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1.
Pain Res Manag ; 2021: 7992580, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34234884

RESUMO

Background: Anxious people appear to exaggerate the severity of aversive experiences such as anxiety and pain. Anxiety towards dental procedures is a common difficulty that may be experienced by dental patients all over the world. The goal of the study is to find out the prevalence of dental anxiety and its associated factors in Chinese adult patients. Methods: A cross-sectional study was conducted on 183 dental adult patients whose age ranged from 18 to 70 years. Demographic details, first and most recent dental visits with experience, the MDAS, and the Visual Analogue Scale for Anxiety (VAS-A) were obtained. Data were analyzed by frequency analysis, chi-square test, and Spearman correlation test. Results: Most of the respondents were female (68.9%) and 30-45 years age group. The mean total score for dental anxiety on the MDAS was 13.63 (3.1). 80.3% of participants suffered from moderate or high dental anxiety. Age must show a strong association with dental anxiety among the participants (p=0.011). The first dental visit experience, the frequency of the dental visit, most recent dental experience, length of time since the most recent dental visit, and postponement of the dental visit are strongly associated with the MDAS score (p=0.001). Conclusions: The MDAS score exhibits that Chinese adult patients have significant dental anxiety and phobia. Identifying patients with dental anxiety as soon as possible is essential to providing better dental care.


Assuntos
Ansiedade ao Tratamento Odontológico/epidemiologia , Dor/epidemiologia , Adulto , Fatores Etários , Idoso , China/epidemiologia , Estudos Transversais , Ansiedade ao Tratamento Odontológico/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Prevalência , Adulto Jovem
4.
Life Sci ; 280: 119724, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34144059

RESUMO

AIMS: Gulf War Illness (GWI) is manifested as multiple chronic symptoms, including chronic pain, chronic fatigue, sleep problems, neuropsychiatric disorders, respiratory, gastrointestinal, and skin problems. No single target tissue or unifying pathogenic process has been identified that accounts for this variety of symptoms. The brainstem has been suspected to contribute to this multiple symptomatology. The aim of this study was to assess the role of the brainstem in chronic sleep problems and pain in GWI veterans. MATERIALS AND METHODS: We enrolled 90 veterans (Age = 50 ± 5, 87% Male) who were deployed to the 1990-91 Gulf War and presented with GWI symptoms. Sleep quality was evaluated using the global Pittsburgh Sleep Quality Index. Pain intensities were obtained with the Brief Pain Inventory sum score. Volumes in cortical, subcortical, brainstem, and brainstem subregions and diffusion tensor metrics in 10 bilateral brainstem tracts were tested for correlations with symptom measures. KEY FINDINGS: Poorer sleep quality was significantly correlated with atrophy of the whole brainstem and brainstem subregions (including midbrain, pons, medulla). Poorer sleep quality also significantly correlated with lower fractional anisotropy in the nigrostriatal tract, medial forebrain tract, and the dorsal longitudinal fasciculus. There was a significant correlation between increased pain intensity and decreased fractional anisotropy in the dorsal longitudinal fasciculus. These correlations were not altered after controlling for age, sex, total intracranial volumes, or additional factors, e.g., depression and neurological conditions. SIGNIFICANCE: These findings suggest that the brainstem plays an important role in the aberrant neuromodulation of sleep and pain symptoms in GWI.


Assuntos
Tronco Encefálico/fisiopatologia , Dor/etiologia , Síndrome do Golfo Pérsico/complicações , Síndrome do Golfo Pérsico/fisiopatologia , Transtornos do Sono-Vigília/etiologia , Tronco Encefálico/patologia , Doença Crônica , Feminino , Guerra do Golfo , Humanos , Masculino , Pessoa de Meia-Idade , Dor/patologia , Dor/fisiopatologia , Síndrome do Golfo Pérsico/patologia , Sono , Transtornos do Sono-Vigília/patologia , Transtornos do Sono-Vigília/fisiopatologia , Veteranos
5.
BMJ Open ; 11(6): e049211, 2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34158307

RESUMO

OBJECTIVES: The aim of this study was to adapt and validate the Pain Assessment in Advanced Dementia (PAINAD) scale in Spanish. DESIGN: Cross-sectional observational study. SETTING: Two health districts of Andalusian provinces, located in the south of Spain, through the Andalusian network of Primary Healthcare centres and four institutions dedicated to the care of patients with dementia. PARTICIPANTS: A total of 100 older people, with a medical diagnosis of dementia and a score on the Global Deterioration Scale between 5 and 7 were assessed using the PAINAD scale. PRIMARY AND SECONDARY OUTCOME MEASURES: Psychometric properties including content validity, construct validity and reliability of the scale have been tested. RESULTS: The overall Item Content Validity Index was excellent (0.95). Regarding construct validity, it was confirmed that a lower use of analgesics implied a lower score on the PAINAD scale (p<0.05). The internal consistency of the scale was 0.76 and it increases to 0.81 if we remove the breathing item. Furthermore, the intraclass correlation coefficient (ICC) used to assess interobserver reliability was 0.94, whereas the ICC used to assess temporary stability was 0.55. CONCLUSIONS: The Spanish version of the PAINAD scale is a valid tool to assess pain in patients with dementia and inability to communicate verbally.


Assuntos
Demência , Idoso , Comunicação , Estudos Transversais , Demência/complicações , Demência/diagnóstico , Humanos , Dor/diagnóstico , Dor/etiologia , Medição da Dor , Psicometria , Reprodutibilidade dos Testes , Espanha , Inquéritos e Questionários
8.
Jt Dis Relat Surg ; 32(2): 414-419, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34145819

RESUMO

OBJECTIVES: This study aims to compare the outcomes of the Winograd method and Vandenbos procedure used to treat an ingrown toenail. PATIENTS AND METHODS: Between January 2017 and February 2020, a total of 145 patients (65 males, 80 females; mean age: 31.45 years; range, 13 to 61 years) who were treated with Winograd or Vandenbos procedure for an ingrown toenail were retrospectively analyzed. Of the patients, 70 underwent the Winograd method (Group 1) and 75 underwent the Vandenbos procedure (Group 2). Postoperative Visual Analog Scale (VAS) scores, demographic data, recurrence/complication rates, and satisfaction of patients were recorded. RESULTS: The mean recovery time was 11.8±2.6 days in Group 1 and 18.0±2.1 days in Group 2 (p<0.001). The mean VAS score was 3.9±0.7 in Group 1 and 7.2±1.0 in Group 2 (p<0.001) during the first postoperative week. Of the patients, 56 (80%) of 70 patients in Group 1 and 74 (98%) of 75 patients in Group 2 were satisfied with the surgery (p<0.001). In terms of cosmetics, 60 (85%) of the patients in Group 1 and 74 (98%) of the patients in Group 2 were satisfied (p=0.003). Recurrence was observed in 10 (14%) patients in Group 1, while no recurrence was observed in Group 2. Six (8.7%) patients in Group 1 and one (1.3%) patient in Group 2 developed complications. CONCLUSION: Low recurrence rates, high satisfaction, and good cosmetic results can be achieved with the Vandenbos procedure, while recovery time and return to work are faster with the Winograd method. The appropriate surgical technique should be selected based on the individual patient.


Assuntos
Unhas Encravadas/cirurgia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Unhas Encravadas/complicações , Dor/etiologia , Medição da Dor , Satisfação do Paciente , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Recidiva , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
9.
Pain Res Manag ; 2021: 6612175, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34136057

RESUMO

Reduction of intravenous line placement pain is one of the most important nursing priorities in the pediatric wards. The present study was aimed at comparing the effect of Hugo's point massage and play on the severity of IV-line placement pain in hospitalized children aged 3-6 years in the pediatric ward. 72 children were selected and assigned randomly to three groups, i.e., control, play, and Hugo point massage. In the massage group, the middle angle between the first and second bones of the palm of the opposite hand was massaged, and the playgroup encouraged bubble-making play. The one-way analysis of variance (ANOVA) did not show a statistically significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups before interventions (p=0.838; p > 0.05). However, the ANOVA test revealed a significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups after the interventions (p=0.006; p < 0.05). The result of the post hoc Scheffe test also showed a statistically significant difference between the mean intensity of IV-line placement pain in both play therapy and Hugo's point massage groups (p=0.028; p < 0.05). Moreover, this test showed that the playgroup children felt less pain than Hugo's point and control group children. This study showed that, in comparison with Hugo's point massage, the play was a more effective way for reducing pain caused by IV-line placement in children, and pediatric nurses can play a significant role in reducing and managing children's pain by using it.


Assuntos
Administração Intravenosa/efeitos adversos , Massagem/estatística & dados numéricos , Manejo da Dor/métodos , Jogos e Brinquedos , Análise de Variância , Criança , Pré-Escolar , Feminino , Mãos/fisiologia , Humanos , Masculino , Dor/etiologia
10.
Mol Med Rep ; 24(2)2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34132379

RESUMO

Given the current outbreak of coronavirus disease 2019 (COVID­19) and the development and implementation of mass vaccination, data are being obtained by analyzing vaccination campaigns. In the present study, 69 healthcare workers who were exposed to patients with severe acute respiratory syndrome coronavirus­2 were monitored for specific immunoglobulin (Ig)G and IgA levels at different time periods. Prior to vaccination, after the first round of vaccination at 21 days (when the second dose of vaccine was administrated) and 24 days after the second round of vaccination, with an mRNA­based vaccine. The basal IgG and IgA levels in previously infected subjects and non­infected subjects notably differed. Vaccination increased the IgG and IgA levels after the first dose in most subjects from both groups, the levels of which further increased following the second round of vaccination. The associations between IgG and IgA levels following the first and second rounds of vaccination demonstrated that in the entire vaccination group, regardless of prior exposure to the infectious agent, the increment and levels of IgG and IgA were similar. Thus, the levels upon vaccination were statistically similar irrespective of the starting base line prior to vaccination. In the present study, seroconversion was achieved in all subjects following the second round of vaccination, with similar antibodies levels.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Adulto , Anticorpos Antivirais/sangue , COVID-19/patologia , COVID-19/virologia , Vacinas contra COVID-19/efeitos adversos , Feminino , Pessoal de Saúde , Humanos , Masculino , Dor/etiologia , SARS-CoV-2/isolamento & purificação , Fatores de Tempo , Vacinação , Vômito/etiologia
11.
Rev Med Suisse ; 17(744): 1194-1199, 2021 Jun 23.
Artigo em Francês | MEDLINE | ID: mdl-34160914

RESUMO

Functional pain disorders are frequent and represent a significant burden in primary care consultations. Scientific advances in neuroscience allow us to understand these syndromes from the perspective of perceptual, vegetative, affective and cognitive dysfunction. Simple tools can be useful in the history and clinical examination, looking specifically for positive signs in favor of a functional pain disorder. It is important to maintain a primary care management, following some principles summarized in expert recommendations. Building a solid trust relationship, a salutogenesis approach and medical and therapeutic deceleration («choose wisely¼) are to be favored.


Assuntos
Nociceptividade , Dor , Humanos , Dor/diagnóstico , Dor/etiologia , Exame Físico , Transtornos Somatoformes , Síndrome
12.
Rev Assoc Med Bras (1992) ; 67(1): 125-130, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34161485

RESUMO

OBJECTIVES: To assess the effect of withdrawal of the antiparkinsonian drug regimen administration on patients with PD and its relation to pain. METHODS: The sample included 22 men and 12 women who were candidates for neurosurgery to control motor signs and symptoms treated with L-dopa as a drug, alone or in combination with others (Cholinergic Antagonists; Dopamine Agents). All of them were examined at two different moments, with and without medication, and analyzed for painful symptoms. The Hoehn and Yahr scale was used for functional staging of the disease. Pain intensity was assessed by using the numerical verbal scale. RESULTS: The mean pain intensity among those on medication {2.17±0.39 (SE)} was significantly lower than in the abstinence group {4.2±0.59 (SE), p=0.006, Wilcoxon}, which corresponded to the increase in the total functional staging score from 93 to 111, respectively. CONCLUSION: The interruption of the administration of specific medications in patients with Parkinson's disease caused, or increased the intensity of, painful discomfort correlated with the intensity of functional impairment. This effect was also observed in women, but it was statistically relevant only for men. The results suggest that pain may be a "red flag" that points to the need for a therapeutic drug review when its presence or worsening is detected.


Assuntos
Doença de Parkinson , Antiparkinsonianos/efeitos adversos , Feminino , Humanos , Levodopa/efeitos adversos , Masculino , Dor/tratamento farmacológico , Dor/etiologia , Doença de Parkinson/tratamento farmacológico
13.
Rev Bras Enferm ; 74(3): e20200831, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34161504

RESUMO

OBJECTIVES: to analyze the characteristics of stigma in the interactions of people with pain and sickle cell disease and the coping strategies adopted. METHODS: qualitative study, conducted in Bahia's reference units between January and July 2018. In-depth interviews were applied to 25 adults, followed by content analysis and interpretation in light of the Sociological Theory of Stigma. RESULTS: four categories emerged from the data: Stigma in interactions with family members; Stigma in interactions with people in the general public; Stigma in interactions with health workers; and Strategies for coping with stigma. FINAL CONSIDERATIONS: in the participants' interactions, stigma produced discrediting pain reports, labeling and stereotyping, blaming patients for not improving their health, discrimination, racism, inadequate pain assessment, and delay in care. Coping included silencing, covering up, aggressive behavior, exposure to risk, reading religious texts and praises, and church attendance.


Assuntos
Anemia Falciforme , Infecções por HIV , Adaptação Psicológica , Adulto , Anemia Falciforme/complicações , Humanos , Dor/etiologia , Estigma Social , Estereotipagem
15.
Ideggyogy Sz ; 74(5-6): 157-170, 2021 May 30.
Artigo em Húngaro | MEDLINE | ID: mdl-34106552

RESUMO

According to the basic assumption of pain research, the activity of pain matrix shows an increase in functional neuroimaging studies during nociceptive stimulation whose extent is correlated with the intensity of the stimulus and that of the emerged experience of pain. Research conducted over the past decade has questioned this assumption. In order to understand the controversial findings I have reviewed new results of pain research. In order to get to know more about "hardware", I reviewed the direct relationships between members of the pain network. With a view to understand the mechanism of the development of pain perception, the "software", I give a brief description of the functioning of the salient as well as attention and executive control network. To have a better understanding of "hardware", I examined the behavior of the pain network of patients incapable of feeling pain in aversive situations. In the review I introduced the thought-provoking knowledge of the pain for all experts, regardless of this specialty by presenting the results of pain research.


Assuntos
Percepção da Dor , Dor , Atenção , Emoções , Humanos , Dor/etiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-34068737

RESUMO

Foot problems are highly prevalent in people with rheumatoid arthritis. This study aims to explore the foot morphology, pain and function in rheumatoid arthritis patients and the relation with the time of disease debut. A cross-sectional study was designed. Footprint, the Foot Posture Index, the hallux valgus prevalence, foot pain and function in 66 rheumatoid arthritis patients and the association with time since diagnosis, were recorded. The Foot Function Index, the Manchester Foot Pain and Disability Index, the Visual Analogic Scale, and the Manchester Scale for hallux valgus were administered and analyzed in two groups, with less and more than 10 years of diagnosis of the disease. A high prevalence of pronated (right 36.8% and left 38.6%) and highly pronated (right 15.8% and left 15.8%) feet was observed, as well as an elevated percentage of low arched footprints (right 68.4 and left 66.7%) and hallux valgus (right 59.6% and left 54.4%). Hallux valgus prevalence, toe deformities and Foot Function Index (Functional limitation) factors were significantly associated with the time since RA diagnosed adjusted for the other factors. The adjusted odds ratio of Hallux valgus prevalence was 4.9 (1.2-19.7). In addition, the foot function was diminished, and foot pain was present in most participants. In conclusion, rheumatoid arthritis patients' feet showed altered morphology and function, and with longer rheumatoid arthritis history, metatarsophalangical stability and foot function, but not pain and global foot posture, were likely to deteriorate.


Assuntos
Artrite Reumatoide , Hallux Valgus , Artrite Reumatoide/complicações , Artrite Reumatoide/epidemiologia , Estudos Transversais , , Hallux Valgus/epidemiologia , Humanos , Dor/epidemiologia , Dor/etiologia
17.
Toxins (Basel) ; 13(5)2021 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-34063282

RESUMO

Viper bite is an uncommon but serious cause of envenoming in Europe, especially in children. Our study aim is to better describe and analyze the clinical course and treatment of viper bite envenoming in a pediatric population. We retrospectively reviewed 24 cases of pediatric viper bites that were admitted to the Pediatric Emergency Department and the Pediatric Intensive Care Unit of the Bambino Gesù Children Hospital in Rome between 2000 and 2020. Epidemiological characteristics of the children, localization of the bite, clinical and laboratory findings, and treatment approaches were evaluated. The median age of the patients was 4.2 years, with male predominance. Most cases of viper bite occurred in the late summer. Most patients required admission to the ward for prolonged observation. The most common presenting signs were pain, local oedema, and swelling. Patients with a high severity score also had a significantly higher white blood cell count and an increase of INR, LDH, and CRP levels. No fatality was reported. Viper bite envenomation is a rare pediatric medical emergency in Italy but may sometimes be severe. A new pediatric severity score may be implemented in the screening of children with viper bites to favor a selective and prompt administration of antivenom.


Assuntos
Antivenenos/administração & dosagem , Mordeduras de Serpentes/epidemiologia , Venenos de Víboras/toxicidade , Viperidae , Adolescente , Animais , Criança , Pré-Escolar , Edema/etiologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Itália/epidemiologia , Masculino , Dor/etiologia , Estudos Retrospectivos , Estações do Ano , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/terapia , Venenos de Víboras/antagonistas & inibidores
18.
Acta Derm Venereol ; 101(6): adv00485, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34043015

RESUMO

Photodermatoses are characterized by the development of skin eruptions following exposure to ultraviolet radiation or visible light. We report here the clinical findings and results of laboratory investigations and phototesting of 6 patients who experience debilitating and excruciating pain after sun exposure ("sun pain") in the absence of any skin eruption. Phototesting with sub-erythemal doses of ultraviolet A radiation triggered localized pain in 4 patients. At follow-up, 3 female patients were found to have developed fibromyalgia, 2 male patients experienced a major depressive disorder, and another male patient had a conversion disorder. One patient also developed allodynia to tactile stimuli and one developed allodynia to thermal and tactile stimuli. Psychiatric conditions should be taken into consideration in patients presenting with excruciating and debilitating pain on exposure to ultraviolet radiation, but with absence of skin eruption. Further research is needed to evaluate whether it represents a type of allodynia triggered by exposure to ultraviolet radiation.


Assuntos
Transtorno Depressivo Maior , Luz Solar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Dor/diagnóstico , Dor/etiologia , Pele , Luz Solar/efeitos adversos , Raios Ultravioleta/efeitos adversos
19.
Brain Behav ; 11(6): e02164, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33949810

RESUMO

OBJECTIVE: In community dwelling older adults, depression and anxiety symptoms can be associated with early cognitive decline. Symptoms of depression and anxiety are common in older adults prior to surgery. However, their significance is unknown. Our objective was to determine whether preoperative depression and anxiety symptoms are associated with postoperative cognitive decline (POCD) and in-hospital delirium, in older surgical patients. METHODS: We conducted a secondary data analysis of postoperative cognitive dysfunction in a cohort study of patients 65 and older undergoing elective noncardiac surgery. We used the Hospital Anxiety and Depression Scale (HADS) to screen for depression and anxiety symptoms at a home visit prior to surgery and 3 months after surgery. Patients with a history of psychiatric (major depressive disorder, bipolar disorder, and schizophrenia) or neurologic disorder (Parkinson's disease and stroke) were excluded from the parent study. RESULTS: Out of the 167 patients, 9.6% (n = 16) reported significant depressive symptoms and 21.6% (n = 36) reported significant anxiety symptoms on preoperative screening. There was no association between preoperative or new-onset postoperative depression and anxiety symptoms and the incidence of delirium or POCD three months after surgery. Patients with preoperative depressive symptoms had higher preoperative pain (scores 69 vs. 35.7, p = .002) and frailty (56 vs. 14.6, p <.001). CONCLUSION: In our cohort, we did not detect an association between preoperative depression and anxiety symptoms and neurocognitive disorders. Preoperative depression and anxiety symptoms were related to physical pain and frailty. Taken together, these suggest that in patients without a formal psychiatric diagnosis, preoperative depression and anxiety symptoms are related to physical state rather than a harbinger of early cognitive decline. Future studies are needed to understand the nature of the relationship between depression and anxiety symptoms and physical state in surgical patients.


Assuntos
Delírio , Transtorno Depressivo Maior , Fragilidade , Idoso , Ansiedade/epidemiologia , Cognição , Estudos de Coortes , Delírio/epidemiologia , Delírio/etiologia , Depressão/epidemiologia , Humanos , Dor/epidemiologia , Dor/etiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Fatores de Risco
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