood vessels. Eventually, the red blood cells get eliminated from the circulation process, which leads to hemolytic anemia. This study examined the comparative effectiveness of supplementation of Omega-3 or vitamin-D to standard therapy (hydroxyurea + Ibuprofen) used for prevention and treatment of pain crises in pediatric patients living with SCD. PATIENTS AND METHODS: 165 patients participated in this randomized, double-blind, standard therapy-controlled, parallel-design trial. The patients were randomly divided into three groups, receiving three capsules of either 1,000 mg Omega-3 fish oil (400 mg EPA and 300 mg DHA) or 1.5 mL vitamin-D (2,800 IU/7 ml) daily for 10 months plus the standard therapy. Lactate dehydrogenase, high-density lipoprotein (HDL), low-density lipoprotein (LDL), hematocrit, reticulocyte count, and white-blood-cell count were determined at baseline (month zero) and end of the 10th month. The pain severity was measured using the visual analog scale method (VAS). Therefore, a 10-cm ruler with a VAS design was used to determine the patient pain intensity. The baseline time point was defined as the time spot before starting to deliver the experimental medication to the patients (month zero). At that time, the biodata of the patient on the frequency of pain episodes and the rest of the variables were collected, and the baseline data were one-year retrospective data. RESULTS: Of 165 patients enrolled in the trial, 150 were included in the final analysis. At the end of the study, there was a significant increase in serum LDL and HDL in the Omega-3 group as compared with the control group (mean of 82 mg/dL vs. 57 mg/dL; p < 0.01 and mean of 47 mg/dL vs. 43 mg/dL; p < 0.028, respectively). Other laboratory parameters were significantly influenced. The number of painful crises and pain levels was significantly decreased in the Omega-3 group compared with the control group (mean of one-episode vs. mean of three episodes; p = 0.01, mean of three on pain scale vs. six on pain scale; p = 0.018). CONCLUSIONS: Results showed that Omega-3 was more effective than vitamin-D or standard treatment alone relative to pain crises and most of the other studied items. Vitamin-D was more effective than standard therapy alone. Clinicians should consider the addition of Omega-3 supplements to the standard therapy and a de-escalation dose plan for the hydroxyurea medication.


Assuntos
Anemia Falciforme , Ácidos Graxos Ômega-3 , Anemia Falciforme/complicações , Anemia Falciforme/tratamento farmacológico , Método Duplo-Cego , Ácidos Graxos Ômega-3/uso terapêutico , Humanos , Hidroxiureia/uso terapêutico , Dor/tratamento farmacológico , Estudos Retrospectivos , Vitamina D , Vitaminas/uso terapêutico
5.
Cochrane Database Syst Rev ; 8: CD010738, 2022 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-35930364

RESUMO

BACKGROUND: Venous leg ulcers are a chronic health problem that cause considerable economic impact and affect quality of life for those who have them. Primary wound contact dressings are usually applied to ulcers beneath compression therapy to aid healing, promote comfort and control exudate. There are numerous dressing products available for venous leg ulcers and hydrogel is often prescribed for this condition; however, the evidence base to guide dressing choice is sparse. OBJECTIVES: To assess the effects of hydrogel wound dressings on the healing of venous leg ulcers in any care setting. SEARCH METHODS: In May 2021, we searched the Cochrane Wounds Specialised Register, CENTRAL, Ovid MEDLINE, Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies, reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials (RCTs), either published or unpublished, that compared the effects of hydrogel dressing with other dressings on the healing of venous leg ulcers. We excluded trials evaluating hydrogel dressings impregnated with antimicrobial, antiseptic or analgesic agents as these interventions are evaluated in other Cochrane Reviews. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We included four RCTs (10 articles) in a qualitative analysis. Overall, 272 participants were randomised, in sample sizes ranging from 20 to 156 participants. The mean age of the included population in the trials ranged from 55 to 68 years, 37% were women based on studies that reported the sex of participants. The studies compared hydrogel dressings with the following: gauze and saline, alginate dressing, manuka honey and hydrocolloid. Two studies were multicentre and the others were single-centre trials. Length of treatment using hydrogel dressing was four weeks in three studies and two weeks in one study. The follow-up period was the same as the duration of treatment in three studies and in one study the follow-up for wound healing was at 12 weeks after four weeks of treatment. Overall risk of bias was high for all trials because at least one of the three key criteria (selection bias, detection bias and attrition bias) was at high risk. Hydrogel compared with gauze and saline It is uncertain whether there is a difference in complete wound healing (risk ratio (RR) 5.33, 95% confidence interval (CI) 1.73 to 16.42; 1 trial, 60 participants) or change in ulcer size (mean difference (MD) -1.50, 95% CI -1.86 to -1.14; 1 trial, 60 participants) between interventions because the certainty of the evidence is very low. Data reported from one trial were incomplete for time-to-ulcer healing. Hydrogel compared with alginate dressing It is uncertain whether there is a difference in change in ulcer size between hydrogel and alginate gel because the certainty of the evidence is very low (MD -41.80, 95% CI -63.95 to -19.65; 1 trial, 20 participants). Hydrogel compared with manuka honey It is uncertain whether there is a difference in complete wound healing (RR 0.75, 95% CI 0.46 to 1.21; 1 trial, 108 participants) or incidence of wound infection (RR 2.00, 95% CI 0.81 to 4.94; 1 trial, 108 participants) between interventions because the certainty of the evidence is very low. Hydrogel compared with hydrocolloid One study (84 participants) reported on change in ulcer size between hydrogel and hydrocolloid; however, further analysis was not possible because authors did not report standard errors or any other measurement of variance of a set of data from the means. Therefore, it is also uncertain whether there is a difference in change in ulcer size between hydrogel and hydrocolloid because the certainty of the evidence is very low. No studies provided evidence for the outcomes: recurrence of ulcer, health-related quality of life, pain and costs. Overall, independent of the comparison, the certainty of evidence is very low and downgraded twice due to risk of bias and once or twice due to imprecision for all comparisons and outcomes. AUTHORS' CONCLUSIONS: There is inconclusive evidence to determine the effectiveness of hydrogel dressings compared with gauze and saline, alginate dressing, manuka honey or hydrocolloid on venous leg ulcer healing. Practitioners may, therefore, consider other characteristics such as costs and symptom management when choosing between dressings. Any future studies assessing the effects of hydrogel on venous wound healing should consider using all the steps from CONSORT, and consider key points such as appropriate sample size with the power to detect expected differences, appropriate outcomes (such as time-to-event analysis) and adverse effects. If time-to-event analysis is not used, at least a longer follow-up (e.g. 12 weeks and above) should be adopted. Future studies should also address important outcomes that the studies we included did not investigate, such as health-related quality of life, pain and wound recurrence.


Assuntos
Hidrogéis , Úlcera Varicosa , Idoso , Alginatos/uso terapêutico , Bandagens , Feminino , Humanos , Hidrogéis/uso terapêutico , Masculino , Pessoa de Meia-Idade , Dor/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Úlcera/tratamento farmacológico , Úlcera Varicosa/terapia
6.
Perm J ; 26(2): 132-137, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35933673

RESUMO

Introduction Essential tremor (ET) is a common movement disorder in the elderly. Bilateral postural tremor usually involves the hands and forearms; the primary diagnostic criteria can be with or without a kinetic tremor. Anticonvulsants are frequently prescribed as a primary medication, and botulinum toxin and deep brain stimulation as secondary options. In this case report, a patient with ET received medical painting therapy guided by the principles of anthroposophy and the work of Liane Collot d´Herbois. Case Presentation A 78-year-old woman presented ET, depression and bipolar symptoms. Additionally, she reported insomnia, constipation, lumbar pain, and sciatic pain. Current medications included lithium carbonate, folic acid, levothyroxine, and zinc, and she had refused to take propranolol for her ET. She agreed to begin medical painting therapy. Over 5 months, she had 16 sessions of medical painting therapy, carried out in 2 stages. The first stage consisted of 6 free painting sessions for patient evaluation, followed by the second stage of 10 therapeutic sessions. Conclusion The patient reported an increased quality of life (including emotional aspects) and a decrease in her ET, as evidenced by the patient's handwriting. Further research is needed to understand the strengths and limitations of this therapy for ET and related conditions.


Assuntos
Tremor Essencial , Idoso , Anticonvulsivantes/uso terapêutico , Tremor Essencial/diagnóstico , Tremor Essencial/tratamento farmacológico , Feminino , Humanos , Dor/tratamento farmacológico , Qualidade de Vida , Tremor/complicações , Tremor/tratamento farmacológico
7.
Perm J ; 26(2): 83-88, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35933677

RESUMO

The purpose of this article is to provide a synopsis of the current medical understanding of lateral hip pain, highlighting greater trochanteric pain syndrome (GTPS) and its relation to lateral hip pain. Common causes of lateral hip pain, GTPS as a cause of lateral hip pain, prevalence of GTPS, clinical presentation of GTPS, associated risk factors, history and physical examination, laboratory testing, diagnostic imaging, and treatment options are described. A quiz serves to assist readers in their understanding of the presented material.


Assuntos
Bursite , Fêmur , Bursite/complicações , Bursite/diagnóstico por imagem , Fêmur/diagnóstico por imagem , Quadril/diagnóstico por imagem , Humanos , Dor/etiologia , Síndrome
8.
Curr Opin Support Palliat Care ; 16(3): 174-179, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35929564

RESUMO

PURPOSE OF REVIEW: Oral pain is a common complaint in patients with cancer. This review aims to summarize the knowledge on the causes and approach to management of oral pain garnered over the past 2 years. RECENT FINDINGS: A systematic review and meta-analysis included in the review, assessed cannabinoid versus placebo and showed only a small effect on pain, physical function, and sleep quality. Another review showed that chemical neurolysis as an adjunctive therapy, is effective in patients with pain of shorter chronicity and refractory head and neck cancer-related pain. SUMMARY: Patients with cancer frequently experience oral pain because of a variety of factors. Factors inherent in the type and location of the malignancy, the modality of cancer treatment, and a holistic approach to management together contribute to their overall pain experience. Basic oral care should be implemented wherever possible, before, during, and after cancer treatment.


Assuntos
Neoplasias , Dor , Canabinoides/uso terapêutico , Humanos , Metanálise como Assunto , Neoplasias/complicações , Bloqueio Nervoso , Dor/tratamento farmacológico , Dor/etiologia , Revisões Sistemáticas como Assunto
9.
BMC Public Health ; 22(1): 1498, 2022 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-35931966

RESUMO

BACKGROUND: Road traffic injuries (RTIs), primarily musculoskeletal in nature, are the leading cause of unintentional injury worldwide, incurring significant individual and societal burden. Investigation of a large representative cohort is needed to validate early identifiable predictors of long-term work incapacity post-RTI. Therefore, up until two years post-RTI we aimed to: evaluate absolute occurrence of return-to-work (RTW) and occurrence by injury compensation claimant status; evaluate early factors (e.g., biopsychosocial and injury-related) that influence RTW longitudinally; and identify factors potentially modifiable with intervention (e.g., psychological distress and pain). METHODS: Prospective cohort study of 2019 adult participants, recruited within 28 days of a non-catastrophic RTI, predominantly of mild-to-moderate severity, in New South Wales, Australia. Biopsychosocial, injury, and compensation data were collected via telephone interview within one-month of injury (baseline). Work status was self-reported at baseline, 6-, 12-, and 24-months. Analyses were restricted to participants who reported paid work pre-injury (N = 1533). Type-3 global p-values were used to evaluate explanatory factors for returning to 'any' or 'full duties' paid work across factor subcategories. Modified Poisson regression modelling was used to evaluate factors associated with RTW with adjustment for potential covariates. RESULTS: Only ~ 30% of people with RTI returned to full work duties within one-month post-injury, but the majority (76.7%) resumed full duties by 6-months. A significant portion of participants were working with modified duties (~ 10%) or not working at all (~ 10%) at 6-, 12-, and 24-months. Female sex, low education, low income, physically demanding occupations, pre-injury comorbidities, and high injury severity were negatively associated with RTW. Claiming injury compensation in the fault-based scheme operating at the time, and early identified post-injury pain and psychological distress, were key factors negatively associated with RTW up until two years post-injury. CONCLUSIONS: Long-term work incapacity was observed in 20% of people following RTI. Our findings have implications that suggest review of the design of injury compensation schemes and processes, early identification of those at risk of delayed RTW using validated pain and psychological health assessment tools, and improved interventions to address risks, may facilitate sustainable RTW. TRIAL REGISTRATION: This study was registered prospectively with the Australian New Zealand Clinical Trials Registry (ACTRN12613000889752).


Assuntos
Acidentes de Trânsito , Dor , Acidentes de Trânsito/psicologia , Adulto , Austrália , Estudos de Coortes , Feminino , Humanos , Estudos Prospectivos
10.
BMC Cancer ; 22(1): 860, 2022 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-35933326

RESUMO

BACKGROUND: The adjuvant treatment with Aromatase Inhibitor (AI) is considered standard of care for postmenopausal breast cancer (BC) women with hormone receptor-positive (HR +), however, it often causes adverse effects such as cancer-related fatigue (CRF). The high prevalence of vitamin D deficiency in postmenopausal women who start adjuvant AI supports the hypothesis that hypovitaminosis D would be one of the biological explanations for toxicity of AI. This study aimed to identify the relationship between 25-hydroxyvitamin D [25(OH)D] and CRF, and to analyze their associations and effects on depression, anxiety, functional disability, muscle/joint aches and HRQL. METHODS: This prospective study included 89 postmenopausal women diagnosed with HR + early BC in adjuvant endocrine therapy with AI. Anthropometric and body composition assessments were performed, as well as dietary assessments by application of 24-h dietary recall, at three time points, totaling 24 months of follow-up. The women completed the Cervantes Scale (CS), Hospital Anxiety and Depression Scale (HADS) and Health Assessment Questionnaire (HAQ). The CRF was determined from the Functional Assessment of Chronic Illness Therapy-fatigue (FACIT-F). The serum 25(OH)D was determined by electrochemiluminescence, with cut-off point above 75 nmol/L adopted as sufficiency. Generalized Linear Model (GLzM) and Generalized Mixed Model (GMM) analysis were used. RESULTS: At baseline, 36% (n = 32) of the women presented CRF and 39.3% (n = 35) had 25(OH)D below 75 nmol/L. None of the women reached the Estimated Average Requirements (EAR) of vitamin D. The causality between 25(OH)D and CRF was not significant. Longitudinally, lower levels of 25(OH)D had a negative effect on anxiety (p = 0.020), Menopause and Health (p = 0.033) and Vasomotor scores (p = 0.007). Also, the CRF had a negative effect on anxiety (p = 0.028); depression (p = 0.027); functional disability (p = 0.022); HRQL (p = 0.007); Menopause and Health (p = 0.042), Psychological (p = 0.008) and Couple Relations (p = 0.008) domains; and on Health (p = 0.019) and Aging (p = 0.036) subdomains. Vasomotor subdomain (ß = -2.279, p = 0.045) and muscle/joint aches (ß = -0.779, p = 0.013) were significant with CRF only at baseline. CONCLUSIONS: This study found negative effect of body adiposity on CRF. Still, the clinical relevance of 25(OH)D and CRF is highlighted, especially that of CRF, considering the consistent impact on several adverse effects reported by BC survivors during adjuvant endocrine therapy.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Deficiência de Vitamina D , Ansiedade/etiologia , Inibidores da Aromatase/efeitos adversos , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/psicologia , Calcifediol , Depressão/etiologia , Fadiga/induzido quimicamente , Fadiga/tratamento farmacológico , Feminino , Humanos , Dor/tratamento farmacológico , Estudos Prospectivos , Qualidade de Vida , Sobreviventes , Vitamina D/análogos & derivados , Deficiência de Vitamina D/complicações
11.
BMC Anesthesiol ; 22(1): 250, 2022 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-35933333

RESUMO

BACKGROUND: Humane treatment requires the provision of appropriate sedation and analgesia during medical diagnosis and treatment. However, limited information is available about the status of procedural analgesic interventions in Chinese hospitals. Therefore, a nationwide survey was established to identify challenges and propose potential improvement strategies. METHODS: Forty-three members of the Pain Group of Chinese Society of Anesthesiology established and reviewed the questionnaire, which included (1) general information on the hospitals, (2) the sedation/analgesia rate in gastrointestinal endoscopy, labor, flexible bronchoscopy, hysteroscopy in China, (3) staff assignments, (4) drug use for procedural analgesic interventions, and (5) difficulties in procedural analgesic interventions. The data were obtained using an online questionnaire sent to the chief anesthesiologists of Chinese hospitals above Grade II or members of the Pain Group of Chinese Society of Anesthesiology. RESULTS: Valid and complete questionnaires were received from 2198 (44.0%) hospitals, of which 64.5% were Grade III. The overall sedation/analgesia rates were as follows: gastroscopy (50.6%), colonoscopy (53.7%), ERCP (65.9%), induced abortion (67.5%), labor (42.3%), hysteroscopy (67.0%) and fiber bronchoscopy (52.6%). Compared with Grade II hospitals, Grade III hospitals had a higher proportion of procedural analgesic interventions services except for induced abortion. On average (median [IQR]), each anesthesiologist performed 5.7 [2.3-11.4] cases per day, with 7.3 [3.2-13.6] performed in Grade III hospitals and 3.4 [1.8-6.8] performed in Grade II hospitals (z = -7.065, p < 0.001). CONCLUSIONS: Chinese anesthesiologists have made great efforts to achieve procedural analgesic interventions, as evidenced by the increased rate. The uneven health care provided by hospitals at different levels and in different regions and the lack of anesthesiologists are the main barriers to optimal procedural analgesic interventions.


Assuntos
Analgesia , Anestesiologia , Analgésicos/uso terapêutico , Feminino , Hospitais , Humanos , Dor , Gravidez
12.
Inn Med (Heidelb) ; 63(8): 830-839, 2022 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-35925074

RESUMO

BACKGROUND: A sizable part of post-COVID syndrome meets the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). A doubling of cases of ME/CFS within the next years is therefore projected. OBJECTIVES: Presentation of the current state of knowledge on ME/CFS. MATERIALS AND METHODS: Unsystematic review of the literature and of own contributions in research and patient care. RESULTS AND CONCLUSIONS: ME/CFS is a neuroimmunological disease, mostly infection-induced, usually persisting throughout life. Clinically it is characterized by fatigue lasting at least 6 months and the defining core feature of exercise intolerance (post-exertional malaise, PEM). Exercise intolerance is defined as a worsening of symptoms after (even mild) everyday exertion, which usually begins after several hours or on the following day, is still noticeable at least 14 h after exertion, and often lasts for several days (up to weeks or longer). Furthermore, ME/CFS is characterized by pain, disturbances of sleep, thinking and memory, and dysregulation of the circulatory, endocrine, and immune systems. As a separate clinical entity, ME/CFS should be distinguished from chronic fatigue, which occurs as a symptom of a range of very different diseases. The diagnosis of ME/CFS is made clinically using established international diagnostic criteria and requires careful stepwise diagnosis to exclude other diagnoses. A causal therapy for ME/CFS has not been established; the focus is on symptoms relief, treatment of the often accompanying orthostatic intolerance, and assistance with anticipatory energy management (pacing).


Assuntos
COVID-19 , Síndrome de Fadiga Crônica , COVID-19/complicações , Síndrome de Fadiga Crônica/diagnóstico , Humanos , Dor
13.
Anaesthesiologie ; 71(8): 646-660, 2022 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-35925200

RESUMO

Postdural puncture headache (PDPH) is one of the most important complications of peripartum neuraxial analgesia. Loss of cerebrospinal fluid volume and pressure as well as compensatory intracranial vasodilation are assumed to be responsible. Potentially severe long-term sequelae necessitate the correct diagnosis of PDPH, exclusion of relevant differential diagnoses (with atypical symptoms and when indicated via imaging techniques) and rapid initiation of effective treatment. Nonopioid analgesics, caffeine and occasionally theophylline, gabapentin and hydrocortisone are the cornerstones of pharmacological treatment, while the timely placement of an autologous epidural blood patch (EBP) represents the gold standard procedure when symptoms persist despite the use of analgesics. Procedures using neural treatment are promising alternatives, especially when an EBP is not desired by the patient or is contraindicated. Interdisciplinary and interprofessional consensus standard procedures can contribute to optimization of the clinical management of this relevant complication.


Assuntos
Obstetrícia , Cefaleia Pós-Punção Dural , Placa de Sangue Epidural/métodos , Feminino , Humanos , Dor , Cefaleia Pós-Punção Dural/diagnóstico , Gravidez , Punção Espinal/efeitos adversos
14.
PLoS One ; 17(8): e0271310, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35925904

RESUMO

BACKGROUND: COVID-19 can cause some individuals to experience chronic symptoms. Rates and predictors of chronic COVID-19 symptoms are not fully elucidated. OBJECTIVE: To examine occurrence and patterns of post-acute sequelae of SARS-CoV2 infection (PASC) symptomatology and their relationship with demographics, acute COVID-19 symptoms and anti-SARS-CoV-2 IgG antibody responses. METHODS: A multi-stage observational study was performed of adults (≥18 years) from 5 US states. Participants completed two rounds of electronic surveys (May-July 2020; April-May 2021) and underwent testing to anti-SARS-CoV-2 nucleocapsid protein IgG antibody testing. Latent Class Analysis was used to identify clusters of chronic COVID-19 symptoms. RESULTS: Overall, 390 adults (median [25%ile, 75%ile] age: 42 [31, 54] years) with positive SARS-CoV-2 antibodies completed the follow-up survey; 92 (24.7%) had ≥1 chronic COVID-19 symptom, with 11-month median duration of persistent symptoms (range: 1-12 months). The most common chronic COVID-19 symptoms were fatigue (11.3%), change in smell (9.5%) or taste (5.6%), muscle or joint aches (5.4%) and weakness (4.6%). There were significantly higher proportions of ≥1 persistent COVID-19 symptom (31.5% vs. 18.6%; Chi-square, P = 0.004), and particularly fatigue (15.8% vs. 7.3%, P = 0.008) and headaches (5.4% vs. 1.0%, P = 0.011) in females compared to males. Chronic COVID-19 symptoms were also increased in individuals with ≥6 acute COVID-19 symptoms, Latent class analysis revealed 4 classes of symptoms. Latent class-1 (change of smell and taste) was associated with lower anti-SARS-CoV-2 antibody levels; class-2 and 3 (multiple chronic symptoms) were associated with higher anti-SARS-CoV-2 antibody levels and more severe acute COVID-19 infection. LIMITATIONS: Ambulatory cohort with less severe acute disease. CONCLUSION: Individuals with SARS-CoV-2 infection commonly experience chronic symptoms, most commonly fatigue, changes in smell or taste and muscle/joint aches. Female sex, severity of acute COVID-19 infection, and higher anti-SARS-CoV-2 IgG levels were associated with the highest risk of having chronic COVID-19 symptoms.


Assuntos
COVID-19 , Adulto , Anticorpos Antivirais , Fadiga , Feminino , Humanos , Imunoglobulina G , Masculino , Dor , RNA Viral , SARS-CoV-2
15.
Zhonghua Yi Xue Za Zhi ; 102(29): 2283-2289, 2022 Aug 09.
Artigo em Chinês | MEDLINE | ID: mdl-35927060

RESUMO

Objective: To investigate the clinical efficacy of the modified Latarjet procedure in the treatment of recurrent anterior subluxation of the shoulder by "coaxial co-arc" reconstruction of the glenoid cavity. Methods: The clinical data of 103 cases (106 shoulders) of recurrent anterior dislocation of the shoulder admitted to the First Affiliated Hospital of the Army Military Medical University from January 2005 to December 2020 were retrospectively studied. Out of these cases, 84 were males and 19 were females; 31 with left-sided injuries while 75 with right-sided injuries, with a mean age of (29.4±11.5) years (16-61 years). The preoperative anterior fear test was positive, and a modified Latarjet procedure was used to reconstruct the shoulder glenoid defect through a "coaxial co-arc". The Rowe score, simple shoulder test (SST) score, and Visual analogue scale (VAS) score of pain were used to assess the shoulder's function. Parameters such as the postoperative shoulder recurrent dislocation rate, shoulder body external rotation angle, and subscapularis muscle strength changes were recorded postoperatively. Moreover, radiographs and CT scans were used to check for the incidence of osteoarthritis (Samson-Prieto score). Results: After a mean follow-up of 9.0 years (1 to 16 years), bony healing occurred 3 to 6 months postoperatively. The Rowe score improved from 40.4±6.5 preoperatively to 93.2±2.5 (P<0.001), the SST score improved from 5.2±1.3 preoperatively to 10.1±1.5 (P<0.001), and the VAS pain score decreased from 3.5±1.9 preoperatively to 1.1±1.2 (P<0.001) at the final follow-up. The angle of lateral external rotation of the shoulder joint was 58.8°±15.6° preoperatively and 57.6°±14.5° postoperatively with no statistically significant difference (P>0.05). There was no statistically significant difference in the measurement of subscapularis muscle strength between the healthy side and the affected side (P>0.05). In 89.6% of patients after surgery, coaxial co-arc reconstruction of the shoulder glenoid was obtained, and the shoulder glenoid defect and postoperative inclusion angle were significantly improved compared with those before surgery (P<0.001). Postoperatively, new-onset osteoarthritis developed in 7 cases (7/98), arthritis progressed in 2 cases (2/8), incisional healing was poor in 2 cases (2/98), and revision surgery was performed in 2 cases (2/98) due to bone mass detachment. Conclusion: Coracoid osteotomy and concentric coaxial reconstruction of the glenoid cavity elicits adequate good clinical efficacy for cases of recurrent anterior shoulder dislocation, with low recurrence rates, low revision rates and low incidence of osteoarthritis.


Assuntos
Cavidade Glenoide , Luxações Articulares , Instabilidade Articular , Osteoartrite , Luxação do Ombro , Articulação do Ombro , Adolescente , Adulto , Artroscopia/métodos , Feminino , Cavidade Glenoide/cirurgia , Humanos , Luxações Articulares/complicações , Instabilidade Articular/etiologia , Instabilidade Articular/cirurgia , Masculino , Osteoartrite/complicações , Osteotomia/efeitos adversos , Dor , Recidiva , Estudos Retrospectivos , Luxação do Ombro/complicações , Luxação do Ombro/cirurgia , Articulação do Ombro/cirurgia , Adulto Jovem
16.
BMC Infect Dis ; 22(1): 670, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927648

RESUMO

BACKGROUND: Vibrio vulnificus infections develop rapidly and are associated with a high mortality rate. The rates of diagnosis and treatment are directly associated with mortality. CASE PRESENTATION: We describe an unusual case of a 61-year-old male patient with chronic liver disease and diabetes who presented with a chief complaint of pain in both lower legs due to V. vulnificus infection in winter. Within 12 h of arrival, typical skin lesions appeared, and the patient rapidly developed primary sepsis. Despite prompt appropriate antibiotic and surgical treatment, the patient died 16 days after admission. CONCLUSION: Our case findings suggest that V. vulnificus infection should be suspected in patients with an unclear infection status experiencing pain of unknown origin in the lower legs, particularly in patients with liver disease or diabetes, immunocompromised status, and alcoholism.


Assuntos
Diabetes Mellitus , Fasciite Necrosante , Hepatopatias , Sepse , Vibrioses , Vibrio vulnificus , Fasciite Necrosante/complicações , Fasciite Necrosante/diagnóstico , Humanos , Perna (Membro) , Masculino , Pessoa de Meia-Idade , Dor , Sepse/complicações , Sepse/diagnóstico , Vibrioses/complicações , Vibrioses/diagnóstico
17.
Rev Bras Enferm ; 75(5): e20220114, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35920516

RESUMO

OBJECTIVE: To analyze the effects of the technique of virtual reality guided imagery in the vital signs of hematopoietic stem-cell transplantation patients. METHOD: Quasi-experimental study with 35 participants who received an intervention using virtual reality guided imagery with progressive muscle relaxation, applied three times a week for four weeks in a referral hospital for transplants in the south of Brazil. Data collected included: temperature, arterial pressure, respiratory rate, heart rate, pain, and oxygen saturation, before and after each intervention. The comparisons were analyzed using Wilcoxon's test. RESULTS: There was a clinical significance between the mean measurements before and after for respiratory rate (p=0.00) in all stages, and for the variables Heart rate, Temperature, and Oxygen saturation from the 1st to the 12th measurements (p=0.05). CONCLUSION: The intervention was low cost, easy to apply, and showed positive effects, presenting itself as an option for patient-focused care.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Imagens, Psicoterapia , Brasil , Frequência Cardíaca , Humanos , Imagens, Psicoterapia/métodos , Dor
18.
Georgian Med News ; (325): 27-32, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35920576

RESUMO

Palliative care is a comprehensive approach that includes medical, psychological, social, and spiritual support for patients to achieve the best quality of life for patients with incurable diseases and their relatives. Nurses are one of the main links that make up mobile palliative care teams they occupy an ideal position to provide quality care at the patient's bedside. However, the knowledge and skills of nurses remain at a low level and limiting high-quality palliative care. The purpose of this review is to study the problems of readiness of nursing staff to provide palliative care. A search for scientific articles in English and Russian published no later than 2015 was conducted in databases (Scopus, EBSCOhost, Wiley, PubMed). The study was conducted in February-April 2022. Fifty publications were selected as the analytical material for the review. Nurses often experience a lack of knowledge about pain relief, care for people with dementia, pain recognition, the use of special pain assessment tools, social and cultural traditions, and beliefs of patients. Many studies confirm the lack of awareness about the essence, philosophy, and principles of palliative care. The main barriers are the lack of specialized education, lack of clarity and delineation of responsibilities between specialists, heavy workload in the workplace, and limited legitimacy. Kazakhstan has carried out many reforms in the palliative care field, however, according to statistics, over 80% of medical personnel do not have basic knowledge about palliative care. The results indicate the need to develop educational programs on palliative care for all medical universities and colleges, where special attention should be paid to the cultural characteristics of patients, communication skills, and skills of step-by-step anesthesia. A clear division of functional responsibilities, the delegation of authority, and the reduction of the burden on nurses will improve the quality of palliative nursing care.


Assuntos
Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Recursos Humanos de Enfermagem , Humanos , Dor , Cuidados Paliativos , Qualidade de Vida
19.
BMJ Open Qual ; 11(3)2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35914816

RESUMO

INTRODUCTION: Pain management after elective, unilateral total hip and knee arthroplasty (THA and TKA) should use a multimodal approach. At discharge, challenges include ensuring correct prescribing practices to optimise analgesia and rationalise opioid use as well as ensuring patients are adequately educated to take these medications safely and effectively in the community. This audit cycle reports on a prescriber and patient education intervention using printed guidelines, educational outreach and prescription standardisation along with a patient information sheet to address the high unplanned readmission rate following THA and TKA at our institution. METHODS: Two cohorts of patients were identified before (2016) and after (2019) the introduction of the educational package. The primary outcome was the unplanned hospital readmission rate in the 42 days following discharge. Secondary outcomes were the compliance with the set prescribing standards and the prescription of strong opioid medications (morphine or oxycodone) on discharge. RESULTS: There was a reduction in the readmission rate from 20.4% to 10.0% (p=0.004). Readmission rates for pain and constipation were also reduced. The prescribing of tramadol (p<0.001) and non-steroidal anti-inflammatory drugs (p<0.001) both increased while the number of patients who received a strong opioid at discharge decreased (p<0.001) as did the number of patients who received a sustained release strong opioid (p<0.001). CONCLUSION: We have observed significant improvement in discharge prescribing which coincided with a reduction in unplanned readmissions after elective TKA and THA. Our approach used prescriber guidelines, education and standardisation with printed information for patients to enhance understanding and recall.


Assuntos
Analgesia , Artroplastia de Quadril , Artroplastia do Joelho , Analgésicos Opioides/uso terapêutico , Humanos , Dor/induzido quimicamente , Manejo da Dor , Alta do Paciente , Readmissão do Paciente
20.
BMC Palliat Care ; 21(1): 140, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35918682

RESUMO

BACKGROUND: Palliative care is among the standards of care in cancer treatment that should be provided to those in need within the existing healthcare system. In Ethiopia, patients with cervical cancer experience a long wait for curative radiotherapy, while the level of palliative care delivery is unknown. In this study, we aimed to evaluate the practice of palliative care among women diagnosed with advanced cervical cancer. METHODS: A hospital-based cross-sectional study was conducted. Using a structured questionnaire, face-to-face interviews were made with randomly selected patients with advanced cervical cancer. Information on patient characteristics, medical records, and knowledge, attitude and practice of palliative care was captured, analysed, and presented. Data collection was conducted following ethical standards after obtaining approval from the hospital. RESULTS: A total of 385 patients were interviewed, most of whom were over 50 years and illiterate. The patients had poor knowledge regarding comprehensive palliative care, a good attitude, and poor practices. Most patients either do not know about palliative care or consider it solely as a pain treatment. The patients expressed a good attitude towards palliative care; however, their attitude towards talking about suffering, death, and dying was poor. Almost all patients have received some form of palliative care. However, poor pain control, inadequate education and counselling, and poor social, economic, and spiritual supports were documented. CONCLUSIONS: Patients with advanced cervical cancer expressed a good attitude but had poor knowledge and practice of comprehensive palliative care. The palliative care delivery needs to address the communication, psychosocial, economic, and spiritual components of the comprehensive palliative care.


Assuntos
Cuidados Paliativos , Neoplasias do Colo do Útero , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais , Humanos , Dor , Cuidados Paliativos/psicologia , Neoplasias do Colo do Útero/terapia
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