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1.
Trials ; 22(1): 586, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479613

RESUMO

BACKGROUND: Non-specific chronic neck pain (NCNP) is a common musculoskeletal disorder which has caused a huge economic burden due to its expensive health costs and high re-occurrence rate. Yijinjing and Tuina are widely used for non-specific chronic neck pain in China. But there is little scientific evidence to evaluate their efficacy for NCNP. The aim of this research is to compare the efficacy of Yijinjng combined with Tuina versus Tuina for patients with NCNP. METHODS/DESIGN: A randomized controlled trial in which 102 patients with non-specific chronic neck pain will be recruited and randomly allocated to either the Tuina group or the Yijinjng combined with Tuina group in a 1:1 ratio. The interventions for both groups will be carried out three times a week for 8 weeks. The patients in the two groups will receive follow-up 1 month after the intervention. The primary outcome will be the changes in the visual analog scale (VAS). Secondary outcomes will be measured by the Neck Disability Index (NDI), Self-Rating Anxiety Scale (SAS), and Tissue Hardness and Active Range of Motion (AROM). The data will be analyzed at the baseline, 4 weeks during the intervention, at the end of the intervention, and 1 month after the intervention. The significance level sets as 5%. The safety of interventions will be evaluated after each treatment session. DISCUSSION: The purpose of this trial is to determine whether Yijinjing combined with Tuina is not inferior to Tuina for patients with NCNP. This study will provide clinicians and stakeholders much-needed knowledge for a complementary and alternative therapy for patients with non-specific chronic neck pain. TRIAL REGISTRATION: ChiCTR registry (ChiCTR) 2000036805 . Registered on August 25, 2020.


Assuntos
Dor Crônica , Cervicalgia , Dor Crônica/diagnóstico , Dor Crônica/terapia , Humanos , Cervicalgia/diagnóstico , Cervicalgia/terapia , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular , Resultado do Tratamento
2.
Soins Pediatr Pueric ; 42(322): 37-39, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34489080

RESUMO

Not having access to language, the infant is deprived of an essential means of communicating its painful experience. The assessment of their pain in the emergency room is therefore quite complex. A study carried out in the paediatric emergency department of the Centre hospitalier intercommunal de Créteil shows that it is possible to improve this aspect thanks, among other things, to continuous training and the presence of experts in children's pain within the team.


Assuntos
Serviço Hospitalar de Emergência , Criança , Humanos , Lactente , Medição da Dor
3.
J Refract Surg ; 37(9): 582-589, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34506240

RESUMO

PURPOSE: To compare the efficacy of oral codeine plus acetaminophen versus oxycodone plus acetaminophen for severe pain control following photorefractive keratectomy (PRK). METHODS: This single-center trial randomized 200 patients to receive codeine 30 mg/acetaminophen 325 mg (codeine group) or oxycodone 5 mg/acetaminophen 325 mg (oxycodone group)every 4 hours as needed for severe pain for 4 days following PRK. Patients recorded postoperative pain, tablet consumption, and tetracaine use. Patients were monitored at postoperative 1 day, 1 week, and 1, 3, and 6 months for visual acuity and follow-up. Study outcomes were mean postoperative pain, treatment and tetracaine use, and visual acuity. RESULTS: Analysis of 197 patients who completed the trial (97 codeine group and 100 oxycodone group) showed mean pain scores were lower in the codeine group throughout the intervention period. Mean pain scores were higher in the oxycodone group than the codeine group on postoperative days 2 and 4 (P = .017 and P = .034, respectively). The oxycodone group consumed more tablets than the codeine group, with a difference on postoperative day 2 (P = .019), and used a greater number of tetracaine drops (P = .015). Repeated measures analysis of variance showed significant improvement in visual acuity in both groups with no difference in visual outcomes (P = .81). CONCLUSIONS: Codeine/acetaminophen is as effective and safe as oxycodone/acetaminophen for pain control following PRK, with no clinical difference in overall pain control and long-term visual outcomes. This implies that treating postoperative pain after PRK with a Schedule III opioid (codeine) is effective and potentially decreases the risk of misuse by a higher regulated Schedule II opioid (oxycodone), lowering the potential for abuse and dependence. [J Refract Surg. 2021;37(9):582-589.].


Assuntos
Oxicodona , Ceratectomia Fotorrefrativa , Codeína , Método Duplo-Cego , Humanos , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Estudos Prospectivos
4.
Artigo em Alemão | MEDLINE | ID: mdl-34507383

RESUMO

For many years now, effective pharmacological and non-pharmacological treatment approaches for acute and chronic pain exist, as well as organisational strategies for their implementation in hospitals. Nevertheless, there remain considerable deficits in pain management and the portion of patients with severe or long-lasting pain in non-surgical units is often high. There is a considerable potential to improve quality and structures of pain mangement in non-surgical hospital settings in Germany. Recently, legal requirements to establish a structured perioperative pain management were introduced. This should not be seen as a signal that pain management is less important in non-surgical disciplines. On the contrary - it should raise awareness for more clinical and health services research to further develop and validate appropriate approaches and concepts to improve pain treatment in this field.


Assuntos
Manejo da Dor , Dor , Alemanha , Hospitais , Humanos , Medição da Dor
5.
Artigo em Alemão | MEDLINE | ID: mdl-34507384

RESUMO

The number of non-surgical patients in the hospital setting with pain due to medical conditions or comorbidities and/or invasive procedures or treatments is high. Compared to perioperative pain management, the portion of patients and/or conditions that require more than an approach focused on pharmacological treatment of nociceptive pain is considerably higher. Rather, treatment often requires the differentiated use of co-analgesics, non-pharmacological treatments, physiotherapy, occupational therapy, psychological assessment and interventsions and educational approaches, ideally in the form of closely coordinated interdisciplinary treatment. The assessment and treatment of acute and especially chronic pain should follow the biopsychosocial concept of pain, especially if risk factors for chronification have been identified, if patients receive high-dose therapy with analgesics or have preexisting a chronic pain disorder.


Assuntos
Dor Crônica , Manejo da Dor , Analgésicos/uso terapêutico , Dor Crônica/terapia , Humanos , Pacientes Internados , Medição da Dor
6.
Arch Esp Urol ; 74(7): 639-644, 2021 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-34472431

RESUMO

INTRODUCTION: Chronic bladder disorders are a common condition. Endovesical hyaluronic acid is one of the therapeutic options for these patients. It is intended to verify the effectiveness and safety of treatment with intravesical instillations of hyaluronic acidin patients with bladder symptoms. MATERIAL AND METHODS: We present a series of 32 patients who received intravesical instillations of hyaluronic acid. Demographic characteristics, tolerance, and complications were analyzed, and symptoms before and after treatment were compared. Symptomatic relief achieved with treatment was assessed using the Patient Global Improvement Impression Scale (PGI-I). RESULTS: The median age was 74 years (IQR 60-78) and 65.6% were women. Median follow-up was 10 months (IQR 7-14). Eleven patients were diagnosed with radiotherapy-induced cystitis, 17 with bladder pain syndrome/interstitial cystitis (BPS/IC), and 4 with recurrent cystitis. After treatment, symptoms improved in 81.8% of patients with radical cystitis, 82.3% of patients with BPS/IC, and 75% of the patients with recurrent cystitis. The incidence of hematuria was reduced from 46.9% to 9.4% (p<0.001), filing symptoms from 62.5% to 12.5% (p<0.001) and pain from 40.6% to 12.5% (p= 0.004). 100% of the patients tolerated the treatment well and only 2 adverse effects were recorded (urinary tract infection and acute urine retention). During follow-up, 65.6% showed total control of symptoms and 15.6% partial control, achieving a greater response in the group of patients with hematuria (73.3%). 61.3% of the patients perceived relief of symptoms after treatment according to the PGI-I scale. 88.9% maintained symptomatic improvement at the end of the follow-up. CONCLUSION: Intravesical hyaluronic acid is a safe and effective treatment for filling symptoms, hematuria, and pain in patients with chronic cystopathies. Patients with radiotherapy-induced cystitis seem to especially benefit from treatment.


Assuntos
Cistite Intersticial , Ácido Hialurônico , Administração Intravesical , Idoso , Cistite Intersticial/tratamento farmacológico , Feminino , Humanos , Ácido Hialurônico/uso terapêutico , Medição da Dor , Resultado do Tratamento
7.
Isr Med Assoc J ; 23(9): 595-600, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34472236

RESUMO

BACKGROUND: Limited data exist regarding the safety of ultrasound-guided femoral nerve blockade (US-FNB) in patients with hip fractures treated with anti-Xa direct oral anticoagulants (DOAC). OBJECTIVES: To compare the safety outcomes of US-FNB to conventional analgesia in patients with hip fractures treated with anti-Xa DOAC. METHODS: This observational exploratory prospective study included 69 patients who presented to our emergency department (ED) in 3 years with hip fracture and who were treated with apixaban or rivaroxaban. Patients received either a US-FNB (n=19) or conventional analgesics (n=50) based on their preference and, and the presence of a trained ED physician qualified in performing US-FNB. Patients were observed for major bleeding events during and 30 days after hospitalization. The degree of preoperative pain and opioid use were also observed. RESULTS: We found no significant difference in the number of major bleeding events between groups (47.4% vs. 54.0%, P = 0.84). Degree of pain measured 3 and 12 hours after presentation was found to be lower in the US-FNB group (median visual analog scale of pain improvement from baseline of -5 vs. -3 (P = 0.002) and -5 vs.-4 (P = 0.023), respectively. Opioid administration pre-surgery was found to be more than three times more common in the conventional analgesia group (26.3% vs.80%, P < 0.0001). CONCLUSIONS: Regarding patients treated with Anti-Xa DOAC, US-FNB was not associated with an increase in major bleeding events compared to conventional analgesia, although it was an effective means of pain alleviation. Larger scale randomized controlled trials are required to determine long-term safety and efficacy.


Assuntos
Inibidores do Fator Xa/administração & dosagem , Fraturas do Quadril/cirurgia , Bloqueio Nervoso/métodos , Dor Pós-Operatória/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Analgésicos/administração & dosagem , Analgésicos Opioides/administração & dosagem , Estudos de Coortes , Serviço Hospitalar de Emergência , Inibidores do Fator Xa/efeitos adversos , Feminino , Nervo Femoral/diagnóstico por imagem , Hemorragia/epidemiologia , Hemorragia/etiologia , Humanos , Masculino , Bloqueio Nervoso/efeitos adversos , Medição da Dor , Projetos Piloto , Estudos Prospectivos , Pirazóis/administração & dosagem , Pirazóis/efeitos adversos , Piridonas/administração & dosagem , Piridonas/efeitos adversos , Rivaroxabana/administração & dosagem , Rivaroxabana/efeitos adversos , Ultrassonografia de Intervenção
8.
Artigo em Russo | MEDLINE | ID: mdl-34481441

RESUMO

Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants (MR) are successfully used to relieve pain, both in monotherapy and in combinations. The use of fixed drug combinations not only greatly facilitates daily clinical practice and increases patient adherence, but due to the potentiation of pharmacological effects, it allows to achieve better treatment results. This paper presents 3 clinical cases of successful inpatient use of a fixed combination of diclofenac 75 mg and orphenadrine 30 mg in the form of an infusion solution (NEODOLPASSE) for relief of acute back musculoskeletal pain syndrome.


Assuntos
Dor Aguda , Diclofenaco , Dor Aguda/tratamento farmacológico , Anti-Inflamatórios não Esteroides/uso terapêutico , Diclofenaco/uso terapêutico , Humanos , Orfenadrina/uso terapêutico , Medição da Dor
9.
Bone Joint J ; 103-B(9): 1514-1525, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34465156

RESUMO

AIMS: The aims of this study were to investigate the ability to kneel after total knee arthroplasty (TKA) without patellar resurfacing, and its effect on patient-reported outcome measures (PROMs). Secondary aims included identifying which kneeling positions were most important to patients, and the influence of radiological parameters on the ability to kneel before and after TKA. METHODS: This prospective longitudinal study involved 209 patients who underwent single radius cruciate-retaining TKA without patellar resurfacing. Preoperative EuroQol five-dimension questionnaire (EQ-5D), Oxford Knee Score (OKS), and the ability to achieve four kneeling positions were assessed including a single leg kneel, a double leg kneel, a high-flexion kneel, and a praying position. The severity of radiological osteoarthritis (OA) was graded and the pattern of OA was recorded intraoperatively. The flexion of the femoral component, posterior condylar offset, and anterior femoral offset were measured radiologically. At two to four years postoperatively, 151 patients with a mean age of 70.0 years (SD 9.44) were included. Their mean BMI was 30.4 kg/m2 (SD 5.36) and 60 were male (40%). They completed EQ-5D, OKS, and Kujala scores, assessments of the ability to kneel, and a visual analogue scale for anterior knee pain and satisfaction. RESULTS: The ability to kneel in the four positions improved in between 29 (19%) and 53 patients (35%) after TKA, but declined in between 35 (23%) and 46 patients (30%). Single-leg kneeling was most important to patients. After TKA, 62 patients (41%) were unable to achieve a single-leg kneel, 76 (50%) were unable to achieve a double-leg kneel, 102 (68%) were unable to achieve a high-flexion kneel and 61 (40%) were unable to achieve a praying position. Posterolateral cartilage loss significantly affected preoperative deep flexion kneeling (p = 0.019). A postoperative inability to kneel was significantly associated with worse OKS, Kujala scores, and satisfaction (p < 0.05). Multivariable regression analysis identified significant independent associations with the ability to kneel after TKA (p < 0.05): better preoperative EQ-5D and flexion of the femoral component for single-leg kneeling; the ability to achieve it preoperatively and flexion of the femoral component for double-leg kneeling; male sex for high-flexion kneeling; and the ability to achieve it preoperatively, anterior femoral offset, and patellar cartilage loss for the praying position. CONCLUSION: The ability to kneel was important to patients and significantly influenced knee-specific PROMs, but was poorly restored by TKA with equal chances of improvement or decline. Cite this article: Bone Joint J 2021;103-B(9):1514-1525.


Assuntos
Artroplastia do Joelho , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Idoso , Fenômenos Biomecânicos , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Estudos Longitudinais , Masculino , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Medição da Dor , Dor Pós-Operatória/diagnóstico , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/fisiopatologia , Articulação Patelofemoral/cirurgia , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Inquéritos e Questionários
10.
Medicine (Baltimore) ; 100(35): e26873, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477120

RESUMO

ABSTRACT: Meloxicam is commonly administrated to control postoperative pain in orthopedic surgery, while its efficacy in total knee arthroplasty (TKA) is not clear. Therefore, this study aimed to explore the postoperative analgesic effect and tolerance of meloxicam in knee osteoarthritis (OA) patients undergoing TKA.Totally, 128 knee OA patients scheduled for TKA were enrolled in this randomized, controlled, double-blind study, then randomized into meloxicam group (N = 65) and control group (N = 63) as 1:1 ratio. Patients took meloxicam or placebo from 4 hours (h) to 72 h after TKA. Patients were followed up at 6 h, 12 h, day (D)1, D2, D3, D7, month (M)1, and M3.Pain visual analog scale score at rest was decreased in meloxicam group at 12 h, D1 and D3 compared to control group; pain visual analog scale score at flexion was reduced in meloxicam group at 6 h, 12 h, D1, D2, and D3 compared to control group. Additional and total consumption of patient-controlled analgesia were both attenuated in meloxicam group compared to control group. Furthermore, patient satisfaction score was higher on D1, D2, D3 in meloxicam group compared to control group. However, no difference of hospital for special surgery knee score score at M1 or M3 was found between the 2 groups. Moreover, the occurrence of adverse events was similar between the 2 groups.Meloxicam displays good effect on controlling postoperative pain and improving patient satisfaction, while does not affect long-term knee function recovery or safety profile in knee OA patients undergoing TKA.


Assuntos
Meloxicam/normas , Osteoartrite do Joelho/tratamento farmacológico , Idoso , Anti-Inflamatórios não Esteroides/normas , Anti-Inflamatórios não Esteroides/uso terapêutico , Artroplastia do Joelho/métodos , Artroplastia do Joelho/estatística & dados numéricos , Distribuição de Qui-Quadrado , Método Duplo-Cego , Feminino , Humanos , Masculino , Meloxicam/uso terapêutico , Pessoa de Meia-Idade , Manejo da Dor/métodos , Manejo da Dor/estatística & dados numéricos , Medição da Dor/métodos , Recuperação de Função Fisiológica
11.
Nutrients ; 13(7)2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34371824

RESUMO

Delayed-onset muscle soreness (DOMS) is associated with increases in acute inflammatory and biochemical markers, muscle swelling, pain, and reduced functional performance. This study aimed to investigate the preventative effects of crocodile blood supplementation on DOMS induced by eccentric exercise. Sixteen healthy males were randomly allocated to either a crocodile blood (CB, n = 8) or a placebo (PL, n = 8) treatment. Participants receiving the CB treatment consumed four capsules of freeze-dried CB powder (1 g day-1) over 18 days. Participants receiving the other treatment were administered a placebo over the same period. An eccentric exercise protocol was performed, and functional performance, visual analogue scale (VAS)-measured pain, knee range of movement (ROM), thigh circumference (swelling), and cytokines, enzymes, and biochemical parameters were assessed immediately after exercise as well as after 24 h, 48 h, and 72 h. CB supplementation could significantly maintain maximum voluntary isometric contraction (MVIC) at 24 h (p = 0.001) and 48 h after exercise (p = 0.001) when comparing values at different times for the CB group. In the CB group, thigh circumference decreased only immediately after eccentric exercise (p = 0.031) in comparison with pre-eccentric exercise values. An 18-day supplementation (1 g day-1) of crocodile blood does aid in the maintenance of functional performance and muscle swelling after eccentric exercise. Our data indicate that 1 g day-1 of crocodile blood supplementation should be safe for human consumption.


Assuntos
Jacarés e Crocodilos/sangue , Suplementos Nutricionais , Exercício Físico/fisiologia , Doenças Musculares/prevenção & controle , Mialgia/prevenção & controle , Animais , Biomarcadores/análise , Método Duplo-Cego , Edema/etiologia , Edema/fisiopatologia , Edema/prevenção & controle , Voluntários Saudáveis , Humanos , Contração Isométrica/efeitos dos fármacos , Masculino , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/fisiopatologia , Doenças Musculares/etiologia , Doenças Musculares/fisiopatologia , Mialgia/etiologia , Mialgia/fisiopatologia , Medição da Dor , Desempenho Físico Funcional , Amplitude de Movimento Articular/efeitos dos fármacos , Adulto Jovem
12.
Appl Ergon ; 97: 103548, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34391990

RESUMO

Measurement of pressure threshold has found its applications in the fields of medical sciences and product design. Hence it has been a profound area of research interest for several decades. However, hardly any detailed investigation has been undertaken to measure the pressure threshold in the head region. In this study, Pressure Discomfort Threshold (PDT) and Pressure Pain Threshold (PPT) were measured for two hundred eighteen healthy Chinese adults at seventy-six anatomical locations, and further statistical analyses were performed on the acquired data to understand the relationship between different demographic parameters. The results suggest that the pressure sensitivity is low in the vertex region, moderate in the forehead and temporal area, and high in the facial and nasal region. From this study, pressure sensitivity maps were developed for PDT and PPT for Chinese adults. The measured pressure threshold data showed no significant relationship with age and Body Mass Index (BMI).


Assuntos
Limiar da Dor , Projetos de Pesquisa , Adulto , China , Humanos , Medição da Dor , Pressão
13.
J Pak Med Assoc ; 71(7): 1716-1719, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34410233

RESUMO

OBJECTIVE: To determine the effects of Mulligan mobilisation with Kinesio Tex tape on pain and disability in anterior innominate dysfunction in females. Methods: The quasi-experimental study was conducted from March to August 2018 at the Allied Hospital and Javeed Medical Complex, Faisalabad, Pakistan, and comprised women with anterior innominate dysfunction. The subjects were divided into group A, which was treated with therapeutic ultrasound, Mulligan mobilisation and Kinesio taping, and group B, which was treated with therapeutic ultrasound and Mulligan mobilisation. Data was taken at baseline and after 10 days to measure pain and disability using visual analogue scale and Modified Oswestry Disability Questionnaire. Data was analysed using SPSS 20. RESULTS: Of the 30 women, there were 15(50%) in group A with a mean age of 32.80±6.02 years and 15(50%) in group B with a mean age of 34.20±6.51 years. Both groups showed significant improvement in pain and disability post-treatment (p<0.05), with group A showing more improvement than group B in terms of disability (p=0.001), but not in terms of pain (p=0.20). CONCLUSIONS: Both Mulligan mobilisation along with Kineso Tex tape and Mulligan mobilisation alone were found to be effective in reducing pain and disability, with the tape showing better improvement in pain and disability compared to those receiving mobilisation alone.


Assuntos
Fita Atlética , Adulto , Feminino , Humanos , Dor , Medição da Dor , Paquistão , Amplitude de Movimento Articular
14.
J Pak Med Assoc ; 71(7): 1720-1724, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34410234

RESUMO

OBJECTIVE: To determine the effects of thoracic spine manipulation on pain pressure sensitivity of rhomboids muscles and thoracic spine mobility. METHODS: The randomised controlled trial was conducted at the Women Institute of Rehabilitation Sciences, Abbottabad, Pakistan, from July to December 2019, and comprised subjects aged 18-30 years having active trigger points in rhomboid muscle. The subjects were randomised into experimental group A and control group B. The eperimental group received thoracic manipulation along with conventional physical therapy, while the control group only received conventional physical therapy. The intervention lasted 2 sessions per week for 3 weeks. Pre- and post-intervention assessment was done with numeric pain rating scale, algometry, inclinometer and the neck disability index. Data was analysed using SPSS 20. RESULTS: Of the 60 subjects, there were 30(50%) in each of the two groups. There were 21(70%) females and 9(30%) males in group A with an overall mean age of 23.86±4.56 years. In group B, there were 18(60%) females and 12(40%) males, with an overall mean age of 23.93±3.96. There was significant improvement in terms of pain (p<0.01) and pain pressure sensitivity (p<0.05). All outcome measures showed significant intra-group differences (p<0.000). CONCLUSIONS: Upper thoracic spine manipulation was found to be more effective in treating interscapular pain and pain pressure threshold of trigger points in rhomboid muscles. Clinical Trial Number: This trial was registered at www.ClinicalTrails.gov with registry number NCT04179214.


Assuntos
Manipulação da Coluna , Pontos-Gatilho , Adulto , Feminino , Humanos , Masculino , Músculos , Cervicalgia/terapia , Medição da Dor , Amplitude de Movimento Articular , Vértebras Torácicas , Resultado do Tratamento , Adulto Jovem
15.
Medicine (Baltimore) ; 100(33): e26767, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414933

RESUMO

OBJECTIVE: The aim of this study was to investigate the effect of Ma Yinglong Shexiang Hemorrhoids Cream combined with pearl powder on pain and complications in patients with severe pressure ulcers. METHODS: One hundred seventeen patients with severe pressure ulcers hospitalized and treated in our hospital (January 2019--December 2019) were divided into Ma Yinglong Musk Hemorrhoid Cream Group (MY Group), Pearl Powder Group (PP Group), and combination with Ma Yinglong Musk Hemorrhoid Cream and Pearl Powder Group (MP group), 39 patients in each group. There was no significant difference in the general data of patients in MY group, PP group, and MP group. By analyzing the differences in clinical efficacy, secondary effects, scar incidence, pain, and clinical indicators of patients in the MY group, PP group, and MP group, the effects of Mayinglong Shexiang Hemorrhoid Cream combined with pearl powder in the treatment of pain and complications in patients with severe pressure ulcers were explored. RESULTS: After treatment, compared with the MY group and the PP group, the MP group had a higher clinical efficacy than the MY group and the PP group. Compared with MY group and PP group, the healing time, dressing change times, and dressing change time of MP group were better than MY group (P < .05). After treatment, the VAS score and incidence of secondary effects of the MP group was significantly lower than that of the MY group and PP group (P < .05). The incidence and area of scar formation in the MP group were lower than those in the MY group and the PP group (P < .05). CONCLUSION: Compared with Ma Yinglong Musk Hemorrhoid Cream or Pearl Powder, combination of Ma Yinglong Musk Hemorrhoid Cream and Pearl Powder are more effective in treating severe pressure ulcer patients, and can significantly reduce the pain in the affected area and reduce the occurrence of complications.


Assuntos
Medicina Tradicional Chinesa , Manejo da Dor/métodos , Dor/tratamento farmacológico , Dor/etiologia , Lesão por Pressão/complicações , Adulto , Feminino , Hemorroidas/tratamento farmacológico , Humanos , Masculino , Pomadas , Medição da Dor , Pós , Índice de Gravidade de Doença
16.
Artigo em Inglês | MEDLINE | ID: mdl-34444281

RESUMO

Modified-active release therapy (mART) was developed to treat patients experiencing upper quarter pain. The objective of the study was to determine the effectiveness of the mART in treating pain, promoting function, and measuring emotions in patients with scapulocostal syndrome (SCS) and masticatory myofascial pain (MMP). A stratified-randomized controlled trial was employed in 38 participants separated into two groups. All participants underwent the same series visual analog scale (VAS), pressure pain threshold (PPT), mouth opening (MO), maximum mouth opening (MMO), craniovertebral angle (CV-angle), and pain catastrophizing scale Thai version (PCS-Thai-version) at the baseline. The mART group underwent the mART program three times a week for 4 weeks with a hot pack and an educational briefing while the control group received only a hot pack and the educational briefing. After treatment, both groups showed significant improvement (p < 0.05) in all parameters except MO, MMO, and CV-angle. When comparing outcomes between the groups, the mART group showed a statistically significant greater number of improvements than did the control group. In conclusion, the mART program can improve pain experienced by patients with SCS and MMP and it can be used as an adjuvant technique with conservative treatment.


Assuntos
Síndromes da Dor Miofascial , Humanos , Síndromes da Dor Miofascial/terapia , Dor , Medição da Dor , Limiar da Dor , Resultado do Tratamento , Escala Visual Analógica
17.
Trials ; 22(1): 574, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34454582

RESUMO

INTRODUCTION: Mechanical neck pain (MNP) is a commonly occurring musculoskeletal condition that is usually managed using electrical modalities, joint mobilization techniques, and therapeutic exercises, but has limited evidence of their efficacy. Pathology (densification) of the deep cervical fascia that occurs due to the increased viscosity of hyaluronic acid (HA) may induce neck pain and associated painful symptoms of the upper quarter region. Fascial manipulation (FM) and yoga poses are considered to reduce the thixotropy of the ground substances of the deep fascia and improve muscle function. The purpose of this study is to investigate the effect of FM and sequential yoga poses (SYP) when compared to the usual care on pain, function, and oculomotor control in MNP. METHODS: This FaCe-Man trial will recruit 160 patients with subacute and chronic mechanical neck pain diagnosed using predefined criteria. Participants will be randomized to either the intervention group or the usual care group, using a random allocation ratio of 1:1. Patients in the intervention group will receive FM (4 sessions in 4 weeks) and SYP (12 weeks) whereas the standard care group will receive cervical mobilization/ thoracic manipulation (4 sessions in 4 weeks) and therapeutic exercises (12 weeks). The primary outcome is the change in the numeric pain rating scale (NPRS). The secondary outcomes include changes in the patient-specific functional scale and oculomotor control, myofascial stiffness, fear-avoidance behavior questionnaire, and elbow extension range of motion during neurodynamics test 1. DISCUSSION: If found effective, FM along with SYP investigated in this trial can be considered as a treatment strategy in the management of mechanical neck pain. Considering the magnitude of the problem, and the pragmatic and patient-centered approach to be followed, it is worth investigating this trial. TRIAL REGISTRATION: ClinicalTrials.gov CTRI/2020/01/022934 . Registered on January 24, 2020 with ctri.nic.in. Clinical Trials Registry - India.


Assuntos
Manipulação da Coluna , Ioga , Humanos , Cervicalgia/diagnóstico , Cervicalgia/terapia , Medição da Dor , Postura , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Rev Assoc Med Bras (1992) ; 67(2): 213-217, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34406244

RESUMO

OBJECTIVE: To investigate the efficacy of a short-term application of Transcutaneous Electric Nerve Stimulation to relieve rest pain in patients with chronic limb-threatening ischemia. METHODS: In patients ³18 years old, with chronic limb-threatening ischemia and rest pain ³3 in the Visual Analogue Scale, without diabetic neuropathy were randomly assigned to 1) Transcutaneous Electric Nerve Stimulation (100 Hz, 200 µs) or 2) sham intervention, both during one or two 20 min treatment sessions. The primary outcome was pain intensity, assessed by the visual analogue scale (0-10 cm) and described by the McGill Pain Questionnaire. We used a t-test for difference of means. RESULTS: A total of 169 patients were assessed, 23 met the study criteria and were randomized. Thirty-four applications were performed in two days: in the 17 Transcutaneous Nerve Stimulation and 17 sham. The within-group analysis indicated a pain decrease in both groups (Transcutaneous Electric Nerve Stimulation, from 7-3.9 cm, p<0.0001, and sham from 5.8-3.2 cm, p<0.0001). No statistically significant difference was verified between-groups (p=0.5). CONCLUSIONS: Both groups showed a decrease in rest pain of 54 and 55%, respectively. However, there was no difference between short-term high-frequency Transcutaneous Electric Nerve Stimulation and sham intervention to relieve ischemic rest pain in chronic limb-threatening ischemia patients.


Assuntos
Estimulação Elétrica Nervosa Transcutânea , Humanos , Pacientes Internados , Isquemia/terapia , Dor , Medição da Dor , Resultado do Tratamento
19.
Medicina (Kaunas) ; 57(8)2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34440949

RESUMO

Background and Objectives: Tinnitus is a condition that negatively affects the quality of life and is difficult to treat. Theta burst stimulation (TBS), a new method of repetitive transcranial magnetic stimulation (rTMS), is a promising treatment approach because it shows stronger and more prolonged effects in a shorter time of stimulation than other rTMS protocols. However, the therapeutic effect of TBS for tinnitus was inconsistent. We hypothesized that more stimulation would be more effective. Therefore, this study aimed to explore the safety and effectiveness of multiple daily rounds of TBS over five consecutive days. Materials and Methods: The continuous TBS (cTBS) protocol is 300 pulses/day, but we applied 8 sessions of 300 pulses in a day (total 2400 pulses/day). A total of 15 patients with tinnitus were randomly assigned to treatment and sham groups. Outcome measurements were taken three times: before and after 5-day of stimulation; at a 1-3 month follow-up visit. Outcome measurements were the degree of annoyance due to ear fullness, duration of tinnitus, visual analog scales of tinnitus for annoyance, Tinnitus Handicap Inventory, pitch, loudness, minimum masking level, and residual inhibition. Results: Five-day cTBS was completed without adverse events. We did not find any significant therapeutic effect in the treatment group, but we needed to be cautious to interpret our result due to the small sample size. Conclusions: In conclusion, multiple rounds of cTBS in a day may be safe. Further research is needed in a larger sample size to determine the effectiveness and confirm the safety.


Assuntos
Zumbido , Humanos , Medição da Dor , Qualidade de Vida , Projetos de Pesquisa , Zumbido/terapia , Estimulação Magnética Transcraniana , Resultado do Tratamento
20.
Medicina (Kaunas) ; 57(8)2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34440970

RESUMO

Background and Objectives This systematic review aims to evaluate the efficacy of Tele-Rehabilitation for decreasing pain in patients with knee osteoarthritis (OA). Materials and Methods: Following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), three electronic databases (CINAHL, PubMed, PEDro), along with the addition of grey literature, were used to collect information. Randomized control trials (RCTs) comparing tele-rehabilitation (TR) to office-based-rehabilitation (OB) were critically appraised using the 2005 University of Oxford Standard. A total of 139 articles (PubMed = 132, CINAHL = 5, PEDro = 0, grey literature = 2) were acquired. Results: After the screening, three RCTs were included in our review. Their results show no statistically significant differences between TR and OB intervention. Furthermore, their results showed an overall reduction in pain in both groups from the baseline to the end of the study. However, each intervention's clinical efficiency was dependent on the exercise protocol itself and not on the method of delivery. There is a potential ceiling effect to the amount of therapy a patient can receive in which additional therapy would no longer lead to improved recovery. Conclusions: Our review suggests evidence that TR's efficacy is similar to that of OB for improvement of WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score parameters in patients suffering from knee OA.


Assuntos
Osteoartrite do Joelho , Telerreabilitação , Exercício Físico , Humanos , Dor , Medição da Dor
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