Pain prevalence in hospitalized patients at a tertiary academic medical center: Exploring severe persistent pain

Objective

The pain prevalence of inpatients is not a well-studied medical issue in Asia. We have aimed to evaluate pain prevalence and characterize those patients who have suffered from severe, persistent pain.

Methods

We investigated pain prevalence using a quota sampling from 19 general wards during the year 2018. Using a structured questionnaire, eight interviewers visited patients at an age ≥ 20 years, and who had been staying in general wards for ≥ 3 days. Those patients were excluded if they were unable to respond to the interview questions. If they reported pain during hospitalization, the maximum pain level and the duration of pain suffered in the past 24 hours were assessed. Care-related pain was also surveyed.

Results

A total of 1,034 patients (M/F, 537/497) completed the survey. Amongst them, 719 patients (69.5%) experienced pain, with moderate and severe pain levels being 27.3% and 43%, respectively. Surgery was considered as it related to pain, including significantly severe pain. The top 3 care-related pain causes were needle pain, wound dressing, and change in position/chest percussion. Change in position/chest percussion and rehabilitation were associated with severe, persistent pain.

Conclusions

Pain is common in approximately 70% of inpatients, with surgery being associated with severe pain. Mobilization and rehabilitation may lead to severe, persistent pain. The periodic study of pain prevalence is essential in order to provide precise pain management.

Contributions of major components to the antimutagenic effect of Hsian-tsao (Mesona procumbens Hemsl.)

Our aim was to determine the antimutagenic activity of various solvent extracts from an herb Mesona procumbens Hemsl, normally called Hsian-tsao in China. We also investigated the relationships between the special components in the water extract of Hsian-tsao (WEHT) and the antimutagenic activity. It was found that the extracts at 0-0.6 mg/plate from three solvents (water, methanol, and ethyl acetate) exhibited a dose-dependent antimutagenic effect against benzo[a]pyrene [B(a)P] and 2-amino-3-methylimidazo(4,5-f)quinoline (IQ), both are indirect mutagens in Salmonella tester strains TA98 and TA100. The WEHT from three different plantations revealed a similar inhibitory effect on the mutagenicity of IQ in TA 98 at 2.5-5.0 mg/plate. The inhibitory effect of WEHT on the mutagenicity of IQ correlates with their polyphenol and ascorbic acid contents but not with their chlorophyll contents. These findings suggest that the antimutagenicity activity of WEHT may be attributed mainly to their polyphenolic compounds and ascorbic acid.

Protective effect of extracts of Mesona procumbens Hemsl. on DNA damage in human lymphocytes exposed to hydrogen peroxide and UV irradiation

In the present study, the protective effect of water extracts from Hsian-tsao (WEHT) on DNA damage in human lymphocytes induced by UV-C and/or H(2)O(2) was evaluated using single-cell electrophoresis (comet assay). No toxicity was found in WEHT towards human lymphocytes. WEHT did not cause DNA damage at lower concentrations of 0.05 and 0.1 mg/ml, while it did cause slight DNA damage at a concentration of 0.5-2.5 mg/ml when compared with the control group. When WEHT was mixed with H(2)O(2) for reaction, it exhibited a slight inhibitory effect on DNA damage induced by H(2)O(2). Moreover, when WEHT and lymphocytes were irradiated by UV-C and then incubated for 35 min, the DNA damage decreased with an increase of the concentration of WEHT. Thus, WEHT could reduce UV-C-induced DNA damage, and WEHT had a more protective effect on UV-C than on H(2)O(2)-induced DNA damage. The protective effect of WEHT on DNA damage might be due to the fact that it contains polyphenol compounds and/or other active components.

High-performance liquid chromatographic analyser for guanidino compounds using benzoin as a fluorogenic reagent

An automatic analyser based on high-performance liquid chromatography has been developed for the quantification of biogenic guanidino compounds in human physiological fluids. Fourteen guanidino compounds are mutually separated within 35 min on a cation-exchange column with a stepwise gradient elution of pH and/or ionic strength in the mobile phase and then converted automatically to their fluorescent derivatives with benzoin. The method in this system is simple, rapid and sensitive; the lower limits of detection are 5-50 pmol for monosubstituted guanidino compounds, 1 nmol for creatine and 20 nmol for creatinine in 100 microliter of injection volume.