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Park H, Lee H. Effects of hand-press pellet on pain and daily life of elders with chronic lower back pain: randomized controlled trial. BMC Complement Med Ther 2024; 24:182. [PMID: 38702676 PMCID: PMC11067148 DOI: 10.1186/s12906-024-04481-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND For elderly people with chronic lower back pain who need long-term management, there is a need for a nursing intervention study that is effective, is easy to perform, and applies complementary and alternative therapies to manage pain without repulsion. Hand pressure therapy is a treatment indigenous to Korea used to reduce pain and improve functions of daily life by applying acupuncture, pressure sticks, and moxibustion to parts of the hand as they relate to parts of the body. This research is to identify the effects of pellet pressed on the hand on pain and the daily lives of elders with chronic lower back pain (CLBP). METHODS The hand pressed-pellet intervention period was six weeks long. Twenty-seven patients in the intervention group and twenty-four patients in the placebo control group were recruited from elderly over sixty-five who used welfare centers. In the intervention group, hand pressed-pellet therapy was conducted in eleven acupressure response zones related to CLBP, and the placebo control group was provided with similar therapy and zones, but unrelated to CLBP. The research tool measured the intensity of CLBP using the Visual Analogue Scale (VAS), the Korean Owestry Disability Index (K-ODI), which are subjective indicators, and the Compact Digital Algometer, which is an objective indicator. RESULT The pain intensity (VAS) measured after six weeks of hand pressed-pellet therapy showed significant difference between the two groups compared to their pain before the experiment (F = 60.522, p < .001). There was a significant difference between the two groups in the pain pressure threshold using pressure statistics (F = 8.940, p < .001), and in CLBP dysfunction evaluation index (K-ODI) after applying pressed pellet to the hand (Z = - 3.540, p < .001). CONCLUSION Subjective indicators were measured to verify the effect of hand pressed-pellet therapy on CLBP, and the result confirmed that the hand pressed-pellet therapy was effective in alleviating CLBP. TRIAL REGISTRATION The study was registered retrospectively with reference number KCT0008024 on 23/12/2022.
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Affiliation(s)
- Hyojung Park
- Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, South Korea.
| | - Hyejin Lee
- Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, South Korea
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Holmes SD, Resnick B, Galik E, Levy S, Scherr S, O'Brien E. Examining pain, function, behavioral symptoms and associations with engagement in meaningful activity for residents with dementia in assisted living. Aging Ment Health 2024:1-7. [PMID: 38651198 DOI: 10.1080/13607863.2024.2342963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES The purpose of this study was to examine factors associated with engagement in meaningful activity among residents with dementia in assisted living. We hypothesized that greater functional independence, less pain, and lower behavioral and psychological symptom severity would be associated with higher engagement in meaningful activity after controlling for residents' age, gender, comorbidities, and cognition. Understanding factors associated with engagement in meaningful activity can help to inform strategies for optimizing engagement among residents with dementia in assisted living. METHOD This descriptive study used baseline data from a randomized controlled trial, Meaningful Activity for Managing Behavioral Symptoms of Distress (MAC-4-BSD). Linear regression was used to examine factors associated with engagement in meaningful activity. RESULTS A total of 71 residents from 5 assisted living settings were included in the sample. Most participants were female (n = 52, 73%), White (n = 62, 87%), and mean age was 85 years old (SD = 8.2). Controlling for age, gender, comorbidities, and cognition, pain was significantly associated with engagement in meaningful activity (b= -2.09, p < 0.05). There were no associations found between function and behavioral symptoms with engagement in meaningful activity. CONCLUSION Findings from this study show that pain is a significant factor that is negatively associated with residents' engagement in meaningful activity. Ongoing research is needed to help improve pain management for residents with dementia in assisted living and support their engagement in meaningful activity.
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Affiliation(s)
- Sarah D Holmes
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Barbara Resnick
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Elizabeth Galik
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Sorah Levy
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Susan Scherr
- Berman School of Nursing and Health Professions, Stevenson University, Owings Mills, MD, USA
| | - Erin O'Brien
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
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3
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Homan M, Rath SUL, Green VLS, Hutson J, Myers MJ, Guggenheimer JD. Examining the Impact of Far-Infrared Technology on Quality of Life in Older Adults. Int J Aging Hum Dev 2024:914150241231188. [PMID: 38532698 DOI: 10.1177/00914150241231188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
The purpose of this study was to examine the effects of far-infrared (FIR) heat on quality of life (QOL) in older adults. Participants were assigned to either a convective heat group (CON) or a convective and FIR group. Participants received six, 30-min heat sessions over the course of three weeks. Pre- and post-assessments included physical measures such as range of motion, gait speed, Timed Up and Go, and hand grip strength. Standardized questionnaires were used to determine pain severity and its interference with daily life, and the impact pain had on overall QOL. Pain severity was significantly reduced (from 3.31 to 2.5, p < .05) in the FIR group from pre-to-post, and pain interference was significantly reduced (from 1.26 to 0.43, p < .05) in the CON group from pre-to-post testing. Findings suggest that heat therapy was successful in reducing pain over time.
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Dong HJ, Peolsson A, Johansson MM. Effects of proactive healthcare on pain, physical and activities of daily living functioning in vulnerable older adults with chronic pain: a pragmatic clinical trial with one- and two-year follow-up. Eur Geriatr Med 2024:10.1007/s41999-024-00952-9. [PMID: 38446408 DOI: 10.1007/s41999-024-00952-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/24/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE To investigate the changes in pain, physical and activities of daily living (ADL) functioning in vulnerable older adults with chronic pain after proactive primary care intervention. METHODS This study was embedded in a prospective, pragmatic, matched-control multicenter trial at 19 primary care practices in Sweden, with proactive medical and social care (Intervention Group, IG, n = 134) in comparison with usual care (Control Group, CG, n = 121). Patients with chronic pain, defined as pain experienced longer than 3 months, were included in this subgroup analysis. Data on pain aspects, physical and ADL functioning were collected in the questionnaires at baseline, one- and two-year follow-up (FU-1 and FU-2). Data on prescribed pain medications was collected by local health authorities. RESULTS Mean age was 83.0 ± 4.7 years with almost equal representation of both genders. From baseline until FU-2, there were no significant within-group or between-group changes in pain intensity. Small adjustments of pain medication prescriptions were made in both groups. Compared to FU-1, the functional changes were more measurable at FU-2 as fewer participants had impaired physical functioning in IG (48.4%) in comparison to CG (62.6%, p = 0.027, Effect Size φ = 0.14). Higher scores of ADL-staircase (more dependent) were found in both groups (p < 0.01, Effect Size r = 0.24 in CG and r = 0.16 in IG). CONCLUSION Vulnerable older adults with chronic pain seemed to remain physical and ADL functioning after proactive primary care intervention, but they may need tailored strategies of pain management to improve therapeutic effects. TRIAL REGISTRATION ClinicalTrials.gov 170608, ID: NCT03180606.
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Affiliation(s)
- Huan-Ji Dong
- Pain and Rehabilitation Centre, Division of Praevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, University Hospital, Linköping University, 581 85, Linköping, Sweden.
| | - Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linköping University, Linköping, Sweden
| | - Maria M Johansson
- Department of Activity and Health, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Acute Internal Medicine and Geriatrics, Linköping University, Linköping, Sweden
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5
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Saragih ID, Suarilah I, Saragih IS, Lin YK, Lin CJ. Efficacy of serious games for chronic pain management in older adults: A systematic review and meta-analysis. J Clin Nurs 2024; 33:1185-1194. [PMID: 38291564 DOI: 10.1111/jocn.17012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/14/2023] [Accepted: 01/07/2024] [Indexed: 02/01/2024]
Abstract
AIMS AND OBJECTIVES To synthesise and appraise the evidence of the efficacy of serious games in reducing chronic pain among older adults. BACKGROUND Chronic pain in older adults generally results in a substantial handicap due to decreased mobility, exercise avoidance and various concerns that affect their overall quality of life. While serious games have been widely used as a pain management approach, no reviews have thoroughly examined their efficacy for chronic pain management in older adult populations. DESIGN A systematic review and meta-analysis. METHODS The CINAHL, the Cochrane Library, Embase, Medline, PubMed and Web of Science databases were comprehensively searched to find articles published from their inception until 17 April 2023. RoB-2 was used to assess the risk of bias in the included studies. The efficacy of serious games for pain management in older individuals was investigated using pooled standardised mean differences (SMDs) in pain reduction using a random effect model. RESULTS The meta-analysis comprised nine randomised controlled trials that included 350 older adult patients with pain. Serious games effectively alleviated pain in this group (pooled SMD = -0.62; 95% confidence interval: -1.15 to -0.10), although pain-related disability and fear require further investigation. CONCLUSIONS Serious games tended to effectively reduce pain in this older adult group; however, due to a lack of randomised controlled trials, the analysis found lower effectiveness in reducing pain-related disability and fear. Further studies are accordingly required to confirm these findings. RELEVANCE TO CLINICAL PRACTICE The findings of the study emphasise the importance of serious games to increase the motivation of older adults to exercise as one of the safe and extensively used pain management strategies. Serious games that effectively reduce chronic pain in older adults are characterised as consisting of diverse physical activities delivered through consoles, computer-based activities and other technologies. PATIENT OR PUBLIC CONTRIBUTIONS Serious games are recommended as being potentially useful and practical for reducing pain in older adults.
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Affiliation(s)
| | - Ira Suarilah
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | | | - Yen-Ko Lin
- Department of Medical Humanities and Education, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Medical Education and Humanizing Health Professional Education, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Ju Lin
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Chen J, Wu Y, Li L, He F, Zou B, Zhuang Y, Tuersun Y, Yang J, Wu F, Kan Y, Lyu K, Lu Y, Ming WK, Sun X, Wang D. How is family health related to health-related quality of life among middle-aged and older adults in rural China? A cross-sectional study. Int J Older People Nurs 2024; 19:e12605. [PMID: 38374792 DOI: 10.1111/opn.12605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 12/30/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is unequal between countries and regions, and the emphasis on HRQOL of populations of low-income countries and regions is unprecedented. OBJECTIVES To examine the association between family health and HRQOL among middle-aged and older adults in rural China, and determine whether this association differs by age, gender and chronic disease subgroup. METHODS Cross-sectional survey carried out from July to September 2021. The participants were 1059 people aged 46 and over living in rural China. We used the European Quality of Life Five Dimension Five Level (EQ-5D-5L) and Family Health Scale-Short Form (FHS-SF) to assess health-related quality of life (HRQOL) and family health, respectively. RESULTS The mean EQ-VAS was 75.66, the mean EQ index score was 0.92, and the mean FHS was 37.90 in rural middle-aged and older adults. After Bonferroni correction, generalised linear regression models showed that FHS was significantly associated with the EQ-VAS (β = 0.829; 95% confidence interval [CI]: 0.660 to 0.997; p < .001) and the EQ index score (β = 0.003; 95%CI: 0.001 to 0.004; p < .001). Binary logistic regression models showed that FHS was associated with three dimensions of HRQOL (mobility, self-care and usual activities) (p < .01). Based on subgroup analyses, the effect of FHS on EQ-VAS and the EQ index score was significant in three subgroups after Bonferroni correction (p < .01), but the association between FHS and the dimensions of HRQOL differed by age, gender and chronic disease group (p > .01). CONCLUSIONS This study is the first to explore that family health and its dimensions are significant positive predictors of HRQOL among middle-aged and older adults in rural China. Family-based measures may have more potential and value because better family health significantly improves HRQOL. IMPLICATIONS FOR PRACTICE In the health strategy, the government and primary health care workers should include family health as an indicator and assess it before and after the implementation of the strategy.
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Affiliation(s)
- Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
- Institute of Health Management, Southern Medical University, Guangzhou, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Lehuan Li
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Feiying He
- Southern Medical University, Guangzhou, China
| | - Biqing Zou
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Yishan Zhuang
- School of Public Health, Southern Medical University, Guangzhou, China
| | | | - Jiao Yang
- School of Public Health, Capital Medical University, Beijing, China
| | - Fangjing Wu
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Yifan Kan
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Ke Lyu
- School of Public Health, China Medical University, Shenyang, China
| | - Yefeng Lu
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
- Institute of Health Management, Southern Medical University, Guangzhou, China
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7
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Djurišić M. Immune receptors and aging brain. Biosci Rep 2024; 44:BSR20222267. [PMID: 38299364 PMCID: PMC10866841 DOI: 10.1042/bsr20222267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/08/2024] [Accepted: 01/29/2024] [Indexed: 02/02/2024] Open
Abstract
Aging brings about a myriad of degenerative processes throughout the body. A decrease in cognitive abilities is one of the hallmark phenotypes of aging, underpinned by neuroinflammation and neurodegeneration occurring in the brain. This review focuses on the role of different immune receptors expressed in cells of the central and peripheral nervous systems. We will discuss how immune receptors in the brain act as sentinels and effectors of the age-dependent shift in ligand composition. Within this 'old-age-ligand soup,' some immune receptors contribute directly to excessive synaptic weakening from within the neuronal compartment, while others amplify the damaging inflammatory environment in the brain. Ultimately, chronic inflammation sets up a positive feedback loop that increases the impact of immune ligand-receptor interactions in the brain, leading to permanent synaptic and neuronal loss.
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Affiliation(s)
- Maja Djurišić
- Departments of Biology, Neurobiology, and Bio-X, Stanford University, Stanford, CA 94305, U.S.A
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Siaton BC, Hogans BB, Frey-Law LA, Brown LM, Herndon CM, Buenaver LF. Pain, comorbidities, and clinical decision-making: conceptualization, development, and pilot testing of the Pain in Aging, Educational Assessment of Need instrument. FRONTIERS IN PAIN RESEARCH 2024; 5:1254792. [PMID: 38455875 PMCID: PMC10918012 DOI: 10.3389/fpain.2024.1254792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/26/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Pain is highly prevalent in older adults and often contextualized by multiple clinical conditions (pain comorbidities). Pain comorbidities increase with age and this makes clinical decisions more complex. To address gaps in clinical training and geriatric pain management, we established the Pain in Aging-Educational Assessment of Need (PAEAN) project to appraise the impacts of medical and mental health conditions on clinical decision-making regarding older adults with pain. We here report development and pilot testing of the PAEAN survey instrument to assess clinician perspectives. Methods Mixed-methods approaches were used. Scoping review methodology was applied to appraise both research literature and selected Medicare-based data. A geographically and professionally diverse interprofessional advisory panel of experts in pain research, medical education, and geriatrics was formed to advise development of the list of pain comorbidities potentially impacting healthcare professional clinical decision-making. A survey instrument was developed, and pilot tested by diverse licensed healthcare practitioners from 2 institutions. Respondents were asked to rate agreement regarding clinical decision-making impact using a 5-point Likert scale. Items were scored for percent agreement. Results Scoping reviews indicated that pain conditions and comorbidities are prevalent in older adults but not universally recognized. We found no research literature directly guiding pain educators in designing pain education modules that mirror older adult clinical complexity. The interprofessional advisory panel identified 26 common clinical conditions for inclusion in the pilot PAEAN instrument. Conditions fell into three main categories: "major medical", i.e., cardio-vascular-pulmonary; metabolic; and neuropsychiatric/age-related. The instrument was pilot tested by surveying clinically active healthcare providers, e.g., physicians, nurse practitioners, who all responded completely. Median survey completion time was less than 3 min. Conclusion This study, developing and pilot testing our "Pain in Aging-Educational Assessment of Need" (PAEAN) instrument, suggests that 1) many clinical conditions impact pain clinical decision-making, and 2) surveying healthcare practitioners about the impact of pain comorbidities on clinical decision-making for older adults is highly feasible. Given the challenges intrinsic to safe and effective clinical care of older adults with pain, and attendant risks, together with the paucity of existing relevant work, much more education and research are needed.
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Affiliation(s)
- Bernadette C. Siaton
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
- Geriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD, United States
| | - Beth B. Hogans
- Geriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD, United States
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Laura A. Frey-Law
- Department of Physical Therapy and Rehabilitative Science, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Lana M. Brown
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
| | - Christopher M. Herndon
- Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, IL, United States
- Department of Family and Community Medicine, St. Louis University School of Medicine, St. Louis, MO, United States
| | - Luis F. Buenaver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
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You J, Shin YK, Seol GH. Alleviating effect of lavender (Lavandula angustifolia) and its major components on postherpetic pain: a randomized blinded controlled trial. BMC Complement Med Ther 2024; 24:54. [PMID: 38267936 PMCID: PMC10807075 DOI: 10.1186/s12906-024-04362-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Postherpetic neuralgia (PHN) causes severe pain which can lead to decreased quality-of-life. This study aimed to evaluate the effects of inhalation of lavender (Lavandula angustifolia) oil and its major components (linalool and linalyl acetate) on the pain in patients with PHN. METHODS This study was performed at an outpatient clinic. Sixty-four patients with postherpetic neuralgia were randomly allocated to a control group (almond oil) or one of three experimental groups (lavender oil, linalool, or linalyl acetate diluted in almond oil at concentration of 1% v/v), and the participants inhaled the aroma by natural breathing. Quality, severity, and intensity of pain were measured before and after the intervention. RESULTS Six patients discontinued the intervention for personal reasons; hence, data from 58 patients were analyzed (control group, n = 14; 1% lavender oil group, n = 15; 1% linalool, n = 15; 1% linalyl acetate, n = 14). Reduction in sensory pain was greater in the 1% lavender oil group, 1% linalool group, and 1% linalyl acetate group than in the control group (all P < 0.001). Reduction in affective pain was greater in the 1% lavender group (P < 0.001) and the 1% linalool group (P = 0.007) than in the control group. Decreases in pain severity and intensity were significantly greater in all three intervention groups than in the control group. CONCLUSIONS Inhalation of lavender oil and its major volatile components effectively reduced the quality, severity, and intensity of postherpetic pain, suggesting that lavender oil, linalool, and linalyl acetate may each be an effective intervention for reducing pain in patients with postherpetic neuralgia. TRIAL REGISTRATION This study was retrospectively registered on the Clinical Research Information Service. REGISTRATION NUMBER KCT0007772, first registration 06/10/2022.
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Affiliation(s)
- Jiyeong You
- Department of Basic Nursing Science, College of Nursing, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - You Kyoung Shin
- Department of Basic Nursing Science, College of Nursing, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Geun Hee Seol
- Department of Basic Nursing Science, College of Nursing, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
- BK21 FOUR Program of Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, Republic of Korea.
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Mookerjee N, Schmalbach N, Antinori G, Thampi S, Windle-Puente D, Gilligan A, Huy H, Andrews M, Sun A, Gandhi R, Benedict W, Chang A, Sanders B, Nguyen J, Keesara MR, Aliev J, Patel A, Hughes I, Millstein I, Hunter K, Roy S. Association of Risk Factors and Comorbidities With Chronic Pain in the Elderly Population. J Prim Care Community Health 2024; 15:21501319241233463. [PMID: 38366930 PMCID: PMC10874592 DOI: 10.1177/21501319241233463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/19/2024] Open
Abstract
INTRODUCTION/OBJECTIVE Chronic pain disorders affect about 20% of adults in the United States, and it disproportionately affects individuals living in the neighborhoods of extreme socioeconomic disadvantage. In many instances, chronic pain has been noted to arise from an aggregation of multiple risk factors and events. Therefore, it is of importance to recognize the modifiable risk factors. The aim of this study was to investigate the comorbid medical conditions and risk factors associated with chronic pain disorders in patients aged 65 years and older. METHODS Our team retrospectively reviewed medical records of elderly patients (65 years and older) who were evaluated in our outpatient medicine office between July 1, 2020 and June 30, 2021 for acute problems, management of chronic medical problems, or well visits. We divided our patients into a group who suffered from chronic pain disorder, and another group who did not have chronic pain disorder. The association of variables were compared between those groups. RESULTS Of the 2431 patients, 493 (20.3%) had a chronic pain disorder. A higher frequency of females in the group with chronic pain disorder was found compared to the group without a chronic pain disorder (60.6% vs 55.2%; P = .033). The mean ages between the two groups were similar in the group with a chronic pain disorder compared to the group without (76.35 ± 7.5 year vs 76.81 ± 7.59 year; P = .228). There were significant associations of certain comorbidities in the group with a chronic pain disorder compared to the group without a chronic pain disorder, such as depression (21.9% vs 15.2%; P < .001), anxiety (27.0% vs 17.1%; P < .001), chronic obstructive pulmonary disease (8.7% vs 6.1%; P = .036), obstructive sleep apnea (16.8% vs 11.6%; P = .002), gastroesophageal reflux disease (40.8% vs 29.0%; P < .001), osteoarthritis (49.3% vs 26.1%; P < .001), other rheumatologic diseases (24.9% vs 19.4%; P = .006), and peripheral neuropathy (14.4% vs 5.3%; P < .001). CONCLUSION Female sex, depression, anxiety, chronic obstructive pulmonary disease, obstructive sleep apnea, gastroesophageal reflux disease, osteoarthritis, other rheumatologic diseases, and peripheral neuropathy were significantly associated with chronic pain disorder in elderly patients, while BMI was not associated with chronic pain disorder.
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Affiliation(s)
- Neil Mookerjee
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | | | | | | | - Amy Gilligan
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ha Huy
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Megha Andrews
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Angela Sun
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Roshni Gandhi
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Austin Chang
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ben Sanders
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Justin Nguyen
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Janet Aliev
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Aneri Patel
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Isaiah Hughes
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ian Millstein
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Krystal Hunter
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Satyajeet Roy
- Cooper Medical School of Rowan University, Camden, NJ, USA
- Cooper University Health Care, Camden, NJ, USA
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11
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Aldanyowi SN. Novel Techniques for Musculoskeletal Pain Management after Orthopedic Surgical Procedures: A Systematic Review. Life (Basel) 2023; 13:2351. [PMID: 38137952 PMCID: PMC10744474 DOI: 10.3390/life13122351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Effective postoperative pain management is critical for recovery after orthopedic surgery, but often remains inadequate despite multimodal analgesia. This systematic review synthesizes evidence on innovative modalities for enhancing pain control following major orthopedic procedures. Fifteen randomized controlled trials and comparative studies evaluating peripheral nerve blocks, local anesthetic infiltration, cryotherapy, transcutaneous electrical stimulation, adjunct medications, and other techniques are included. Thematic analysis reveals that peripheral nerve blocks and local anesthetic infiltration consistently demonstrate reduced pain scores, opioid consumption, and side effects versus conventional analgesia alone. Oral multimodal medications also show promise as part of opioid-sparing regimens. Adjunctive approaches like cryotherapy, music, and dexmedetomidine require further research to optimize protocols. Despite promising innovations, critical knowledge gaps persist regarding comparative effectiveness, optimal interventions and dosing, combination strategies, cost-effectiveness, and implementation. High-quality randomized controlled trials using standardized protocols are essential to guide the translation of enhanced multimodal regimens into clinical practice. This review provides a framework for pursuing research priorities and advancing evidence-based postoperative pain management across orthopedic surgeries.
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Affiliation(s)
- Saud N Aldanyowi
- Orthopedic Surgery, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia
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12
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Webber SC, Liu Y, Jiang D, Ripat J, Nowicki S, Tate R, Barclay R. Verification of a comprehensive framework for mobility using data from the Canadian Longitudinal Study on Aging: a structural equation modeling analysis. BMC Geriatr 2023; 23:823. [PMID: 38066452 PMCID: PMC10704626 DOI: 10.1186/s12877-023-04566-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Mobility within and between life spaces is fundamental for health and well-being. Our objective was to verify a comprehensive framework for mobility. METHODS This was a cross-sectional study. We used structural equation modeling to estimate associations between latent factors with data from the Canadian Longitudinal Study on Aging for participants 65-85 years of age (65+, n = 11,667) and for adults with osteoarthritis (OA) aged 45-85 (n = 5,560). Latent factors included life space mobility, and physical, psychosocial, environmental, financial, and cognitive elements. Personal variables (age, sex, education) were covariates. RESULTS The models demonstrated good fit (65+: CFI = 0.90, RMSEA (90% CI) = 0.025 (0.024, 0.026); OA: CFI = 0.90, RMSEA (90% CI) = 0.032 (0.031, 0.033)). In both models, better psychosocial and physical health, and being less afraid to walk after dark (observed environmental variable) were associated with greater life space mobility. Greater financial status was associated with better psychosocial and physical health. Higher education was related to better cognition and finances. Older age was associated with lower financial status, cognition, and physical health. Cognitive health was positively associated with greater mobility only in the 65 + model. Models generated were equivalent for males and females. CONCLUSIONS Associations between determinants described in the mobility framework were verified with adults 65-85 years of age and in an OA group when all factors were considered together using SEM. These results have implications for clinicians and researchers in terms of important outcomes when assessing life space mobility; findings support interdisciplinary analyses that include evaluation of cognition, depression, anxiety, environmental factors, and community engagement, as well as physical and financial health. Public policies that influence older adults and their abilities to access communities beyond their homes need to reflect the complexity of factors that influence life space mobility at both individual and societal levels.
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Affiliation(s)
- Sandra C Webber
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, R106-771 McDermot Ave, Winnipeg, MB, R3E 0T6, Canada.
| | - Yixiu Liu
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Depeng Jiang
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Jacquie Ripat
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Scott Nowicki
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Robert Tate
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, R106-771 McDermot Ave, Winnipeg, MB, R3E 0T6, Canada
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Figueiredo T, Midão L, Sampaio R, Carrilho J, Coelho C, Cerullo G, Di Paola A, Carfì A, Onder G, Costa E. Managing Non-Cancer Chronic Pain in Frail Older Adults: A Pilot Study Based on a Multidisciplinary Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7150. [PMID: 38131702 PMCID: PMC10742826 DOI: 10.3390/ijerph20247150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
Considering the multidimensionality of chronic pain, it is crucial to develop comprehensive strategies for its effective management. However, establishing well-defined, evidence-based guidelines for such approaches remains challenging. To overcome this, we present the finding from a 4-month intervention to enhance the management of non-cancer chronic pain in older adults with pre-frailty and frailty. The intervention's core elements comprised a multidisciplinary individualized plan, a case manager, and patient education. This pilot study involved 22 participants (≥65 years). It assessed changes in pain frequency and intensity (pain scale), frailty (Fried frailty phenotype criteria), and medication adherence (Brief Adherence Rating Scale) before and after the 4-month intervention. The results were encouraging: pain frequency and intensity and frailty score tended to decrease, and medication adherence showed significant improvement. This preliminary small-scale pilot study provides a foundation for further research and for exploring the potential scalability of this multidisciplinary patient-centred intervention.
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Affiliation(s)
- Teodora Figueiredo
- UCIBIO—Applied Molecular Biosciences Unit, Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (T.F.); (L.M.); (J.C.); (C.C.)
- Porto4Ageing—Competences Centre on Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Luís Midão
- UCIBIO—Applied Molecular Biosciences Unit, Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (T.F.); (L.M.); (J.C.); (C.C.)
- Porto4Ageing—Competences Centre on Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
| | - Rute Sampaio
- Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Joana Carrilho
- UCIBIO—Applied Molecular Biosciences Unit, Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (T.F.); (L.M.); (J.C.); (C.C.)
- Porto4Ageing—Competences Centre on Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Constantino Coelho
- UCIBIO—Applied Molecular Biosciences Unit, Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (T.F.); (L.M.); (J.C.); (C.C.)
- Porto4Ageing—Competences Centre on Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Giovanni Cerullo
- Palliative Care, Centro Hospitalar Universitário do Algarve, 8000-386 Algarve, Portugal;
| | | | - Angelo Carfì
- Fondazione Policlinico Gemelli IRCCS, 00168 Rome, Italy (A.C.)
| | - Graziano Onder
- Fondazione Policlinico Gemelli IRCCS, 00168 Rome, Italy (A.C.)
- Department of Geriatric and Orthopedic Sciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Elísio Costa
- UCIBIO—Applied Molecular Biosciences Unit, Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (T.F.); (L.M.); (J.C.); (C.C.)
- Porto4Ageing—Competences Centre on Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
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Chen L, Qin Q, Huang P, Cao F, Yin M, Xie Y, Wang W. Chronic pain accelerates cognitive impairment by reducing hippocampal neurogenesis may via CCL2/CCR2 signaling in APP/PS1 mice. Brain Res Bull 2023; 205:110801. [PMID: 37931808 DOI: 10.1016/j.brainresbull.2023.110801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
Patients with chronic pain often have cognitive impairment; this is especially true in elderly patients with neurodegenerative diseases such as Alzheimer's disease (AD), but the mechanism underlying this association remains unclear. This was addressed in the present study by investigating the effect of chronic neuropathic pain on hippocampal neurogenesis and cognitive impairment using amyloid precursor protein/presenilin 1 (APP/PS1) double transgenic mice subjected to spared-nerve injury (SNI). The Von Frey test was performed to determine the mechanical threshold of mouse hind limbs after SNI. The Morris water maze test was used to evaluate spatial learning and memory. Doublecortin-positive (DCX+), 5-bromo-2'-deoxyuridine (BrdU)+, BrdU+/neuronal nuclei (NeuN)+, and C-C motif chemokine ligand 2 (CCL2)+ neurons in the dentate gyrus of the hippocampus were detected by immunohistochemistry and immunofluorescence analysis. CCL2 and C-C chemokine receptor type 2 (CCR2) protein levels in the mouse hippocampus were analyzed by western blotting. The results showed that APP/PS1 mice with chronic neuropathic pain induced by SNI had significant learning and memory impairment. This was accompanied by increased CCL2 and CCR2 expression and decreases in the number of DCX+, BrdU+, and BrdU+/NeuN+ neurons. These results suggest that chronic neuropathic pain is associated with cognitive impairment, which may be caused by CCL2/CCR2 signaling-mediated inhibition of hippocampal neurogenesis. Thus, therapeutic strategies that alleviate neuropathic pain can potentially slow cognitive decline in patients with AD and other neurodegenerative diseases.
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Affiliation(s)
- Lili Chen
- Department of Pain, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Qin Qin
- Department of Pain, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Panchuan Huang
- Department of Pain, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Fangli Cao
- Department of Pain, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Maojia Yin
- Department of Pain, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Yachen Xie
- Department of Pain, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Wuchao Wang
- Department of Pain, Daping Hospital, Army Medical University, Chongqing 400042, China.
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Kerckhove N, Bornier N, Mulliez A, Elyn A, Teixeira S, Authier N, Bertin C, Chenaf C. Prevalence of Chronic Pain Among People with Dementia: A Nationwide Study Using French Administrative Data. Am J Geriatr Psychiatry 2023; 31:1149-1163. [PMID: 37468390 DOI: 10.1016/j.jagp.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/02/2023] [Accepted: 06/24/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Alzheimer's disease or Related Dementia (ADRD) is known to disturb pain perception and reduce the ability to report it, resulting in underestimation by practitioners and sub-optimal medical management. The aim of this study was to estimate the prevalence of all types of CP among people with ADRD. DESIGN Nationwide cross-sectional study. SETTINGS French community-dwelling and nursing home residents. PARTICIPANTS People with ADRD, >40 years old, treated with cholinesterase inhibitors or memantine, or with a diagnosis/long-term illness of ADRD and matched with a comparison sample. SETTINGS French community-dwelling and nursing home residents. PARTICIPANTS People with ADRD, >40 years old, treated with cognitive stimulants (cholinesterase inhibitors and memantine) or with a diagnosis/long-term illness of ADRD and matched with a comparison sample (non-ADRD). MEASUREMENTS The capture-recapture method was performed to provide estimates of the prevalence of CP. People treated with analgesic drugs for ≥6 months consecutively or with a medical diagnosis of CP (ICD-10 codes) or referred to a pain center were considered as having CP. RESULTS A total of 48,288 individuals were included, of which 16,096 had ADRD and 32,192 without ADRD. The estimated prevalence of CP in people with ADRD was from 57.7% [52.9;63.3] to 57.9%[53.0;63.9], and slightly higher than the non-ADRD sample (from 49.9%[47.0;53.2] to 50.4%[47.3;53.9], p <0.001). CONCLUSIONS The prevalence of CP among people living with ADRD was at least the same as or better than individuals without ADRD. This result should alert practitioners' attention to the need for effective pain assessment and management in this population who has difficulties to express and feel pain.
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Affiliation(s)
- Nicolas Kerckhove
- Service de Pharmacologie médicale (NK, NB, ST, NA, CB, CC), Centres Addictovigilance et Pharmacovigilance, Centre d'Evaluation et de Traitement de la Douleur, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, NEURO-DOL, F-63000 Clermont-Ferrand, France; Université Clermont Auvergne (NK, NA, CB, CC), Institut Analgesia, Clermont-Ferrand, France.
| | - Nadège Bornier
- Service de Pharmacologie médicale (NK, NB, ST, NA, CB, CC), Centres Addictovigilance et Pharmacovigilance, Centre d'Evaluation et de Traitement de la Douleur, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Aurélien Mulliez
- Direction de la recherche clinique et de l'innovation (AM), Clermont-Ferrand, France
| | - Antoine Elyn
- Centre d'Évaluation et de Traitement de la Douleur (AE), Service de Neurochirurgie, Pôle Neuroscience, Hôpital Purpan, Pierre Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Place du Dr Joseph Baylac, Toulouse, France; RECaP F-CRIN, Groupe « Soins Primaires » (AE), Réseau national de Recherche en Épidémiologie Clinique et en Santé Publique, Inserm, France
| | - Sarah Teixeira
- Service de Pharmacologie médicale (NK, NB, ST, NA, CB, CC), Centres Addictovigilance et Pharmacovigilance, Centre d'Evaluation et de Traitement de la Douleur, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Nicolas Authier
- Service de Pharmacologie médicale (NK, NB, ST, NA, CB, CC), Centres Addictovigilance et Pharmacovigilance, Centre d'Evaluation et de Traitement de la Douleur, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, NEURO-DOL, F-63000 Clermont-Ferrand, France; Université Clermont Auvergne (NK, NA, CB, CC), Institut Analgesia, Clermont-Ferrand, France; Observatoire Français des Médicaments Antalgiques (OFMA) (NA, CB, CC), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Célian Bertin
- Service de Pharmacologie médicale (NK, NB, ST, NA, CB, CC), Centres Addictovigilance et Pharmacovigilance, Centre d'Evaluation et de Traitement de la Douleur, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, NEURO-DOL, F-63000 Clermont-Ferrand, France; Université Clermont Auvergne (NK, NA, CB, CC), Institut Analgesia, Clermont-Ferrand, France; Observatoire Français des Médicaments Antalgiques (OFMA) (NA, CB, CC), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Chouki Chenaf
- Service de Pharmacologie médicale (NK, NB, ST, NA, CB, CC), Centres Addictovigilance et Pharmacovigilance, Centre d'Evaluation et de Traitement de la Douleur, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, NEURO-DOL, F-63000 Clermont-Ferrand, France; Université Clermont Auvergne (NK, NA, CB, CC), Institut Analgesia, Clermont-Ferrand, France; Observatoire Français des Médicaments Antalgiques (OFMA) (NA, CB, CC), Université Clermont Auvergne, Clermont-Ferrand, France
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16
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Obekpa EO, McCurdy SA, Schick V, Markham CM, Gallardo KR, Wilkerson JM. Health-related quality of life and recovery capital among recovery residents taking medication for opioid use disorder in Texas. Front Public Health 2023; 11:1284192. [PMID: 38054070 PMCID: PMC10694473 DOI: 10.3389/fpubh.2023.1284192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
Background Recovery from opioid use disorder (OUD) includes improvements in health-related quality of life (HRQOL) and is supported by recovery capital (RC). Little is known about RC and HRQOL among recovery residents taking medication for OUD. We described HRQOL and RC and identified predictors of HRQOL. Methods Project HOMES is an ongoing longitudinal study implemented in 14 recovery homes in Texas. This is a cross-sectional analysis of data from 358 participants' on HRQOL (five EQ-5D-5L dimensions-mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and RC (Assessment of Recovery Capital scores) collected from April 2021 to June 2023. Statistical analyses were conducted using T-, Chi-squared, and Fisher's exact tests. Results Most participants were 35 years/older (50.7%), male (58.9%), non-Hispanic White (68.4%), heterosexual (82.8%), and reported HRQOL problems, mainly anxiety/depression (78.4%) and pain/discomfort (55.7%). Participants who were 35 years/older [mean (SD) = 42.6 (7.3)] were more likely to report mobility and pain/discomfort problems than younger participants. Female participants were more likely to report pain/discomfort problems than male participants. Sexual minorities were more likely to report anxiety/depression problems than heterosexual participants. Married participants and those in committed relationships were more likely to report problems conducting self-care than single/never-married participants. Comorbid conditions were associated with mobility, pain/discomfort, and usual activities problems. Most participants reported high social (65.4%), personal (69.0%), and total (65.6%) RC. Low personal RC was associated with mobility (aOR = 0.43, CI = 0.24-0.76), self-care (aOR = 0.13, CI = 0.04-0.41), usual activities (aOR = 0.25, CI = 0.11-0.57), pain/discomfort (aOR = 0.37, CI = 0.20-0.68), and anxiety/depression (aOR = 0.33, CI = 0.15-0.73) problems. Low total RC was associated with problems conducting self-care (aOR = 0.20, CI = 0.07-0.60), usual activities (aOR = 0.43, CI = 0.22-0.83), pain/discomfort problems (aOR = 0.55, CI = 0.34-0.90), and anxiety/depression (aOR = 0.20, CI = 0.10-0.41) problems. Social RC was not associated with HRQOL. Conclusion Personal and total RC and comorbid conditions predict HRQOL. Although the opioid crisis and the increasing prevalence of comorbidities have been described as epidemics, they are currently being addressed as separate public health issues. Our findings underscore the importance of ensuring residents are provided with interprofessional care to reduce the burden of comorbidities, which can negatively impact their OUD recovery. Their RC should be routinely assessed and enhanced to support their recovery and improve HRQOL.
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Affiliation(s)
- Elizabeth O. Obekpa
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Sheryl A. McCurdy
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Vanessa Schick
- Department of Management, Policy, and Community Health, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Christine M. Markham
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Kathryn R. Gallardo
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Johnny Michael Wilkerson
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
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Aurelian S, Ciobanu A, Cărare R, Stoica SI, Anghelescu A, Ciobanu V, Onose G, Munteanu C, Popescu C, Andone I, Spînu A, Firan C, Cazacu IS, Trandafir AI, Băilă M, Postoiu RL, Zamfirescu A. Topical Cellular/Tissue and Molecular Aspects Regarding Nonpharmacological Interventions in Alzheimer's Disease-A Systematic Review. Int J Mol Sci 2023; 24:16533. [PMID: 38003723 PMCID: PMC10671501 DOI: 10.3390/ijms242216533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
One of the most complex and challenging developments at the beginning of the third millennium is the alarming increase in demographic aging, mainly-but not exclusively-affecting developed countries. This reality results in one of the harsh medical, social, and economic consequences: the continuously increasing number of people with dementia, including Alzheimer's disease (AD), which accounts for up to 80% of all such types of pathology. Its large and progressive disabling potential, which eventually leads to death, therefore represents an important public health matter, especially because there is no known cure for this disease. Consequently, periodic reappraisals of different therapeutic possibilities are necessary. For this purpose, we conducted this systematic literature review investigating nonpharmacological interventions for AD, including their currently known cellular and molecular action bases. This endeavor was based on the PRISMA method, by which we selected 116 eligible articles published during the last year. Because of the unfortunate lack of effective treatments for AD, it is necessary to enhance efforts toward identifying and improving various therapeutic and rehabilitative approaches, as well as related prophylactic measures.
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Affiliation(s)
- Sorina Aurelian
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- Gerontology and Geriatrics Clinic Division, St. Luca Hospital for Chronic Illnesses, 041915 Bucharest, Romania
| | - Adela Ciobanu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Roxana Cărare
- Faculty of Medicine, University of Southampton, Southampton SO16 7NS, UK;
| | - Simona-Isabelle Stoica
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
- Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Aurelian Anghelescu
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
- Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Vlad Ciobanu
- Computer Science Department, Politehnica University of Bucharest, 060042 Bucharest, Romania;
| | - Gelu Onose
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Constantin Munteanu
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
- Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iași, Romania
| | - Cristina Popescu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Ioana Andone
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Aura Spînu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Carmen Firan
- NeuroRehabilitation Compartment, The Physical and Rehabilitation Medicine & Balneology Clinic Division, Teaching Emergency Hospital of the Ilfov County, 022104 Bucharest, Romania;
| | - Ioana Simona Cazacu
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Andreea-Iulia Trandafir
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Mihai Băilă
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Ruxandra-Luciana Postoiu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Andreea Zamfirescu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- Gerontology and Geriatrics Clinic Division, St. Luca Hospital for Chronic Illnesses, 041915 Bucharest, Romania
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Lao Y, Li Z, Bai Y, Li W, Wang J, Wang Y, Li Q, Dong Z. Glial Cells of the Central Nervous System: A Potential Target in Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Pain Res Manag 2023; 2023:2061632. [PMID: 38023826 PMCID: PMC10661872 DOI: 10.1155/2023/2061632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/24/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023]
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common diseases of the male urological system while the etiology and treatment of CP/CPPS remain a thorny issue. Cumulative research suggested a potentially important role of glial cells in CP/CPPS. This narrative review retrospected literature and grasped the research process about glial cells and CP/CPPS. Three types of glial cells showed a crucial connection with general pain and psychosocial symptoms. Microglia might also be involved in lower urinary tract symptoms. Only microglia and astrocytes have been studied in the animal model of CP/CPPS. Activated microglia and reactive astrocytes were found to be involved in both pain and psychosocial symptoms of CP/CPPS. The possible mechanism might be to mediate the production of some inflammatory mediators and their interaction with neurons. Glial cells provide a new insight to understand the cause of complex symptoms of CP/CPPS and might become a novel target to develop new treatment options. However, the activation and action mechanism of glial cells in CP/CPPS needs to be further explored.
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Affiliation(s)
- Yongfeng Lao
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Zewen Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yanan Bai
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Laboratory Medicine Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Weijia Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Jian Wang
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yanan Wang
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Qingchao Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhilong Dong
- Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
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Syed O, Jancic P, Fink AB, Knezevic NN. Drug Safety and Suicidality Risk of Chronic Pain Medications. Pharmaceuticals (Basel) 2023; 16:1497. [PMID: 37895968 PMCID: PMC10609967 DOI: 10.3390/ph16101497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/13/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023] Open
Abstract
Chronic pain is one of the main leading causes of disability in the world at present. A variety in the symptomatology, intensity and duration of this phenomenon has led to an ever-increasing demand of pharmacological treatment and relief. This demand for medication, ranging from well-known groups, such as antidepressants and benzodiazepines, to more novel drugs, was followed by a rise in safety concerns of such treatment options. The validity, frequency, and diversity of such concerns are discussed in this paper, as well as their possible effect on future prescription practices. A specific caution is provided towards the psychological safety and toll of these medications, regarding suicidality and suicidal ideation. Most significantly, this paper highlights the importance of pharmacovigilance and underscores the necessity of surveillance programs when considering chronic pain medication.
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Affiliation(s)
- Osman Syed
- Advocate Illinois Masonic Medical Center, Department of Anesthesiology, Chicago, IL 60657, USA; (O.S.); (P.J.); (A.B.F.)
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL 60515, USA
| | - Predrag Jancic
- Advocate Illinois Masonic Medical Center, Department of Anesthesiology, Chicago, IL 60657, USA; (O.S.); (P.J.); (A.B.F.)
| | - Adam B. Fink
- Advocate Illinois Masonic Medical Center, Department of Anesthesiology, Chicago, IL 60657, USA; (O.S.); (P.J.); (A.B.F.)
- Harborview Medical Center, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98104, USA
| | - Nebojsa Nick Knezevic
- Advocate Illinois Masonic Medical Center, Department of Anesthesiology, Chicago, IL 60657, USA; (O.S.); (P.J.); (A.B.F.)
- Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA
- Department of Surgery, University of Illinois, Chicago, IL 60612, USA
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Van Zundert TC, Gatt SP, van Zundert AA. Anesthesia and perioperative pain relief in the frail elderly patient. Saudi J Anaesth 2023; 17:566-574. [PMID: 37779574 PMCID: PMC10540986 DOI: 10.4103/sja.sja_628_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 10/03/2023] Open
Abstract
Demand for anesthesia and analgesia for the frail elderly is continuously increasing as the likelihood of encountering very elderly, very vulnerable, and very compromised patients has, ever so subtly, increased over the last three decades. The anesthesiologist has, increasingly, been obliged to offer professional services to frail patients. Fortunately, there has been a dramatic improvement in medications, methods of drug delivery, critical monitoring, and anesthesia techniques. Specific methodologies peculiar to the frail are now taught and practiced across all anesthesia subspecialties. However, administering anesthesia for the frail elderly is vastly different to giving an anesthetic to the older patient. Frail patients are increasingly cared for in specialized units-geriatric intensive therapy units, post-acute care services, palliative, hospices, and supportive care and aged care facilities. Several medications (e.g., morphine-sparing analgesics) more suited to the frail have become universally available in most centers worldwide so that best-practice, evidence-based anesthesia combinations of drugs and techniques are now increasingly employed. Every anesthetic and pain management techniques in the frail elderly patient are going to be discussed in this review.
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Affiliation(s)
| | - Stephen P Gatt
- Discipline of Anaesthesia, Critical Care and Emergency Medicine, University of New South Wales, Kensington, NSW, Australia and Udayana University, Bali, Indonesia
| | - André A.J. van Zundert
- Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, and The University of Queensland, Brisbane, Queensland, Australia
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Xie FL, Ren LJ, Xu WD, Xu TL, Ge XQ, Li W, Ge XM, Zhou WK, Li K, Zhang YH, Wang Z. Preoperative and postoperative complications as risk factors for delayed gastric emptying following pancreaticoduodenectomy: A single-center retrospective study. World J Gastrointest Surg 2023; 15:1941-1949. [PMID: 37901734 PMCID: PMC10600768 DOI: 10.4240/wjgs.v15.i9.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/21/2023] [Accepted: 07/18/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Mortality rates after pancreaticoduodenectomy (PD) have significantly decreased in specialized centers. However, postoperative morbidity, particularly delayed gastric emptying (DGE), remains the most frequent complication following PD. AIM To identify risk factors associated with DGE after the PD procedure. METHODS In this retrospective, cross-sectional study, clinical data were collected from 114 patients who underwent PD between January 2015 and June 2018. Demographic factors, pre- and perioperative characteristics, and surgical complications were assessed. Univariate and multivariate analyses were performed to identify risk factors for post-PD DGE. RESULTS The study included 66 males (57.9%) and 48 females (42.1%), aged 33-83 years (mean: 62.5), with a male-to-female ratio of approximately 1.4:1. There were 63 cases (55.3%) of PD and 51 cases (44.7%) of pylorus-preserving pancreatoduodenectomy. Among the 114 patients who underwent PD, 33 (28.9%) developed postoperative DGE. Univariate analysis revealed significant differences in four of the 14 clinical indexes observed: pylorus preservation, retrocolonic anastomosis, postoperative abdominal complications, and early postoperative albumin (ALB). Logistic regression analysis further identified postoperative abdominal complications [odds ratio (OR) = 4.768, P = 0.002], preoperative systemic diseases (OR = 2.516, P = 0.049), and early postoperative ALB (OR = 1.195, P = 0.003) as significant risk factors. CONCLUSION Postoperative severe abdominal complications, preoperative systemic diseases, and early postoperative ALB are identified as risk factors for post-PD DGE.
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Affiliation(s)
- Fang-Liang Xie
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Li-Jun Ren
- Operating Theatre, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Wei-Dong Xu
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Tong-Lei Xu
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Xia-Qing Ge
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Wei Li
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Xu-Ming Ge
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Wen-Kai Zhou
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Kai Li
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Yun-Hai Zhang
- Department of Pain, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
| | - Zhong Wang
- Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
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Li Y. Development and external validation of a diagnostic model for cardiometabolic-based chronic disease : results from the China health and retirement longitudinal study (CHARLS). BMC Cardiovasc Disord 2023; 23:417. [PMID: 37612688 PMCID: PMC10464030 DOI: 10.1186/s12872-023-03418-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Cardiovascular disease(CVD) is the leading cause of death in the world. Cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for sustainable and early, evidence-based therapeutic targeting to mitigate the ravagest and development of CVD. CMBCD include dysglycemia, hypertension, and/or dyslipidemia progressing to downstream CVD events. OBJECTIVES The objective of our research was to develop and externally validate a diagnostic model of CMBCD. METHODS Design: Multivariable logistic regression of a cohort for 9,463 participants aged at least 45 years were drawn from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). SETTING The 2018 wave of the CHARLS. PARTICIPANTS Diagnostic model development: Totally 6,218 participants whose individual ID < 250,000,000,000. External validation: Totally 3,245 participants whose individual ID > 250,000,000,000. OUTCOMES CMBCD . RESULTS CMBCD occurred in 25.5%(1,584/6,218)of individuals in the development data set and 26.2%(850 /3,245)of individuals in the validation data set. The strongest predictors of CMBCD were age, general health status, location of residential address, smoking, housework ability, pain, and exercise tolerance. We developed a diagnostic model of CMBCD. Discrimination was the ability of the diagnostic model to differentiate between people who with and without CMBCD. This measure was quantified by calculating the area under the receiver operating characteristic(ROC) curve(AUC).The AUC was 0.6199 ± 0.0083, 95% confidence interval(CI) = 0.60372 ~ 0.63612. We constructed a nomograms using the development database based on age, general health status, location of residential address, smoking, housework ability, pain, and exercise tolerance. The AUC was 0.6033 ± 0.0116, 95% CI = 0.58066 ~ 0.62603 in the validation data set. CONCLUSIONS We developed and externally validated a diagnostic model of CMBCD. Discrimination, calibration, and decision curve analysis were satisfactory.
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Affiliation(s)
- Yong Li
- Department of General Medicine, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
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Canever JB, Cândido LM, de Souza Moreira B, Danielewicz AL, Cimarosti HI, Lima-Costa MF, de Avelar NCP. A nationwide study on pain manifestations and sleep problems in community-dwelling older adults: findings from ELSI-Brazil. Eur Geriatr Med 2023; 14:307-315. [PMID: 36759417 DOI: 10.1007/s41999-023-00751-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE Sleep problems are common and affect approximately 36-70% of older adults worldwide and can be associated with negative outcomes such as pain. There is believed to be a bidirectional relationship between sleep problems and pain, modulated by inflammation and stress. The objective was to investigate the association between self-reported sleep problems and pain manifestations. METHODS A cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (2019-2021) was conducted. The exposure variables were self-reported sleep problems: poor sleep quality, insomnia (initial, intermediate, and final), and daytime sleepiness. The outcomes were self-reported pain manifestations: frequent pain, moderate/intense/strong pain, and pain-related disability. Logistic regressions were performed to verify the association between exposures and outcomes. RESULTS A total of 6875 community-dwelling older adults participated in this study (71.1 ± 8.3 years; 54.4% female). Older adults with self-reported poor sleep quality, initial, intermediate and final insomnia, and daytime sleepiness had, respectively, 1.99 (95% CI 1.57-2.53), 1.47 (95% CI 1.11-1.97), 1.65 (95% CI 1.27-2.14), 1.69 (95% CI 1.29-2.22), and 1.76 (95% CI 1.35-2.29) greater odds of reporting frequent pain. The odds of moderate/intense/strong pain were higher in older adults that reported poor sleep quality (OR: 2.21; 95% CI 1.08-4.51). Older adults with self-reported poor sleep quality, initial, intermediate and final insomnia, and daytime sleepiness had, respectively, 1.84 (95% CI 1.11-3.02), 1.73 (95% CI 1.14-2.62), 1.80 (95% CI 1.19-2.73), 1.58 (95% CI 1.07-2.34), and 1.63 (95% CI 1.11-2.39) greater odds of reporting pain-related disability. CONCLUSION Self-reported sleep problems are associated with pain manifestations in older adults. The results may help in the proposition of programs and public health policies.
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Affiliation(s)
- Jaquelini Betta Canever
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Department of Pharmacology, R. Eng. Agronômico Andrei Cristian Ferreira, s/n, Florianópolis, Santa Catarina, 88040-900, Brazil. .,Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, 320188906-072, Araranguá, Santa Catarina, Brazil.
| | - Letícia Martins Cândido
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, 320188906-072, Araranguá, Santa Catarina, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais and Oswaldo Cruz Foundation-Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Lúcia Danielewicz
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, 320188906-072, Araranguá, Santa Catarina, Brazil
| | - Helena Iturvides Cimarosti
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Department of Pharmacology, R. Eng. Agronômico Andrei Cristian Ferreira, s/n, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais and Oswaldo Cruz Foundation-Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Núbia Carelli Pereira de Avelar
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, 320188906-072, Araranguá, Santa Catarina, Brazil
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Puto G, Repka I, Muszalik M. Factors Correlating with Functional Capacity in Older People with Chronic Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2748. [PMID: 36768110 PMCID: PMC9915534 DOI: 10.3390/ijerph20032748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Chronic pain in older people is a global health problem not only in terms of a negative subjective feeling, but also as a social and economic factor. Deterioration of functional capacity is one of the main symptoms of chronic pain; therefore, it should be assessed as a basic parameter in the life of older people. The aim of the study was to analyze the factors which have an impact on the functional capacity of older people with chronic pain. MATERIAL AND METHODS The study was conducted among 181 people over 65 suffering from chronic pain lasting more than 6 months. The study used a questionnaire that included questions about demographic and social characteristics and the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Pain Measure-24 (GPM-24). RESULTS In the study group, a positive correlation was found between: coexisting diseases and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A positive correlation was also found between the Geriatric Depression Scale (GDS) and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A significantly negative correlation was found between: AMTS, ADL, IADL performance and: withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of total GPM-24 score. CONCLUSIONS Chronic pain is more common in people with disabilities in basic and complex activities of daily living, with limited efficiency in cognitive functions and an increased sense of depression. The standard in everyday practice and clinical trials should be taking a history of chronic pain in every older person, monitoring the pain's intensity and accompanying characteristics by using a multidimensional scale for assessing pain in older people.
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Affiliation(s)
- Grażyna Puto
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Kopernika 25 Street, 31-501 Krakow, Poland
| | - Iwona Repka
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Kopernika 25 Street, 31-501 Krakow, Poland
| | - Marta Muszalik
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
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Prevalence and Predictors of Chronic Postsurgical Pain After Video-Assisted Thoracoscopic Surgery: A Systematic Review and Meta-analysis. Pain Ther 2023; 12:117-139. [PMID: 36227420 PMCID: PMC9845490 DOI: 10.1007/s40122-022-00439-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/15/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Determining the prevalence of chronic postsurgical pain (CPSP) after video-assisted thoracoscopic surgery (VATS) and identifying CPSP predictors should improve the prognosis of patients undergoing VATS. Although several studies have investigated predictors of CPSP after VATS, there were significant dissimilarities in the findings due to the confounding of predictors. METHODS PubMed, Cochrane, MEDLINE, Web of Science, Chinese Biomedical Literature, and China National Knowledge Infrastructure databases were comprehensively searched using the Medical Subject Headings terms "pain, postoperative," "thoracic surgery, video-assisted," and all related free terms from inception until March 27, 2022. The Stata metaprop package was used to comprehensively analyze the incidence of CPSP following VATS. Furthermore, the pooled odds ratios (OR) or the standardized mean differences (SMD) and their corresponding 95% confidence intervals (95% CI) were calculated, and qualitative analyses were performed for predictors that could not be assessed quantitatively to evaluate the effects of the included risk factors on the occurrence of CPSP. Unadjusted odds ratios were utilized to consider the impact of non-significant estimates if the original study did not report them. RESULTS Of the 4302 studies, 183 were considered eligible, and 17 were finally included in this study. The overall incidence of CPSP after VATS was 35.3% (95% CI 27.1-43.5%). The qualitative synthesis results revealed that female sex, age, and acute postoperative pain were definite predictors of CPSP after VATS. The number of ports, operation time, duration of drainage, and insufficient analgesia were also considered predictors. Consistent, quantitative synthesis results also showed that the aforementioned predictors were closely related to the occurrence of CPSP after VATS. Only by quantitative analysis, postoperative chemotherapy and an educational level less than junior school were also risk factors for CPSP. Other predictors displayed no evidence or unclear evidence of association with CPSP after VATS. CONCLUSION This study preliminarily determined the incidence of CPSP after VATS based on the existing literature. Female sex, age, and acute pain were identified as risk factors for CPSP after VATS, and other potential risk factors were also identified and analyzed. However, as a result of the inclusion of retrospective studies and inevitable limitations in this systematic review and meta-analysis, the results of this study still need to be verified by large-scale prospective clinical studies. TRIAL REGISTRATION CRD42022323179.
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Lakha SF, Assimakopoulos D, Mailis A. Comparison of Older and Younger Patients Referred to a Non-interventional Community Pain Clinic in the Greater Toronto Area (GTA). Pain Ther 2023; 12:213-224. [PMID: 36284073 PMCID: PMC9845447 DOI: 10.1007/s40122-022-00435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/09/2022] [Indexed: 01/21/2023] Open
Abstract
AIM To compare demographic and pain characteristics of older (≥ 65) vs younger (< 65) chronic non-cancer pain patients referred to a community pain clinic in the Greater Toronto Area (GTA), Ontario, Canada. METHODS This is a retrospective study of 644 consecutive new patients with pain seen during 2016-2017 (older group n = 126; younger group n = 518). Demographic characteristics, Brief Pain Inventory pain ratings, and diagnosis were obtained using retrospective chart review. Patients were classified into group I (pure biomedical pathology), group II (mixed biomedical causes and psychological factors) and group III (no detectable physical pathology but psychological factors were considered important). RESULTS Older patients comprised 19.6% of the overall population (higher than the average GTA older population). Regarding older vs younger group, male/female ratio was 1:1.3 vs 1:1.7 respectively, while 71% of the older patients were foreign born vs 37% of the younger group (p < 0.001). Low back was the most prevalent pain site for both groups; 70% of the older patients were classified as group I vs 35% of the younger patients (p < 0.0001), and only 6% as group III (vs 18% of the younger population, p < 0.05). CONCLUSION The study points to considerable differences between younger and older patients with pain with the latter presenting with significant biomedical pathology but lesser psychopathology. The results are comparable to those obtained from a university pain clinic as well as a rural Northern Ontario clinic. Implications of the study for planning of pain care are discussed.
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Affiliation(s)
- Shehnaz Fatima Lakha
- Pain and Wellness Centre, 2301 Major Mackenzie Dr. West, Unit #101, Vaughan, ON Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Sciences, University of Toronto, Toronto, ON Canada
| | - Demetry Assimakopoulos
- Pain and Wellness Centre, 2301 Major Mackenzie Dr. West, Unit #101, Vaughan, ON Canada ,grid.231844.80000 0004 0474 0428University Health Network, Comprehensive Integrated Pain Program Rehabilitation Pain Service, Toronto, ON Canada
| | - Angela Mailis
- Pain and Wellness Centre, 2301 Major Mackenzie Dr. West, Unit #101, Vaughan, ON Canada ,grid.17063.330000 0001 2157 2938Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON Canada
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Seeman MV. Use of metaphors when treating unexplained medical symptoms. World J Clin Cases 2023; 11:332-341. [PMID: 36686355 PMCID: PMC9850979 DOI: 10.12998/wjcc.v11.i2.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/02/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023] Open
Abstract
The words one chooses to describe personal pain mirror current usage, but may also hold echoes of an individual’s lived experience. They may provide clues to the origin of physical symptoms that are medically hard to explain. The aim of this commentary is to propose, on the basis of the available literature, that verbal metaphors can prove effective in the psychotherapy of such conditions. I provide a case history of a 45 year old woman referred to psychiatry because of extreme ‘burning’ pain in her mouth and tongue. She had been to numerous doctors, had undergone a variety of tests, had tried many medical treatments, and had been prescribed a number of different pharmaceutical agents. She had changed her diet, done her daily dental mouth exercises, drunk a lot of water, but the burning continued and interfered, with her job (she was a teacher), her friendships, and her everyday life. This made her angry and recalcitrant to therapy, but the metaphor ‘burning with rage,’ as applicable to her pain, worked to establish a good alliance that led to a decrease of symptoms. Burning Mouth Syndrome is a medically unexplained condition of complex etiology that psychotherapy alone cannot reverse. The literature bears out, however, that the use of metaphors can help to open avenues of psychological exploration that accelerate adaptation to pain and improve quality life.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto M5S 1A1, Ontario, Canada
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Limsomwong P, Ingviya T, Fumaneeshoat O. The trend of opioid prescriptions among cancer patients in a tertiary hospital: A multimethod quantitative study. Front Oncol 2023; 13:1138169. [PMID: 37114139 PMCID: PMC10128996 DOI: 10.3389/fonc.2023.1138169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Pain is a major symptom in cancer patients. World Health Organization recommends opioids as the main analgesic agent. Few studies have examined the amount of opioid uses in cancer patients in Southeast Asia, however, none of them have examined the factors associated with the amount of opioid uses which were lower than required. Objectives To assess the trends and factors associated with opioid prescriptions for cancer patients in Songklanagarind Hospital, the largest referral center in Southern Thailand. Design Multi-method quantitative study. Methods We reviewed the electronic medical records of 20,192, outpatients aged ≥18 years diagnosed with cancer between 2016 and 2020 who received opiod prescriptions. Oral morphine equivalents (OME) were calculated using the standard conversion factors and the OME trend during the study period was assessed by a generalized additive model. Factors affecting the morphine equivalent daily dose (MEDD) were assessed using multiple linear regression with a generalized estimating equation. Results The mean overall MEDD for all study patients was 27.8 ± 21.9 mg per day per patient. The bone and articular cartilage cancer patients had the highest MEDD. For every 5-year increase in the duration of cancer, the MEDD increased by 0.02 (95% confidence interval [CI]: 0.01 - 0.04). Patients with stage 4 cancer received a higher average MEDD of 4.04 (95% CI: 0.30-7.62) as compared to those with stage 1 cancer. Patients with bone metastasis received a average higher MEDD of 4.03 (95% CI: 0.82-7.19) compared to those without. Age was inversely associated with the MEDD. Patients aged 42-58, 59-75 and >76years old received MEDDs of 4.73 (95% CI: 2.31-7.15), 6.12 (95% CI: 3.66-8.59) and 8.59 (95% CI: 6.09-11.09) compared with those aged 18-42 years old. Brain metastasis was inversely associated with MEDD of 4.49 (95% CI: 0.61-8.37) compared to those without. Conclusion Opioid use in cancer patients in this study is lower than the average global usage. Promoting opioid prescriptions for pain management through medical education can help doctors overcome opiophobia.
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Affiliation(s)
- Pawita Limsomwong
- Department of Family and Preventive Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Thammasin Ingviya
- Department of Family and Preventive Medicine, Prince of Songkla University, Songkhla, Thailand
- Division of Digital Innovation and Data Analytics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Orapan Fumaneeshoat
- Department of Family and Preventive Medicine, Prince of Songkla University, Songkhla, Thailand
- *Correspondence: Orapan Fumaneeshoat,
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Putilina MV. [A complex of B vitamins, choline and inosine in the treatment of chronic pain]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:114-119. [PMID: 37084375 DOI: 10.17116/jnevro2023123041114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Chronic pain is an independent disease associated with multiple changes in the nervous, endocrine and immune systems. The use of B vitamins is pathogenetically justified. Unlike others, the CompligamB complex contains almost all fractions of B vitamins, inosine and para-aminobenzoic acid, which provides an additional therapeutic effect. The effects of vitamins are summarized, in some cases they are potentiated, while none of them can replace the other, so it is advisable to use vitamin complexes.
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Affiliation(s)
- M V Putilina
- Pirogov Russian National Research Medical University, Moscow, Russia
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Huerta Ojeda Á, Toro-Zepeda V, Jofré-Saldía E, Bravo M, Parra C, Campos-Armijo G, Jorquera-Aguilera C, Albornoz Hernández M, Yeomans-Cabrera MM, Galdames Maliqueo S. Relationship between Asymmetries and Functional Autonomy in Older Chilean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15063. [PMID: 36429784 PMCID: PMC9690387 DOI: 10.3390/ijerph192215063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
The objectives of this study were: (a) to determine asymmetries, both lower limb (LL) and upper limb (UL), in Chilean older adults, and (b) to relate asymmetries to FA in both LL and UL. Forty-one older adults voluntarily participated in this study (mean ± standard deviation [SD]: age 72.0 ± 8.0 years, LL asymmetries 13.78 ± 14.87%, UL asymmetries 10.70 ± 8.85%, FA 40.35 ± 16.26 points). The variables were: (1) asymmetries of LL and UL, assessed through a force platform and handgrip, respectively; (2) FA, assessed through the Latin American Group for Maturity (GDLAM) and the GDLAM index of autonomy (GI) protocol. The relationship between the variables was performed through Spearman's correlation. The analysis showed that 39% of the participants presented asymmetries above 15% in the LL. Likewise, this 39% of older adults presented a lower FA than their peers with asymmetries below 15% in the LL (≤15%: 35.64 ± 12.26 points vs. >15%: 47.69 ± 19.23 points, p = 0.003). The analysis showed a small correlation between LL and GI asymmetries (r = 0.27, p = 0.07) and a small but negative correlation between UL and GI (r = -0.21). The mean values of asymmetries of both LL and UL are within 'normal' parameters. However, several older adults were identified as being at risk. In parallel, older adults who presented a higher level of asymmetries in LL showed a lower level of FA.
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Affiliation(s)
- Álvaro Huerta Ojeda
- Núcleo de Investigación en Salud, Actividad Física y Deporte ISAFYD, Universidad de Las Américas, Viña del Mar 2531098, Chile
| | - Vanieska Toro-Zepeda
- Facultad de Ciencias, Escuela de Nutrición y Dietética, Magíster en Nutrición para la Actividad Física y el Deporte, Universidad Mayor, Santiago 8580745, Chile
| | - Emilio Jofré-Saldía
- Facultad de Educación y Ciencias Sociales, Instituto del Deporte y Bienestar, Universidad Andres Bello, Santiago 7550000, Chile
- Instituto de Ciencias de la Salud, Universidad de O’Higgins, Rancagua 2841935, Chile
| | - Maximiliano Bravo
- Servicio de Medicina Interna, Departamento de Geriatría, Hospital Carlos Van Buren, Valparaíso 2341131, Chile
| | - Carol Parra
- Laboratorio de Investigación en Nutrición y Alimentos (LINA), Departamento de Salud, Comunidad y Gestión, Facultad de Ciencias de la Salud, Universidad de Playa Ancha, Valparaíso 2340000, Chile
| | - Gaspar Campos-Armijo
- Núcleo de Investigación en Salud, Actividad Física y Deporte ISAFYD, Universidad de Las Américas, Viña del Mar 2531098, Chile
| | - Carlos Jorquera-Aguilera
- Facultad de Ciencias, Escuela de Nutrición y Dietética, Universidad Mayor, Santiago 8580745, Chile
| | - Makarena Albornoz Hernández
- Facultad Ciencias de la Actividad Física y del Deporte, Universidad de Playa Ancha de Ciencias de la Educación, Valparaíso 2340000, Chile
| | | | - Sergio Galdames Maliqueo
- Facultad Ciencias de la Actividad Física y del Deporte, Universidad de Playa Ancha de Ciencias de la Educación, Valparaíso 2340000, Chile
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Saragih ID, Suarilah I, Son NT, Lee BO. Efficacy of non-pharmacological interventions to reduce pain in people with dementia: A systematic review and meta-analysis. J Clin Nurs 2022. [PMID: 35880258 DOI: 10.1111/jocn.16444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify the efficacy of non-pharmacological interventions designed to reduce pain in people with dementia. BACKGROUND Pain is prevalent among patients with dementia but frequently remains untreated. Although non-pharmacological interventions have been used to reduce pain in people with dementia, the efficacy of these interventions for pain management in people with dementia has not been thoroughly synthesised. DESIGN Systematic review and meta-analysis. METHODS The study was conducted in accordance with PRISMA guidelines and Cochrane criteria for systematic reviews. A comprehensive search was performed using the Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, OVID and Web of Science databases, from databases inception to 13 March 2022. The modified Cochrane risk-of-bias tool (ROB-2) was used to evaluate the methodological quality of each included study. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were synthesised using a random-effects model to assess the efficacy of non-pharmacological interventions for reducing pain in people with dementia (using Stata 16.0). RESULTS The final analysis assessed 12 studies, including 989 persons with dementia. Non-pharmacological interventions were found to reduce pain in 4-8 weeks after the interventions (SMD: -0.32; 95% CI: -0.62 to -0.02). However, the effects of intervention frequency and patient age remain unknown. CONCLUSIONS Non-pharmacological interventions are effective for reducing pain in people with dementia. Further investigations remain necessary to explore the effectiveness of specific non-pharmacological therapies for pain reduction in people with dementia (e.g. aromatherapy, play activity, singing or robotic care). RELEVANCE TO CLINICAL PRACTICE The findings of this study can guide healthcare practitioners when considering the use of non-pharmacological pain management methods for people with dementia and may improve the implementation of these methods in clinical practice. PATIENT OR PUBLIC CONTRIBUTIONS The study suggests non-pharmacological interventions to reduce pain and underlines the relevance of health provider's viewpoints. The types, duration and length of follow-up of non-pharmacological interventions can be offered based on patient's conditions and the standard of clinical practice.
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Affiliation(s)
| | - Ira Suarilah
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Nguyen Thi Son
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.,Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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