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1.
Acta Odontol Scand ; 78(1): 13-19, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31287346

RESUMO

Objective: To estimate the prevalence of dental anxiety, and to explore factors that may increase the risk of reporting dental anxiety among 18-year-old Norwegians in 2016. A further objective was to report changes in dental anxiety since 1996.Material and methods: An anonymous survey from a strategic sample of upper secondary students (n = 351) in 2016 with high response rate (93%) was compared with the results of an investigation of a similar population conducted in 1996.Results: The prevalence of dental anxiety and dental distrust was reduced from 1996 to 2016. Dental Fear Survey (DFS) from 19 to 8% (p < .001), and Dental Belief Survey (DBS) from 15 to 6% (p < .001). Geer Fear Scale (GFS) which measure phobic anxiety did not show a similar reduction (17 versus 15%, p = .37). Phobic anxiety, avoidance behaviour, self-reported poor oral health and previous experiences of pain were all associated with dental anxiety.Conclusion: The prevalence of dental anxiety was reduced from 1996 to 2016, but 8% still report dental anxiety. Proper pain management and use of behavioural management techniques still needs to be highlighted to prevent development of dental anxiety, avoidance behaviour and poor oral health.


Assuntos
Ansiedade ao Tratamento Odontológico/epidemiologia , Medo , Adolescente , Ansiedade ao Tratamento Odontológico/etiologia , Ansiedade ao Tratamento Odontológico/psicologia , Assistência Odontológica/psicologia , Humanos , Noruega/epidemiologia , Saúde Bucal , Dor/epidemiologia , Dor/psicologia , Prevalência , Odontologia em Saúde Pública , Fatores de Risco , Inquéritos e Questionários
2.
Soins ; 64(841): 9-11, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31864517

RESUMO

Post-traumatic stress disorder is an adjustment disorder combining psychological and physical symptoms. Faced with the pain associated with post-traumatic stress disorder, it is important to know how to differentiate between the pain linked to the physical injury at the time of the traumatic event and the psychogenic pain. Identifying these pains and studying their aetiology, combined with an assessment of the patient's psychological state and life history, enables multi-disciplinary care to be put in place to improve the patient's prognosis and can help to improve recognition of these disorders.


Assuntos
Dor/epidemiologia , Transtornos Psicofisiológicos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Humanos , Dor/psicologia
3.
Mayo Clin Proc ; 94(12): 2437-2443, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31685265

RESUMO

OBJECTIVE: To evaluate trends in the clinical development of new pain and reformulated pain medications given the ongoing opioid crisis and the public health burden of inadequately controlled pain. METHODS: We conducted a retrospective cohort study of new drugs starting clinical testing between January 1, 2000, and December 31, 2015. We searched two comprehensive commercial databases of global research and development activity. The primary outcomes were trends in new and reformulated pain drugs starting clinical testing, proportion of new pain drugs targeting a novel biological pathway, and rates and reasons for discontinuation of development. RESULTS: The proportion of new pain drugs entering phase 1 testing (relative to all new drug trials) declined from 2.5% between 2000 and 2002 to 1.7% between 2013 and 2015. No significant changes in the proportion of new pain drugs entering phase 2 or phase 3 trials were observed. Most new pain drugs failed to reach late-stage clinical development, with 52% of pain drugs successfully advancing from phase 1 to phase 2 and 11% advancing from phase 2 to phase 3 trials. The number of reformulated products starting clinical testing increased over the study period and was greater than that for new analgesics in 2012 and every year thereafter. CONCLUSION: Pain drug development activity has largely shifted from new therapeutics to reformulated ones. New policies, such as increased funding for basic pain research, may help address the urgent need for new therapies for pain.


Assuntos
Analgésicos Opioides/uso terapêutico , Desenvolvimento de Medicamentos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Dor/tratamento farmacológico , Humanos , Dor/diagnóstico , Dor/epidemiologia , Estudos Retrospectivos
4.
Medicine (Baltimore) ; 98(44): e17667, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689780

RESUMO

Post-stroke depression (PSD) constitutes an important complication of stroke, leading to great disability. After stroke, the prevalence rate of depression is about 30%. Depression also affects rehabilitation motivation, delays function recovery, and increases family and social burden. The objective of this study was to explore the effect of social support on depression in chronic stroke patients and the relationship between demographic and disease characteristics. Total samples were randomly divided into an intervention group (n = 31) and a control group (n = 31). Sixteen social support interventions were performed over 8 weeks. Social support programs were implemented 2 times a week. Depressive symptoms were assessed at the second week, 4th week, 8th week, and 4 weeks after the end of the study using the 10-item Center for the Epidemiological Studies of Depression Short Form (CES-D10). There was a significant correlation between depression and the economic status of the patients with chronic stroke, satisfaction in leisure, the presence or absence of caregivers, the duration of stroke, and with or without pain. A significant difference was found between two groups after social support for 8 weeks. Our findings suggest that remission of PSD needs at least 8 weeks of social support.


Assuntos
Depressão/epidemiologia , Depressão/terapia , Educação em Saúde/métodos , Apoio Social , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/epidemiologia , Idoso , Ansiedade/epidemiologia , Ansiedade/terapia , Cuidadores , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Renda , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Fatores Socioeconômicos
5.
Pan Afr Med J ; 34: 29, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762897

RESUMO

Introduction: The aim of the present study was to describe the clinical and radiological features of knee osteoarthritis in Congolese outpatients attending the University Hospital of Kinshasa (UHK). Methods: A cross-sectional study was performed in the rheumatology unit of the UHK from January to August 2012. Patients were consecutively recruited. The diagnosis of Osteoarthritis (OA) was based on the criteria of the American College for Rheumatology. Demographic, clinical and x-rays data were collected. The X-rays severity was assessed according to Kellgren and Lawrence's method. Results: 1049 patients attended the Rheumatology unit of the UHK during the study period. An accurate diagnosis was reported for 839 patients, of whom 376 (44.8%) suffered from OA. Knee OA was diagnosed in 118 patients (31.4% of all OA patients). 101 patients accepted to be included in the study, 78 women (77.2%) and 23 men (22.8%). Their average age was 58.9 ± 10 years. A body mass index (BMI) ≥ 25kg/m2 was observed in 68 patients of whom 28 were obese (BMI ≥ 30kg/m2). The main symptoms were a mechanical pain (100%), swelling (40.6%), crepitus (79.2%) and mobility reduction (X%). Knee deformities were observed in some patients. At baseline, radiological damages > stage 2 of Kellgren-Lawrence were found in 70 patients. Conclusion: Knee OA is a common disease among outpatients who attend the unit of Rheumatology of the UHK. Its clinical profile is the same as what is reported in the literature. Obesity and skeletal abnormalities are encountered in the majority of patients.


Assuntos
Obesidade/epidemiologia , Osteoartrite do Joelho/diagnóstico por imagem , Dor/epidemiologia , Adulto , Idoso , Estudos Transversais , República Democrática do Congo , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/fisiopatologia , Dor/etiologia
6.
J Drugs Dermatol ; 18(10): 1012-1018, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31584780

RESUMO

Background: The use of topical therapy is a key component in the management of almost all psoriasis patients. Topicals are considered first-line therapy for mild disease and are having an increasing role in moderate or severe psoriasis as an integral part of combination therapy. Halobetasol has been shown be effective in moderate or severe localized plaque psoriasis, and tazarotene affords important effects on epidermal hyperproliferation that may be important in more severe disease. Objective: To investigate the efficacy, safety and tolerability of a once-daily application of a fixed combination halobetasol propionate 0.01% and tazarotene 0.045% (HP/TAZ) lotion in comparison with its vehicle in patients with severe localized plaque psoriasis (as defined by an Investigator Global Assessment (IGA) of 4 and Body Surface Area (BSA) of 3%-12%. Methods: Post hoc analysis of two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies. Sixty-two patients with severe localized psoriasis (mean BSA 7.4) randomized (2:1) to receive HP/TAZ lotion or vehicle, once-daily for 8 weeks, with a 4-week posttreatment follow-up. Efficacy assessments included treatment success (defined as at least a 2-grade improvement from baseline in the IGA score and a score of 'clear' or 'almost clear'), impact on individual signs of psoriasis (erythema, plaque elevation, and scaling) at the target lesion, BSA, reduction in mean baseline IGAxBSA and achievement of a clinically meaningful response (number of patients who achieved at least a 75% improvement in IGAxBSA). Safety and treatment emergent adverse events (TEAEs) were evaluated throughout. Results: By week 8, 34.8% of patients were treatment successes compared with 0.0% on vehicle (P=0.004). HP/TAZ lotion was also significantly superior in reducing psoriasis signs and symptoms and improving BSA. At week 8, 47.4% (erythema), 66.4% (plaque elevation), and 65.4% (scaling) subjects achieved at least a 2-grade improvement, compared with 14.0% (P=0.016), 14.8% (P<0.001) and 14.7% (P<0.001) respectively with vehicle. Patients treated with HP/TAZ lotion achieved a 32.8% reduction in baseline mean BSA, compared with a 39.6% increase with vehicle (P=0.013). HP/TAZ lotion achieved a statistically significant superior reduction in mean IGAxBSA compared to vehicle from week 2 (P<0.001 versus vehicle). By week 8, almost half of the patients treated with HP/TAZ lotion achieved a clinically meaningful response (IGAxBSA-75) and a 52.9% reduction in mean IGAxBSA score compared with a 17.5% increase in those patients treated with vehicle (P<0.001). One patient (2.6%) treated with HP/TAZ lotion discontinued due to AE. Most frequently reported treatment related AEs were application site pain (7.9%), contact dermatitis (5.3%) and pruritus (5.3%). Conclusions: HP/TAZ lotion provides significantly greater efficacy than vehicle that is both rapid and sustained, in patients with severe localized plaque psoriasis, with good tolerability and safety over 8 weeks' once-daily use. J Drugs Dermatol. 2019;18(10):1012-1018.


Assuntos
Clobetasol/análogos & derivados , Fármacos Dermatológicos/administração & dosagem , Ácidos Nicotínicos/administração & dosagem , Psoríase/tratamento farmacológico , Creme para a Pele/administração & dosagem , Adulto , Clobetasol/administração & dosagem , Clobetasol/efeitos adversos , Dermatite de Contato/epidemiologia , Dermatite de Contato/etiologia , Fármacos Dermatológicos/efeitos adversos , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ácidos Nicotínicos/efeitos adversos , Dor/epidemiologia , Dor/etiologia , Prurido/epidemiologia , Prurido/etiologia , Psoríase/diagnóstico , Índice de Gravidade de Doença , Creme para a Pele/efeitos adversos , Resultado do Tratamento
7.
Spine (Phila Pa 1976) ; 44(20): E1206-E1210, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31574066

RESUMO

STUDY DESIGN: This was a correlational study. OBJECTIVE: Determine the range of pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) scores for patients treated for adolescent idiopathic scoliosis (AIS) and assess correlation with Scoliosis Research Society-22 (SRS-22) domain scores. SUMMARY OF BACKGROUND DATA: Patient reported outcome (PRO) measures are important metrics for measuring health status in diverse patient populations. PROMIS is increasingly being used in orthopedic practice. Existing literature compares PROMIS measures favorably to legacy measures in numerous adult orthopedic conditions. This study sought to define the range of PROMIS mobility, pain interference, and peer relationships scores for adolescents treated for AIS. Furthermore, correlations between these domains and equivalent domains in the legacy PRO, SRS-22, were determined. METHODS: Pediatric PROMIS and SRS-22 were obtained at routine clinical visits for AIS at a tertiary care children's hospital from January 2017 to October 2017. Spearman correlations were performed to examine the associations between three pediatric PROMIS domains and the SRS-22 domains. Only patients who completed both PRO measures were included in the analyses. Radiographic measurements were performed at each visit assessing sagittal and coronal deformity and overall spinal balance. RESULTS: One hundred thirteen patients with a mean age of 14.4 (standard deviation [SD] = 2.1) years completed the assessments. The mean pediatric PROMIS domain scores included: mobility 50.9 (interquartile range [IQR] 36.2-65.6); pain interference 45.9 (IQR 28.9-62.9); peer relations 52.6 (IQR 38.3-64.9).PROMIS mobility was strongly correlated with SRS-22 function (r = 0.65; P < 0.001). PROMIS pain interference was strongly correlated with SRS-22 pain (r = 0.70; P < 0.001). PROMIS peer relations was moderately correlated with SRS-22 Mental Health (r = 0.41; P < 0.001) and self-image (r = 0.34; P < 0.001). CONCLUSION: In AIS patients pediatric PROMIS pain interference and mobility correlate strongly with SRS-22 pain and function domains, while PROMIS peer relationships demonstrates moderate correlations with SRS-22 mental health and self-image. LEVEL OF EVIDENCE: 2.


Assuntos
Nível de Saúde , Sistemas de Informação/normas , Medidas de Resultados Relatados pelo Paciente , Escoliose/diagnóstico , Escoliose/cirurgia , Sociedades Médicas/normas , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Dor/diagnóstico , Dor/epidemiologia , Dor/cirurgia , Medição da Dor/métodos , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Escoliose/epidemiologia
8.
Artigo em Alemão | MEDLINE | ID: mdl-31529183

RESUMO

BACKGROUND: Pain not only causes suffering in children and adolescents, but also leads to school absenteeism, medication intake, medical treatment, and an increased risk of recurrent pain in adulthood. OBJECTIVES: Based on data from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017), the 3­month prevalence of recurrent headache, abdominal and back pain in girls and boys is reported, and is compared with the prevalence from the KiGGS baseline survey (2003-2006). The consequences of recurrent headache were also explored. MATERIALS AND METHODS: Data from >11,000 participants (KiGGS Wave 2) and from >12,000 (KiGGS baseline) participants aged between 3 and 17 years were analyzed. For 3­ to 10-year-olds, parents/guardians answered the questions, while 11- to 17-year-olds provided information themselves. RESULTS: In 3­ to 10-year-olds, recurrent abdominal pain was most prevalent, affecting one third of girls and one quarter of boys. Headache was the most frequent type of pain in 11- to 17-year-olds, affecting almost every second girl and about every third boy. The 3­month prevalence of recurrent headache, abdominal and back pain has increased in girls and boys, especially in the age groups 7 to 10 years and 11 to 13 years. Among recurrent headache sufferers, adolescents take medication almost twice as often as children. CONCLUSIONS: Headache, abdominal, and back pain are still and with increasing prevalence very common symptoms in children and adolescents in Germany. Their prevention requires a holistic view of children's health in the psychosocial living environment, and healthcare context.


Assuntos
Dor/epidemiologia , Dor Abdominal/epidemiologia , Adolescente , Adulto , Dor nas Costas/epidemiologia , Criança , Saúde da Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Cefaleia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
9.
Postgrad Med ; 131(7): 473-478, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31522582

RESUMO

Objectives: Non-motor symptoms (NMS) range from neuropsychiatric to pain and are an important but underexplored feature of restless legs syndrome (RLS). There are currently no tools available which enable the holistic assessment of NMS in RLS in clinical practice. The primary aim of this study was to systematically assess NMS prevalence and burden in patients with RLS using the NMS Questionnaire (NMSQuest) validated for Parkinson's disease. Methods: Patients with idiopathic RLS according to the criteria of the international RLS study group (IRLSSG) were included. Patients underwent a physical examination and clinical interview as well as completed the NMS Questionnaire and the international restless legs syndrome study group (IRLSSG) rating scale. Results: Seventy-four patients with primary RLS were included (mean age 64.6 ± 14.4 years, 62.2% female, mean disease duration 23.5 ± 17.8 years, mean Levodopa equivalent daily dose 63.3 ± 67.4 mg). On average patients reported an IRLSSG rating scale score of 24.8 ± 8.2 (maximum 40) and NMSQuest score of 9.9 ± 5.0 (maximum 30). Patients reported a minimum of two NMS with the majority (39.2%) reporting a moderate NMS burden, followed by severe (28.4%) and very severe (17.6%) burden. The most frequent NMS were insomnia (89.2%) followed by nocturia (70.3%), feeling sad (59.5%), forgetfulness (54.1%), urgency (47.3%), feeling anxious (43.2%), unexplained pain (41.9%), difficulty concentrating (40.5%) and dizziness (40.5%). There were no significant differences in NMSQuest total scores according to disease duration and gender (p = 0.739, p = 0.849). Conclusion: In conclusion, this study is one of the first to address NMS in RLS systematically and the data underlines the need to holistically assess NMS in RLS in order to deliver true value-based healthcare for these patients.


Assuntos
Ansiedade/epidemiologia , Tontura/epidemiologia , Transtornos da Memória/epidemiologia , Noctúria/epidemiologia , Dor/epidemiologia , Síndrome das Pernas Inquietas/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Idoso , Estudos de Coortes , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome das Pernas Inquietas/fisiopatologia , Tristeza , Índice de Gravidade de Doença , Inquéritos e Questionários
10.
Niger J Clin Pract ; 22(8): 1049-1054, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417046

RESUMO

Background: Keloid is a major complication of wound healing. The clinical spectrum ranges from unaesthetic lesions minimally invading the adjacent skin to large grotesque lesions sometimes associated with contractures. Subjects and Methods: The patients were seen over 2 years in a tertiary hospital setting. The following information was obtained with a proforma: the biodata, etiology of keloid, region affected, symptoms, and treatment prior to presentation. The keloids were examined and the sizes were grouped into small, medium, and large keloids; the severities of symptoms were determined using the visual analog scale. Results: 159 patients with 224 keloids were seen over 2-year period with male-to-female ratio of 1:1.24. The most common causes of keloid were trauma and acne (27.0% and 20.1%, respectively). The trunk had a statistically significant higher number of symptomatic keloid compared with other regions keloids. The larger keloids were more symptomatic compared with the smaller ones, P = 0.000. There were more pruritic keloids than painful ones. About 25% of patients had positive family history in first-degree relative, 16% in second-degree relative, and their keloid are more symptomatic than those without family history. Conclusion: In view of the burden of keloids, early treatment is advised. Unnecessary trauma and extra piercing should be avoided; elective surgeries that are deferrable should be postponed until when necessary.


Assuntos
Queloide/patologia , Dor/etiologia , Adulto , Demografia , Feminino , Humanos , Queloide/epidemiologia , Masculino , Nigéria/epidemiologia , Dor/epidemiologia , Escala Visual Analógica , Cicatrização
11.
BMC Public Health ; 19(1): 1149, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438930

RESUMO

OBJECTIVES: The aim of this study is to 1) investigate the pain situation among working adults in China; 2) explore the self-initiate pain reliving strategies applied by working adults; and 3) collect people's interests and suggestions to the topics of the online pain education program. METHODS: This is an exploratory survey through WeChat. The study was conducted from May 2018 to December 2018. Participants were recruited following the snowball sampling. In total of 664 people were recruited and 502 satisfied the criteria. SPSS was used for data analysis. Descriptive statistical analysis were used to present the utilization of pain treatments and suggested topics. Chi-square test, independent multiple logistic regression and Spearman's correlation were used to analysis the data. RESULTS: The overall incidence of pain among the participants is 45% and higher among female (63%) than male (37%). Neck (68.72%, 4.10 ± 2.31), shoulder (62.56%, 3.78 ± 2.41) and head (49.34%, 4.23 ± 2.52) are reported as the most common and severe pain sites. Working is affected by pain and the results show that there is a negative correlation between pain intensity and work (rs = - 0.194) among the working population. Non-pharmacological treatments (55.77%) were chosen more by pain suffers. Totally 63.39% of participants show interests in the online pain education program and physical and psychological impact of pain is the most suggested topic (22.51%). CONCLUSION: The pain prevalence is high among working adults in China. Impact of pain on work is a significant problem for the working adults. It is important to identify people at risk and deliver timely intervention to reduce pain. People showed their willingness in joining the online program. Therefore, future online pain education program can be developed.


Assuntos
Educação em Saúde , Determinação de Necessidades de Cuidados de Saúde , Dor/epidemiologia , Adolescente , Adulto , China/epidemiologia , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem
12.
Medicine (Baltimore) ; 98(35): e16953, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464935

RESUMO

BACKGROUND: Patients with large defects in the annulus fibrosus following lumbar discectomy have high rates of symptomatic reherniation. The Barricaid annular closure device provides durable occlusion of the annular defect and has been shown to significantly lower the risk of symptomatic reherniation in a large European randomized trial. However, the performance of the Barricaid device in a United States (US) population has not been previously reported. DESIGN AND METHODS: This is a historically controlled post-market multicenter study to determine the safety and efficacy of the Barricaid device when used in addition to primary lumbar discectomy in a US population. A total of 75 patients with large annular defects will receive the Barricaid device following lumbar discectomy at up to 25 sites in the US and will return for clinical and imaging follow-up at 4 weeks, 3 months, and 1 year. Trial oversight will be provided by a data safety monitoring board and imaging studies will be read by an independent imaging core laboratory. Patients treated with the Barricaid device in a previous European randomized trial with comparable eligibility criteria, surgical procedures, and outcome measures will serve as historical controls. Main outcomes will include back pain severity, leg pain severity, Oswestry Disability Index, health utility on the EuroQol-5 Dimension questionnaire, complications, symptomatic reherniation, and reoperation. Propensity score adjustment using inverse probability of treatment weighting will be used to adjust for differences in baseline patient characteristics between the US trial participants and European historical controls. ETHICS AND DISSEMINATION: This study was approved by a central institutional review board. The study results of this trial will be widely disseminated at conference proceedings and published in peer-reviewed journals. The outcomes of this study will have important clinical and economic implications for all stakeholders involved in treating patients with lumbar discectomy in the US. STUDY REGISTRATION: ClinicalTrials.gov (https://clinicaltrials.gov): NCT03986580. LEVEL OF EVIDENCE: 3.


Assuntos
Discotomia/métodos , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Adulto , Idoso , Avaliação da Deficiência , Feminino , Nível de Saúde , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Vigilância de Produtos Comercializados , Pontuação de Propensão , Qualidade de Vida , Reoperação/estatística & dados numéricos , Índice de Gravidade de Doença , Estados Unidos
13.
Lupus ; 28(9): 1148-1153, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31369342

RESUMO

OBJECTIVE: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with treatment manifestations that can cause changes in appearance, including skin rashes, alopecia, vitiligo, and scars. SLE has been shown to adversely impact body image outcomes, and previous research has identified that greater disease activity is associated with worse body image outcomes which, in turn, are associated with greater depressive symptoms. For patients with SLE who also experience significant pain, poor body image outcomes may further compromise wellbeing and lead to greater depressive symptoms. The role of pain in body image has not been explored in SLE. Thus, the present study examined whether body image (specifically, body image-related quality of life) serves as a mediator of the relationship between pain and depressive symptoms among patients with SLE. METHODS: Multiple mediation analysis was used to examine the hypothesis that body image-related quality of life mediates the relationship between pain and depressive symptoms in a sample of patients with SLE (N = 135) from an urban region in Los Angeles, California. RESULTS: The sample was predominately female (92.6%) with a mean disease duration of approximately 17 years. Approximately one-quarter of the sample had elevated depressive symptoms. Body image-related quality of life was a significant mediator in the relationship between pain and depressive symptoms. The model accounted for 51% of the total variance in depressive symptoms (R2 = 0.51). CONCLUSION: This cross-sectional study suggested that body image-related quality of life may mediate the effects of pain on depressive symptoms among patients with SLE.


Assuntos
Imagem Corporal/psicologia , Depressão/epidemiologia , Lúpus Eritematoso Sistêmico/psicologia , Dor/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Depressão/etiologia , Feminino , Humanos , Los Angeles , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Qualidade de Vida , Adulto Jovem
14.
Rev Lat Am Enfermagem ; 27: e3155, 2019 Jul 18.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31340343

RESUMO

OBJECTIVE: to evaluate pain in people living with human immunodeficiency virus/acquired immunodeficiency syndrome and to relate it to sociodemographic and clinical factors, depressive symptoms and health-related quality of life. METHOD: descriptive, analytical, observational, cross-sectional and quantitative study. Three hundred and two (302) people assisted at a specialized care service participated in the study. Instruments were used to evaluate sociodemographic and clinical data, depressive symptoms, and health-related quality of life. Descriptive, bivariate analysis and multiple logistic regression were used. RESULTS: the incidence of pain of mild intensity was 59.27%, recurrent in the head, with interference in mood, mostly affecting females and individuals with no schooling/low schooling. Women were more likely to have moderate or severe pain. People aged 49 to 59 years had greater pain intensity than people aged 18 to 29 years. The variables depressive symptoms and pain were directly proportional. The higher the health-related quality of life and schooling, the lower was the possibility of presence of pain. CONCLUSION: presence of pain is of concern and has association with female sex, lack of schooling/low schooling, worse level of health-related quality of life and presence of depressive symptoms.


Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Depressão/complicações , Infecções por HIV/complicações , Medição da Dor/estatística & dados numéricos , Dor/etiologia , Qualidade de Vida , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/psicologia , Prevalência , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
15.
Ital J Pediatr ; 45(1): 81, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300026

RESUMO

BACKGROUND: Functional Pain (not detectable organic cause) is often associated with psychological problems and, according to literature, it can lead to severe manifestations. The purpose of the study was to investigate the correlation between functional pain and psychological disagreement, in a series of school students. METHODS: An observational questionnaire-based study was performed. A questionnaire was given to a group of students of primary school; the following data were collected in the questionnaire: a) sex and age; b) functional pain; c) relation with relatives, teachers and schoolfellows: d) school failure. STATISTICAL METHODS: P-value of concordance test and P-value of correlation have been performed with MINITAB 15.1 software. RESULTS: Eight hundred nine students, 354 females, 455 males, median age 14 years, participated to the study. Functional Pain was referred from 537/809 students (66%): 265 Females, 272 males: p = 0.155. The difference between the number of pain episodes in females vs. males was statistically significant (p = 0,511), as pain intensity vs. the number of episodes in females (p = 0.001). The most frequent location of pain was abdomen in females, limbs in males. Psychological disagreement was referred from 513/809 students (63%) (260 females; 253 males: p = 0,150). Psychological disagreement was reported with parents (19); siblings (22); other relatives (18); teachers: 42, schoolfellows: 366, relatives as well as school fellows: 46. The correlation between disagreement and functional pain in all the students included in the study was statistically significant (p < 0.001). CONCLUSIONS: most students reported psychological disagreement and pain. The most frequent cause of disagreement was schoolfellows' behaviour. The study shows a student's lack of discussing of their problems with parents, teachers, peer. According to literature, confiance would be a useful treatment for avoiding psychological disagreements and functional pain.


Assuntos
Dor/psicologia , Estudantes/psicologia , Adolescente , Feminino , Humanos , Itália/epidemiologia , Masculino , Dor/epidemiologia , Medição da Dor , Fatores de Risco , Inquéritos e Questionários
16.
Int J Nurs Pract ; 25(5): e12766, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31313430

RESUMO

AIM: The aim of this study was to determine the incidence of falls among community-dwelling older adults and the impact of pain and insomnia on falls. METHODS: This cross-sectional study recruited 659 older adults. Pain was assessed by the Geriatric Pain Measure, and insomnia was assessed by the Insomnia Severity Index. The history of falls was assessed within the last 12 months. Risk factors for falls were determined using logistic regression analysis. RESULTS: The incidence of falls within the last year was 37.2%. Based on the analyses, pain and insomnia were found to be risk factors for falls. CONCLUSION: In this study, falls were observed as a common problem among community-dwelling older adults, and pain and insomnia were determined as risk factors for falls. Therefore, pain and insomnia should be addressed when prevention of falls among community-dwelling older adults are planned by health care professionals including nurses.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Dor/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Incidência , Vida Independente , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Turquia/epidemiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-31315166

RESUMO

This report summarises Australian passive surveillance data for adverse events following immunisation (AEFI) for 2017 reported to the Therapeutic Goods Administration and describes reporting trends over the 18-year period 1 January 2000 to 31 December 2017. There were 3,878 AEFI records for vaccines administered in 2017; an annual AEFI reporting rate of 15.8 per 100,000 population. There was a 12% increase in the overall AEFI reporting rate in 2017 compared with 2016. This increase in reported adverse events in 2017 compared to the previous year was likely due to the introduction of the zoster vaccine (Zostavax®) provided free for people aged 70­79 years under the National Immunisation Program (NIP) and also the state- and territory-based meningococcal ACWY conjugate vaccination programs. AEFI reporting rates for most other individual vaccines in 2017 were similar to 2016. The most commonly reported reactions were injection site reaction (34%), pyrexia (17%), rash (15%), vomiting (8%) and pain (7%). The majority of AEFI reports (88%) described non-serious events. Two deaths were reported that were determined to have a causal relationship with vaccination; they occurred in immunocompromised people contraindicated to receive the vaccines.


Assuntos
Doenças do Sistema Imunitário/epidemiologia , Vacinação/efeitos adversos , Vacinas/efeitos adversos , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Idoso , Austrália/epidemiologia , Criança , Pré-Escolar , Exantema/induzido quimicamente , Exantema/epidemiologia , Feminino , Febre/induzido quimicamente , Febre/epidemiologia , Vacina contra Herpes Zoster , Humanos , Programas de Imunização , Lactente , Reação no Local da Injeção/epidemiologia , Masculino , Pessoa de Meia-Idade , Dor/induzido quimicamente , Dor/epidemiologia , Vigilância da População , Vacinação/normas , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem , Vômito/induzido quimicamente , Vômito/epidemiologia , Adulto Jovem
18.
AJR Am J Roentgenol ; 213(4): 755-761, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31287724

RESUMO

OBJECTIVE. The purpose of this study was to evaluate the prevalence and severity of pain reported during image-guided percutaneous biopsies and to identify factors associated with increased reported pain. MATERIALS AND METHODS. In this retrospective study, a database of adult patients who underwent CT- or ultrasound-guided percutaneous core needle biopsy between July 22, 2013, and February 1, 2018, was reviewed. Data collected included patient age and sex, biopsy site, biopsy type (lesion or parenchymal), needle gauge, number of passes, use of sedation, and whether it was the patient's first recorded biopsy. The maximum procedure-related pain reported on a 0-10 numeric rating scale was recorded. Multivariable logistic regression with generalized estimating equations was used to assess the association between covariates and patient-reported pain. RESULTS. A total of 13,344 biopsy procedures were performed in 10,474 patients. Patients reported no pain (0 of 10 scale) during 9765 (73.2%) procedures. Female sex, younger age at biopsy, undergoing IV sedation, and larger needle diameter were all associated with increases in patient-reported pain. Biopsies of renal allografts were the least likely to be painful, followed by hepatic allografts. CONCLUSION. Patients typically report mild or no pain from image-guided biopsy performed by radiologists. Younger patients and women report greater pain. This information can assist preprocedural counseling and reassurance of patients and may help them predict procedure-related patient needs.


Assuntos
Biópsia Guiada por Imagem/efeitos adversos , Dor/epidemiologia , Dor/etiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Medidas de Resultados Relatados pelo Paciente , Prevalência , Radiografia Intervencionista , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X , Ultrassonografia de Intervenção
19.
Ann Ist Super Sanita ; 55(2): 161-169, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31264639

RESUMO

BACKGROUND: Job quality and evaluation of workers' health have both medical and social important implications. We studied health-related quality of life (HRQL) in nurses who perform their activity in night shifts. METHODS: A cross-sectional study was conducted between October and November 2014. Nurses who attended night shift in the Siena Teaching Hospital (Azienda Ospedaliera Universitaria Senese - AOUS) were sampled using EpiInfo software (confidence interval 95%) and investigated using the SF-36 Questionnaire. Our results were compared with the Italian general population (Apolone, 1997). A Descriptive analysis was conducted. Wilcoxon test, Pearson coefficient, t-test, Wilcoxon signed-rank test and logistic regression were used for the statistical investigation. RESULTS: 197 questionnaires were analyzed. Females were 71.7%; mean age was 39.2 years (DS 8.6); smokers were 37.8%. Males scores were higher than those of females in all dimensions of physical and mental health (p <0.05). The time taken to reach the place of work appeared to influence the dimension of General Health (coeff. -0.17); we found a worsening of 0.17 points of this dimension for every minute spent in travel. Men and nurses with more working years had a better score in Physical Pain dimension. AOUS nurses scored significantly (p <0.05) less compared with the correspondent Italian general population in General Health, Energy-fatigue, Social functioning, Physical functioning and Bodily pain. CONCLUSIONS: There is a significant relationship between night work and HRQL of nurses. The health profile of AOUS nurses' ranks below the values of the Italian general population in various dimensions.


Assuntos
Recursos Humanos de Enfermagem no Hospital/psicologia , Qualidade de Vida , Jornada de Trabalho em Turnos/psicologia , Tolerância ao Trabalho Programado/psicologia , Adulto , Estudos Transversais , Características da Família , Fadiga/epidemiologia , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Fumar/epidemiologia , Fatores Socioeconômicos , Inquéritos e Questionários , Transportes , Tolerância ao Trabalho Programado/fisiologia
20.
World Neurosurg ; 130: e933-e940, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302276

RESUMO

OBJECTIVE: To assess outcomes in obese patients with chronic obstructive pulmonary disease (COPD) who sustained an osteoporotic vertebral compression fracture (OVCF) treated by percutaneous vertebroplasty (PVP) in the improved prone position and right lateral position. METHODS: Between January 2015 and May 2016, a total of 60 patients were enrolled in this randomized controlled study. Patients in group A were placed in the improved prone position for a bilateral transpedicular technique, and those in group B were placed in the right lateral position for a left transverse process-pedicle approach. Clinical and radiologic outcomes were assessed and compared between the 2 groups during the 12-month follow-up period. RESULTS: All operations were successfully completed without any serious sequelae. The operation time, fluoroscopic time, scores for respiratory condition during the operation, intravertebral cement volume, and incidence of cement leakage were significantly greater in group A compared with group B (P < 0.01). During the follow-up period, all patients in both groups experienced significant improvement in pain relief. Satisfactory functional improvement was obtained at 3 months postoperatively. CONCLUSIONS: Treatment of obese patients with COPD suffering from painful OVCF by PVP in both the improved prone position with a bilateral technique and the right lateral position with a unilateral technique was relatively safe and effective. However, unilateral PVP in the right lateral position was associated with a shorter operation time, limited fluoroscopic time, and minimal cement leakage.


Assuntos
Fraturas por Compressão/cirurgia , Obesidade/cirurgia , Fraturas por Osteoporose/cirurgia , Posicionamento do Paciente/métodos , Doença Pulmonar Obstrutiva Crônica/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Vertebroplastia/métodos , Idoso , Feminino , Seguimentos , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Compressão/epidemiologia , Humanos , Masculino , Obesidade/diagnóstico por imagem , Obesidade/epidemiologia , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/epidemiologia , Dor/diagnóstico por imagem , Dor/epidemiologia , Dor/cirurgia , Manejo da Dor/métodos , Decúbito Ventral , Doença Pulmonar Obstrutiva Crônica/diagnóstico por imagem , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/epidemiologia , Resultado do Tratamento
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