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1.
Dental Press J Orthod ; 25(5): 30-37, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33206826

RESUMO

OBJECTIVE: This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients' routine. METHODS: The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient's routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman's correlation tests. All statistical tests were performed with significance level of 5%. RESULTS: Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). CONCLUSIONS: Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients' daily routine.


Assuntos
Envio de Mensagens de Texto , Adulto , Ansiedade/etiologia , Feminino , Humanos , Masculino , Medição da Dor , Percepção da Dor , Estudos Prospectivos , Adulto Jovem
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1507-1511, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018277

RESUMO

Pain is a subjective experience and clinicians need to treat patients with accurate pain levels. EEG has emerged as a useful tool for objective pain assessment, but due to the low signal-to-noise ratio of pain-related EEG signals, the prediction accuracy of EEG-based pain prediction models is still unsatisfactory. In this paper, we proposed an autoencoder model based on convolutional neural networks for feature extraction of pain-related EEG signals. More precisely, we used EEGNet to build an autoencoder model to extract a small set of features from high-density pain-evoked EEG potentials and then establish a machine learning models to predict pain levels (high pain vs. low pain) from extracted features. Experimental results show that the new autoencoder-based approach can effectively identify pain-related features and can achieve better classification results than conventional methods.


Assuntos
Algoritmos , Eletroencefalografia , Percepção da Dor , Humanos , Redes Neurais de Computação , Dor
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1512-1515, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018278

RESUMO

The patient-clinician relationship is known to significantly affect the pain experience, as empathy, mutual trust and therapeutic alliance can significantly modulate pain perception and influence clinical therapy outcomes. The aim of the present study was to use an EEG hyperscanning setup to identify brain and behavioral mechanisms supporting the patient-clinician relationship while this clinical dyad is engaged in a therapeutic interaction. Our previous study applied fMRI hyperscanning to investigate whether brain concordance is linked with analgesia experienced by a patient while undergoing treatment by the clinician. In this current hyperscanning project we investigated similar outcomes for the patient-clinician dyad exploiting the high temporal resolution of EEG and the possibility to acquire the signals while patients and clinicians were present in the same room and engaged in a face-to-face interaction under an experimentally-controlled therapeutic context. Advanced source localization methods allowed for integration of spatial and spectral information in order to assess brain correlates of therapeutic alliance and pain perception in different clinical interaction contexts. Preliminary results showed that both behavioral and brain responses across the patient-clinician dyad were significantly affected by the interaction style.Clinical Relevance- The context of a clinical intervention can significantly impact the treatment of chronic pain. Effective therapeutic alliance, based on empathy, mutual trust, and warmth can improve treatment adherence and clinical outcomes. A deeper scientific understanding of the brain and behavioral mechanisms underlying an optimal patient-clinician interaction may lead to improved quality of clinical care and physician training, as well as better understanding of the social aspects of the biopsychosocial model mediating analgesia in chronic pain patients.


Assuntos
Encéfalo , Dor Crônica , Manejo da Dor , Relações Profissional-Paciente , Encéfalo/fisiologia , Humanos , Imagem por Ressonância Magnética , Percepção da Dor
4.
Cochrane Database Syst Rev ; 10: CD010686, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33089901

RESUMO

BACKGROUND: Virtual reality (VR) computer technology creates a simulated environment, perceived as comparable to the real world, with which users can actively interact. The effectiveness of VR distraction on acute pain intensity in children is uncertain. OBJECTIVES: To assess the effectiveness and adverse effects of virtual reality (VR) distraction interventions for children (0 to 18 years) with acute pain in any healthcare setting. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and four trial registries to October 2019. We also searched reference lists of eligible studies, handsearched relevant journals and contacted study authors. SELECTION CRITERIA: Randomised controlled trials (RCTs), including cross-over and cluster-RCTs, comparing VR distraction to no distraction, non-VR distraction or other VR distraction. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological processes. Two reviewers assessed risk of bias and extracted data independently. The primary outcome was acute pain intensity (during procedure, and up to one hour post-procedure). Secondary outcomes were adverse effects, child satisfaction with VR, pain-related distress, parent anxiety, rescue analgesia and cost. We used GRADE and created 'Summary of findings' tables. MAIN RESULTS: We included 17 RCTs (1008 participants aged four to 18 years) undergoing various procedures in healthcare settings. We did not pool data because the heterogeneity in population (i.e. diverse ages and developmental stages of children and their different perceptions and reactions to pain) and variations in procedural conditions (e.g. phlebotomy, burn wound dressings, physical therapy sessions), and consequent level of pain experienced, made statistical pooling of data impossible. We narratively describe results. We judged most studies to be at unclear risk of selection bias, high risk of performance and detection bias, and high risk of bias for small sample sizes. Across all comparisons and outcomes, we downgraded the certainty of evidence to low or very low due to serious study limitations and serious or very serious indirectness. We also downgraded some of the evidence for very serious imprecision. 1: VR distraction versus no distraction Acute pain intensity: during procedure Self-report: one study (42 participants) found no beneficial effect of non-immersive VR (very low-certainty evidence). Observer-report: no data. Behavioural measurements (observer-report): two studies, 62 participants; low-certainty evidence. One study (n = 42) found no beneficial effect of non-immersive VR. One study (n = 20) found a beneficial effect favouring immersive VR. Acute pain intensity: post-procedure Self-report: 10 studies, 461 participants; very low-certainty evidence. Four studies (n = 95) found no beneficial effect of immersive and semi-immersive or non-immersive VR. Five studies (n = 357) found a beneficial effect favouring immersive VR. Another study (n = 9) reported less pain in the VR group. Observer-report: two studies (216 participants; low-certainty evidence) found a beneficial effect of immersive VR, as reported by primary caregiver/parents or nurses. One study (n = 80) found a beneficial effect of immersive VR, as reported by researchers. Behavioural measurements (observer-report): one study (42 participants) found no beneficial effect of non-immersive VR (very low-certainty evidence). Adverse effects: five studies, 154 participants; very low-certainty evidence. Three studies (n = 53) reported no adverse effects. Two studies (n = 101) reported mild adverse effects (e.g. nausea) in the VR group. 2: VR distraction versus other non-VR distraction Acute pain intensity: during procedure Self-report, observer-report and behavioural measurements (observer-report): two studies, 106 participants: Self-report: one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) found no evidence of a difference in mean pain change scores (very low-certainty evidence). Observer-report: one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) found no evidence of a difference in mean pain change scores (low-certainty evidence). Behavioural measurements (observer-report): one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) reported a difference in mean pain change scores with fewer pain behaviours in VR group (low-certainty evidence). Acute pain intensity: post-procedure Self-report: eight studies, 575 participants; very low-certainty evidence. Two studies (n = 146) found a beneficial effect favouring immersive VR. Two studies (n = 252) reported a between-group difference favouring immersive VR. One study (n = 59) found no beneficial effect of immersive VR versus television and Child Life non-VR distraction. One study (n = 18) found no beneficial effect of semi-immersive VR. Two studies (n = 100) reported no between-group difference. Observer-report: three studies, 187 participants; low-certainty evidence. One study (n = 81) found a beneficial effect favouring immersive VR for parent, nurse and researcher reports. One study (n = 65) found a beneficial effect favouring immersive VR for caregiver reports. Another study (n = 41) reported no evidence of a difference in mean pain change scores. Behavioural measurements (observer-report): two studies, 106 participants; low-certainty evidence. One study (n = 65) found a beneficial effect favouring immersive VR. Another study (n = 41) reported no evidence of a difference in mean pain change scores. Adverse effects: six studies, 429 participants; very low-certainty evidence. Three studies (n = 229) found no evidence of a difference between groups. Two studies (n = 141) reported no adverse effects in VR group. One study (n = 59) reported no beneficial effect in reducing estimated cyber-sickness before and after VR immersion. 3: VR distraction versus other VR distraction We did not identify any studies for this comparison. AUTHORS' CONCLUSIONS: We found low-certainty and very low-certainty evidence of the effectiveness of VR distraction compared to no distraction or other non-VR distraction in reducing acute pain intensity in children in any healthcare setting. This level of uncertainty makes it difficult to interpret the benefits or lack of benefits of VR distraction for acute pain in children. Most of the review primary outcomes were assessed by only two or three small studies. We found limited data for adverse effects and other secondary outcomes. Future well-designed, large, high-quality trials may have an important impact on our confidence in the results.


Assuntos
Dor Aguda/prevenção & controle , Dor Processual/prevenção & controle , Realidade Virtual , Dor Aguda/diagnóstico , Adolescente , Atenção , Viés , Criança , Pré-Escolar , Humanos , Manejo da Dor/métodos , Medição da Dor , Percepção da Dor , Dor Processual/diagnóstico , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4526-4529, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019000

RESUMO

We developed an objective real-time pain detection method using a smartphone and a wrist-worn wearable device to collect electrodermal activity (EDA) signals. Recently, various researchers have developed pain management applications. However, they rely on subjective self-reported pain scores or the video camera of a smartphone to detect pain, but the latter method's accuracy needs further improvement. In our work, we use a wrist-worn EDA device which transmits data via Bluetooth to a smartphone. A smartphone application was developed to analyze the EDA data so that near real-time processed pain detection information can be displayed. The analysis of EDA is based on estimating time-varying spectral power in the frequency range (0.08-0.24 Hz) associated with the sympathetic nervous system. This time-varying characterization of EDA is termed TVSymp. In this work, we also examined whether removing baseline EDA fluctuations from TVSymp would provide more accurate results. This was carried out by taking the moving average of the EDA response prior to stimulus and subtracting that value from the EDA response post stimulus. This approach is termed modified TVSymp (MTVSymp). Pain stimuli were induced in ten subjects using a thermal grill, which gives intense pain perception without damaging skin tissues. We compared both TVSymp and MTVSymp in detecting pain induced by the thermal grill using machine learning approaches. We found the accuracy of pain detection of TVSymp and MTVSymp to be 80% and 90%, respectively.


Assuntos
Smartphone , Resposta Galvânica da Pele , Humanos , Dor/diagnóstico , Manejo da Dor , Percepção da Dor
6.
Eur J Paediatr Dent ; 21(3): 180-182, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893647

RESUMO

AIM: In paediatric dentistry it is essentials to reduce axiety and fear induced by local anaesthetic injection, in order to obtain patient's cooperation and achieve a successful treatment. Hence, this review is aiming to primary evaluate pain perception in paediatric patients when using a computer-controlled local anaesthetic delivery system (C-CLADS) compared to traditional injection. MATERIALS AND METHODS: A database literature search was conducted on both MEDLINE and Cochrane Central Register of Controlled Trials and a data extraction table was created to perform a critical evaluation of each scientific article. The primary results were the perception of pain during anaesthesia and the patient's behaviour, the secondary the amount of anaesthetic required and its duration over time. RESULTS: In the review were included 7 clinical studies regarding paediatric patients where split-mouth designs or group division were used. The age range was between 5 and 17 years old. Pain and fear parameters were measured by visual analogue scales, behavioural scales, heart rate and satisfaction questionnaires. CONCLUSION: Substantial heterogeneity between clinical trials was observed, which led to difficult comparison. Computerised devices have proved to be interesting in reducing pain during anaesthesia, improving the approach to the paediatric patient. It is advisable to conduct research with anxious subjects and patients under the age of 4, because no evidence has been found in the literature. It is recommended to conduct further research with anxious subjects and patients below the age of 4, where Relative Analgesia by Langa or pharmacological anxiolysis are frequently used.


Assuntos
Anestesia Dentária , Odontopediatria , Adolescente , Anestesia Local , Anestésicos Locais , Criança , Pré-Escolar , Humanos , Percepção da Dor
7.
Am J Orthod Dentofacial Orthop ; 158(5): e83-e90, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32978017

RESUMO

INTRODUCTION: The primary aim of this study was to investigate and compare perceived pain intensity and oral health-related quality of life (OHRQOL) results during the activation phase of rapid maxillary expansion (RME), with tooth-borne and bone-borne devices. In addition, a secondary aim of this study was to evaluate the correlation between pain scales and the shortened Oral Health Impact Profile (OHIP-14) questionnaire. METHODS: Thirty-six subjects (16 girls and 20 boys) with a mean age of 12.3 years (standard deviation, 0.82 years) were randomized into 2 groups. Group A received treatment with hyrax appliance, and group B received a computer-guided skeletal RME appliance. The same type of expansion screw and screw activation or expansion protocol were used. Two rating scales were used to assess the subject's pain during the activation phase of RME: a Graphic Rating Scale for Pain (GRS) and the Wong-Baker Faces Pain Scale (FPS). The OHIP-14 was used to evaluate the impact of RME on OHRQOL before the beginning of the treatment at day 3 and day 7 follow-ups. Painkillers were forbidden during the active phase of RME. Descriptive statistics, Student t test, and Pearson correlation were used. Significance was set at P ≤0.05. RESULTS: A total of 36 subjects, divided into 2 groups, were treated in the study. Regarding the level of pain, the Student t test showed statistically significant higher pain in group B-although only on the first day of screw activation (GRS, P = 0.01; FPS, P  <0.01). For the following days, there were no significant differences in pain levels between groups. The OHIP-14 showed no statistically significant difference at baseline (P = 0.32) and day 3 (P = 0.88) and day 7 (P = 0.85) follow-ups between the 2 groups. The Pearson correlation coefficient showed a statistically significant association between the 2 different scales of pain (GRS and FPS) but not a statistically significant correlation between GRS and FPS scales and OHIP-14. CONCLUSIONS: A higher perceived pain intensity in the patients treated using a bone-borne computer-guided skeletal RME appliance was limited to the first day of screw activation. There were no statistically significant differences between the 2 types of treatment in terms of their impact on OHRQOL and no statistically significant correlation between pain scales and the OHIP-14 questionnaire.


Assuntos
Percepção da Dor , Técnica de Expansão Palatina , Qualidade de Vida , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Saúde Bucal , Dor
8.
Ther Umsch ; 77(6): 239-245, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32930083

RESUMO

Neuroanatomy and Pathophysiology of Pain Perception Abstract. Nociception, the possibility of our sensory nervous system to detect painful and therefore potentially harmful stimuli, is crucial for survival. In essence it serves as a "detect and protect" mechanism. For this reason, many features of this complex network, for example the nociceptors, are evolutionary highly preserved. To guarantee an adequate and fast response to prevent tissue damage, the information has to be processed in a fast and stable manner. To this account, the network is designed to be able to potentiate the information at any level. However, sometimes triggered by pathophysiological factors like inflammation, this functional and structural plasticity can become maladaptive, leading to chronification of pain and in this way become a disease itself. Nociception starts in the periphery by activation of a nociceptor which is a highly specialized neuron of the somatosensory nervous system. Some of them are thinly myelinated Aδ fibers, others unmyelinated C fibers. The free nerve endings in the skin or other tissues are equipped with different receptors and ion channels to translate noxious stimuli (like temperature or pressure) into electrochemical signals. These are transmitted to the dorsal horn of the spinal cord, where the second neuron is activated via excitatory amino acids (like glutamate) and other substances, a process which is modulated by inhibitory interneurons. This second neuron projects to cerebral locations, mostly to the thalamus but also to hypothalamus and amygdala, where the usually fast emotional and vegetative reaction is generated. The third order neuron then terminates in the somatosensory cortex and is embedded in a complex network, the so called "pain matrix". Areas involved are for example the prefrontal cortex, where decision making happens, and the limbic structures, where pain memory and learning processes take place. Descending projections from the locus coeruleus, raphe nuclei and the rostroventral medulla oblongata to the spinal cord can either facilitate or inhibit the nociceptive information. Sensitization leading to enhanced activation of the nociceptive pathways can take place at any level, which can become a "circulus vitiosus", finally underlying a chronic pain disorder.


Assuntos
Neuroanatomia , Nociceptores , Humanos , Dor , Percepção da Dor , Medula Espinal
9.
Evid Based Dent ; 21(3): 98-99, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32978540

RESUMO

Design Randomised controlled trial.Study population Sixty patients aged 10-18 years requiring fixed orthodontic treatment were randomly allocated to the study or control group. Anxiety levels and somatosensory amplification were evaluated. All patients received general verbal instructions on orthodontic treatment (dietary habits, oral hygiene maintenance and pain). Patients in the study group also received written information (a take-home leaflet) on orthodontic pain characteristics and management. Patients, clinicians and statistician were blinded to the patient allocation.Outcome measure The primary outcome was the pain intensity and the secondary outcome was analgesic consumption.Data analysis Multilevel regression analysis of variance (ANOVA) for repeated measures with split plot design.Results Pain perception and analgesic consumption were significantly higher in the control group only during the first two days after appliance placement (P <0.05).Conclusions Combining verbal and written information diminished pain perception and analgesic consumption in orthodontic patients in the first days after appliance placement.


Assuntos
Percepção da Dor , Dor , Adolescente , Criança , Humanos , Medição da Dor , Redação
10.
PLoS One ; 15(8): e0232412, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822348

RESUMO

Models designed to detect abnormalities that reflect disease from facial structures are an emerging area of research for automated facial analysis, which has important potential value in smart healthcare applications. However, most of the proposed models directly analyze the whole face image containing the background information, and rarely consider the effects of the background and different face regions on the analysis results. Therefore, in view of these effects, we propose an end-to-end attention network with spatial transformation to estimate different pain intensities. In the proposed method, the face image is first provided as input to a spatial transformation network for solving the problem of background interference; then, the attention mechanism is used to adaptively adjust the weights of different face regions of the transformed face image; finally, a convolutional neural network (CNN) containing a Softmax function is utilized to classify the pain levels. The extensive experiments and analysis are conducted on the benchmarking and publicly available database, namely the UNBC-McMaster shoulder pain. More specifically, in order to verify the superiority of our proposed method, the comparisons with the basic CNNs and the-state-of-the-arts are performed, respectively. The experiments show that the introduced spatial transformation and attention mechanism in our method can significantly improve the estimation performances and outperform the-state-of-the-arts.


Assuntos
Atenção , Redes Neurais de Computação , Percepção da Dor , Humanos , Processamento de Imagem Assistida por Computador
11.
Med Care ; 58 Suppl 2 9S: S116-S124, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32826781

RESUMO

BACKGROUND: Long-term opioid therapy for chronic pain arose amid limited availability and awareness of other pain therapies. Although many complementary and integrative health (CIH) and nondrug therapies are effective for chronic pain, little is known about CIH/nondrug therapy use patterns among people prescribed opioid analgesics. OBJECTIVE: The objective of this study was to estimate patterns and predictors of self-reported CIH/nondrug therapy use for chronic pain within a representative national sample of US military veterans prescribed long-term opioids for chronic pain. RESEARCH DESIGN: National two-stage stratified random sample survey combined with electronic medical record data. Data were analyzed using logistic regressions and latent class analysis. SUBJECTS: US military veterans in Veterans Affairs (VA) primary care who received ≥6 months of opioid analgesics. MEASURES: Self-reported use of each of 10 CIH/nondrug therapies to treat or cope with chronic pain in the past year: meditation/mindfulness, relaxation, psychotherapy, yoga, t'ai chi, aerobic exercise, stretching/strengthening, acupuncture, chiropractic, massage; Brief Pain Inventory-Interference (BPI-I) scale as a measure of pain-related function. RESULTS: In total, 8891 (65%) of 13,660 invitees completed the questionnaire. Eighty percent of veterans reported past-year use of at least 1 nondrug therapy for pain. Younger age and female sex were associated with the use of most nondrug therapies. Higher pain interference was associated with lower use of exercise/movement therapies. Nondrug therapy use patterns reflected functional categories (psychological/behavioral, exercise/movement, manual). CONCLUSIONS: Use of CIH/nondrug therapies for pain was common among patients receiving long-term opioids. Future analyses will examine nondrug therapy use in relation to pain and quality of life outcomes over time.


Assuntos
Analgésicos Opioides/uso terapêutico , Dor Crônica/terapia , Terapias Complementares/estatística & dados numéricos , Medicina Integrativa/estatística & dados numéricos , Veteranos/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Analgésicos Opioides/administração & dosagem , Dor Crônica/tratamento farmacológico , Terapias Complementares/métodos , Feminino , Nível de Saúde , Humanos , Medicina Integrativa/métodos , Masculino , Pessoa de Meia-Idade , Manejo da Dor , Percepção da Dor , Qualidade de Vida , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos , United States Department of Veterans Affairs , Saúde dos Veteranos
12.
Pediatrics ; 146(Suppl 1): S70-S74, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32737236

RESUMO

The alleviation of suffering has always been central to the care of the sick. Yet as medical technology has advanced and life-sustaining treatments multiplied, medicine's capacity to both prevent and create suffering has grown exponentially. In pediatric medicine, the ability to stave off death with life-sustaining treatments allows children to survive but also to suffer in ways that are diverse and unprecedented. However, although parents and pediatric clinicians broadly agree that all children can suffer, there is little published literature in which researchers analyze or clarify the concept of pediatric suffering. This gap is worrisome, especially in light of growing concerns that the label of suffering is used to justify end-of-life decision-making and mask quality-of-life determinations for pediatric patients with profound neurologic impairment. Moreover, the awareness that some children can experience suffering but cannot communicate whether and how they are suffering creates a problem. Does the determination of suffering in a nonverbal child lie in the judgement of clinicians or parents? In this article, I will address several important questions related to the suffering of children through an analysis of two prevalent conceptualizations of pediatric suffering and suggest a possible avenue forward for future scholarship.


Assuntos
Temas Bioéticos , Tomada de Decisão Clínica/ética , Percepção da Dor/fisiologia , Angústia Psicológica , Terminologia como Assunto , Bibliometria , Criança , Pré-Escolar , Dissidências e Disputas , Humanos , Lactente , Futilidade Médica/ética , Comunicação não Verbal/fisiologia , Percepção da Dor/ética , Qualidade de Vida , Suspensão de Tratamento/ética
13.
J Indian Soc Pedod Prev Dent ; 38(2): 184-189, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32611866

RESUMO

Background and Aim of the Study: The topical anesthetic property of clove remains unexplored even though it has been widely used in dentistry since ages. Hence, the aim of the study was to compare the topical anesthetic efficiency of precooling with ice, clove-papaya based topical gel and benzocaine gel in pediatric patients. Methodology: Sixty healthy children aged 9-10 years who required local anesthetic injections for dental procedures were selected and divided into three groups with 20 patients each. In the first visit, written consent and intraoral screening of the patients were performed. In the second visit, the topical anesthetic agents were applied in the respective groups for 1 min and later local anesthetic injections were administered. Pain perception was evaluated using Sound, Eye, Motor Scale (SEM scale) and Wong Baker Faces Pain Rating Scale (WBFPRS), tabulated, and statistically analyzed. A. Results: The test results demonstrated that benzocaine group has the highest mean WBFPRS score followed by clove-papaya group and then ice cone group. The ice group showed the least mean SEM scale score, followed by the benzocaine group and then clove-papaya group. However, the mean WBFPRS score and the mean SEM scale score did not show any statistically significant difference. Interpretation and Conclusion: All the three topical anesthetic agents provided similar surface anesthesia in children. The newly introduced clove-papaya based topical anesthetic gel showed encouraging results, hence can be used as a potent topical anesthetic agent.


Assuntos
Anestesia Dentária , Carica , Syzygium , Anestésicos Locais , Benzocaína , Criança , Humanos , Lidocaína , Medição da Dor , Percepção da Dor
14.
Artigo em Inglês | MEDLINE | ID: mdl-32635281

RESUMO

Pain and depressive states may have a negative impact on the quality of life of individuals with stroke. The aim of this study was to evaluate the effects of a program of Ai Chi aquatic therapy on pain, depression, and quality of life in a sample of people with stroke. Forty-five participants received physiotherapy treatment on dry land (control group), an experimental group received aquatic Ai Chi therapy, and a combined therapy group received alternating sessions of physiotherapy on dry land and aquatic Ai Chi therapy. The Visual Analog Scale (VAS) scale for pain, the resilience scale, and the SF-36 quality of life scale were used as outcome measures. Statistically significant differences were found in the experimental group and the combined intervention group for post treatment pain and resilience (p < 0.001). Concerning the SF-36, statistically significant changes (p < 0.01) were found in the experimental group and the combined therapy group for all items except general health, vitality, and social function, where no between group differences were observed (p = 0.001). In conclusion, physical exercise performed in water has positive effects on several factors that contribute towards improving the mood and quality of life of people with acquired brain injury.


Assuntos
Terapia por Exercício , Qualidade de Vida , Acidente Vascular Cerebral/terapia , Humanos , Dor , Percepção da Dor , Modalidades de Fisioterapia
15.
PLoS One ; 15(6): e0234160, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559202

RESUMO

Pain is evolutionarily hardwired to signal potential danger and threat. It has been proposed that altered pain-related associative learning processes, i.e., emotional or fear conditioning, might contribute to the development and maintenance of chronic pain. Pain in or near the face plays a special role in pain perception and processing, especially with regard to increased pain-related fear and unpleasantness. However, differences in pain-related learning mechanisms between the face and other body parts have not yet been investigated. Here, we examined body-site specific differences in associative emotional conditioning using electrical stimuli applied to the face and the hand. Acquisition, extinction, and reinstatement of cue-pain associations were assessed in a 2-day emotional conditioning paradigm using a within-subject design. Data of 34 healthy subjects revealed higher fear of face pain as compared to hand pain. During acquisition, face pain (as compared to hand pain) led to a steeper increase in pain-related negative emotions in response to conditioned stimuli (CS) as assessed using valence ratings. While no significant differences between both conditions were observed during the extinction phase, a reinstatement effect for face but not for hand pain was revealed on the descriptive level and contingency awareness was higher for face pain compared to hand pain. Our results indicate a stronger propensity to acquire cue-pain-associations for face compared to hand pain, which might also be reinstated more easily. These differences in learning and resultant pain-related emotions might play an important role in the chronification and high prevalence of chronic facial pain and stress the evolutionary significance of pain in the head and face.


Assuntos
Condicionamento Clássico , Face , Mãos , Dor/psicologia , Adulto , Sinais (Psicologia) , Estimulação Elétrica , Extinção Psicológica , Medo/psicologia , Feminino , Humanos , Masculino , Rememoração Mental , Percepção da Dor/fisiologia , Limiar da Dor
16.
PLoS One ; 15(6): e0234405, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32598346

RESUMO

Chronic pain is a complex experience that has now become a major public health issue. This has prompted many researchers to study attention, understanding it to be a crucial factor that allows altering the experience of pain, while attributing considerable importance to sustained attention. Accordingly, the main studies in this field stress the importance of emotion regulation processes and emotions on the perception of painful stimuli and attentional processes themselves. Nevertheless, only a handful of studies have been found that directly study the relationship between these variables. Within this context, this article sets out to analyse emotional regulation processes, emotional variables (depression and anxiety), the experience of pain, and age on the ability to maintain the vigilance response in a sample of patients with chronic pain. This involved selecting a sample of 49 patients with rheumatoid arthritis and examining their performance in an ad-hoc sustained attention test. With a view to complying with the study's main purpose, the participants were also assessed through the use of the following self-report measures: the Beck Depression Inventory (BDI-I); the Hospital Anxiety and Depression Scale (HADS); the McGill Pain Questionnaire, and the Difficulties in Emotion Regulation Scale (DERS). Linear regression analyses revealed a significant impact of the aging process on the performance times in the attention task. Likewise, age and depression recorded a significant correlation with the mistakes made during the task. These results suggest that higher depression levels and an older age might be related to a worse adaptation to pain management techniques based on attention processes, such as mindfulness.


Assuntos
Envelhecimento/psicologia , Atenção , Dor Crônica/psicologia , Depressão/psicologia , Emoções , Adulto , Idoso , Ansiedade/psicologia , Artrite Reumatoide/fisiopatologia , Artrite Reumatoide/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção da Dor , Análise de Regressão , Autorrelato , Fatores Socioeconômicos , Espanha
18.
PLoS One ; 15(6): e0234807, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584841

RESUMO

OBJECTIVE: To investigate the co-occurrence of tinnitus-related distress and pain experiences alongside psychological factors that may underlie their association. METHOD: Patients with chronic tinnitus (N = 1238) completed a questionnaire battery examining tinnitus-related distress and affective and sensory pain perceptions. A series of simple, parallel- and serial multiple mediator models examined indirect effects of psychological comorbidities as well as -process variables including depressivity, perceived stress and coping attitudes. Moderator and moderated mediation analyses examined differential relational patterns in patients with decompensated vs. compensated tinnitus. RESULTS: There were significant associations between tinnitus-related distress and pain perceptions. These were partially mediated by most specified variables. Psychological comorbidities appeared to influence tinnitus-pain associations through their impact on depressivity, perceived stress, and coping attitudes. Some specific differences in affective vs. sensory pain perception pathways emerged. Patients with decompensated tinnitus yielded significantly higher symptom burden across all measured indices. Tinnitus decompensation was associated with heightened associations between [1] tinnitus-related distress and pain perceptions, depressivity and negative coping attitudes; and [2] most psychological comorbidities and sensory, but not affective pain perception. Moderated mediation analyses revealed stronger indirect effects of depressivity and anxiety in mediating affective-, and anxiety in mediating sensory pain perception in patients with decompensated tinnitus. CONCLUSION: Psychological constructs mediate the co-occurrence of tinnitus- and pain-related symptoms across different levels of tinnitus-related distress. Psychological treatment approaches should conceptualize and address individualised interactions of common cognitive-emotional processes in addressing psychosomatic symptom clusters across syndromatic patients with varying distress levels.


Assuntos
Percepção da Dor , Zumbido/psicologia , Adaptação Psicológica , Doença Crônica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato
19.
Ann Thorac Cardiovasc Surg ; 26(4): 196-201, 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32493872

RESUMO

OBJECTIVE: To evaluate the effect of music therapy on the chronic pain and midterm quality of life of patients after mechanical valve replacement. METHODS: Patients were divided into two groups according to whether or not they received music therapy. The patients in the music group received 30 minutes of music therapy every day for 6 months after the operation. The patients in the control group received standard treatment and had 30 minutes of quiet rest time every day in the same period. The short-form of McGill Pain Questionnaire (SF-MPQ) was used to evaluate the degree of postoperative chronic pain, and the SF-36 was used to evaluate the midterm quality of life of patients. RESULTS: In terms of the degree of postoperative chronic pain, the score of the pain rating index (PRI) emotional item in the music group was significantly lower than that in the control group. In the evaluation of the postoperative midterm quality of life using the SF-36, the emotional function score in the music group was significantly higher than that in the control group. CONCLUSION: This study preliminarily showed that music therapy can effectively reduce chronic pain and improve midterm quality of life after surgery.


Assuntos
Valva Aórtica/cirurgia , Dor Crônica/terapia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Valva Mitral/cirurgia , Musicoterapia , Dor Pós-Operatória/terapia , Qualidade de Vida , China , Dor Crônica/diagnóstico , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Percepção da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/fisiopatologia , Dor Pós-Operatória/psicologia , Fatores de Tempo , Resultado do Tratamento
20.
J Oral Pathol Med ; 49(6): 505-513, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32531809

RESUMO

BACKGROUND: Burning mouth syndrome (BMS) is a chronic pain disorder affecting the oral cavity. Previous work has shown promising analgesic results of bodily illusions in other chronic pain conditions. The aim of this proof-of-concept, pilot study was to investigate whether bodily illusions reduce pain in BMS patients. METHODS: Nine participants diagnosed with BMS underwent bodily illusions using a MIRAGE-mediated reality system. All participants completed four conditions and performed standardised movements of the tongue. First, a baseline condition was performed while the tongue was viewed at normal size and colour. Then, three conditions were performed in random order: resizing shrink, colour-based (blue tongue) and incongruent movement illusions. During each condition, participants rated overall pain intensity and the intensity of burning pain/sensation on the tongue. RESULTS: There was no difference in overall pain intensity ratings between conditions. However, a significant effect of condition was found for burning pain/sensation of the tongue. The colour illusion significantly reduced burning pain compared with baseline (MD = -12.8, 95% CI -20.7 to -4.8), corresponding to an average pain reduction of 32%. Exploratory analyses showed the colour illusion also significantly reduced pain compared with the shrink illusion (MD = -11.7, 95% CI -22.2 to -1.1). CONCLUSION: Using visual illusions to change tongue colour to blue resulted in significant reductions in burning pain/sensations in BMS patients for the duration of the illusion. This proof-of-concept study suggests that BMS patients may benefit from bodily illusions, and supports additional research using larger samples and more comprehensive control conditions.


Assuntos
Síndrome da Ardência Bucal , Ilusões , Percepção da Dor , Humanos , Dor , Projetos Piloto
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