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1.
J Nurs Care Qual ; 38(1): E9-E15, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36066846

RESUMO

BACKGROUND: Nonpharmacological interventions are needed to reduce pain during vaccine administration in infants. PURPOSE: To determine the effect of the Buzzy device, which is a combination of cold and vibration, on pain during measles-mumps-rubella (MMR) vaccine administration in 12-month-old infants. METHODS: A prospective randomized controlled experimental research design was used. RESULTS: A total of 60 infants were included in the study. During and after vaccine injection, pain scores of infants who had the Buzzy device were significantly lower than those of infants in the control group ( P = .001). CONCLUSIONS: Buzzy application may be an effective method in reducing pain during MMR vaccine administration. Use of the device is recommended for infants receiving vaccinations.


Assuntos
Vacina contra Sarampo-Caxumba-Rubéola , Dor , Lactente , Humanos , Estudos Prospectivos , Vacina contra Sarampo-Caxumba-Rubéola/efeitos adversos , Injeções , Dor/etiologia , Dor/prevenção & controle , Vacinação/efeitos adversos
2.
Medicine (Baltimore) ; 101(43): e31628, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316855

RESUMO

RATIONALE: Heterotopic ossification (HO), an ectopic bone formation in soft tissue around the joint, is a complication observed in stroke patients. HO around the hip joint causes a reduction in the functional ability of patients by generating pain and limiting range of motion (ROM). In addition, it results in impaired mobility, ultimately affecting quality of life and increasing the mortality of patients. Extracorporeal shock wave therapy (ESWT) has demonstrated efficacy in treating soft tissue inflammation and has been used to reduce patients' pain in HO. However, almost none of the studies reported degradation in the size of HO on images obtained before and after ESWT application. PATIENT CONCERNS AND DIAGNOSIS: We report a case of a 36-year-old man who developed HO around both hip joints 3 months after bilateral pontine hemorrhage. INTERVENTIONS: Seven months after HO development, ESWT was administered to the area of HO every other day for a total of 10 sessions. OUTCOMES: Immediately following treatment, the ROM of both hip joints increased. Thus the patient was able to maintain a sitting posture without having to be bound to the wheelchair. In addition, the tolerable sitting time before groaning increased from less than ten minutes to almost 60 minutes by the end of all ESWT sessions. Unlike other previous reports, a diminished HO size was confirmed by comparing plain X-rays and bone scans obtained before and after treatment sessions. LESSONS: In this case, we report an objective size reduction in HO in radiologic findings after applying ESWT to both hips. ESWT is a safe, easy-to-apply, and noninvasive modality. We would like to emphasize the use of ESWT as a treatment option for HO to decrease the extent of HO, as well as to improve pain, spasticity and function in patients with stroke.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Ossificação Heterotópica , Acidente Vascular Cerebral , Masculino , Humanos , Adulto , Tratamento por Ondas de Choque Extracorpóreas/métodos , Qualidade de Vida , Resultado do Tratamento , Tomografia Computadorizada por Raios X/efeitos adversos , Ossificação Heterotópica/complicações , Ossificação Heterotópica/terapia , Dor/etiologia , Acidente Vascular Cerebral/complicações , Hemorragia Cerebral/complicações
3.
Medicine (Baltimore) ; 101(43): e31206, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316871

RESUMO

BACKGROUND: Migraine is a primary headache disorder that causes debilitating throbbing pain. Several functional MRI (fMRI) and voxel-based morphometry (VBM) studies have been used to investigate the structural and functional alteration in migraine. Here, we aim to study the converged brain regions of functional and structural abnormalities in gray matter volume (GMV) associated with pain processing and management in migraineurs and healthy controls (HC). METHODS: A systematic search through PubMed and Sleuth was carried out for peer-reviewed functional and structural neuroimaging studies on migraine patients and HC yielded a total of 1136 studies. We performed an activation likelihood estimation (ALE) meta-analysis on VBM and pain stimulation task-based fMRI studies to investigate the converged areas of GMV and functional abnormalities between migraineurs and HC. We performed two subgroup analyses between migraine with aura (MwA) and migraine without aura (MwoA) relative to HC, and between chronic migraine (CM) and episodic migraine (EM) compared to HC. RESULTS: The total sample included 16 fMRI and 22 VBM studies, consisting of 1295 migraine patients, compared to 995 HC. In fMRI analysis, ALE maps for pain stimulation tasks revealed hyperactivation in migraineurs in the substantia nigra compared to HC, whereas hypoactivation was seen in the cerebellum. For the VBM analysis, ALE clusters of increased GMV in migraineurs were observed in the parahippocampus and putamen nucleus. Whereas clusters of reduced GMV in migraineurs were seen in the frontal gyri. Compared to HC, MwoA patients showed a GMV reduction in the insula, and anterior cingulate, whereas MwA patients showed GMV reduction in the cerebellum, cingulate gyrus, and insula. CM patients showed decreased GMV in the precentral gyrus, whereas EM patients showed decreased GMV in the parahippocampus, and inferior frontal gyrus when compared to HC. CONCLUSIONS: Our findings represent a potential biomarker for the diagnosis and management of migraine, by showing clustered brain regions of abnormal patterns of activation and GMV changes between migraineurs and HC which might be associated with hyposensitivity to pain in migraineurs. Further studies are required to determine disease progression or therapeutic interventions' effect on migraine.


Assuntos
Enxaqueca com Aura , Enxaqueca sem Aura , Humanos , Funções Verossimilhança , Substância Cinzenta , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Dor/etiologia
4.
Bone Joint J ; 104-B(11): 1209-1214, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36317343

RESUMO

AIMS: Spinal anaesthesia has seen increased use in contemporary primary total knee arthroplasties (TKAs). However, controversy exists about the benefits of spinal in comparison to general anaesthesia in primary TKAs. This study aimed to investigate the pain control, length of stay (LOS), and complications associated with spinal versus general anaesthesia in primary TKAs from a single, high-volume academic centre. METHODS: We retrospectively identified 17,690 primary TKAs (13,297 patients) from 2001 to 2016 using our institutional total joint registry, where 52% had general anaesthesia and 48% had spinal anaesthesia. Baseline characteristics were similar between cohorts with a mean age of 68 years (SD 10), 58% female (n = 7,669), and mean BMI of 32 kg/m2 (SD 7). Pain was evaluated using oral morphine equivalents (OMEs) and numerical pain rating scale (NPRS) data. Complications including 30- and 90-day readmissions were studied. Data were analyzed using an inverse probability of treatment weighted model based on propensity score that included many patient and surgical factors. Mean follow-up was seven years (2 to 18). RESULTS: Patients treated with spinal anaesthesia required fewer postoperative OMEs (p < 0.001) and had lower NPRS scores (p < 0.001). Spinal anaesthesia also had fewer cases of altered mental status (AMS; odds ratio (OR) 1.3; p = 0.044), as well as 30-day (OR 1.4; p < 0.001) and 90-day readmissions (OR 1.5; p < 0.001). General anaesthesia was associated with increased risk of any revision (OR 1.2; p = 0.021) and any reoperation (1.3; p < 0.001). CONCLUSION: In the largest single institutional report to date, we found that spinal anaesthesia was associated with significantly lower OME use, lower risk of AMS, and lower overall 30- and 90-day readmissions following primary TKAs. Additionally, spinal anaesthesia was associated with reduced risk of any revision and any reoperation after accounting for numerous patient and operative factors. When possible and safe, spinal anaesthesia should be considered in primary TKAs.Cite this article: Bone Joint J 2022;104-B(11):1209-1214.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Humanos , Feminino , Idoso , Masculino , Prótese do Joelho/efeitos adversos , Estudos Retrospectivos , Artroplastia do Joelho/efeitos adversos , Reoperação/efeitos adversos , Anestesia Geral/efeitos adversos , Dor/etiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia
5.
Int J Geriatr Psychiatry ; 37(12)2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36317464

RESUMO

BACKGROUND: People with dementia are at risk of unplanned hospital admissions and commonly have painful conditions. Identifying pain is challenging and may lead to undertreatment. The psychometric properties of the Pain Assessment in Advanced Dementia (PAINAD) scale, in medical inpatients with dementia have not been evaluated. METHODS: A secondary data analysis from a longitudinal study of 230 people with dementia admitted to two acute general hospitals in London, UK. Internal consistency, inter-rater reliability, test-retest reliability, concurrent validity, construct validity and discriminant validity of PAINAD were tested at rest and in movement. RESULTS: This predominantly female (65.7%) sample had a mean age of 87.2 (Standard Deviation; SD = 5.92) years. Inter-rater reliability showed an intra-class correlation (ICC) of 0.92 at rest and 0.98 in movement, test-retest reliability ICC was 0.54 at rest and 0.66 in movement. Internal consistency was 0.76 at rest and 0.80 in movement (Cronbach's α). Concurrent validity was weak between PAINAD and a self-rating level of pain (Kendall's Tau; τ = 0.29; p > 0.001). There was no correlation between PAINAD and a measure of behavioural and psychological symptoms of dementia, suggesting no evidence of convergent validity. PAINAD scores were higher during movement than rest, providing evidence of discriminant validity (z = -8.01, p < 0.001). CONCLUSIONS: We found good inter-rater reliability and internal consistency. The test-retest reliability was modest. This study raises concerns about the validity of the PAINAD in general acute hospitals. This provides an insight into pain assessment in general acute hospitals which may inform further refinements of the PAINAD.


Assuntos
Demência , Hospitais Gerais , Feminino , Humanos , Idoso de 80 Anos ou mais , Masculino , Medição da Dor , Psicometria , Reprodutibilidade dos Testes , Demência/complicações , Demência/diagnóstico , Demência/psicologia , Estudos Longitudinais , Dor/etiologia , Dor/complicações
6.
Neurosurg Focus ; 53(5): E12, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36321286

RESUMO

OBJECTIVE: Spine hepatocellular carcinoma (HCC) metastases severely worsen quality of life and prognosis, with the role of radiotherapy being controversial. The authors systematically reviewed the literature on radiotherapy for spine metastatic HCCs. METHODS: The PubMed, Scopus, Web of Science, and Cochrane databases were searched according to the PRISMA guidelines to include studies of radiotherapy for spine metastatic HCCs. Outcomes, complications, and local control were analyzed with indirect random-effect meta-analyses. RESULTS: The authors included 12 studies comprising 713 patients. The median time interval from diagnosis of HCC to spine metastases was 12 months (range 0-105 months). Most lesions were thoracic (35.9%) or lumbar (24.7%). Radiotherapy was delivered with conventional external-beam (67.3%) or stereotactic (31.7%) techniques. The median dose was 30.3 Gy (range 12.5-52 Gy) in a median of 5 fractions (range 1-20 fractions). The median biologically effective dose was 44.8 Gy10 (range 14.4-112.5 Gy10). Actuarial rates of postradiotherapy pain relief and radiological response were 87% (95% CI 84%-90%) and 70% (95% CI 65%-75%), respectively. Radiation-related adverse events and vertebral fractures had actuarial rates of 8% (95% CI 5%-11%) and 16% (95% CI 10%-23%), respectively, with fracture rates significantly higher after stereotactic radiotherapy (p = 0.033). Fifty-eight patients (27.6%) had local recurrences after a median of 6.8 months (range 0.1-59 months), with pooled local control rates of 61.6% at 6 months and 40.8% at 12 months, and there were no significant differences based on radiotherapy type (p = 0.068). The median survival was 6 months (range 0.1-62 months), with pooled rates of 52.5% at 6 months and 23.4% at 12 months. CONCLUSIONS: Radiotherapy in spine metastatic HCCs shows favorable rates of pain relief, radiological responses, and local control. Rates of postradiotherapy vertebral fractures are higher after high-dose stereotactic radiotherapy.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Radiocirurgia , Fraturas da Coluna Vertebral , Neoplasias da Coluna Vertebral , Humanos , Carcinoma Hepatocelular/complicações , Neoplasias da Coluna Vertebral/cirurgia , Qualidade de Vida , Neoplasias Hepáticas/complicações , Radiocirurgia/métodos , Fraturas da Coluna Vertebral/complicações , Dor/etiologia , Estudos Retrospectivos
7.
J Wound Care ; 31(11): 898-906, 2022 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-36367803

RESUMO

OBJECTIVE: It is theorised that adhesive-free wound care developed specifically for patients with hidradenitis suppurativa (HS) can improve their quality of life (QoL). Our study aimed to investigate the impact of a novel wound care device on Dermatology Life Quality Index (DLQI) scores, and other factors related to experienced pain, time spent changing dressings, comfort, ease of use and body image. METHOD: A 21-day, single-arm, unblinded, pilot trial was conducted to assess ease of use and the impact of effective wound care on various aspects of wound management in patients with HS. Participants were provided two trial garments and trial dressings as required, to use over a 21-day period in the home setting. A seven-item questionnaire and the DLQI questionnaire was completed on days 0, 7, 14 and 21. RESULTS: All 15 participants were female, aged >18 years old and with a diagnosis of HS. Mean DLQI score at baseline (day 0) was 19.3, which was reduced to 4.53 on day 21, a significant improvement in 100% of participants (p<0.001). High levels of dressing-related pain, assessed using an 11-point Visual Analogue Scale, reduced from 5.53 at baseline to 0.8 on day 21. Other significant improvements in terms of patient comfort, time spent on changing dressings, body confidence and the dressing's ability to retain exudate were also noted. CONCLUSION: The results illustrated the improvement made to study participants' day-to-day activities and QoL when effective HS-specific wound care products were provided. Wound care is an essential component in the treatment journey of patients.


Assuntos
Hidradenite Supurativa , Humanos , Feminino , Adolescente , Masculino , Hidradenite Supurativa/terapia , Hidradenite Supurativa/diagnóstico , Qualidade de Vida , Projetos Piloto , Bandagens , Dor/etiologia
8.
Zhonghua Yi Xue Za Zhi ; 102(42): 3395-3400, 2022 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-36372770

RESUMO

Objective: To evaluate the quality of life and influencing factors of patients with herpes zoster (HZ) seen in hospitals. Methods: Based on Zoster Brief Pain Inventory (ZBPI) and Five-level EuroQol Five-dimensional Questionnaire (EQ-5D-5L), a cross-sectional survey was conducted to evaluate the pain severity and quality of life of 332 HZ cases seen in 22 hospitals of Lu'an City (Anhui Province), Zibo City (Shandong Province) and Tongchuan City (Shaanxi Province) from October to December 2021. The censored least absolute deviations (CLAD) model was used to analyze the related factors affecting the changes of patients' health utility values. Results: The 45.5% of 332 HZ cases were male. The median (Q1,Q3) age was 59 (50, 68) years. 59.64% of them assessed by ZBPI had moderate to severe pain in the past 24 hours (worst pain score≥5), and that of PHN cases was 84.8%(39/46). 77.7% (258/332), 77.4% (257/332) and 74.1% (246/332) of all patients reported that pain interfered with sleep, mood and general activities, respectively. Aging [ß40-49y (95%CI)=-0.11 (-0.15, -0.08); ß50-59y (95%CI)=-0.03 (-0.05, 0.00); ß60-69y (95%CI)=-0.09 (-0.12, -0.06); ß70-90y(95%CI)=-0.16 (-0.19, -0.12)], working status (unemployed) [ßfarmer (95%CI)=0.15 (0.13, 0.18); ßretirees(95%CI)=0.21 (0.18, 0.24); ßemployee (95%CI)=0.13 (0.10, 0.16) ], complications[ßPHN (95%CI)=-0.08 (-0.13, -0.04); ßother complications (95%CI)=-0.12 (-0.15, -0.08)], within 30 days after onset [ß(95%CI)=-0.01 (-0.03, 0.01)] and treatment [ßother complications (95%CI)=-0.09 (-0.11, -0.06)] were related factors for the decline of health utility value (all P values <0.05). Conclusions: More than half of the patients with HZ had moderate to severe pain in the past 24 hours, which had a serious negative impact on the physical and mental health of the patients. Elderly patients, acute patients and patients with complications had lower health utility values and worse health status. We suggest that eligible people be vaccinated with HZ vaccine as soon as possible.


Assuntos
Herpes Zoster , Qualidade de Vida , Humanos , Masculino , Idoso , Feminino , Radioisótopos de Ítrio , Estudos Transversais , Herpes Zoster/complicações , Herpes Zoster/prevenção & controle , Herpesvirus Humano 3 , Dor/etiologia , Fatores de Risco
9.
Rev Med Liege ; 77(11): 672-677, 2022 Nov.
Artigo em Francês | MEDLINE | ID: mdl-36354230

RESUMO

Coxalgia is one of the most common painful complaints in orthopedic surgery. The management of a "traumatic" hip is relatively well codified, however atraumatic coxalgia is more difficult to diagnose and explore. The history and a well-conducted clinical examination are essential for the management of coxalgia. The diagnosis is already well oriented by a simple X-ray and the presence or absence of inflammatory signs on the blood test. This article aims to provide a guideline for the diagnostic approach to coxalgia.


La coxalgie est une des plaintes douloureuses les plus fréquentes en chirurgie orthopédique. La prise en charge d'une hanche «traumatique¼ est relativement bien codifiée, par contre les coxalgies atraumatiques sont plus difficiles à diagnostiquer et explorer. L'anamnèse et un examen clinique bien conduit sont primordiaux pour la prise en charge de la coxalgie. Le diagnostic est déjà bien orienté par une simple radiographie et la présence ou non de signe inflammatoire à la prise de sang. Cet article vise à donner une ligne de conduite à la démarche diagnostique face à la coxalgie.


Assuntos
Quadril , Dor , Humanos , Quadril/cirurgia , Dor/diagnóstico , Dor/etiologia , Radiografia
10.
Arthritis Res Ther ; 24(1): 252, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36369217

RESUMO

BACKGROUND: Pain-sensitized osteoarthritis and fibromyalgia patients characteristically show nociceptive system augmented responsiveness as a common feature. However, sensitization can be originally related to the peripheral injury in osteoarthritis patients, whereas pain and bodily discomfort spontaneously occur in fibromyalgia with no apparent origin. We investigated the distinct functional repercussion of pain sensitization in the cerebral cortex in both conditions. METHODS: Thirty-one pain-sensitized knee osteoarthritis patients and 38 fibromyalgia patients were compared with matched control groups. And new samples of 34 sensitized knee osteoarthritis and 63 fibromyalgia patients were used to directly compare each condition. A combined measure of local functional connectivity was estimated to map functional alterations in the cerebral cortex at rest. RESULTS: In osteoarthritis, weaker local connectivity was identified in the insula, which is a cortical area processing important aspects of the brain response to painful stimulation. In contrast, fibromyalgia patients showed weaker connectivity in the sensorimotor cortex extensively affecting the cortical representation of the body. CONCLUSIONS: In osteoarthritis, weaker insular cortex connectivity is compatible with reduced neural activity during metabolic recovery after repeated activation. In the fibromyalgia neurophysiological context, weaker connectivity may better express both reduced neural activity and increased excitability, particularly affecting the sensorimotor cortex in patients with spontaneous body pain. Such a combination is compatible with a central gain enhancement mechanism, where low sensory tolerance results from the over-amplification of central sensory reception to compensate a presumably weak sensory input. We propose that deficient proprioception could be a factor contributing to weak sensory input.


Assuntos
Fibromialgia , Osteoartrite do Joelho , Humanos , Fibromialgia/complicações , Osteoartrite do Joelho/complicações , Medição da Dor , Imageamento por Ressonância Magnética/métodos , Dor/etiologia , Córtex Cerebral , Encéfalo
11.
Cochrane Database Syst Rev ; 11: CD015023, 2022 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-36354070

RESUMO

BACKGROUND: Newborn infants affected by hypoxic-ischemic encephalopathy (HIE) undergo therapeutic hypothermia. As this treatment seems to be associated with pain, and intensive and invasive care is needed, pharmacological interventions are often used. Moreover, painful procedures in the newborn period can affect pain responses later in life, impair brain development, and possibly have a long-term negative impact on neurodevelopment and quality of life. OBJECTIVES: To determine the effects of pharmacological interventions for pain and sedation management in newborn infants undergoing therapeutic hypothermia. Primary outcomes were analgesia and sedation, and all-cause mortality to discharge. SEARCH METHODS: We searched CENTRAL, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the trial register ISRCTN in August 2021. We also checked the reference lists of relevant articles to identify additional studies. SELECTION CRITERIA: We included randomized controlled trials (RCT), quasi-RCTs and cluster-randomized trials comparing drugs used for the management of pain or sedation, or both, during therapeutic hypothermia: any opioids (e.g. morphine, fentanyl), alpha-2 agonists (e.g. clonidine, dexmedetomidine), N-Methyl-D-aspartate (NMDA) receptor antagonist (e.g. ketamine), other analgesics (e.g. paracetamol), and sedatives (e.g. benzodiazepines such as midazolam) versus another drug, placebo, no intervention, or non-pharmacological interventions.  Primary outcomes were analgesia and sedation, and all-cause mortality to discharge. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies identified by the search strategy for inclusion. We planned to use the GRADE approach to assess the certainty of evidence. We planned to assess the methodological quality of included trials using Cochrane Effective Practice and Organisation of Care Group (EPOC) criteria (assessing randomization, blinding, loss to follow-up, and handling of outcome data). We planned to evaluate treatment effects using a fixed-effect model with risk ratio (RR) for categorical data and mean, standard deviation (SD), and mean difference (MD) for continuous data.  MAIN RESULTS: We did not find any completed studies for inclusion. Amongst the four excluded studies, topiramate and atropine were used in two and one trial, respectively; one study used dexmedetomidine and was initially reported in 2019 to be a randomized trial. However, it was an observational study (correction in 2021). We identified one ongoing study comparing dexmedetomidine to morphine. AUTHORS' CONCLUSIONS: We found no studies that met our inclusion criteria and hence there is no evidence to recommend or refute the use of pharmacological interventions for pain and sedation management in newborn infants undergoing therapeutic hypothermia.


Assuntos
Dexmedetomidina , Hipotermia Induzida , Recém-Nascido , Humanos , Dexmedetomidina/uso terapêutico , Clonidina/uso terapêutico , Dor/tratamento farmacológico , Dor/etiologia , Derivados da Morfina , Estudos Observacionais como Assunto
12.
J Coll Physicians Surg Pak ; 32(11): 1441-1447, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36377012

RESUMO

OBJECTIVE: To determine the effects of Kinesio taping on pain, functional performance, range of motion, and postural stability in patients with knee osteoarthritis. STUDY DESIGN: Randomised double-blind controlled trial. PLACE AND DURATION OF STUDY: Department of Physical Medicine and Rehabilitation, University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Turkey, from November 2019 to October 2021. METHODOLOGY: Fifty-seven patients with knee osteoarthritis (grade II or higher) according to the Kellgren-Lawrence classification received Kinesio tape or sham-Kinesio tape on the rectus femoris muscle three times a week. Patients were evaluated using the visual analogue scale (VAS), Western ontario and McMaster Universities Osteoarthritis Index (WOMAC), 50-meter walk time, range of motion (ROM), and postural stability index at baseline, 1st hour, 3rd week, 7th week. A mixed model analysis of repeated measures was used to test the effect of KT on outcome measures. Calculations were based on an intention-to-treat analysis. RESULTS: The only significant difference between groups was in the dynamic medio-lateral stability index [F (2.6,144.1)=3.83, p=0.015], indicating the inferiority of KT at week 3. There were differences within groups in 50-meter walking time and VAS at rest, which showed improvements over time in both groups. No significant difference was found between or within groups for other outcomes. CONCLUSION: The KT intervention for three consecutive weeks showed no superiority over sham-KT in terms of pain intensity, knee-related health status, knee ROM, functional performance, and postural stability. KEY WORDS: Kinesio taping, Knee osteoarthritis, Pain, Gait, Functions.


Assuntos
Fita Atlética , Osteoartrite do Joelho , Humanos , Método Duplo-Cego , Força Muscular/fisiologia , Osteoartrite do Joelho/terapia , Dor/etiologia , Amplitude de Movimento Articular/fisiologia , Resultado do Tratamento
13.
Medicine (Baltimore) ; 101(44): e31347, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36343076

RESUMO

RATIONALE: The incidence of snapping popliteus tendon syndrome, a type of lateral knee snapping, is not high, so making an accurate diagnosis is difficult. A proper treatment following an accurate diagnosis is essential for improvement. Very few cases have been reported of its treatment. PATIENT CONCERNS: An 18-year-old male patient had experienced painful popping in the lateral part of the knee during knee flexion for 3 years before his hospital visit. DIAGNOSES: Snapping popliteus tendon syndrome. INTERVENTIONS: The patient underwent an all-arthroscopic surgery. Tendon debulking and tissue debridement around the popliteus tendon was conducted, but the snapping did not resolve. The enlarged tubercle was excised through an arthroscopic procedure using a burr, and the surgery was finished after confirming that snapping was resolved. OUTCOMES: Full range of motion (ROM) was recovered 6 weeks after surgery and the snapping did not recur. LESSONS: Snapping popliteus tendon syndrome is a disease that is hardly recognized due to its low prevalence and difficulty in diagnosis, and it requires close observation of the patient before surgery. The location of the tenderness and the snapping occurrence must also be carefully identified. Our procedure is an entirely arthroscopic technique; as it has the prominent advantage of a speedy recovery and easy rehabilitation, it could also be helpful to set treatment standards for this disease in the future.


Assuntos
Artroscopia , Tendões , Masculino , Humanos , Adolescente , Artroscopia/efeitos adversos , Tendões/cirurgia , Articulação do Joelho/cirurgia , Dor/etiologia , Perna (Membro) , Síndrome
14.
Int J Clin Pract ; 2022: 4082618, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36340966

RESUMO

Objective: The aim of this study was to compare the therapeutic effects of the mini-open incision and conventional open surgery for carpal tunnel syndrome (CTS). Methods: The clinical data of 52 patients with CTS treated at the First Affiliated Hospital of the University of Science and Technology of China from October 2020 to February 2022 were retrospectively analyzed. The patients were divided into the conventional open surgery group (28 cases) and the mini-open incision group (24 cases) according to different surgical incisions applied. The incision length, operation time, time until postoperative return to work, and complications were observed in the two groups. The Visual Analog Scale (VAS) for pain at one day, one month, and three months after surgery and the Boston Carpal Tunnel Questionnaire scores before, at one month, and at three months after surgery were compared between the two groups. Results: The incision length, operation time, and time until return to work in the mini-open incision group were all shorter than those in the conventional open surgery group (2.58 ± 0.35 vs. 7.32 ± 0.61 cm, 18.67 ± 2.62 vs. 29.46 ± 3.42 min, and 5.33 ± 1.40 vs. 13.86 ± 2.70 d, respectively), and differences were statistically significant (P < 0.05 in all). The VAS scores in the mini-open incision group were lower than those in the conventional open surgery group at one day and one month after surgery, while the difference in the VAS scores at three months after surgery was not statistically significant between the two groups. There was no statistically significant difference in neurological recovery between the two groups at postoperative follow-ups (P > 0.05). The incidences of postoperative scar hyperplasia and scar pain were higher in the conventional open surgery group than those in the mini-open incision group, and differences were statistically significant (P < 0.05 in both). Conclusion: Mini-open incision surgery for CTS was a safe and reliable procedure with a precise therapeutic effect, minimal surgical trauma, and high postoperative comfort for patients and could achieve enhanced recovery. Trial Registration. This trial is registered with ChiCTR2200064631.


Assuntos
Síndrome do Túnel Carpal , Ferida Cirúrgica , Humanos , Síndrome do Túnel Carpal/cirurgia , Síndrome do Túnel Carpal/complicações , Cicatriz/complicações , Nervo Mediano/cirurgia , Dor/etiologia , Estudos Retrospectivos , Ferida Cirúrgica/complicações , Resultado do Tratamento
15.
Sci Rep ; 12(1): 18498, 2022 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-36323716

RESUMO

Fine-needle aspiration biopsy (FNAB) is a routine diagnostic test for thyroid nodules. The use of local anesthesia (LA) before the procedure is still controversial. This prospective study aimed to evaluate the degree of pain and specimen adequacy in liquid-based cytology (LBC) for FNAB of thyroid nodules with and without LA. A total of 100 consecutive patients with thyroid nodules who underwent FNAB with and without LA between January and December 2020 were included. Patients who received LA had a significantly lower immediate pain scale score (P = 0.01). Multivariate analysis demonstrated that no use of LA (odds ratio [OR] = 3.48, 95% confidence interval [CI] = 1.50-8.10, P = 0.004) and lesion abutting the trachea (OR = 6.14, 95% CI = 1.56-24.12, P = 0.009) were independently and significantly associated with pain degree immediately after FNAB. A higher proportion of patients who previously underwent FNAB thought that LA was helpful and should be performed prior to FNAB. However, the use of LA did not improve the specimen adequacy (P = 0.075). The results showed that administration of LA with a proper technique before ultrasound-guided FNAB might reduce immediate pain after the procedure, and patients may experience more pain when the aspirated nodules abut the trachea.


Assuntos
Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Humanos , Nódulo da Glândula Tireoide/patologia , Biópsia por Agulha Fina/métodos , Anestesia Local , Estudos Prospectivos , Dor/etiologia , Neoplasias da Glândula Tireoide/patologia , Estudos Retrospectivos , Sensibilidade e Especificidade
17.
Hematol Oncol Clin North Am ; 36(6): 1137-1149, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36400535

RESUMO

Health-related quality of life (HRQoL) represents the practical effects of an illness in terms of symptoms and impacts, and of consequent treatments, as perceived by the patient. HRQoL is a complex multidimensional phenomenon in sickle cell disease (SCD) involving external stressors, thought patterns, emotional distress, physiological arousal, pain, and other complications of SCD. Social determinants of health comprise food and housing security, employment and education, and experiences of racism and discrimination; these social determinants also potentially affect health, HRQoL, and access to health care. Interventions must be implemented in partnership between individuals with SCD and their health-care providers.


Assuntos
Anemia Falciforme , Qualidade de Vida , Humanos , Qualidade de Vida/psicologia , Anemia Falciforme/terapia , Anemia Falciforme/complicações , Dor/etiologia
18.
Ann Emerg Med ; 80(6): e93-e94, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36404006
19.
BMJ Open ; 12(11): e061099, 2022 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-36379658

RESUMO

INTRODUCTION: Fatigue and pain are the main symptoms of rheumatic and musculoskeletal diseases (RMDs). Healthcare professionals have a primary role in helping patients to manage both these symptoms, which are part of a complex network of co-occurring factors including sleep problems, psychological distress, social support, body weight, diet, inactive lifestyle and disease activity. The patterns of relationships (networks) between these factors and these symptoms, fatigue and pain, are largely unknown. The current proposal aims to reveal them using network estimation techniques. We will also consider differences in networks for subgroups of people with (1) different RMDs and (2) different clusters (profiles) of biopsychosocial factors. METHODS AND ANALYSIS: Adults with at least one RMD will be recruited to this online cross-sectional observational project. To provide a complete overview, a large sample size from different countries will be included. A brief online survey, using 0-10 numeric rating scales will measure, for the past month, levels of fatigue and pain as well as scores on seven biopsychosocial factors. These factors were derived from literature and identified by interviews with patients, health professionals and rheumatologists. Using this input, the steering committee of the project decided the factors to be measured giving priority to those that can be modified in self-management support in community health centres worldwide. Network estimation techniques are used to detect the complex patterns of relationships between these biopsychosocial factors, fatigue and pain; and how these differ for subgroups of people with different RMDs and profiles. ETHICS AND DISSEMINATION: Ethical approval of national Institutional Review Boards was obtained. The online survey includes an information letter and informed consent form. The findings will be disseminated via conferences and publications in peer-reviewed scientific journals, while public media channels will be used to inform people with RMDs and other interested parties.


Assuntos
Doenças Musculoesqueléticas , Doenças Reumáticas , Adulto , Humanos , Estudos Transversais , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/diagnóstico , Fadiga/etiologia , Dor/etiologia , Pessoal de Saúde , Doenças Reumáticas/complicações , Doenças Reumáticas/diagnóstico
20.
Acta Clin Croat ; 61(1): 149-152, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36398085

RESUMO

Spinal subdural hematoma caused by lumbar puncture is a rare state of acute blood clot in spinal subdural space, and in some cases, it can be the cause of local compression and consecutive neurological symptoms. We present a 36-year-old female patient who was hospitalized due to persistent headache despite pharmacological therapy. Therefore, we performed lumbar puncture in order to measure intracranial pressure and evaluate cerebrospinal fluid. After lumbar puncture, the patient was complaining of pain in the lumbar region. Emergency magnetic resonance imaging (MRI) of the lumbosacral (LS) region was performed to show acute subdural hematoma of up to 7.3 mm in the dorsal part of the spinal canal at the level of L1 vertebra to the inferior endplate of L4 vertebra. Repeat LS MRI after 3 hours showed unchanged finding. The patient reported gradual regression of pain in the LS region over the next few days, therefore conservative treatment was applied. Patients with a previously known blood clotting disorder and patients on anticoagulation therapy have worse outcome as compared with patients without such disorders. During treatment, it is necessary to monitor patient clinical state and consider the need of surgical treatment.


Assuntos
Hematoma Subdural Espinal , Feminino , Humanos , Adulto , Hematoma Subdural Espinal/diagnóstico , Hematoma Subdural Espinal/etiologia , Hematoma Subdural Espinal/patologia , Punção Espinal/efeitos adversos , Vértebras Lombares , Imageamento por Ressonância Magnética , Dor/etiologia
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