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1.
Recurso educacional aberto em Inglês | CVSP - Regional | ID: oer-3976

RESUMO

A Doença Arterial Periférica afeta perto de 4% de todos os canadenses com mais de 40 anos e até 20% dos indivíduos com mais de 75 anos, pondo as doenças arteriais de membros inferiores com o sem úlcera, no meio de uma preocupação crescente. Esta preocupação também se extende à dor de difícil manejo, que é um dos principais sintomas desta doença que impacta grandemente a Qualidade de Vida Relacionada à Saúde destes indivíduos e aumenta o custo de tratamento para a sociedade e o sistema de saúde. Neste webinar, o Dr. Kevin Woo da Queen’s University em Kingston (ON, Canadá) apresenta algumas das melhores prácticas clínicas para o manejo da dor isquêmica na Doença Arterial Periférica. O webinar é promovido pelo Programa de Pós-Graduação em Enfermagem na Saúde do Adulto (PROESA) da Escola de Enfermagem da Universidade de São Paulo, e apoiado pelo programa Líderes Emergentes nas Américas (ELAP) do Governo Canadiense e pela Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) do Governo Brasileiro.


Assuntos
Doença Arterial Periférica , Dor , Manejo da Dor
2.
BMC Womens Health ; 21(1): 355, 2021 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627209

RESUMO

BACKGROUND: Endometriosis is a common benign gynecological disease that has the potential to debilitate due to pain and reduced quality of life. Treatment modalities such as hormones and surgery have limitations and do not treat all dimensions of the problems caused by endometriosis, and physical activity (PA) and exercise have been suggested as alternative treatments. Aim of this study was to perform a systematic review and meta-analysis to assess the effect of PA and exercise on endometriosis-associated symptoms. METHODS: Eleven databases were searched systematically. Study selection, quality assessment, and data extraction were carried out by two independent researchers in accordance with PRISMA guidelines. Eligibility criteria were women with diagnosed endometriosis receiving an intervention (PA and/or exercise). The primary outcome was pain intensity, but all outcomes were accepted. RESULTS: This study screened 1045 citations for eligibility. Four interventional studies were identified, of which one showed fatal design flaws and so was excluded. Three studies, two randomized controlled trials (RCT) and one pre-post study with no control group, involving 109 patients were included in a descriptive synthesis. The interventions included flexibility and strength training, cardiovascular fitness, and yoga, and were performed from one to four times per week for a total duration of 8-24 weeks, with or without supervision. Only one study found improvements in pain intensity. One study showed decreases in stress levels. Due to the heterogeneity of the study outcomes and measures, as well as confounding factors, a quantitative meta-analysis could not be performed. CONCLUSION: The effect of PA and exercise as treatments for endometrioses-associated symptoms could not be determined due to significant limitations of the included studies. Future research should be based on RCTs of high methodological quality, measuring and reporting relevant core outcomes such as pain, improvements in symptoms and quality of life, and acceptability and satisfaction from the perspectives of patients. Furthermore, these outcomes need to be measured using reliable and validated tools. TRIAL REGISTRATION NUMBER: CRD42021233138.


Assuntos
Endometriose , Endometriose/complicações , Endometriose/terapia , Exercício Físico , Terapia por Exercício , Feminino , Humanos , Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Zhongguo Zhen Jiu ; 41(10): 1175-9, 2021 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-34628754

RESUMO

To summarize the application value of acupuncture in perioperative stress response. Perioperative acupuncture can not only effectively relieve pain and stress response during operation, but also relieve psychological stress response represented by preoperative anxiety before operation, and regulate adaptive immune response after operation. Acupuncture, as a safe non-drug therapy, shows its core advantage of participating in the multidisciplinary intervention of enhance recovery after surgery (ERAS). The future studies need to explore and evaluate the role of acupuncture during perioperative period from multiple dimensions, and gradually reveal the mechanism of acupuncture while establishing the evidence-based basis for acupuncture during perioperative period.


Assuntos
Terapia por Acupuntura , Acupuntura , Ansiedade , Humanos , Dor , Período Perioperatório
4.
Artigo em Chinês | MEDLINE | ID: mdl-34628822

RESUMO

SAPHO syndrome is a rare disease which affects the bones, joints, and skin. It is often misdiagnosed and treated mistakenly because of various clinical manifestations and general lack of awareness about the disease. The pathogenesis is inadequately understood, as a result, current therapy is empirical and aimed to control inflammatory process and alleviate pain. This paper summarizes the clinical manifestations and diagnosis and treatment scheme of SAPHO syndrome, and presents a case of patient with SAPHO syndrome who was treated in our department for bilateral tonsillectomy due to repeated pharyngalgia and fever for 10 years. Interestingly, the patient is getting better after the operation. The case is reported so as to provide reference for the diagnosis and treatment of SAPHO syndrome.


Assuntos
Síndrome de Hiperostose Adquirida , Tonsilite , Síndrome de Hiperostose Adquirida/diagnóstico , Doença Crônica , Humanos , Dor , Pele , Tonsilite/diagnóstico
5.
Ann Palliat Med ; 10(9): 9725-9731, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628898

RESUMO

BACKGROUND: Bone is among the most common metastasis sites in patients with advanced cancer. Approximately two-thirds of bone metastasis results in pain, the majority of which is moderate to unbearable pain, which seriously affects the quality of life of patients. With the development of ablation techniques, microwave ablation (MWA) has great potential to eliminate the pain caused by bone metastasis. This study aimed to evaluate the efficacy and safety of image-guided (computed tomography-guided) percutaneous MWA for metastatic osseous pain. METHODS: This is a retrospective study involving 18 patients with cancer-related pain caused by osseous or soft tissue metastasis in the First Affiliated Hospital of Soochow University from June 2015 to October 2020. All patients (14 men and 4 women; mean age 60.2 years) underwent image-guided percutaneous palliative MWA. A paired-sample t-test was used to compare the changes in Numeric Rating Scale (NRS) score and dosage of morphine preoperatively and postoperatively (at 24 h, 3 days, and 14 days after MWA). In addition, we assessed the level of pain relief according to the patients' subjective feelings. RESULTS: The paired-samples t-test showed that the NRS score (6.83±0.92 vs. 1.67±0.97, P<0.05) and dosage of morphine (85.56±17.23 vs. 32.78±4.61, P<0.05) were significantly decreased at 3 days after MWA. At 14 days after MWA, the NRS score (6.83±0.92 vs. 0.94±0.87, P<0.05) and dosage of morphine (85.56±17.23 vs. 10.56±8.73, P<0.05) were also markedly decreased. Moreover, according to the patients' subjective feeling, 88.89% patients had pain relief postoperatively, while the remaining patients had no progress. CONCLUSIONS: Image-guided (Computed Tomography-guided) percutaneous MWA can effectively relieve pain, thus improving the quality of life in patients with osseous metastasis. MWA is a feasible, safe, and effective treatment for pain caused by bone metastasis.


Assuntos
Neoplasias Ósseas , Micro-Ondas , Neoplasias Ósseas/radioterapia , Feminino , Humanos , Masculino , Micro-Ondas/uso terapêutico , Pessoa de Meia-Idade , Dor , Qualidade de Vida , Estudos Retrospectivos
6.
Ann Palliat Med ; 10(9): 9810-9819, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628907

RESUMO

BACKGROUND: This study sought to classify the level of quality of life in patients with moderate to severe hand trauma, and explore differences in their potential profile characteristics based on the Patient-Reported Outcomes Measurement Information System (PROMIS). METHODS: This was a survey research. A convenience sampling method was used to investigate 296 patients with moderate to severe hand trauma. A general information questionnaire (which was used to gather general demographic data and disease-related data) and PROMIS-57 were administered form November 2020 to May 2021. A latent profile analysis and Chi square test were conducted to analyze the data. RESULTS: Based on quality of life, patients with moderate to severe hand trauma were divided into the following 3 groups: (I) Group C1: the psychosocial-pain low-impact group (38.9%); (II) Group C2: the psychosocial-moderate-impact severe-pain group (43.9%); and (III) Group C3: the psychosocial-pain high-impact group (17.2%). There were significant differences in the distribution of age, educational level, marital status, occupation, monthly income, medical insurance type, family role, subsequent financial resources, cause of the injury, satisfaction with the appearance of the hand, degree of the injury, and impact of the injury on daily life among patients in the different groups (P<0.05). CONCLUSIONS: The quality of life in patients with moderate to severe hand trauma can be identified to provide precise care.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Humanos , Dor , Inquéritos e Questionários
7.
Br J Community Nurs ; 26(10): 498-509, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34632793

RESUMO

Clinicians are under increasing pressure to provide high-quality patient outcomes at a reduced cost. Increasingly, community staff must acquire knowledge on advanced wound care products to cope with the growing caseload demands. This article describes the use of PolyMem® dressings to reduce pain, inflammation, oedema and bruising and their ability to debride and absorb exudate while providing an optimum healing environment. The PolyMem range includes multifunctional dressings for various painful chronic wounds. This article also presents five case studies with particularly good patient outcomes where PolyMem dressings were the primary dressing. All five patients were holistically assessed to enable consistent evidence-based treatment decisions. In four cases, the new PolyMem Silicone Border dressing was used. The patients found the PolyMem Silicone Border dressing comfortable and gentle on removal even when the skin was extremely fragile. The right dressing used at the right time on the right patient can improve patient outcomes.


Assuntos
Bandagens , Glicerol/uso terapêutico , Dor/prevenção & controle , Poliuretanos/uso terapêutico , Lesão por Pressão/enfermagem , Silicones , Higiene da Pele , Humanos , Satisfação do Paciente , Resultado do Tratamento , Cicatrização
8.
Health Qual Life Outcomes ; 19(1): 237, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627269

RESUMO

BACKGROUND: The Oxford Hip Score is used to evaluate the outcome after total hip arthroplasty. The Oxford Hip Score was developed more than 20 years ago with only some degree of patient involvement. We question if the Oxford Hip Score is still relevant for the present-day total hip artrhoplasty patients. We aimed to determine whether the Oxford Hip Score contains items that are relevant for present-day patients with osteoarthritis undergoing total hip arthroplasty, thus investigating the content validity. METHODS: Patients aged 60-75 years, undergoing total hip arthroplasty for primary osteoarthritis were recruited to participate in focus group interviews preoperatively and at 3 and 12 months after primary total hip arthroplasty. We conducted 6 focus group interviews in which 30 patients participated. The interviews were audio-recorded and transcribed verbatim. Using Interpretative Phenomenological Analysis, we inductively organised the interview transcripts into particular items/themes which we then compared to items in the Oxford Hip Score. RESULTS: We identified 6 general items with 41 sub-items. The 6 general items were pain, walking, physical activities, functional abilities, quality of life and psychological health. We found that items in the Oxford Hip Score were all in some way relevant to the patients but that the Oxford Hip Score lacks several important items relevant for present-day total hip artrhoplasty patients, including several physical activities, functional abilities and certain aspects of quality of life and psychological health. CONCLUSION: We found that the Oxford Hip Score lacks important items for present-day patients in our population. Due to findings regarding several additional items that are not present in the Oxford Hip Score, particularly concerning physical activities and quality of life, we question the content validity of the Oxford Hip Score for a present-day population. Our findings indicate a need for a revision of the Oxford Hip Score.


Assuntos
Artroplastia de Quadril , Atividades Cotidianas , Humanos , Dor , Qualidade de Vida , Resultado do Tratamento
9.
BMC Palliat Care ; 20(1): 154, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641829

RESUMO

BACKGROUND: Up to 85% of people with motor neuron disease (MND) report pain, but whether pain has negative impact on quality of life is unclear. The aim was to study associations between pain, disease severity and individual quality of life (IQOL) in patients with MND. METHODS: In this cross sectional study, 61 patients were recruited from four multidisciplinary teams in Sweden, whereof 55 responded to the pain measure (The Brief Pain Inventory - Short form) and were included in the main analyses. Disease severity was measured with the Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised Version, and individual quality of life was measured with a study-specific version of the Schedule for the Evaluation of Individual Quality of Life - Direct Weighting. RESULTS: Forty-one (74%) of the participants who answered BPI-SF (n = 55) reported pain. Thirty-nine (71%) of those reported pain during the past 24 h. The severity of pain was on average moderate, with eight participants (14%) reporting severe pain (PSI ≥ 7). Satisfaction with IQOL for the entire sample was good (scale 1-7, where 1 equals poor quality of life): median 5, interquartile range (IQR) 2.75 and there was no difference in satisfaction with IQOL between those reporting pain/not reporting pain (median 5, IQR 2/median 5, IQR 3.5, Mann-Whitney U = 249, p = 0.452). There was neither any correlation between pain severity and satisfaction with IQOL, nor between disease severity and satisfaction with IQOL. CONCLUSIONS: The results add to the hypothesis that associations between non-motor symptoms such as pain prevalence and pain severity and IQOL in MND are weak. Pain prevalence was high and the results pointed to that some participants experienced high pain severity, which indicate that pain assessments and pain treatments tailored to the specific needs of the MND population should be developed and scientifically evaluated.


Assuntos
Doença dos Neurônios Motores , Qualidade de Vida , Estudos Transversais , Humanos , Doença dos Neurônios Motores/complicações , Dor , Índice de Gravidade de Doença
10.
J Appl Oral Sci ; 29: e20210089, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34614121

RESUMO

BACKGROUND: Optimal orthodontic force results in maximum rate of tooth movement without tissue damage. Even though starting orthodontic treatment with a thicker archwire may shorten treatment duration, the evidence on the effect of using 0.018-inch NiTi as the first alignment archwire on pulpal blood flow (PBF) status is still scarce. OBJECTIVES: to record PBF changes and pain scores associated with using 0.018-inch NiTi as the first alignment archwire during fixed orthodontic treatment. METHODOLOGY: Patients were selected from subjects attending postgraduate orthodontic teaching clinics at Jordan University of Science and Technology. In total, forty healthy patients who exhibited mild lower arch crowding were included. A split-mouth trial design was used. Each patient received two archwire sizes at one time joined in the midline by crimpable hook and applied in the lower arch. Patients were assigned into one of two groups based on archwire sizes used. Group 1: 0.014-inch and 0.018-inch NiTi (Six males, 14 females aged 19.4±1.33 years) and Group 2: 0.016-inch and 0.018-inch NiTi (Seven males, 13 females aged 19.6±1.45 years). The archwire size group was randomly allocated with a 1:1 allocation ratio. A Laser Doppler Flowmeter was used to measure PBF at different time intervals (T0-T5). Pain scores were recorded using a visual analogue scale (VAS). A repeated measures ANOVA and a post-hoc Bonferroni comparison tests were conducted to examine differences at the different time points before and during orthodontic alignment. RESULTS: For all studied archwire sizes, PBF decreased 20 minutes after their placement. Most PBF changes occurred within 24hours and continued to decrease until 72 hours after archwire placement where the maximum reduction was reached. Eventually, normal values were reverted within 1 month. PBF changes were similar between all alignment - groups. CONCLUSIONS: Initial orthodontic alignment with 0.018-inch NiTi does not cause irreversible changes to pulpal vasculature or produces higher pain scores.


Assuntos
Fios Ortodônticos , Dor , Ligas , Humanos , Estudos Prospectivos
12.
J Med Case Rep ; 15(1): 513, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34657632

RESUMO

BACKGROUND: Plantaris tendinopathy and plantaris-associated Achilles tendinopathy can be responsible for chronic pain in the Achilles tendon midportion, often accompanied by medial tenderness. As conservative treatments are less successful for this patient group, proper diagnosis is important for decision making. This report presents a case with plantaris tendinopathy in a rare (superficial) location. CASE PRESENTATION: This article describes a pain history and treatment timeline of a professional Swedish female soccer player (32 years old, Northern European ethnicity, white) who suffered from sharp pain in the Achilles tendon midportion and tenderness on the medial and superficial side for about 2 years. Conservative treatments, including eccentric exercises, were not successful and, to some extent, even caused additional irritation in that region. Ultrasound showed a wide and thick plantaris tendon located on the superficial side of the Achilles tendon midportion. The patient was surgically treated with local removal of the plantaris tendon. After surgery there was a relatively quick (4-6 weeks) rehabilitation, with immediate weight bearing, gradual increased loading, and return to running activities after 4 weeks. At follow-up at 8 weeks, the patient was running and had not experienced any further episodes of sharp pain during change of direction or sprinting. CONCLUSIONS: The plantaris tendon should be considered as a possible source of Achilles tendon pain. This case study demonstrates that the plantaris tendon can be found in unexpected (superficial) positions and needs to be carefully visualized during clinical and imaging examinations.


Assuntos
Tendão do Calcâneo , Futebol Americano , Futebol , Tendinopatia , Tendão do Calcâneo/diagnóstico por imagem , Tendão do Calcâneo/cirurgia , Adulto , Feminino , Humanos , Dor , Tendinopatia/diagnóstico por imagem
13.
BMC Neurol ; 21(1): 403, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34670504

RESUMO

BACKGROUND: The importance of evaluating the pulpal threshold to electrical stimulation, as a side effect of probable neuropathy in Multiple Sclerosis (MS) patients is a novel issue. This study aimed to investigate electrical pulp test thresholds in MS patients without a history of trigeminal neuralgia compared to healthy individuals. METHODS: Sixty-nine maxillary central incisors, belonging to 34 relapsing-remitting MS patients, and 35 healthy individuals were included in this survey. The MS patients matched for intended variables, were 22-50 years old, had a more than 1-year history of MS, no history of trigeminal neuralgia and/or other neuropathy. The electric pulp sensibility test was performed on all samples. Electric pulp testing (EPT) results were recorded based on the pulp tester's grade that evoked a response. Data were analyzed with paired T-test, Mann-Whitney test, and Spearman correlation (P < 0.05). RESULTS: According to the results of this study, the mean values of response to EPT were 1.2 ± 0.5 and 1.8 ± 0.5 in MS patients and healthy individuals, respectively. The pulpal response to EPT between the two groups was significantly different (P < 0.0001). CONCLUSIONS: MS patients showed a significantly reduced response to the electric pulp test in their maxillary central incisors in comparison to matched healthy persons.


Assuntos
Esclerose Múltipla , Neuralgia do Trigêmeo , Adulto , Estudos de Casos e Controles , Humanos , Incisivo , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Dor , Adulto Jovem
14.
BMC Musculoskelet Disord ; 22(1): 883, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663295

RESUMO

BACKGROUND: The purpose of this study was to investigate the longitudinal postoperative relationship between physical activity, psychosocial factors, and physical function in patients undergoing lumbar spine surgery. METHODS: We enrolled 248 participants undergoing surgery for a degenerative lumbar spine condition. Physical activity was measured using a triaxial accelerometer (Actigraph GT3X) at 6-weeks (6wk), 6-months (6M), 12-months (12M) and 24-months (24M) following spine surgery. Physical function (computerized adaptive test domain version of Patient-Reported Outcomes Measurement Information System) and psychosocial factors (pain self-efficacy, depression and fear of movement) were assessed at preoperative visit and 6wk, 6M, 12M and 24M after surgery. Structural equation modeling (SEM) techniques were utilized to analyze data, and results are represented as standardized regression weights (SRW). Overall SRW were computed across five imputed datasets to account for missing data. The mediation effect of each psychosocial factor on the effect of physical activity on physical function were computed [(SRW for effect of activity on psychosocial factor X SRW for effect of psychosocial factor on function) ÷ SRW for effect of activity on function]. Each SEM model was tested for model fit by assessing established fit indexes. RESULTS: The overall effect of steps per day on physical function (SRW ranged from 0.08 to 0.19, p<0.05) was stronger compared to the overall effect of physical function on steps per day (SRW ranged from non-existent to 0.14, p<0.01 to 0.3). The effect of steps per day on physical function and function on steps per day remained consistent after accounting for psychosocial factors in each of the mediation models. Depression and fear of movement at 6M mediated 3.4% and 5.4% of the effect of steps per day at 6wk on physical function at 12M, respectively. Pain self-efficacy was not a statistically significant mediator. CONCLUSIONS: The findings of this study suggest that the relationship between physical activity and physical function is stronger than the relationship of function to activity. However, future research is needed to examine whether promoting physical activity during the early postoperative period may result in improvement of long-term physical function. Since depression and fear of movement had a very small mediating effect, additional work is needed to investigate other potential mediating factors such as pain catastrophizing, resilience and exercise self-efficacy.


Assuntos
Catastrofização , Exercício Físico , Medo , Humanos , Procedimentos Neurocirúrgicos , Dor
15.
J Oral Facial Pain Headache ; 35(3): 175-198, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34609377

RESUMO

AIMS: To assess the efficacy of nonpharmacologic treatments for burning mouth syndrome (BMS). METHODS: PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were systematically searched. Reference lists from the latest systematic reviews (2015 to 2020) on BMS treatment in the PubMed, Scopus, Web of Science, and Cochrane Library databases were also scrutinized. Randomized controlled trials (RCTs) or clinical controlled trials (CCTs) in English were considered eligible. Trials on photobiomodulation were excluded to avoid redundancy with recent publications. Risk of bias was established through the Cochrane Risk of Bias tool for RCTs and the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool for CCTs. RESULTS: This review included 27 RCTs and 6 open clinical trials (OCTs) describing 14 different nonpharmacologic interventions. Eleven trials experimented with 600 to 800 mg/day of alpha-lipoic acid for 30 to 120 days, with 7 placebo-controlled studies showing significant pain relief. Four trials tested topical and systemic capsaicin for 7 to 30 days, with 2 placebo-controlled studies revealing significant efficacy. Four of the 5 trials testing acupuncture offered favorable evidence of pain relief. Two trials reported significant pain relief after a 2- to 3-month regimen with tongue protectors and showed no difference after aloe vera addition. Short-term pain relief was reported in anecdotal placebo-controlled trials deploying tocopherol, catuama, ultramicronized palmitoylethanolamide, group psychotherapy, cognitive therapy, and repetitive transcranial magnetic stimulation of the prefrontal cortex. Most therapies were safe. CONCLUSION: Evidence was collected from highly biased, short-term, heterogenous studies mainly focused on BMS-related pain, with scarce data on quality of life, psychologic status, dysgeusia, and xerostomia. Long-term effectiveness of nonpharmacologic treatments should be further investigated, with a more rigorous, bias-proof study design.


Assuntos
Terapia por Acupuntura , Síndrome da Ardência Bucal , Síndrome da Ardência Bucal/terapia , Capsaicina , Humanos , Dor , Qualidade de Vida
16.
J Clin Pediatr Dent ; 45(4): 273-277, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34534306

RESUMO

Chronic recurrent multifocal osteomyelitis (CRMO) is an uncommon, aseptic, autoinflammatory condition characterized by multifocal bone lesions with pain, swelling, and frequent exacerbations and remissions. It is noteworthy that these lesions occur without any identifiable etiology or microbiologic finding. The clavicle and metaphyses of the long bones are often involved whereas involvement of the mandible is considered rare. It is usually diagnosed by exclusion of other diseases. As it shares most of its features with the more commonly occurring infective osteomyelitis, patients are often unnecessarily subjected to prolonged courses of antibiotics, serial radiation exposures, and repeated bone biopsies. We present a case of CRMO involving the mandible. Our primary objective is to demonstrate the clinical features of this uncommon disorder, highlighting the radiographic appearance. Familiarity with this condition among radiologists greatly increases the likelihood for early diagnosis and formulating an appropriate treatment plan.


Assuntos
Osteomielite , Antibacterianos/uso terapêutico , Doença Crônica , Humanos , Mandíbula/diagnóstico por imagem , Osteomielite/diagnóstico por imagem , Osteomielite/tratamento farmacológico , Dor , Recidiva
17.
Orv Hetil ; 162(38): 1511-1519, 2021 09 19.
Artigo em Húngaro | MEDLINE | ID: mdl-34537716

RESUMO

Összefoglaló. Az új koronavírusként megismert SARS-CoV-2-fertozés legsúlyosabb szövodményeként a gyulladásos folyamatok jelátvivo molekuláinak elszabadulása - az ún. citokinvihar - kritikus légzési elégtelenséggel társuló akut respirációs diszfunkciós szindrómát vagy többszervi gyulladásos szindrómát okoz. Mostanáig igazolódott, hogy a fertozések legnagyobb részben tünetmentesen vagy enyhe tünetekkel zajlanak. A betegség minden szakaszában elofordulhat enyhe vagy középsúlyos, ritkábban intenzív fájdalom, melyek enyhítésére számos fájdalomcsillapítási lehetoség áll rendelkezésre. A pandémia kezdete óta foglalkoznunk kell a tünetek enyhítésével, akár infektológiai osztályon, akár mutéti ellátás alkalmával. A betegek hazaengedését követoen figyelmet kell fordítanunk az intenzív osztályos ellátás utáni és a COVID-19-et követo tünetek és fájdalmak értékelésére. Idoszeru átfogó összefoglalónkban hangsúlyozzuk a különbözo fájdalomcsillapítók szerepét a COVID-19-fertozéssel összefüggo fájdalommal járó folyamatokban. Orv Hetil. 2021; 162(38): 1511-1519. Summary. As the most severe consequence of the new coronavirus SARS-CoV-2 infection, the cytokine storm - caused by the liberalization of several inflammatory mediators - engenders critical respiratory dysfunction syndrome or multisystem inflammatory syndrome. The most proportion of infections has proven symptomless or with very mild signs of disease so far. Mild, moderate, or rarely intense pain can occur in every phase of the disease, for the treatment of which more than a few analgesic possibilities are readily available. From the start of the pandemic, we have been concerning to ameliorate the symptoms, in either the department of infectology, or operating suites. The post-intensive care pain and post-COVID symptoms should be evaluated and treated after discharge. In this timely and comprehensive article, the role and importance of different analgesics are articulated regarding the COVID-associated painful conditions. Orv Hetil. 2021; 162(38): 1511-1519.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Dor , Manejo da Dor , Pandemias
18.
BMC Health Serv Res ; 21(1): 985, 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34537025

RESUMO

BACKGROUND: Cancer care can negatively impact children's subjective well-being. In this research, well-being refers to patients' self-perception and encompasses their hospital and care delivery assessment. Playful strategies can stimulate treatment compliance and have been used to provide psychosocial support and health education; they can involve gamification, virtual reality, robotics, and healthcare environments. This study aims to identify how playfulness, whenever applicable, can be used as a strategy to improve the subjective well-being of pediatric cancer patients in the Brazilian Unified Health System. METHODS: Sixteen volunteers with experience in pediatric oncology participated in the study. They were physicians, psychologists, child life specialists, and design thinking professionals. They engaged in design thinking workshops to propose playful strategies to improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Data collection consisted of participatory observations. All activities were video recorded and analyzed through Thematic Analysis. The content generated by the volunteers was classified into two categories: impact of cancer care on children's self-perception and children's perceptions of the hospital and the care delivery. RESULTS: Volunteers developed strategies to help children deal with time at the hospital, hospital structure, and care delivery. Such strategies are not limited to using playfulness as a way of "having fun"; they privilege ludic interfaces, such as toys, to support psychosocial care and health education. They aim to address cancer and develop communication across families and staff in a humanized manner, educate families about the disease, and design children-friendly environments. Volunteers also generated strategies to help children cope with perceptions of death, pain, and their bodies. Such strategies aim to support understanding the meaning of life and death, comprehend pain beyond physicality, help re-signify cancer and children's changing bodies, and give patients active voices during the treatment. CONCLUSIONS: The paper proposes strategies that can improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Such strategies connect children's experiences as inpatients and outpatients and may inform the implementation of similar projects in other developing countries.


Assuntos
Família , Neoplasias , Adaptação Psicológica , Criança , Comunicação , Humanos , Neoplasias/terapia , Dor
19.
Eur J Paediatr Dent ; 22(3): 230-236, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34544253

RESUMO

AIM: To determine the effect of active distraction when playing PlayStation® video games, compared to passive distraction when watching a cartoon with audiovisual eyeglasses, on parental perception of patients' anxiety, and children's anxiety, pain, behaviour and heart rate during restorative procedures in paediatric dentistry. MATERIALS AND METHODS: Study design: Randomised crossover clinical trial. There were 34 patients in the cartoon film group (passive distraction) and 34 in the Playstation® video game group (active distraction), aged 6-8 years, who required a minimum of 2 visits for restorative treatment. Rimax® iVision 5.0 eyeglasses were used in both groups. Parental perception of patients' anxiety (Modified Corah Dental Anxiety Scale), and children's anxiety (Venham Picture Test), pain (Wong-Baker Faces Scale), behaviour (Frankl Scale) and heart rate were evaluated at each of the treatment visits. Preference for and satisfaction with the audiovisual product were also assessed. RESULTS: There were significant differences in self-reported pain between control (P=0.016) and experimental (P=0.013) visits in both groups, with lower values in the Playstation® video game group. No significant differences were found (P>0.05) in the other variables evaluated with the use of active distraction. A significant increase in heart rate was recorded at each treatment visit (P=0.0001) when the anaesthetic was injected. All the patients wanted to continue watching or playing their chosen cartoon or Playstation® video game during subsequent visits. CONCLUSION: The use of PlayStation® video games for active audiovisual distraction, compared with passive distraction with a cartoon, improved self-reported pain but did not reduce parents' perception of patients' anxiety, pain, global behaviour, or heart rate. Both distraction methods were accepted by paediatric patients.


Assuntos
Anestesia Dentária , Odontopediatria , Ansiedade , Criança , Humanos , Dor , Medição da Dor
20.
N C Med J ; 82(5): 312-320, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34544765

RESUMO

BACKGROUND Sickle cell disease (SCD) is a complex disease associated with many complications and a shortened lifespan. In 2016, the National Heart, Lung and Blood Institute funded 8 centers in the United States to form the Sickle Cell Disease Implementation Consortium, with the goal of improving SCD care. The aim of our study was to describe SCD self-efficacy, pain interference, and barriers to care from the perspective of persons with SCD in the North Carolina center.METHODS Persons with SCD, aged 15 and older were recruited from a large SCD center in North Carolina. Surveys, focus groups, and interviews were completed.RESULTS Fifty-one people completed a survey, and 14 people completed an interview or focus group. Barriers identified in the survey included self-care barriers, misconceptions related to hydroxyurea (an oral medication that reduces rates of pain crisis), limited provider knowledge, and stigma. Concerning self-efficacy, participants reported that they were able to manage their pain symptoms most of the time. Pain interfered most with the ability to participate in social and day-to-day activities.Common themes from the focus groups and interviews included misconceptions about hydroxyurea, pain, provider knowledge, stigma, co-management, transportation, and insurance. Recommendations to improve care included the use of case managers, utilization of treatment guidelines, individualized pain protocols, and effective co-management by providers.LIMITATIONS Participants were recruited from 1 SCD center and may not be representative of the entire SCD population in North Carolina.CONCLUSIONS Participants described many perceived barriers to care, and their responses suggest a need for improvements in patient hydroxyurea education, provider knowledge, and care coordination.


Assuntos
Anemia Falciforme , Anemia Falciforme/tratamento farmacológico , Humanos , Hidroxiureia , Determinação de Necessidades de Cuidados de Saúde , North Carolina , Dor , Estados Unidos
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