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1.
Scand J Trauma Resusc Emerg Med ; 29(1): 161, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34794486

RESUMO

BACKGROUND: As pediatric patients are typically rare among helicopter emergency medical systems (HEMS), children might be at risk for oligo-analgesia due to the rescuer's lack of experience and the fear of side effects. METHODS: In this retrospective analysis, data was obtained from the ÖAMTC HEMS digital database including 14 physician staffed helicopter bases in Austria over a 12-year timeframe. Primary missions involving pediatric trauma patients (< 15 years) not mechanically ventilated on-site were included. Analgesia was assessed and compared between the age groups 0-5, 6-10 and 11-14 years. RESULTS: Of all flight missions, 8.2% were dedicated to children < 15 years. Analgetic drugs were administered in 31.4% of all primary missions (3874 of 12,324), wherefrom 2885 were injured and non-ventilated (0-5 yrs.: n = 443; 6-10 yrs.: n = 902; 11-14 yrs.: n = 1540). The majority of these patients (> 75%) suffered moderate to severe pain, justifying immediate analgesia. HEMS physicians typically chose a monotherapy with an opioid (n = 1277; 44.3%) or Esketamine (n = 1187; 41.1%) followed by the combination of both (n = 324; 11.2%). Opioid use increased (37.2% to 63.4%) and Esketamine use decreased (66.1% to 48.3%) in children < 6 vs. > 10 years. Esketamine was more often administered in extremity (57.3%) than in head (41.5%) or spine injuries (32.3%). An intravenous access was less often established in children < 6 years (74.3% vs. 90.8%; p < 0.001). Despite the use of potent analgesics, 396 missions (13.7%) were performed without technical monitoring. Particularly regarding patient data at handover in hospital, merely < 10% of all missions featured complete documentation. Therefore, sufficient evaluation of the efficacy of pain relief was not possible. Yet, by means of respiratory measures required during transport, severe side effects such as respiratory insufficiency, were barely noted. CONCLUSIONS: In the physician-staffed HEMS setting, pediatric trauma patients liberally receive opioids and Esketamine for analgesia. With regard to severe respiratory insufficiency during transport, the application of these potent analgesics seems safe.


Assuntos
Resgate Aéreo , Analgesia , Serviços Médicos de Emergência , Médicos , Aeronaves , Áustria/epidemiologia , Criança , Humanos , Recém-Nascido , Dor/tratamento farmacológico , Dor/epidemiologia , Dor/etiologia , Sistema de Registros , Estudos Retrospectivos
2.
Artigo em Inglês | MEDLINE | ID: mdl-34769886

RESUMO

Poor sleep quality (SQ) negatively affects pain associated with musculoskeletal disorders (MSD). As the level of economic development of a country determines its sanitary conditions, these can influence the sleep-pain relationship; therefore, it is relevant to generate evidence in the population with MSD in developing countries. This cross-sectional study sought to determine the effect of poor SQ on pain in Chilean individuals with MSD, controlling for sex and duration of pain (in months). METHOD: A total of 228 individuals were included. SQ was measured with the Pittsburg Sleep Quality Index (PSQI), pain (intensity, interference and distress relative to pain) was measured with visual analog scales. Structural equation modeling (SEM) was performed to analyze the effect of SQ on pain. RESULTS: A high frequency of poor SQ was present in the studied group, and was more prevalent in women. The SEM model evidenced that poor SQ predicts greater pain. Sex influences sleep quality and pain, but not pain duration. CONCLUSIONS: These findings indicate that poor SQ predicts higher pain in MSD and that women exhibit worse SQ and more significant pain than men. Our findings support that SQ should be considered in the comprehensive approach to pain in individuals with MSD.


Assuntos
Doenças Musculoesqueléticas , Dor Musculoesquelética , Transtornos do Sono-Vigília , Estudos Transversais , Feminino , Humanos , Masculino , Doenças Musculoesqueléticas/epidemiologia , Dor Musculoesquelética/epidemiologia , Dor/epidemiologia , Sono , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e Questionários
3.
Artigo em Inglês | MEDLINE | ID: mdl-34769791

RESUMO

BACKGROUND: The quality of life in osteoporosis is studied for men rather than for women. Aim of the study was to determine how bone mass density (BMD) relates to life quality components and the severity of pain felt by men affected by osteoporosis. METHODS: Presented research is a cross-sectional study. The cohort of 62 men aged 65 to 85 years was divided into a group with osteoporosis (N = 27) and a group without osteoporosis (N = 35). The participants' quality of life was measured with the Qualeffo41 Questionnaire, BMD was quantified by densitometry, and pain intensity was assessed on the Visual Analogue Scale. RESULTS: We found that lower BMD was strongly correlated to participants' quality of life (r = -0.72), especially the quality of leisure and social activities (r = -0.66), general health perception (r = -0.59), and mobility (r = -0.57). Pain significantly affected general health perception in older men with osteoporosis. General health assessment and pain were highly correlated with each other (r = 0.888). CONCLUSION: BMD and the overall quality of life of the study participants were related to each other. The strongest relationship occurred between reduced BMD and leisure and social activities component. The pain significantly affected participants' general health perception. The results may be employed to create new prophylactic strategies to improve life quality in men with osteoporosis.


Assuntos
Osteoporose , Qualidade de Vida , Absorciometria de Fóton , Idoso , Densidade Óssea , Estudos Transversais , Feminino , Humanos , Masculino , Osteoporose/epidemiologia , Dor/epidemiologia
4.
Medicine (Baltimore) ; 100(41): e27533, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731148

RESUMO

ABSTRACT: Understanding the relationship between pain and physical activity (PA) levels is beneficial for maintaining good health status. However, the impact of pain on changes in PA during the coronavirus disease 2019 (COVID-19) pandemic is unknown. The purpose of this study was to examine whether PA levels pre-, during, and post-COVID-19 state of emergency differ between Japanese adults who had pain after the COVID-19 state of emergency and those who did not.Data were collected from a cross-sectional online survey conducted between October 19 and 28, 2020. The analytic sample consisted of 1967 Japanese adults aged ≥40 years who completed the online survey. Participants completed questionnaires on the presence of pain and duration of PA, defined as the total PA time per week based on activity frequency and time. Participants were asked to report their PA at 3 time points: October 2019 (before the COVID-19 pandemic), April 2020 (during the COVID-19 state of emergency), and October 2020 (after the COVID-19 state of emergency).Among participants aged ≥60 years who reported pain in October 2020, the total PA time was significantly lower than participants who did not report having pain. Furthermore, the total PA time in April 2020 was significantly lower than that in October 2019; however, no significant difference in total PA time was observed between April and October 2020. Among participants aged 40 to 59 years, no significant differences were observed in total PA times at the 3 time points between those with and without pain. In addition, the total PA time in October 2020 significantly increased compared to that in April 2020, although it significantly decreased in April 2020 compared to October 2019.This study suggests that older adults with pain have lower PA levels after the COVID-19 state of emergency.


Assuntos
Exercício Físico , Dor/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
5.
Pain ; 162(11): 2693-2704, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34652321

RESUMO

ABSTRACT: Pain is a major health problem among U.S. young adults. The passage of the Affordable Care Act's young adult mandate in 2010 allowed individuals to remain on their parents' health insurance until age 26. Although studies have documented the positive effects of this mandate on various health outcomes, less is known about its association with self-reported pain among young adults. Using the 2002 to 2018 National Health Interview Survey (N = 48,053) and a difference-in-differences approach, we compared the probabilities of reporting pain at 5 sites (low back, joint, neck, headache/migraine, and facial/jaw) and the number of pain sites between mandate eligible (ages 20-25) and ineligible (ages 26-30) adults before and after the mandate. In fully adjusted models, the mandate was associated with a decline of 2 percentage points in the probability of reporting pain at any site (marginal effect, -0.02; 95% confidence interval [CI], -0.05 to -0.002; weighted sample proportion, 0.37) and in the number of pain sites (coefficient, -0.07; 95% CI, -0.11 to -0.01; weighted sample average, 0.62). These results were primarily driven by the association between the mandate and the probability of reporting low back pain (marginal effect, -0.03; 95% CI, -0.05 to -0.01; weighted sample proportion, 0.20). Additional analyses revealed that the mandate was associated with improvements in access to care and reductions in risk factors for pain-including chronic conditions and risky health behaviors. To the extent that the results are generalizable to other health insurance programs, removing financial barriers to medical care may help reduce pain prevalence.


Assuntos
Cobertura do Seguro , Patient Protection and Affordable Care Act , Adulto , Humanos , Seguro Saúde , Dor/epidemiologia , Prevalência , Estados Unidos/epidemiologia , Adulto Jovem
6.
Medicine (Baltimore) ; 100(43): e27594, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34713836

RESUMO

ABSTRACT: A new inpatient secondary preventive program for patients with musculoskeletal health problems was introduced throughout Austria. The aim of the current work was to evaluate this "Health Prevention Active" program and its possible influences on the quality of medical results upon hospital discharge.This observational study presents monocentric data for 7448 patients (48.99 ±â€Š6.15 years; 53.7% women) with chronic musculoskeletal disorders who completed a 3-week health program. The focus was placed on measuring medical quality outcomes such as BMI, blood pressure, heart rate, pain, subjective ratings, and achieved power output in cycle ergometer exercise testing. We describe pre-post changes before and after the inpatient program and the results of a follow-up survey conducted after 1 year to identify moderating factors related to health outcomes.The medical baseline showed obvious deficits regarding obesity, hypertension, and subjective symptoms. Of all patients, 36.5% were completely inactive. The patient's gender and physical activity had a high impact on the medical baseline status. In total, the majority of patients (86.2%; SMD = -0.78 ±â€Š0.59) responded well to the health prevention program, independent of their ages and lifestyles.Requirements for secondary prevention programs are high. The results of the study reflect the general problems presented by inactivity, obesity, and subjective symptoms like pain. Physical activity was specifically identified as a major factor for the observed medical baseline status.


Assuntos
Exercício Físico , Doenças Musculoesqueléticas/epidemiologia , Doenças Musculoesqueléticas/fisiopatologia , Prevenção Secundária/educação , Prevenção Secundária/métodos , Adulto , Pressão Sanguínea , Índice de Massa Corporal , Doença Crônica , Progressão da Doença , Feminino , Nível de Saúde , Frequência Cardíaca , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Dor/epidemiologia , Fatores de Risco , Fatores Sexuais
7.
Sci Rep ; 11(1): 18643, 2021 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-34545110

RESUMO

The aim of cross-sectional study was to investigate the association between loneliness, increased social isolation, and pain following the COVID-19 outbreak. A total of 25,482 participants, aged 15-79 years, were assessed using an internet survey; the University of California, Los Angeles Loneliness Scale (Version 3), Short Form 3-item (UCLA-LS3-SF3) was used to assess loneliness, and a modified item of the UCLA-LS3-SF3 was used to measure the perception of increased social isolation during the pandemic. The outcome measures included the prevalence/incidence of pain (i.e., headache, neck or shoulder pain, upper limb pain, low back pain, and leg pain), pain intensity, and the prevalence of past/present chronic pain. Pain intensity was measured by the pain/discomfort item of the 5-level version of the EuroQol 5 Dimension scale. Odds ratios of pain prevalence/incidence and past/present chronic pain prevalence according to the UCLA-LS3-SF3 scoring groups (tertiles) and the frequency of the perceived increase in social isolation (categories 1-5) were calculated using multinomial logistic regression analysis. The mean pain intensity values among different loneliness and social isolation levels were tested using an analysis of covariance. Increased loneliness and the severity of the perceived social isolation were positively associated with the prevalence/incidence of pain, pain intensity, and the prevalence of past/present chronic pain.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Surtos de Doenças , Internet , Solidão , Dor/psicologia , Isolamento Social , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Dor Crônica/epidemiologia , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Prevalência , Adulto Jovem
8.
Medicina (Kaunas) ; 57(9)2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34577813

RESUMO

Background and Objectives: The degenerative pathology of the hip joint appears in young age groups, related to fem-oroacetabular impingement, and in advanced age, due to other inflammatory causes, with greater potential for severity in the presence of comorbidities. Objectives: To evaluate the participation of the main causes of osteoarthritis in relation to physical activities, s Body Mass Index (BMI) and television time (TV). Materials and Methods: 54 patients with surgical indication treated at an orthopedic referral university hospital were stratified into groups (Impact: I, Osteonecrosis/rheumatic: II, Infectious/traumatic: III), and the influence of comorbidities on physical activity performance, relative to BMI and TV time. Results: It was observed that the impact group was the most frequent (51.8%), with 79.6% under the age of 60 years. This group followed the general mean (p < 0.05), using the variables of comorbidity and the level of physical activity. Pain intensity, TV time, BMI showed no correlation with physical activity. Conclusion: Morphostructural changes (group I) represented the most frequent etiological group, and severe pain was common in almost the entire sample. Unlike BMI, comorbidity showed a significant relationship with the level of physical activity.


Assuntos
Osteoartrite do Quadril , Comorbidade , Estudos Transversais , Exercício Físico , Humanos , Pessoa de Meia-Idade , Osteoartrite do Quadril/epidemiologia , Osteoartrite do Quadril/cirurgia , Dor/epidemiologia , Dor/etiologia
9.
Pediatr Emerg Care ; 37(10): e621-e624, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34591812

RESUMO

OBJECTIVE: The aim of this study was to determine if young children with high preprocedural anxiety experience increased pain at venipuncture. METHODS: This was secondary analysis of prospectively obtained data from a randomized controlled trial comparing vapocoolant spray with jet-injected lidocaine for venipuncture pain. Children aged 1 to 6 years were enrolled and videotaped. Videos were reviewed and scored for anxiety using the modified Yale Preoperative Anxiety Scale score for preprocedural anxiety (score range, 23-100). High anxiety was defined as greater than 40. Pain at the time of venipuncture was scored using the Face, Legs, Activity, Cry, and Consolability scale (score range 0-10). Moderate to severe pain was defined as greater than 3. Logistic regression assessed patient factors associated with high preprocedural anxiety and evaluated the relationship between preprocedural anxiety and pain during venipuncture. RESULTS: Two hundred five patients were enrolled; 59.5% of patients were male, and 53.7% were White. Mean age was 3.2 years. Prior to the procedure, 67% of patients had high anxiety. Patient age, race, sex, and previous venipuncture were not associated with increased odds of high anxiety. Moderate to severe pain at venipuncture was observed in 65% of children. High preprocedural anxiety was associated with increased odds of moderate to severe pain at venipuncture when controlled for patient characteristics (adjusted odds ratio, 4.62; 95% confidence interval, 2.03-8.54). CONCLUSIONS: Most young children undergoing venipuncture experienced high preprocedural anxiety. Children with high preprocedural anxiety had increased odds of moderate to severe pain at venipuncture. Anxiety-reducing interventions should be explored to reduce pain experienced during venipuncture.


Assuntos
Dor , Flebotomia , Anestésicos Locais , Ansiedade/epidemiologia , Ansiedade/etiologia , Criança , Pré-Escolar , Humanos , Lidocaína , Masculino , Dor/epidemiologia , Dor/etiologia , Medição da Dor , Flebotomia/efeitos adversos
10.
NCHS Data Brief ; (415): 1-8, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34473621

RESUMO

Location-specific pain, such as back, neck, arm, and hip pain is associated with short- and long-term health effects, ranging from minor discomfort to musculoskeletal impairment (1), diminished quality of life (2), and escalating health care costs (3). Existing studies of location-specific pain are mostly limited to small or special populations with limited generalizability (4-6). This report provides national estimates of any pain regardless of body region as well as estimates of back, lower limb (hips, knees, or feet), and upper limb (hands, arms, or shoulders) pain in the past 3 months among U.S. adults aged 18 and over by selected sociodemographic characteristics.


Assuntos
Braço , Qualidade de Vida , Adolescente , Adulto , Humanos , Extremidade Inferior , Dor/epidemiologia , Extremidade Superior
11.
Soc Sci Med ; 287: 114332, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34500321

RESUMO

RATIONALE: Physical pain is one of the most severe of human experiences. It is thus one of the most important to understand. OBJECTIVE: This paper reports the first cross-country study of the links between physical pain and the state of the economy. A key issue examined is how the level of pain in a society is influenced by the unemployment rate. METHODS: The study uses pooled cross-sectional Gallup data from 146 countries (total N > 1.3 million). It estimates fixed-effects regression equations that control for personal characteristics. RESULTS: More than a quarter of the world's citizens are in physical pain. Physical pain is lower in an economic boom and greater in an economic downturn. Estimated effect sizes are substantial. Remarkably, increases in pain are borne almost exclusively by women and found principally in rich nations. These findings have paradoxical aspects. The counter-cyclicality of physical pain is not what would be predicted by conventional economic analysis: during an expansion, people typically work harder and longer, and accidents and injuries increase. Nor are the study results due to unemployed citizens experiencing more pain (although they do). Instead, the study's findings are consistent with an important hypothesis proposed recently, using different kinds of evidence, by brain and behavioural-science researchers (e.g., Wiech and Tracey, 2009; Chou et al.; 2016). The hypothesis is that economic worry can create physical pain. CONCLUSIONS: This study provides the first cross-country evidence that the level of physical pain in a nation depends on the state of the economy. Pain is high when the unemployment rate is high. That is not because of greater pain among people who lose their jobs - it extends far beyond that into wider society. The increase in physical pain in a downturn is experienced disproportionately by women.


Assuntos
Dor , Desemprego , Estudos Transversais , Feminino , Humanos , Dor/epidemiologia
12.
J Clin Rheumatol ; 27(6S): S308-S315, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34525003

RESUMO

OBJECTIVE: To evaluate the reliability and validity of the Spanish version of the Medical Outcomes Study Pain Severity Scale (MOS-PSS) in patients with rheumatic diseases. METHODS: A cross-sectional study was carried out from January 2019 to March 2020 using a nonprobabilistic sampling of consecutive cases. The internal consistency of the scale was evaluated through the Cronbach α coefficient and by the item response theory reliability coefficient. Construct validity was evaluated by factor analysis; relationships between MOS-PSS and visual numeric scale for pain, numeric rating scale for pain, and verbal rating scale for pain; and differences between relevant groups. Item response theory-based methods were used to assess item performance. RESULTS: A clinical sample of 796 outpatients was recruited. Most patients presented moderate to severe pain. Two subscale solutions showed a good model fit in confirmatory factor analysis. The overall model fit of multidimensional generalized partial credit model showed to be adequate. The most discriminating item was "average pain intensity." Evidence revealed disordered thresholds in 2 items. Collapsing categories resulted in ordered thresholds for all items and significantly improving the overall model fit. The MOS-PSS and modified MOS-PSS yielded high reliability. Both scales were very strongly correlated with numeric rating scale for pain, visual numeric scale for pain, and verbal rating scale for pain (ρ ≥ 0.85). All hypotheses related to subgroups comparison were fulfilled. CONCLUSIONS: Overall, the Spanish version of the MOS-PSS showed good reliability and construct validity. Nevertheless, the statistical evidence from this study would suggest the modified MOS-PSS should be the version of choice for measuring pain in Mexican patients with rheumatic diseases.


Assuntos
Dor , Doenças Reumáticas , Estudos Transversais , Humanos , Dor/diagnóstico , Dor/epidemiologia , Dor/etiologia , Reprodutibilidade dos Testes , Doenças Reumáticas/diagnóstico , Inquéritos e Questionários
13.
Neurol India ; 69(4): 979-983, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34507425

RESUMO

Background: Pain is a common and distressing symptom of Parkinson's disease (PD). The relation of pain, its predictors, and its impact on quality of life (QoL) in PD has not been studied in Indian PD patients. Objective: To assess the predictors of pain and investigate its impact on QoL among Indian PD patients. Methodology: We conducted a cross-sectional study on 100 PD patients. The cases were diagnosed according to the UK brain bank criteria. Unified PD Rating Scale (UPDRS) parts III, V, and VI were employed to assess the severity of the disease. King's Parkinson Disease Pain Scale (KPPS) and PD questionnaire-8 (PDQ-8) were used to evaluate pain and QoL, respectively. Results: Prevalence of different pain types in patients with PD was 70%, mainly including musculoskeletal (53%), fluctuation-related (35%), and nocturnal pain (27%). Subjects with pain developed PD symptoms at a younger age and had a longer duration of the disease. A positive correlation was found between KPPS scores and UPDRS parts III and V, while a negative correlation was observed with UPDRS part VI. Pain in PD subjects had a significant impact on the QoL. Conclusions: Most of the PD patients suffered some form of pain with significant correlations with motor disability and poor QoL. Predictors of pain severity among PD patients included a longer disease duration, younger age of disease onset, and a higher levodopa equivalent daily dose (LEDD).


Assuntos
Pessoas com Deficiência , Transtornos Motores , Doença de Parkinson , Estudos Transversais , Humanos , Dor/epidemiologia , Dor/etiologia , Doença de Parkinson/complicações , Doença de Parkinson/epidemiologia , Qualidade de Vida , Índice de Gravidade de Doença
14.
PLoS Med ; 18(9): e1003773, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34582441

RESUMO

BACKGROUND: Long-COVID refers to a variety of symptoms affecting different organs reported by people following Coronavirus Disease 2019 (COVID-19) infection. To date, there have been no robust estimates of the incidence and co-occurrence of long-COVID features, their relationship to age, sex, or severity of infection, and the extent to which they are specific to COVID-19. The aim of this study is to address these issues. METHODS AND FINDINGS: We conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors. The incidence and co-occurrence within 6 months and in the 3 to 6 months after COVID-19 diagnosis were calculated for 9 core features of long-COVID (breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression). Their co-occurrence network was also analyzed. Comparison with a propensity score-matched cohort of patients diagnosed with influenza during the same time period was achieved using Kaplan-Meier analysis and the Cox proportional hazard model. The incidence of atopic dermatitis was used as a negative control. Among COVID-19 survivors (mean [SD] age: 46.3 [19.8], 55.6% female), 57.00% had one or more long-COVID feature recorded during the whole 6-month period (i.e., including the acute phase), and 36.55% between 3 and 6 months. The incidence of each feature was: abnormal breathing (18.71% in the 1- to 180-day period; 7.94% in the 90- to180-day period), fatigue/malaise (12.82%; 5.87%), chest/throat pain (12.60%; 5.71%), headache (8.67%; 4.63%), other pain (11.60%; 7.19%), abdominal symptoms (15.58%; 8.29%), myalgia (3.24%; 1.54%), cognitive symptoms (7.88%; 3.95%), and anxiety/depression (22.82%; 15.49%). All 9 features were more frequently reported after COVID-19 than after influenza (with an overall excess incidence of 16.60% and hazard ratios between 1.44 and 2.04, all p < 0.001), co-occurred more commonly, and formed a more interconnected network. Significant differences in incidence and co-occurrence were associated with sex, age, and illness severity. Besides the limitations inherent to EHR data, limitations of this study include that (i) the findings do not generalize to patients who have had COVID-19 but were not diagnosed, nor to patients who do not seek or receive medical attention when experiencing symptoms of long-COVID; (ii) the findings say nothing about the persistence of the clinical features; and (iii) the difference between cohorts might be affected by one cohort seeking or receiving more medical attention for their symptoms. CONCLUSIONS: Long-COVID clinical features occurred and co-occurred frequently and showed some specificity to COVID-19, though they were also observed after influenza. Different long-COVID clinical profiles were observed based on demographics and illness severity.


Assuntos
COVID-19/complicações , Sobreviventes , Adulto , Idoso , COVID-19/epidemiologia , Estudos de Coortes , Dispneia/epidemiologia , Dispneia/etiologia , Fadiga/epidemiologia , Fadiga/etiologia , Feminino , Gastroenteropatias/epidemiologia , Gastroenteropatias/etiologia , Humanos , Incidência , Influenza Humana/complicações , Influenza Humana/epidemiologia , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/etiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , SARS-CoV-2 , Índice de Gravidade de Doença , Estados Unidos/epidemiologia , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-34574464

RESUMO

A child's illness or disability is a considerable stressor for the mother and a risk factor for many psychological problems and somatic diseases. The purpose of the study was to (1) assess the prevalence of poor SRH and pain, (2) compare self-rated health and pain, (3) and identify the determinants of SRH and pain in mothers of healthy children and children requiring ambulatory observation or hospitalization. The study covered 234 mothers of both healthy and unhealthy children who required outpatient observation or treatment at an intensive care unit, neonatal intensive care unit, or oncology department. To analyse the variables obtained, the following tools were used: Self-Rated Health, Numerical Rating, Interpersonal Support Evaluation List, Peritraumatic Distress Inventory, Modified Hospital Anxiety and Depression Scale, and Impact of Effects Scale-Revised. The self-assessment of health in mothers of healthy children and those in need of outpatient observation or hospitalization at units with various specialities differed in a statistically significant way. The severity of the average and maximum pain among mothers of healthy children and those with a history of disease differed statistically significantly. Poor SRH co-occurred with severe maximum pain in all of the examined groups. Both in the control group and the group of mothers of children requiring outpatient observation, poor SRH co-occurred with a high level of anxiety. Only in the control group was a correlation found between the severity of the average and maximum pain and the severity of anxiety and depression symptoms.


Assuntos
Mães , Pacientes Ambulatoriais , Ansiedade/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Feminino , Hospitalização , Humanos , Recém-Nascido , Dor/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-34574694

RESUMO

Chronic knee pain (CKP) can degrade the quality of life and cause dysfunction, resulting in the loss of independence. Psychological stress not only affects physical and mental health but is also a risk factor for CKP. In this cross-sectional study, we analyzed data from the sixth Korea National Health and Nutrition Examination Survey (2013-2015), and investigated the association between CKP and psychological stress of the Korean general population. The CKP status was determined based on survey responses of self-reported knee pain lasting for more than 30 days during the last 3 months. Psychological stress was classified as none, mild, moderate, or severe. The association between CKP and psychological stress was analyzed using multiple logistic regression analysis considering co-variables and demographic data. Logistic regression analysis adjusting for co-variables indicated that the risk of CKP increased with an increasing degree of stress, from mild (OR = 1.65, 95% CI 1.35-2.03, p < 0.001) to moderate (OR = 2.00, 95% CI 1.56-2.57, p < 0.001) and severe (OR = 3.02, 95% CI 2.08-4.37, p < 0.001). A significant association between the risk of CKP and psychological stress was identified. Therefore, when evaluating patients with CKP, it may be helpful for clinicians to check the degree of stress.


Assuntos
Dor , Qualidade de Vida , Estudos Transversais , Humanos , Inquéritos Nutricionais , Dor/epidemiologia , República da Coreia/epidemiologia , Estresse Psicológico/epidemiologia
17.
Subst Use Misuse ; 56(13): 1951-1961, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34338612

RESUMO

BACKGROUND: opioid use, which includes both prescribed and non-prescribed drugs, is relatively common amongst marginalized populations. Past research has shown that among those who use non-prescribed or diverted opioids recreationally, many were first exposed to the drug as prescribed pain medication. Objective: to better understand the relationship between pain and opioid use in tenants of precarious housing. Methods: in the present study, 440 individuals from a cohort living in homeless or precariously housed conditions in a neighborhood with high rates of poverty and drug use were interviewed for their bodily pain and opioid use. We examined the relationship between bodily pain levels, assessed using the Maudsley Addiction Profile questionnaire, and prescribed, non-prescribed and combined self-reported opioid use in the prior 28 days assessed using the Timeline Followback and Doctor-Prescribed Medication Timeline Followback questionnaires. Results: Analysis of the results indicated that sex (female), age (younger) and early exposure to opioids (≤ age 18) predicted current opioid use, but there was no association between current bodily pain levels and opioid use. Conclusions: these unexpected findings indicate the complex nature of the relationship between pain and opioid use in this population.


Assuntos
Analgésicos Opioides , Transtornos Relacionados ao Uso de Opioides , Adolescente , Analgésicos Opioides/uso terapêutico , Feminino , Habitação , Humanos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Dor/tratamento farmacológico , Dor/epidemiologia , Prescrições
18.
Sleep Med ; 86: 32-39, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34461595

RESUMO

OBJECTIVE: To examine the relationship between sleep disturbance and pain over a 14-year period. METHODS: This study used data from the 2002-2016 waves of the Health and Retirement Study (HRS), an observational study of U.S. adults over age 50 (n = 17,756). Sleep disturbance was measured via four items (assessing difficulty falling asleep, staying asleep, and waking up too early as well as restedness) and pain via two items assessing the presence and degree of pain. Analyses consisted of path analysis; more specifically, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine how pain and sleep disturbance predict one another over two-year intervals after accounting for the trait-like nature of both factors. RESULTS: There was evidence of reciprocal effects between sleep disturbance and pain across some, but not all, intervals. Moreover, the latent variables representing the trait-like nature of sleep disturbance and pain both showed significant variance (p < 0.001), indicating stable differences between persons in sleep and pain. These trait-like characteristics were strongly associated (ß = 0.51, p < 0.001). The findings remained after adjusting the model for baseline age, self-reported health, partner status, depression, years of education, and sex. CONCLUSION: Sleep disturbance and pain are stable experiences. Moreover, there was some evidence that sleep disturbance and pain are bidirectionally linked across time among adults over 50, whereby across some intervals deviations in one's typical level of sleep disturbance predicted corresponding deviations in one's typical level of pain and vice versa. Clinically, this comorbidity and potential longitudinal bidirectionality underscore the importance of evidence-based interventions that target both sleep and pain among older individuals. Further studies should replicate these findings by collecting validated and/or objective sleep and pain measures on a more frequent basis.


Assuntos
Transtornos do Sono-Vigília , Adulto , Comorbidade , Humanos , Pessoa de Meia-Idade , Dor/epidemiologia , Aposentadoria , Sono , Transtornos do Sono-Vigília/epidemiologia
19.
BMC Psychiatry ; 21(1): 416, 2021 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-34416868

RESUMO

BACKGROUND: In light of the ongoing opioid overdose crisis, there is an urgent need for research on the impacts of mental health among people presenting with concurrent pain and substance use. This study examined the effect of depressive symptoms on pain severity and functional interference among people who use drugs (PWUD) during a community-wide overdose crisis. METHODS: From December 1st 2016 to December 31st 2018, 288 participants in two cohort studies of PWUD in Vancouver, Canada completed interviewer-administered questionnaires that included the Brief Pain Inventory and PROMIS Emotional Distress-Depression instruments. Generalized linear regression modelling (GLM) was used to examine the cross-sectional effect of depressive symptoms and other confounding factors on pain severity and interference. RESULTS: Moderate to severe depressive symptoms were significantly associated with greater pain-related functional interference (adjusted ß = 1.24, 95% confidence interval [CI] = 0.33-2.15), but not significantly associated with greater average pain severity (adjusted ß = 0.22, 95% CI = - 0.3 - 0.82), when controlling for confounding variables. Reported daily heroin use (adjusted ß = 1.26, 95% CI = 0.47-2.05) and non-fatal overdose (adjusted ß = 1.02, 95% CI = 0.08-1.96) were also significantly associated with greater pain-related functional interference. CONCLUSIONS: In a substance-using population, greater pain-related functional interference was positively associated with depressive symptoms as well as overdose and daily heroin use. These findings emphasize the need to address the functional impact of pain, mental health comorbidity, and high-risk substance use that may contribute to overdose and other harms.


Assuntos
Depressão , Overdose de Drogas , Estudos de Coortes , Estudos Transversais , Depressão/complicações , Depressão/epidemiologia , Humanos , Dor/complicações , Dor/tratamento farmacológico , Dor/epidemiologia
20.
Am J Phys Anthropol ; 176(2): 308-320, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34397101

RESUMO

OBJECTIVES: Foot and ankle dysfunction in barefoot/minimally shod populations remains understudied. Although factors affecting musculoskeletal pain in Western populations are well-studied, little is known about how types of work, gender, and body shape influence bone and joint health in non-Western and minimally shod communities. This study examines the effect of human variation on locomotor disability in an agrarian community in Madagascar. MATERIALS AND METHODS: Foot measurements were collected along with height, weight, age, and self-report data on daily activity and foot and ankle pain from 41 male and 48 female adults. A short form revised foot function index (FFI-R), that measures functional disability related to foot pain, was calculated. Raw and normalized foot measurements were compared by gender and used in a multiple linear regression model to determine predictors of FFI-R. RESULTS: Compared to men, women reported higher FFI-R scores (p = 0.014), spent more time on their feet (p = 0.019), and had higher BMIs (p = 0.0001). For their weight, women had significantly smaller and narrower feet than men. Bimalleolar breadth (p = 0.0005) and foot length (p = 0.0223) standardized by height, time spent on feet (p = 0.0102), ankle circumference standardized by weight (p = 0.0316), and age (p = 0.0090) were significant predictors of FFI-R score. DISCUSSION: Our findings suggest that human variation in anatomical and behavioral patterns serve as significant explanations for increased foot and ankle pain in women in this non-Western rural population. Foot and ankle pain were prevalent at similar levels to those in industrialized populations, indicating that research should continue to examine its effect on similar barefoot/minimally shod communities.


Assuntos
Tornozelo , , Dor , População Rural/estatística & dados numéricos , Adolescente , Adulto , Tornozelo/anatomia & histologia , Tornozelo/patologia , Antropologia Física , Feminino , Pé/anatomia & histologia , Pé/patologia , Humanos , Madagáscar/epidemiologia , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/patologia , Dor/fisiopatologia , Sapatos/estatística & dados numéricos , Caminhada , Adulto Jovem
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