Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.909
Filtrar
1.
Health Qual Life Outcomes ; 19(1): 181, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34284776

RESUMO

BACKGROUND: The study aimed to appraise the health-related quality of life (HRQoL) measured by the five-level EuroQol-5 dimensions (EQ-5D-5L) in amyotrophic lateral sclerosis (ALS), and to explore the associations between non-motor symptoms (mood changes, cognitive disturbances and sleep disturbances). METHODS: EQ-5D-5L descriptive scores were converted into a single aggregated "health utility" score. A calibrated visual analog scale (EQ-VAS) was used for self-rating of current health status. Multiple logistic regression analysis was used to explore the factors associated with HRQoL. RESULTS: Among the 547 enrolled ALS patients who were assessed using EQ-5D-5L, the highest frequency of reported problems was with usual activities (76.7%), followed by self-care (68.8%) and anxiety/depression (62.0%). The median health utility score was 0.78 and the median EQ-VAS score was 70. Clinical factors corresponding to differences in the EQ-5D-5L health utility score included age of onset, onset region, the ALS Functional Rating Scale-Revised (ALSFRS-R) score, and King's College stages. Patients with depression, anxiety, and poor sleep had lower health utility scores. Patients with excessive daytime sleepiness and rapid eye movement sleep behavior disorder had lower EQ-VAS scores. Multivariate logistic analysis indicated that ALSFRS-R scores, depression, and anxiety were associated with health utility scores. After adjusting other parameters, ALSFRS-R score, stages, and depression were significantly associated with EQ-VAS scores (P < 0.05). CONCLUSION: This study examined HRQoL in ALS patients using the Chinese version of the EQ-5D-5L scale across different stages of the disease. We found that HRQoL is related to disease severity and to mood disturbances. Management of non-motor symptoms may help improve HRQoL in ALS patients.


Assuntos
Esclerose Amiotrófica Lateral/diagnóstico , Qualidade de Vida , Atividades Cotidianas , Adulto , Idoso , Esclerose Amiotrófica Lateral/psicologia , Ansiedade , Disfunção Cognitiva , Depressão , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Medição da Dor , Autocuidado , Índice de Gravidade de Doença , Inquéritos e Questionários , Escala Visual Analógica
2.
Zhonghua Yi Xue Za Zhi ; 101(26): 2050-2054, 2021 Jul 13.
Artigo em Chinês | MEDLINE | ID: mdl-34275237

RESUMO

Objective: To analyze the clinical efficacy of multisensory training and rehabilitation treatment in patients with balance disorders. Methods: From January to December 2020, 95 patients with balance disorders in the Vertigo Center of Department of Otorhinolaryngology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were enrolled. All patients were treated according to the treatment guidelines of Chinese Medical Association or expert consensus. Those with poor recovery or unsatisfactory treatment results underwent multisensory training and rehabilitation for 1 month after a comprehensive evaluation. The scores of Visual Analogue Scale (VAS), Dizziness Handicap Inventory (DHI), Berg Balance Scale (BBS), and Activities-specific Balance Confidence Scale (ABC), Somatization Symptom Self-Rating Scale (SSS), 9-item Patient Health Questionnaire (PHQ9) and the 7-item Generalized Anxiety Disorder (GAD7) were evaluated and compared before and after the treatment. Results: Totally, 95 patients were enrolled. There were 34 males and 61 females, aged (44±14) years. VAS (2.1±1.1 vs 5.9±2.5, P<0.01), DHI (15.6±7.7 vs 33.1±13.2, P<0.01), SSS (1.5±0.6 vs 2.4±0.8, P<0.01), PHQ9 (6.0±2.7 vs 8.6±4.3, P=0.01) and GAD7 (5.2±2.6 vs 9.5±2.8, P<0.01) decreased after treatment, while BBS (53.4±10.0 vs 34.8±10.7, P<0.01) and ABC (89.6±8.0 vs 55.7±21.8, P<0.01) increased. Conclusion: Multisensory training and rehabilitation therapy can effectively enhance the vertigo control rate and balance ability in patients with balance disorders, reduce the risk of falling, promote their mental and psychological state, and thus improve the quality of life.


Assuntos
Equilíbrio Postural , Qualidade de Vida , Tontura , Feminino , Humanos , Masculino , Vertigem , Escala Visual Analógica
3.
Medicine (Baltimore) ; 100(26): e26519, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190186

RESUMO

BACKGROUND: The catheter-through-needle (CTN) method involves the insertion of a catheter with an outer diameter smaller than the initial puncture hole. We investigated whether the catheter-over-needle (CON) method is more effective than the CTN method in local anesthetic leakage at the catheter insertion site and catheter dislodgement, and how it affects postoperative pain management. METHODS: Seventy patients scheduled to undergo continuous femoral nerve block for pain control following total knee arthroplasty were enrolled and randomized to receive a perineural catheterization with either the CTN method (group CTN) or CON method (group CON). After ultrasound-guided catheterization, the transparent securement dressing was attached. The study compared the CON and CTN methods in terms of leakage at the catheter insertion site, catheter dislodgement, and postoperative analgesic efficacy for 48 hours postoperatively. RESULTS: Leakage at the catheter insertion site was significantly lower in the group CON (P < .05), while catheter dislodgement was not significantly different between the groups. The other adverse events were not different between the groups. The procedure time was significantly shorter in group CON (P < .05). No significant intergroup differences were observed 48 hours postoperatively in the visual analog scales, the number of patients requiring additional analgesics, and the number of times a bolus dose was injected with an injection pump. CONCLUSION: The CON method was able to shorten the procedure time while reducing the incidence of leakage at the catheter insertion site than the CTN method, and showed similar effects in postoperative pain management.


Assuntos
Artroplastia do Joelho/efeitos adversos , Cateterismo , Nervo Femoral , Bloqueio Nervoso , Dor Pós-Operatória , Ultrassonografia de Intervenção/métodos , Idoso , Analgésicos/uso terapêutico , Anestésicos Locais/administração & dosagem , Artroplastia do Joelho/métodos , Cateterismo/instrumentação , Cateterismo/métodos , Feminino , Humanos , Masculino , Bloqueio Nervoso/efeitos adversos , Bloqueio Nervoso/instrumentação , Bloqueio Nervoso/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde , Manejo da Dor/métodos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/terapia , Ropivacaina/administração & dosagem , Escala Visual Analógica
4.
Medicine (Baltimore) ; 100(22): e26174, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087881

RESUMO

ABSTRACT: Percutaneous vertebroplasty (VP) and kyphoplasty (KP) are well-established minimally invasive surgical procedures for the treatment of osteoporotic vertebral compression fractures (OVCF). However, some drawbacks have been reported regarding these procedures, including height loss, cement leakage, and loss of the restored height after balloon deflation. We performed a novel VP technique to minimize these limitations of conventional procedures. This study aimed to compare radiological and clinical outcomes of our method using a larger-diameter needle versus conventional VP (using a smaller needle) for thoracolumbar OVCF.From April 2016 to May 2017, 107 consecutive patients diagnosed with thoracolumbar OVCF were enrolled. Patients were divided into two groups: group 1 underwent conventional VP, i.e., using a smaller diameter needle, and group 2 underwent VP through a modified method with a larger-diameter needle. For radiological evaluation, parameters related to anterior vertebral height (AVH) and segmental angle were assessed using plain standing radiographs, and patient-reported outcomes were evaluated using the visual analog scale. Cement injection amount and leakage pattern were also analyzed. Group 2 showed a larger anterior vertebral height change than group 1 immediately postoperatively and one year postoperatively. The 1-year postoperatively-AVH maintained better in group 2 than in group 1. Group 2 showed more significant improvement of segmental angle immediately postoperatively than group 1 (3.15° in group 1 vs 9.36° in group 2). IYPo-visual analog scale significantly improved in both groups, with greater improvement in group 2 (3.69 in group 1 vs 5.63 in group 2). A substantially larger amount of cement was injected, with a lower leakage rate in group 2 than in group 1.A novel VP technique using a larger-diameter needle showed superior radiological and clinical outcomes than conventional VP. Therefore, it can be considered a useful treatment option for OVCF.


Assuntos
Fraturas por Compressão/cirurgia , Agulhas/efeitos adversos , Fraturas por Osteoporose/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Vertebroplastia/métodos , Idoso , Estatura/fisiologia , Cimentos Ósseos/efeitos adversos , Cimentos Ósseos/uso terapêutico , Estudos de Casos e Controles , Feminino , Fraturas por Compressão/diagnóstico , Fraturas por Compressão/etiologia , Humanos , Cifoplastia/métodos , Vértebras Lombares/cirurgia , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Agulhas/estatística & dados numéricos , Fraturas por Osteoporose/complicações , Fraturas por Osteoporose/diagnóstico , Medidas de Resultados Relatados pelo Paciente , Radiografia/métodos , Estudos Retrospectivos , Fraturas da Coluna Vertebral/diagnóstico , Vértebras Torácicas/cirurgia , Vertebroplastia/estatística & dados numéricos , Escala Visual Analógica
5.
J Ayub Med Coll Abbottabad ; 33(2): 315-321, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34137552

RESUMO

BACKGROUND: Osteoarthritis is the most common degenerative disease of the synovial joints in the elderly population with hip osteoarthritis as the second most commonly affected joint. A multitude of conservative treatments is used for pain relief and functional improvement including acetaminophen, NSAID, intra-articular corticosteroid, and viscosupplementation (VS). Different preparations of VS based on different molecular weights are commercially available. No systematic review or meta-analysis regarding the use of intra-articular high molecular weight hyaluronic acid (HMWHA) injection for the hip joint was published before. This review analyzes the efficacy of intra-articular HMWHA for hip osteoarthritis. METHODS: PubMed, Google Scholar, Cochrane Library for randomized trials describing the efficacy of HMWHA for hip osteoarthritis was searched. The search terms were osteoarthritis, hip joint, outcomes, viscosupplementation, and high molecular weight hyaluronic acid in different combinations. Standardized mean difference (SMD) in VAS for pain relief and Lequesne index for functional outcomes while risk ratio (RR) for complications was used for data pooling. RESULTS: Four studies comprising 185 and 189 patients in HMWHA and control groups were included, respectively. SMD for VAS and Lequesne index was -0.056 and -0.114, respectively while RR for complication was 0.879. CONCLUSIONS: Intra-articular HMWHA injection provided pain relief, functional improvement, and no severe complications on immediate short term basis. However, the results do not favor treatment with HMWHA over other treatment methods. Randomized trials are further necessary to provide data regarding comparisons between HMWHA for hip osteoarthritis concerning clinicians' convenience, compliance, duration of relief, and cost-effectiveness.


Assuntos
Ácido Hialurônico/administração & dosagem , Osteoartrite do Quadril/tratamento farmacológico , Viscossuplementos/administração & dosagem , Idoso , Humanos , Ácido Hialurônico/química , Injeções Intra-Articulares , Peso Molecular , Osteoartrite do Quadril/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Escala Visual Analógica
6.
J Med Life ; 14(2): 250-256, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104249

RESUMO

This was a clinical trial study that aimed to investigate the efficacy of vaginal chlorhexidine gel in the treatment of vulvovaginal candidiasis, bacterial vaginosis, and nonspecific vaginitis. The study population included patients who complained of vaginal discharge and presented to our University Gynecology Clinic. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software. The student t-test and Mann-Whitney U test were used to analyze the quantitative and ordinal data, respectively. In order to analyze the qualitative data, the Chi-square or Fischer's exact tests were used. The mean satisfaction score in the vulvovaginal candidiasis patients who received chlorhexiine vaginal gel was 9.06 and 8.29 in the patients who received clotrimazole vaginal cream. The Mann-Whitney test did not show a statistically significant difference between mean scores of VAS in these two groups with vulvovaginal candidiasis (P=0.027). Among the patients with bacterial vaginosis, the mean satisfaction score was 8.91 in the chlorhexidine vaginal gel group and 8.72 in the metronidazole tablet group (P=0.607). In the nonspecific vaginitis group, the mean satisfaction score was 8.83 in the chlorhexidine vaginal gel group and 9.17 in the combination group (metronidazole + clotrimazole vaginal cream)(P=0.401). The highest mean visual analog scale score (VAS) score was documented in the combination therapy group. We found that chlorhexidine vaginal gel is a more effective method for the treatment and improvement of vaginal infections. The benefits of chlorhexidine gel have a positive therapeutic effect as a single drug in nonspecific vaginitis, rather than simultaneous administration of two agents.


Assuntos
Candidíase Vulvovaginal/tratamento farmacológico , Clorexidina/uso terapêutico , Clotrimazol/uso terapêutico , Metronidazol/uso terapêutico , Vaginose Bacteriana/tratamento farmacológico , Vulvovaginite/tratamento farmacológico , Adulto , Clotrimazol/administração & dosagem , Quimioterapia Combinada , Feminino , Humanos , Metronidazol/administração & dosagem , Satisfação do Paciente , Escala Visual Analógica
7.
Medicine (Baltimore) ; 100(21): e25995, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032717

RESUMO

BACKGROUND: Chronic kidney disease (CKD)-associated pruritus (CKD-aP) contributes to poor quality of life, including reduced sleep quality and poor sleep quality is a source of patient stress and is linked to lower health-related quality of life. This study aimed to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-aP. METHOD: A multicenter, prospective, randomized, parallel-design, open label interventional study to estimate the effectiveness of zolpidem (10 mg) oral tablets versus acupressure on sleep quality and quality of life in patients with CKD-aP on hemodialysis. A total of 58 hemodialysis patients having sleep disturbance due to CKD-aP completed the entire 8-week follow-up. The patients were divided into a control (acupressure) group of 28 patients and an intervention (zolpidem) group of 30 patients. RESULTS: A total of 58 patients having CKD-aP and sleep disturbance were recruited. In the control group there was a reduction in the PSQI score with a mean ±â€ŠSD from 12.28 ±â€Š3.59 to 9.25 ±â€Š3.99, while in the intervention group the reduction in PSQI score with a mean ±â€ŠSD was from 14.73 ±â€Š4.14 to 10.03 ±â€Š4.04 from baseline to endpoint. However, the EQ5D index score and EQ-visual analogue scale (VAS) at baseline for the control group with a mean ±â€ŠSD was 0.49 ±â€Š0.30 and 50.17 ±â€Š8.65, respectively, while for the intervention group the values were 0.62 ±â€Š0.26 and 47.17 ±â€Š5.82, respectively. The mean EQ5D index score in the control group improved from 0.49 ±â€Š0.30 to 0.53 ±â€Š0.30, but in the intervention group there was no statistical improvement in mean EQ5D index score from 0.62 ±â€Š0.26 to 0.62 ±â€Š0.27 from baseline to week 8. The EQ 5D improved in both groups and the EQ-VAS score was 2.67 points higher at week 8 as compared to baseline in the control group, while in the intervention group the score was 3.33 points higher at week 8 as compared to baseline. Comparing with baseline, the PSQI scores were significantly reduced after week 4 and week 8 (P =  < .001). Furthermore, at the end of the study, the PSQI scores were significantly higher in the control as compared to the intervention group (P = .012). CONCLUSION: An improvement in sleep quality and quality of life among CKD-aP patients on hemodialysis has been observed in both the control and intervention groups. Zolpidem and acupressure safety profiling showed no severe adverse effect other that drowsiness, nausea and daytime sleeping already reported in literature of zolpidem.


Assuntos
Acupressão/métodos , Prurido/terapia , Insuficiência Renal Crônica/complicações , Distúrbios do Início e da Manutenção do Sono/terapia , Zolpidem/administração & dosagem , Acupressão/efeitos adversos , Pontos de Acupuntura , Adolescente , Adulto , Feminino , , Humanos , Masculino , Pessoa de Meia-Idade , Prurido/diagnóstico , Prurido/etiologia , Prurido/psicologia , Qualidade de Vida , Diálise Renal/efeitos adversos , Insuficiência Renal Crônica/terapia , Índice de Gravidade de Doença , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem , Zolpidem/efeitos adversos
8.
Orthopedics ; 44(3): e331-e336, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34039193

RESUMO

Dissatisfaction after shoulder arthroscopy may be influenced by the information that patients receive. Multimedia is an emerging modality of information delivery. The goal of this study was to evaluate whether providing patients with a personalized video of their arthroscopic shoulder surgery improved satisfaction through a multisurgeon randomized controlled study. Patients undergoing arthroscopic shoulder decompression, rotator cuff repair, or labral repair were randomized to either the intervention group, receiving a video recording of their surgery, or the control group, not receiving a video. Patients who had previous ipsilateral shoulder arthroscopy or who could not participate in follow-up were excluded. Patient satisfaction was assessed at 3 months with a visual analog scale (VAS), Likert scale, and Quick Disabilities of the Arm, Hand and Shoulder (QuickDASH) score. The intervention group included 50 participants, and the control group included 47 participants, with 18% loss to follow-up. Mean control group VAS score was 8.5±2.2 and intervention group VAS score was 9.0±1.5, a difference that was not significantly different (P=.27). No statistically significant differences were noted for Likert scale scores and QuickDASH scores. A subgroup analysis of age group, sex, surgeon, and surgical procedure showed no significant differences. Based on these findings, personalized patient videos do not appear to improve satisfaction with surgery. Surgeons should investigate other means to improve patient satisfaction in the small group of dissatisfied patients. [Orthopedics. 2021;44(3):e331-e336.].


Assuntos
Artroscopia/métodos , Satisfação do Paciente , Manguito Rotador/cirurgia , Ombro/cirurgia , Gravação em Vídeo , Adulto , Idoso , Descompressão Cirúrgica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Lesões do Manguito Rotador/cirurgia , Resultado do Tratamento , Escala Visual Analógica
9.
Int J Clin Pract ; 75(7): e14198, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33792117

RESUMO

BACKGROUND: The use of horse-riding simulators in the treatment of chronic low back pain has drawn considerable attention for its efficacy and acceptability to reduce chronic low back pain; because of the similarities in movements provided by equine-assisted therapies and the possible accessibility advantages. However, the results are conflicting. This study aimed to perform a meta-analysis of randomised controlled trials to assess the impact of treatments based on horse-riding simulators on chronic low back pain. METHODS: A systematic literature search up to January 2021 was performed and 11 studies were detected with 543 subjects with chronic low back pain at the baseline of the study, 257 of them were using horse-riding simulators, and 255 of them were inactive control group who continued their usual care, and similar kind of physical therapy (control). They reported a comparison between horse-riding simulators and control to reduce chronic low back pain. Mean differences (MD) with 95% confidence intervals (CIs) were calculated assessing the impact of treatments based on horse-riding simulators on chronic low back pain using the continuous method with a random or fixed-effect model. RESULTS: Significantly higher change-from-baseline pain outcomes was observed in Visual Analogue Scale (MD, -4.36; 95% CI, -6.24 to -2.30, P < .001), and Roland Morris Disability Questionnaire change-from-baseline (MD, -2.32; 95% CI, -3.52 to -1.12, P < .001) with horse-riding simulators compared with control. CONCLUSIONS: Using horse-riding simulators may lower the risk of chronic low back pain. This relationship forces us to recommend the use of horse-riding simulators to avoid any complications that could occur with chronic low back pain.


Assuntos
Dor Crônica , Terapia Assistida por Cavalos , Dor Lombar , Animais , Dor Crônica/terapia , Cavalos , Humanos , Dor Lombar/terapia , Medição da Dor , Modalidades de Fisioterapia , Escala Visual Analógica
10.
J Cardiothorac Surg ; 16(1): 102, 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33882970

RESUMO

BACKGROUND: There are no studies on the use of dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia (PCIA) in females undergoing thoracic surgery. We postulate that introducing dexmedetomidine to a combination of dezocine-based PCA drugs and sufentanil will increase female patients' global satisfaction degree. METHODS: One hundred fifty-two female patients with physical classification type I or II according to the American Society of Anesthesiologists undergoing thoracoscopic surgery were arbitrarily classified into two categories, either receiving sufentanil and dezocine-based PCIA (group C) or incorporating dexmedetomidine with sufentanil and dezocine-based PCIA (group D). The patients' global satisfaction degree, postoperative nausea and vomiting (PONV), PCA bolus, rescue analgesia requirements, drug-related adverse effects, rest and coughing visual analogue scale (VAS) ratings, and Ramsay sedation scores (RSS) were measured at 6, 12, 24, 36 and 48 h after surgery. RESULTS: Compared with the C group, the patient satisfaction degree was significantly higher; pain scores at rest and coughing were significantly different at 6, 12, 24, 36 and 48 h postoperatively; less rescue analgesia and PCA bolus were required; and a lower incidence of PONV was found in the D group. There were non-significant trends for the sedation scores and drug-related adverse effects in both groups. CONCLUSIONS: Dexmedetomidine combined with sufentanil and dezocine increased female patients' global satisfaction degree after thoracoscopic surgery. This effect could be linked to the improvement in postoperative analgesia and reduction in postoperative nausea and vomiting; the combined treatment did not increase drug-related adverse effects in female patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry number, ChiCTR2000030429 . Registered on March 1, 2020.


Assuntos
Analgesia Controlada pelo Paciente/efeitos adversos , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/uso terapêutico , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Dexmedetomidina/administração & dosagem , Dor Pós-Operatória/cirurgia , Satisfação do Paciente , Sufentanil/administração & dosagem , Tetra-Hidronaftalenos/administração & dosagem , Adulto , Analgesia/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Manejo da Dor , Medição da Dor , Dor Pós-Operatória/etiologia , Período Pós-Operatório , Toracoscopia , Fatores de Tempo , Resultado do Tratamento , Escala Visual Analógica
11.
J Speech Lang Hear Res ; 64(5): 1571-1580, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33909472

RESUMO

Purpose The reliability of auditory-perceptual judgments between listeners is a long-standing problem in the assessment of voice disorders. The purpose of this study was to determine whether a relatively novel experimental scaling method, called visual sort and rate (VSR), yielded stronger reliability than the more frequently used method of visual analog scales (VAS) for ratings of overall severity (OS) and breathiness (BR) in speakers with voicedisorders. Method Fifty speech samples were selected from a database of speakers with voice disorders. Twenty-two inexperienced listeners provided ratings of OS or BR in four rating blocks: VSR-OS, VSR-BR, VAS-OS, and VSR-BR. For the VAS task, listeners rated each speaker for BR or OS using a vertically oriented 100-mm VAS. For the VSR task, stimuli were distributed into sets of samples with a range of speaker severities in each set. Listeners sorted and ranked samples for OS or BR within each set, and final ratings were captured on a vertically oriented 100-mm VAS. Interrater variability, defined as the mean of the squared differences between a listener's ratings and group mean ratings, and intrarater reliability (Pearson r) were compared across rating tasks for OS and BR using paired t tests. Results Results showed that listeners had significantly less interrater variability (better reliability) when using VSR methods compared to VAS for judgments of both OS and BR. Intrarater reliability was high across rating tasks and dimensions; however, ratings of BR were significantly more consistent within individual listeners when using VAS than when using VSR. Conclusions VSR is an experimental method that decreases variability of auditory-perceptual judgments between inexperienced listeners when rating speakers with a range of dysphonic severities and disorders. Future research should determine whether a clinically viable tool may be developed based on VSR principles and whether such benefits extend to experienced listeners.


Assuntos
Disfonia , Percepção da Fala , Disfonia/diagnóstico , Humanos , Julgamento , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Acústica da Fala , Medida da Produção da Fala , Escala Visual Analógica , Qualidade da Voz
12.
J Urol ; 206(2): 373-381, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33819072

RESUMO

PURPOSE: Pain is the leading cause of unplanned emergency department visits and readmissions after ureteroscopy, making postoperative analgesic stewardship a priority given the current opioid epidemic. We conducted a double-blinded, randomized controlled trial, with noninferiority design, comparing nonsteroidal anti-inflammatory drugs to opiates for postoperative pain control in patients undergoing ureteroscopy for urolithiasis. MATERIALS AND METHODS: Patients were randomized and blinded to either oxycodone (5 mg) or ketorolac (10 mg), taken as needed, with 3 nonblinded oxycodone rescue pills for breakthrough pain. Primary study outcome was visual analogue scale pain score on postoperative days 1-5. Secondary outcomes included medication utilization, side effects, and Ureteral Stent Symptom Questionnaire scores. RESULTS: A total of 81 patients were included (43 oxycodone, 38 ketorolac). The 2 groups had comparable patient, stone, and perioperative characteristics. No differences were found in postoperative pain scores, study medication or rescue pill usage, or side effects. Higher maximum pain scores on days 1-5 (p <0.05) and higher questionnaire score (28.1 vs 21.7, p=0.045) correlated with analgesic usage, irrespective of treatment group. Patients receiving ketorolac reported significantly fewer days confined to bed (mean±SD 1.3±1.3 vs 2.3±2.6, p=0.02). There was no difference in unscheduled postoperative physician encounters. CONCLUSIONS: This is the first double-blinded randomized controlled trial comparing nonsteroidal anti-inflammatory drugs and opiates post-ureteroscopy, and demonstrates noninferiority of nonsteroidal anti-inflammatory drugs in pain control with similar efficacy, safety profile, physician contact and notably, earlier convalescence compared to the opioid group. This provides strong evidence against routine opioid use post-ureteroscopy, justifying continued investigation into reducing postoperative opiate prescriptions.


Assuntos
Analgésicos Opioides/uso terapêutico , Cetorolaco/uso terapêutico , Dor Pós-Operatória/prevenção & controle , Ureteroscopia , Anti-Inflamatórios não Esteroides/uso terapêutico , Convalescença , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxicodona/uso terapêutico , Estudos Prospectivos , Escala Visual Analógica
13.
Biomed Res Int ; 2021: 6620746, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33860042

RESUMO

The mixed reality (MR) technique has recently been widely used in the orthopedic surgery with satisfactory results reported. However, few studies have focused on the application of MR in the Lumbar fracture (LF). In this retrospective study, our aim is to analyze some findings by investigating the feasibility of MR applied to lumbar fracture treatment. Posterior vertebrectomy has been operated on 7 patients. The MR-based intraoperative three-dimensional image-guided navigation system (MITINS) was used to assist implantation of pedicle screws. The feasibility and safety of pedicle screw implantation were assessed by postsurgery radiography. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to assess the pain level and recovery situation before and after surgery. 57 pedicle screws were safely and precisely placed into three-dimensional lumbar models by using MITINS. No screw was found outside the pedicle of the models, and it was not necessary for the X-ray to provide extra locative information during the operation with the use of MITINS. In summary, the application of MITINS is feasible, safe, and accurate while the lumbar fracture surgery is processing, providing satisfactory assistance for spine surgeons.


Assuntos
Realidade Aumentada , Vértebras Lombares/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Idoso , Avaliação da Deficiência , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Fraturas da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Escala Visual Analógica
14.
Artigo em Russo | MEDLINE | ID: mdl-33834718

RESUMO

OBJECTIVE: To assess the efficacy and safety of high (300 mg) doses of the biologically active additive neurouridin (Unifarm) as part of complex therapy of patients with nonspecific low-back pain. MATERIAL AND METHODS: Fifty patients (30 in the main group and 20 patients in the control group) were studied using a visual analogue scale (VAS), data from a general clinical analysis of blood and urine, a wide range of biochemical parameters, including liver function tests, glucose levels, creatinine, electrolyte levels. RESULTS AND CONCLUSION: The positive effect of treatment with neurouridin on the dynamics of changes in pain according to the VAS was noted, a dose-dependent effect was revealed: patients at higher doses (300 mg of uridine monophosphate) showed a more significant regression of pain symptoms compared to standard doses. During the study, there were no serious adverse events allergic reactions. No clinically significant deviations of laboratory parameters were recorded.


Assuntos
Dor Lombar , Dor nas Costas , Suplementos Nutricionais , Humanos , Dor Lombar/tratamento farmacológico , Medição da Dor , Resultado do Tratamento , Escala Visual Analógica
15.
Arthroscopy ; 37(5): 1486-1487, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33896502

RESUMO

Clinically important outcome assessment has been a point of increasing emphasis in the orthopaedic literature. The minimal clinically important difference, patient acceptable symptom state, and substantial clinical benefit are the most reported in the hip preservation literature. Maximal outcome improvement (MOI) is now also being reported; however, its relation to patients undergoing hip preservation surgery is not well understood. The threshold values that represented satisfaction with surgery were 54.8%, 52.5%, 55.5%, and 55.8% of the MOI for the modified Harris Hip Score, Nonarthritic Hip Score, visual analog scale score for pain, and International Hip Outcome Tool-12 score, respectively. Although the MOI is helpful for characterizing outcome improvement, established measures such as substantial clinical benefit may be better used to grade outcomes in patients with high preoperative function.


Assuntos
Impacto Femoroacetabular , Artroscopia , Humanos , Dor , Resultado do Tratamento , Escala Visual Analógica
16.
J Hand Surg Asian Pac Vol ; 26(2): 207-213, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33928857

RESUMO

Background: Primary treatment of trigger digits is conservative including stretching, night splinting and combination of heat and ice. When these methods fail, invasive methods such as corticosteroid injection, percutaneous release and open surgery are used. The purpose of this study is to compare the efficacy of two outpatient methods of percutaneous trigger finger release (PTFR) and corticosteroid injection (CI). Methods: This study is a randomized clinical trial that was performed with 6-month follow up. A total of 83 patients with trigger finger treated either with corticosteroid injection (n:40) or percutaneous release of the A1 pulley (n:43) were enrolled in this study. Demographic data were recorded before intervention. Pain score (VAS criterion), disease stage (Quinnell criteria), patient satisfaction and complications such as paresthesia, scarring, and stiffness (decrease in the range of motion) were recorded after the intervention. We used SPSS program (statistical package for the social science SPSS version 16) to perform the analysis. Results: There were 18 male (21.7%) and 65 female (78.3%) patients, whose mean age was 52.54 ± 11.45 (28-85) years. There was a significant difference between the degree of pain at the time of the third, sixth weeks and sixth months in two groups. The degree of pain was lower in the CI group in the third and sixth weeks but it was lower in the PTFR group in the sixth month. Satisfaction of the patients in the sixth month was significantly higher in the PTFR group. The incidence of stiffness was also significantly lower in the PTFR group in the sixth month. Conclusions: Patients in PTFR group had greater recovery and satisfaction level and lower recurrence rate and pain. Therefore PTFR may be used as a substitute for CI in the treatment of trigger finger from the beginning especially in patients who do not want to have open surgery.


Assuntos
Glucocorticoides/uso terapêutico , Procedimentos Ortopédicos , Dedo em Gatilho/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Injeções Intra-Articulares , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Satisfação do Paciente , Escala Visual Analógica
17.
Medicine (Baltimore) ; 100(17): e25363, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33907093

RESUMO

ABSTRACT: Visual analogue scales are widely used to measure subjective responses. Norris' 16 visual analogue scales (N_VAS) measure subjective feelings of alertness and mood. Up to now, different scientists have clustered items of N_VAS into different ways and Bond and Lader's way has been the most frequently used in clinical research. However, there are concerns about the stability of this clustering over different subject samples and different drug classes. The aim of this study was to test whether Bond and Lader's clustering was stable in terms of subject samples and drug effects. Alternative clustering of N_VAS was tested.Data from studies with 3 types of drugs: cannabinoid receptor agonist (delta-9-tetrahydrocannabinol [THC]), muscarinic antagonist (scopolamine), and benzodiazepines (midazolam and lorazepam), collected between 2005 and 2012, were used for this analysis. Exploratory factor analysis (EFA) was used to test the clustering algorithm of Bond and Lader. Consensus clustering was performed to test the stability of clustering results over samples and over different drug types. Stability analysis was performed using a three-cluster assumption, and then on other alternative assumptions.Heat maps of the consensus matrix (CM) and density plots showed instability of the three-cluster hypothesis and suggested instability over the 3 drug classes. Two- and four-cluster hypothesis were also tested. Heat maps of the CM and density plots suggested that the two-cluster assumption was superior.In summary, the two-cluster assumption leads to a provably stable outcome over samples and the 3 drug types based on the data used.


Assuntos
Análise por Conglomerados , Interpretação Estatística de Dados , Conjuntos de Dados como Assunto/normas , Medição da Dor/métodos , Escala Visual Analógica , Adulto , Algoritmos , Benzodiazepinas/uso terapêutico , Agonistas de Receptores de Canabinoides/uso terapêutico , Consenso , Estudos Cross-Over , Método Duplo-Cego , Análise Fatorial , Humanos , Masculino , Antagonistas Muscarínicos/uso terapêutico , Medição da Dor/normas , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes
18.
BMC Health Serv Res ; 21(1): 387, 2021 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902580

RESUMO

BACKGROUND: Competition-promoting reforms and economic incentives are increasingly being introduced worldwide to improve the performance of healthcare delivery. This study considers such a reform which was initiated in 2009 for elective hip replacement surgery in Stockholm, Sweden. The reform involved patient choice of provider, free establishment of new providers and a bundled payment model. The study aimed to examine its effects on hip replacement surgery quality as captured by patient reported outcome measures (PROMs) of health gain (as indicated by the EQ-5D index and a visual analogue scale (VAS)), pain reduction (VAS) and patient satisfaction (VAS) one and six years after the surgery. METHODS: Using patient-level data collected from multiple national registers, we applied a quasi-experimental research design. Data were collected for elective primary total hip replacements that were carried out between 2008 and 2012, and contain information on patient demography, the surgery and PROMs at baseline and at one- and six-years follow-up. In total, 36,627 observations were included in the analysis. First, entropy balancing was applied in order to reduce differences in observable characteristics between treatment groups. Second, difference-in-difference analyses were conducted to eliminate unobserved time-invariant differences between treatment groups and to estimate the causal treatment effects. RESULTS: The entropy balancing was successful in creating balance in all covariates between treatment groups. No significant effects of the reform were found on any of the included PROMs at one- and six-years follow-up. The sensitivity analyses showed that the results were robust. CONCLUSIONS: Competition and bundled payment had no effects on the quality of hip replacement surgery as captured by post-surgery PROMs of health gain, pain reduction and patient satisfaction. The study provides important insights to the limited knowledge on the effects of competition and economic incentives on PROMs.


Assuntos
Artroplastia de Quadril , Humanos , Medição da Dor , Medidas de Resultados Relatados pelo Paciente , Suécia , Resultado do Tratamento , Escala Visual Analógica
19.
Artigo em Inglês | MEDLINE | ID: mdl-33810455

RESUMO

INTRODUCTION: Self-reported physical fitness (PF) provides an accurate measure of PF, specifically for young people. The Visual Analogue Scale (VAS) is one of the most used psychosocial measurement methods. The main arguments in favor of VAS are its ease of use and comprehension, particularly for less educated participants. There are some scales that assess self-perception of PF, but the VAS presented in this study covers a higher range of responses and a number of variables than other already validated measures. AIMS: The aim was to determine the concurrent validity of the Visual Analogue Fitness Perception Scale for Adolescents (FP VAS A) (Sub-study 1) and check its reliability (Sub-study 2). METHODS: Anthropometric and body composition measurements were performed, as well as PF tests (manual dynamometry, Course Navette, 4 × 10 m, and sit and reach). The International Fitness Scale (IFIS) and FP VAS A were used to assess self-reported PF. RESULTS: Two sub-studies were carried out: in sub-study 1 a total of 67 students (26 males and 41 females aged 12-16 years) participated. The results showed a significant direct correlation between the level of PF and self-perception of PF (IFIS and FP VAS A), with the FP VAS A obtaining a higher correlation with PF (r = 0.444 to 0.666) than the IFIS and PF (r = 0.154 to 0.557). In sub-study 2 (test-retest of the FP VAS A), a total of 217 students (120 males and 97 females aged 12-17 years) participated. It showed a moderate reliability for all items; the intraclass correlation coefficient (ICC) was between 0.800 and 0.870, and kappa values ranged from 0.622 (endurance) to 0.458 (flexibility). In addition, Cronbach's α for the total was 0.860. CONCLUSION: This study showed good validity and reliability for the FP VAS A in adolescents.


Assuntos
Exercício Físico , Aptidão Física , Adolescente , Criança , Feminino , Humanos , Masculino , Percepção , Reprodutibilidade dos Testes , Escala Visual Analógica
20.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(4): 324-328, 2021 Apr 09.
Artigo em Chinês | MEDLINE | ID: mdl-33832032

RESUMO

Objective: To test the reproducibility of the visual analogue scale (VAS) used in the evaluation of the esthetic effect of anterior dental implants, and to explore the factors that affect the correlation between VAS and pink esthetic score/white esthetic score (PES/WES). Methods: From January 2018 to August 2019, a total of 108 doctors and patients were recruited in the Department of Prosthodontics, Implantology and Fourth Clinical Division of Peking University School and Hospital of Stomatology. Among them, there were 35 dental implant specialists who were familiar with PES/WES [implant specialist group, 25 males, 10 females, (37.3±4.5) years old], 34 dentists who were not familiar with PES/WES [dentist group, specialized in Prosthodontics, Periodontology, Orthodontics, and Oral Maxillofacial Surgery, 24 males, 10 females, (36.1±4.2) years old], 39 patients [patient group, 28 males, 11 females, (45.4±8.3) years old]. Twenty oral pictures of patients [12 males, 8 females, (43.7±6.4) years old] treated in the Department of Prosthodontics, Peking University School and Hospital of Stomatology from December 2016 to December 2017 were taken for single implant restoration for esthetic evaluation with VAS. Score 0 for evaluation of not beautiful and score 10 for very beautiful. Re-evaluation of the same 20 pictures with VAS after 1 month, and perform repeatability evaluation of VAS using chi-square test were conducted. At the same time, 13 implant specialists were randomly selected, to score the same photos with PES/WES. The PES scoring elements were the fullness of the mesial gingival papilla, the fullness of the distal gingival papilla, the curvature of the gingival margin, the protrusion of the root surface, the color and the texture of the soft tissue. The scoring elements of WES were crown shape, crown contour, crown color, surface texture, transparency and individual characteristics in order. Pearson correlation analysis was used to evaluate the correlation between the score of VAS and PES/WES. And the influence of the group on the correlation between PES/WES and VAS was analyzed. Results: The PES score was 7.5±1.8, and the WES score was 7.6±1.9 and the total score was 15.1±3.4. The VAS score of the implant specialist group was 6.8±1.8. The repeatability test of the two VAS results in the patient group was not statistically significant (Kappa=0.012, P>0.05); the two VAS results of the implant specialist group and the dentist group both had good repeatability (Kappa=0.727 and 0.556, P<0.01). The VAS score was weakly correlated with the total PES/WES score (r=0.27, P<0.01). The VAS score was correlated with the score elements in PES/WES (P<0.01), and the color (r=0.20) and shape (r=0.22) of the crown were the larger correlation coefficients. The correlation coefficients between the VAS score and the PES/WES scoring system decreased among the implant specialist group (r=0.49, moderate correlation), the dentist group (r=0.25, weak correlation) and the patient group (r=0.12, P>0.05). Conclusions: The consistency of VAS and PES/WES is affected by the cognition of the scorer. The combination of the two scoring systems is feasible and necessary for physicians to evaluate the overall esthetic effect of implant restoration.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Adulto , Coroas , Prótese Dentária Fixada por Implante , Estética Dentária , Estudos de Viabilidade , Feminino , Humanos , Masculino , Maxila , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Resultado do Tratamento , Escala Visual Analógica
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...