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Feingold D, Gliksberg O, Brill S, Amit BH, Lev-Ran S, Kushnir T, Sznitman SR. Conceptualizing problematic use of medicinal Cannabis: Development and preliminary validation of a brief screening questionnaire. Addict Behav 2024; 158:108122. [PMID: 39128420 DOI: 10.1016/j.addbeh.2024.108122] [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: 01/28/2024] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 08/13/2024]
Abstract
The use of Medicinal Cannabis (MC) for treating chronic pain is increasing, globally, yet the definition of problematic MC use remains unclear. Defining problematic use of cannabis in medical and non-medical contexts may be fundamentally different since individuals prescribed MC often experience physical dependence, which do not necessarily imply pathology. We aimed to conceptualize problematic use of MC and develop a brief questionnaire for identifying and quantifying problematic MC use. Content validation used a broad definition of problematic substance use, adapting and compiling an initial list of 36 items from various sources: (a) screening tools for assessing problematic prescription opioid medication use; (b) screening tools for problematic recreational cannabis use and (c) qualitative interviews with MC patients. 390 American self-identified chronic pain patients holding a MC card rated each item from the initial list on a 5-point frequency scale and filled out questionnaires assessing various clinical outcomes. Following initial item titration, a multi-group measurement invariance comparison strategy, using two external indicators: alcohol-related problems and depression, resulted a final eight-item list that met fit quality in a baseline model, presented excellent internal consistency reliability (α = 0.929), and significantly correlated with anxiety and low quality of life. Items in the final list related predominantly to negative consequences of MC use. Problematic use of MC is characterized by negative physiological, social, emotional and functional consequences. The final eight-item list was named the Medicinal Cannabis Negative Consequences Scale (MCNCS), emerging as a brief measure for problematic MC use and demonstrating preliminary reliability and validity, which could aid clinicians and researchers.
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Affiliation(s)
| | - Or Gliksberg
- Department of Psychology, Ariel University, Ariel, Israel.
| | - Silviu Brill
- Pain Institute, Sourasky Medical Center, Tel Aviv, Israel.
| | - Ben H Amit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sourasky Medical Center, Tel Aviv, Israel.
| | - Shaul Lev-Ran
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Center on Addiction, Netanya, Israel; Lev Hasharon Medical Center, Netanya, Israel.
| | - Talma Kushnir
- Department of Psychology, Ariel University, Ariel, Israel; Adelson School of Medicine, Ariel University, Israel.
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Leroux A, Crainiceanu C, Zeger S, Taub M, Ansari B, Wager TD, Bayman E, Coffey C, Langefeld C, McCarthy R, Tsodikov A, Brummet C, Clauw DJ, Edwards RR, Lindquist MA. Statistical modeling of acute and chronic pain patient-reported outcomes obtained from ecological momentary assessment. Pain 2024; 165:1955-1965. [PMID: 38718196 DOI: 10.1097/j.pain.0000000000003214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 01/11/2024] [Indexed: 05/18/2024]
Abstract
ABSTRACT Ecological momentary assessment (EMA) allows for the collection of participant-reported outcomes (PROs), including pain, in the normal environment at high resolution and with reduced recall bias. Ecological momentary assessment is an important component in studies of pain, providing detailed information about the frequency, intensity, and degree of interference of individuals' pain. However, there is no universally agreed on standard for summarizing pain measures from repeated PRO assessment using EMA into a single, clinically meaningful measure of pain. Here, we quantify the accuracy of summaries (eg, mean and median) of pain outcomes obtained from EMA and the effect of thresholding these summaries to obtain binary clinical end points of chronic pain status (yes/no). Data applications and simulations indicate that binarizing empirical estimators (eg, sample mean, random intercept linear mixed model) can perform well. However, linear mixed-effect modeling estimators that account for the nonlinear relationship between average and variability of pain scores perform better for quantifying the true average pain and reduce estimation error by up to 50%, with larger improvements for individuals with more variable pain scores. We also show that binarizing pain scores (eg, <3 and ≥3) can lead to a substantial loss of statistical power (40%-50%). Thus, when examining pain outcomes using EMA, the use of linear mixed models using the entire scale (0-10) is superior to splitting the outcomes into 2 groups (<3 and ≥3) providing greater statistical power and sensitivity.
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Affiliation(s)
- Andrew Leroux
- Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado, Aurora, CO, United States
| | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Scott Zeger
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Margaret Taub
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Briha Ansari
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Tor D Wager
- Department of Psychological and Brain Science, Dartmouth College, Hanover, NH, United States
| | - Emine Bayman
- Departments of Biostatistics and
- Anesthesia, University of Iowa, Iowa City, IA, United States
| | | | - Carl Langefeld
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston Salem, NC, United States
- The Comprehensive Cancer Center of Wake Forest University, Winston Salem, NC, United States
| | - Robert McCarthy
- Department of Anesthesiology, Rush University, Chicago, IL, United States
| | | | - Chad Brummet
- Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Daniel J Clauw
- Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Robert R Edwards
- Harvard Medical School, Department of Anesthesiology, Pain Management Center, Brigham and Women's Hospital, Chestnut Hill, MA, United States
| | - Martin A Lindquist
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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Langer D, Horwitz A, Melchior H, Atoun E, Mazor-Karsenty T. Understanding the implications of hand impairments in light of the International Classification of Function model. J Hand Ther 2024:S0894-1130(24)00047-4. [PMID: 39218760 DOI: 10.1016/j.jht.2024.05.004] [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: 09/19/2023] [Revised: 04/24/2024] [Accepted: 05/16/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Incorporating an occupation-based assessment along with or in place of an assessment of body functions and structures is not performed routinely in hand therapy practice. PURPOSE (a) Explore correlations between body functions, activities and participation (A&P), and quality of life (QOL); (b) assess the extent to which personal factors and body functions contribute to variations in A&P and QOL; (c) compare the QOL of individuals with and without hand impairment (HI). STUDY DESIGN Cross-sectional. METHODS Seventy-seven patients (Mean age=43.70 SD=17.56; 47 males and 30 females) with chronic and acute hand impairment were recruited from two hand clinics and matched with healthy participants. Assessments were administered to participants in their first visit to the hand clinic. QOL was measured with the World Health Organization QOL questionnaire; A&P with the Disabilities of the Arm Shoulder and Hand (DASH) questionnaire; pain with the Patient-Rated Wrist/Hand Evaluation; hand function with The Functional Dexterity Test, Jamar Dynamometer and Pinch Gauge. RESULTS Significant correlations were found between QOL and A&P, dexterity, and pain, as well as between A&P and hand strength and pain. Personal factors, hand function, and pain collectively explained 28.9% of QOL variance and 61.4% of A&P variance. Pain emerged as the sole significant contributor to QOL variance, while both hand function and pain significantly influenced A&P variance. Comparisons between the study group and controls highlighted significant differences in QOL domains, with the HI group reporting lower perceived QOL in physical, social, and environmental domains. CONCLUSION The significance of adopting a comprehensive approach in HI intervention was highlighted. A complex interplay of factors across different levels of the International Classification of Functioning, Disability and Health (ICF) framework imply that clinicians should avoid fixating exclusively on isolated factors or specific domains.
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Affiliation(s)
- Danit Langer
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Department of Occupational Therapy, Shaare Zedek Medical Center, Jerusalem, Israel.
| | - Avigayil Horwitz
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Department of Hand Therapy, Barzilai Medical Center, Ashkelon, Israel
| | - Hanna Melchior
- Department of Occupational Therapy, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ehud Atoun
- Department of Orthopedic Surgery, Barzilai Medical Center, Ashkelon, Israel
| | - Tal Mazor-Karsenty
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Lohmander LS, Peltonen M, Andersson-Assarsson JC, Sjöholm K, Taube M, Jacobson P, Svensson PA, Carlsson LMS, Ahlin S. Work-restricting musculoskeletal pain after bariatric surgery or usual obesity care in the Swedish Obese Subjects study. Obesity (Silver Spring) 2024. [PMID: 39210593 DOI: 10.1002/oby.24128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE The objective of this study was to study the recovery from, and incidence of, work-restricting musculoskeletal pain after bariatric surgery compared with usual obesity care. METHODS Pain in different body regions was monitored using questionnaires in the nonrandomized, prospective, controlled Swedish Obese Subjects (SOS) study, which included 2007 participants treated with bariatric surgery and a matched control group of 2040 participants receiving usual obesity care at primary health care centers. Self-reported pain in the neck and shoulders, back, hips, knees, and ankles was captured from questionnaires administered at baseline and after 1, 2, 3, 4, 6, 8, 10, 15, and 20 years. RESULTS Compared with matched controls, bariatric surgery was associated with better recovery from baseline work-restricting knee and ankle pain in both the short (1-4 years) and long term (up to 20 years), as well as from back and hip pain in the short term. In participants without pain at baseline, bariatric surgery was associated with a lower incidence of developing new pain in the knee and ankle in the short and long term. CONCLUSIONS Bariatric surgery was associated with better recovery from pain, primarily in weight-bearing joints, as well as with prevention of pain development in the knee and ankle compared with matched controls receiving usual obesity care.
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Affiliation(s)
- L Stefan Lohmander
- Orthopaedics, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden
| | - Markku Peltonen
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | | | - Kajsa Sjöholm
- Department of Molecular and Clinical Medicine, Institute of Medicine at the Sahlgrenska Academy, Gothenburg, Sweden
| | - Magdalena Taube
- Department of Molecular and Clinical Medicine, Institute of Medicine at the Sahlgrenska Academy, Gothenburg, Sweden
| | - Peter Jacobson
- Department of Molecular and Clinical Medicine, Institute of Medicine at the Sahlgrenska Academy, Gothenburg, Sweden
| | - Per-Arne Svensson
- Department of Molecular and Clinical Medicine, Institute of Medicine at the Sahlgrenska Academy, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena M S Carlsson
- Department of Molecular and Clinical Medicine, Institute of Medicine at the Sahlgrenska Academy, Gothenburg, Sweden
| | - Sofie Ahlin
- Department of Molecular and Clinical Medicine, Institute of Medicine at the Sahlgrenska Academy, Gothenburg, Sweden
- Region of Västra Götaland, NU Hospital Group, Department of Clinical Physiology, Trollhättan, Sweden
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Shrestha S, Sapkota S, Teoh SL, Kc B, Paudyal V, Lee SWH, Gan SH. Comprehensive assessment of pain characteristics, quality of life, and pain management in cancer patients: a multi-center cross-sectional study. Qual Life Res 2024:10.1007/s11136-024-03725-w. [PMID: 39105961 DOI: 10.1007/s11136-024-03725-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Pain is the most common complaint among cancer patients, significantly impairing their health-related quality of life (HRQOL). There is limited evidence on the characteristics of pain among cancer patients in Nepal with low-resource settings. OBJECTIVES The primary objective of this study was to evaluate the clinical characteristics of pain, factors influencing pain intensity, and the association of pain severity with quality of life (QoL) among cancer patients. Secondary objectives included investigating perceived barriers to pain management and medication adherence among these patients. METHODS This multi-center, cross-sectional study enrolled adult patients (over 18 years old) with reported cancer diagnoses experiencing pain. Socio-demographic characteristics (e.g., age, gender, educational status), clinical characteristics (e.g. cancer diagnosis, staging), and pain characteristics (e.g., duration, type, location, medicines used for pain management, etc.) were recorded. Outcomes were assessed using the Numeric rating scale (NRS), Pain management Index, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire, Barriers Questionnaire II, Medication Adherence Rating Scale, and Hospital Anxiety and Depression Scale. RESULTS Four hundred and eight patients participated in the study. The mean ± SD age was 54.87 ± 15.65, with 226 patients (55.4%) being female. The most common cancer diagnoses were cervical (17.6%), lung (11.8%), and colon/rectum (12.0%) cancers. The most common pain locations were the head and neck (27.0%); a majority (55.6%) reported pain duration of more than 3 months. Nociceptive pain was reported by 42.4% of patients; the mean ± SD of NRS was 4.31 ± 2.69, with 32.4% of patients experiencing moderate pain. Patients with mixed pain type (B = 1.458, p < 0.001) or pain in multiple sites (B = 1.175, p < 0.001), lower Karnofsky Performance Status (KPS) (B = -1.308, p < 0.001), and specific cancer diagnoses such as prostate (B = -2.045, p = 0.002), pancreatic (B = 1.852, p = 0.004), oesophageal (B = 1.674, p = 0.012), and ovarian cancer (B = 1.967, p = 0.047), experienced varying degrees of increased NRS score. The combined chemotherapy and radiotherapy treatment modality was associated with a lower NRS score (B = -0.583, p = 0.017). A significant inverse relationship was observed between pain severity and global health status/QoL (B = -37.36, p < 0.001. Key barriers to pain management included moderate perceptions of physiological effects, communication issues between doctors and patients, and concerns about the harmful effects of pain medicine. The prevalence of non-adherence to pain medications was 13.97%. CONCLUSION In conclusion, this study highlights the multi-faceted nature of pain management and QoL for cancer patients in Nepal with low-resource settings. These findings underscore the multifactorial nature of pain perception in cancer patients, with mixed pain types, pain in multiple sites, lower KPS, and specific cancer diagnoses, all contributing significantly to pain severity. Additionally, pain severity was associated with declining QoL. These findings contribute valuable insights into the complex aspects of cancer pain and its broader implications for the well-being of patients, offering a foundation for targeted interventions and improved pain management strategies in the context of cancer care in low-resource settings.
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Affiliation(s)
- Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia.
| | - Simit Sapkota
- Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Bagmati Province, Nepal
- Department of Clinical Oncology, Civil Service Hospital, Minbhawan, Kathmandu, Bagmati Province, Nepal
| | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
| | - Bhuvan Kc
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental 21 Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well Being Cluster, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
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Kougious R, Lung T, Humburg P, Delbaere K, van Schooten KS. The relationship between pain, quality of life and physical activity in older community living Australians. Geriatr Nurs 2024; 59:306-311. [PMID: 39098268 DOI: 10.1016/j.gerinurse.2024.07.021] [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: 01/28/2024] [Revised: 07/02/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024]
Abstract
The objective of this analysis was to investigate the relationship between pain and quality of life and physical activity as a mediator in the relationship between pain and quality of life. This study utilised a combination of questionnaire data from 503 community-living people aged 70-years and over concerning quality of life, pain, and physical activity. Participants with higher levels of pain intensity experienced lower quality of life and engaged in lessphysical activity (P < 0.05). Physical activity was a mediator in the relationship between pain and quality of life(6.5 %). This study confirms an association between pain and quality of life and highlights physical activ-ity as an essential component of this relationship; further research is needed to understand the mechanism of this relationship.
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Affiliation(s)
- Rohan Kougious
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
| | - Thomas Lung
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Peter Humburg
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Mark Wainwright Analytical Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; School of Population Health, University of New South Wales, Sydney, Australia.
| | - Kimberley S van Schooten
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; School of Population Health, University of New South Wales, Sydney, Australia
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Costa MFFD, Bilobran MA, de Oliveira LC, Muniz AHR, Chelles PA, Sampaio SGDSM. Correlation Between Cancer Pain and Quality of Life in Patients With Advanced Cancer Admitted to a Palliative Care Unit. Am J Hosp Palliat Care 2024; 41:882-888. [PMID: 37559447 DOI: 10.1177/10499091231195318] [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] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Cancer pain is one of the most prevalent manageable symptoms in patients with advanced cancer, and it has a negative impact on quality of life (QoL). OBJECTIVE The aim of this study is to examine the correlation between cancer pain and QoL in patients with advanced cancer who are hospitalized in a palliative care unit. METHODS This study is a cross-sectional analysis of patients with advanced cancer who were hospitalized with cancer pain at a specialized palliative care unit between June 2021 and February 2022. Pain intensity and its impact on daily activities were assessed using the Brief Pain Inventory (BPI), while the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 15 PAL (QLQ-C15-PAL) was used to evaluate QoL. RESULTS A total of 104 patients with cancer pain were included, with a mean age of 53.6 years (±14.1). Most of the patients were female (65.38%), and the most common primary tumor site was in the gastrointestinal tract (22.11%). The most frequently reported site of cancer pain was the abdomen (32.69%). The mean duration of cancer pain was 52.3 days (±6.2). The domains of QoL most strongly correlated with cancer pain were weakness (coefficient = .52, P < .001), nausea (coefficient = .36, P < .001), and the physical domain (coefficient = -.30, P < .001). CONCLUSION Cancer pain is strongly correlated with a deterioration in QoL in patients with advanced cancer, and its management should be pursued as a strategy for optimizing QoL.
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Affiliation(s)
| | - Marcela Amitrano Bilobran
- Palliative Care Unit, National Cancer Institute, Rio de Janeiro, Brazil
- Prevent Senior, Palliative Care, Rio de Janeiro, Brazil
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Sun F, Zimmer Z, Brouard N. Rural-urban residence and life expectancies with and without pain. Health Place 2024; 89:103305. [PMID: 38968815 DOI: 10.1016/j.healthplace.2024.103305] [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: 03/23/2024] [Revised: 05/18/2024] [Accepted: 06/21/2024] [Indexed: 07/07/2024]
Abstract
This paper analyzes rural-urban disparities in life expectancy with and without pain among upper-middle age and older adults. Data are from the nationally representative Health and Retirement Study, 2000-2018, N = 18,160, age 53+. Interpolated Markov Chain software, based on the multistate life tables, is used to calculate absolute and relative pain expectancies by age, sex, rural-suburban-urban residence and U.S. regions. Results show significant rural disadvantages versus those in urban and often suburban areas. Example: males at 55 in rural areas can expect to live 15.1 years, or 65.2 percent pain-free life, while those in suburban areas expect to live 1.7 more years, or 2.6 percentage points more, pain-free life and urban residents expect to live 2.4 more year, or 4.7 percentage points more. The rural disadvantage persists for females, with differences being a little less prominent. At very old age (85+), rural-urban differences diminish or reverse. Rural-urban pain disparities are most pronounced in the Northeast and South regions, and least in the Midwest and West. The findings highlight that rural-urban is an important dimension shaping the geography of pain. More research is needed to disentangle the mechanisms through which residential environments impact people's pain experiences.
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Affiliation(s)
- Feinuo Sun
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, United States.
| | - Zachary Zimmer
- Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Nicolas Brouard
- Department of Mortality Health and Epidemiology, French Institute for Demographic Studies, Paris, France
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Murin PJ, Khasiyev F, Profirovic J, Fedorova M, Kafaie J. Comparing FGFR-3 and TS-HDS Seropositive Small Fiber Neuropathy: Unique Patient Features, Symptoms, Laboratory, and Nerve Conduction Study Findings. J Clin Neuromuscul Dis 2024; 25:171-177. [PMID: 38771226 DOI: 10.1097/cnd.0000000000000478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
OBJECTIVES Small fiber neuropathy presents a significant diagnostic and therapeutic challenge. To solve this challenge, efforts have been made to identify autoantibodies associated with this condition. Previous literature has often considered tri-sulfated heparin disaccharide (TS-HDS) and fibroblast growth factor receptor 3 (FGFR3) as a singular seropositive group and/or focused primarily on symptomatic associations. METHODS One hundred seventy-two small fiber neuropathy patients with a Washington University Sensory Neuropathy panel were selected for TS-HDS seropositivity, FGFR-3 seropositivity, and seronegative controls. Data were collected to on the demographic, symptomatic, and laboratory profiles of each subgroup. RESULTS Percent female (P = 0.0043), frequency of neuropathic pain symptoms (P = 0.0074), and erythrocyte sedimentation rate (P = 0.0293), vitamin D (P < 0.0001), and vitamin B12 (P = 0.0033) differed between the groups. Skin biopsy was more frequently normal within both the FGFR-3 and the TS-HDS cohort (P = 0.0253). CONCLUSIONS TS-HDS and FGFR-3 display a distinct phenotype from both controls and one another. Immunoglobulin M (IgM) against FGFR-3 and IgM against TS-HDS may be individually valuable markers for the development of distinct clinical phenotypes.
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Affiliation(s)
- Peyton J Murin
- Department of Neurology, Saint Louis University, Saint Louis, MO
| | - Farid Khasiyev
- Department of Neurology, Saint Louis University, Saint Louis, MO
| | - Jasmina Profirovic
- Department of Pharmaceutical and Administrative Sciences, St. Louis College of Pharmacy at UHSP, St. Louis, MO
| | | | - Jafar Kafaie
- Department of Neurology, Saint Louis University, Saint Louis, MO
- Department of Pharmacology and Physiology, Saint Louis University, Saint Louis, MO
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Kittelsen TB, Lorentsen VB, Castor C, Lee A, Kvarme LG, Winger A. It's about living a normal life: parents' quality of life when their child has a life-threatening or life-limiting condition - a qualitative study. BMC Palliat Care 2024; 23:92. [PMID: 38589835 PMCID: PMC11003040 DOI: 10.1186/s12904-024-01417-3] [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: 02/08/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Pediatric palliative care (PPC) seeks to enhance the quality of life (QoL) for both children and their families. While most studies within PPC have focused on the ill child's QoL, less is known about parents' experiences of their own QoL. The aim of this study was to explore parents' QoL when their child has a life-threatening or life-limiting condition. METHODS The study has a qualitative, hermeneutic phenomenological design inspired by van Manen's phenomenology of practice. In-depth interviews were conducted with 12 fathers and 12 mothers of children living with cancer or a genetic condition. A deeper understanding of parents' lived experiences was obtained through an adapted photo elicitation method. Two rounds of thematic analysis were conducted, covering both the photo elicitation data, and interview data. RESULTS The findings describe four themes related to parents' QoL: living a normal life, giving my child a good life, having time to fulfill siblings' needs, and feeling heard and respected in the health and social care system. CONCLUSIONS The complexity of elements shaping parents' QoL is evident. The interconnectedness between parents, the ill child, siblings, and interactions with the health and social care system, highlights the need to understand and address diverse aspects in enhancing parents QoL.
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Affiliation(s)
- Trine Brun Kittelsen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Pilestredet 32, Oslo, 0167, Norway.
| | - Vibeke Bruun Lorentsen
- Faculty of Health Sciences, Institute for Nursing, VID Specialized University, Oslo, Norway
| | | | - Anja Lee
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital HF, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Pilestredet 32, Oslo, 0167, Norway
| | - Anette Winger
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Pilestredet 32, Oslo, 0167, Norway
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Jang EH, Eum YJ, Yoon D, Sohn JH, Byun S. Comparing multimodal physiological responses to social and physical pain in healthy participants. Front Public Health 2024; 12:1387056. [PMID: 38638471 PMCID: PMC11025361 DOI: 10.3389/fpubh.2024.1387056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Background Previous physiology-driven pain studies focused on examining the presence or intensity of physical pain. However, people experience various types of pain, including social pain, which induces negative mood; emotional distress; and neural activities associated with physical pain. In particular, comparison of autonomic nervous system (ANS) responses between social and physical pain in healthy adults has not been well demonstrated. Methods We explored the ANS responses induced by two types of pain-social pain, associated with a loss of social ties; and physical pain, caused by a pressure cuff-based on multimodal physiological signals. Seventy-three healthy individuals (46 women; mean age = 20.67 ± 3.27 years) participated. Behavioral responses were assessed to determine their sensitivity to pain stimuli. Electrocardiogram, electrodermal activity, photoplethysmogram, respiration, and finger temperature (FT) were measured, and 12 features were extracted from these signals. Results Social pain induced increased heart rate (HR) and skin conductance (SC) and decreased blood volume pulse (BVP), pulse transit time (PTT), respiration rate (RR), and FT, suggesting a heterogeneous pattern of sympathetic-parasympathetic coactivation. Moreover, physical pain induced increased heart rate variability (HRV) and SC, decreased BVP and PTT, and resulted in no change in FT, indicating sympathetic-adrenal-medullary activation and peripheral vasoconstriction. Conclusion These results suggest that changes in HR, HRV indices, RR, and FT can serve as markers for differentiating physiological responses to social and physical pain stimuli.
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Affiliation(s)
- Eun-Hye Jang
- Mobility User Experience Research Section, Electronics Telecommunication and Research Institute, Daejeon, Republic of Korea
| | - Young-Ji Eum
- Bio-Chemical Analysis Team, Korea Basic Science Institute, Cheongju, Republic of Korea
| | - Daesub Yoon
- Mobility User Experience Research Section, Electronics Telecommunication and Research Institute, Daejeon, Republic of Korea
| | - Jin-Hun Sohn
- Department of Psychology, Chungnam National University, Daejeon, Republic of Korea
| | - Sangwon Byun
- Department of Electronics Engineering, Incheon National University, Incheon, Republic of Korea
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12
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Murin PJ, Massabki I, Kafaie J. Anti-Plexin-D1 Seropositive Small Fiber Neuropathy: Clinical Phenotype, Demographics, and Literature Review. J Clin Neuromuscul Dis 2024; 25:132-140. [PMID: 38441929 DOI: 10.1097/cnd.0000000000000472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVES Small fiber neuropathy (SFN) is a subtype of painful neuropathies defined by dysfunction of the Aδ and unmyelinated C fibers. It presents with both neuropathic pain and dysautonomia symptoms, posing a significant diagnostic and therapeutic challenge. To address this challenge, research has been conducted to identify autoantibodies and define their association with phenotypes. METHODS Eleven cases of anti-plexin-D1 seropositive SFN were reviewed, along with relevant literature, in attempt to better define anti-plexin-D1 SFN demographics, symptoms, associated medical conditions, and therapeutics. RESULTS Anti-plexin-D1 SFN typically presents in female patients, with neuropathic pain, normal skin biopsy findings, and normal nerve conduction studies. Anti-plexin-D1 shows an association with concurrent chronic pain, with almost half of the patients undergoing an interventional procedure. CONCLUSIONS Anti-plexin-D1 represents a unique subgroup of SFN, defined by distinct demographics, phenotype, biopsy findings, and therapeutic management.
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Affiliation(s)
- Peyton J Murin
- Department of Neurology, Saint Louis University, Saint Louis, MO
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13
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Buonanno P, Iacovazzo C, Marra A, de Siena AU, Josu T, Zampi M, Sedda D, Servillo G, Vargas M. Potential Role of Focal Microvibration (Equistasi ®) in the Management of Chronic Pain: A Pilot Study. Pain Ther 2024; 13:185-198. [PMID: 38057548 PMCID: PMC10796875 DOI: 10.1007/s40122-023-00562-6] [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: 09/21/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION Chronic pain is one of the leading causes of medical consultation with a dramatic psychophysical and socioeconomic impact. Focal microvibration (Equistasi®) is a revolutionary technology that converts the thermal energy of the skin into vibration. Equistasi® was shown to be effective in the treatment of gait and balance dysfunction in many pathological conditions such as Parkinson's disease and multiple sclerosis. Our aim was to explore the efficacy of focal microvibration in the management of chronic pain. METHODS We randomized 60 patients with pain of different origin into two groups: an experimental group (group E) treated with Equistasi, and a control group (group C) treated with standard pharmacological therapy. Pain, disability, and working capacity were evaluated by Brief Pain Inventory (BPI), Oswestry Disability Index (ODI), and Work Ability Index (WAI) at the baseline and after 7 (T7), 15 (T15), 30 (T30), 60 (T60), and 90 (T90) days. RESULTS According to BPI, average and worst pain in the last 24 h significantly decreased in group E at T15 and this result persisted up to T90; pain interference on general activity, mood, waling ability, normal work, relations with other people, sleep, and enjoyment of life decreased in group E with a significant improvement from T15. Lifting activity and work ability in relation to demands also significantly improved in group E. No significant changes in BPI, ODI, and WAI scores were recorded in group C during the follow-up. CONCLUSIONS Focal microvibration can be an effective tool for managing chronic pain in combination with other therapies.
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Affiliation(s)
- Pasquale Buonanno
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Carmine Iacovazzo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Annachiara Marra
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Andrea Uriel de Siena
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Tatiana Josu
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Maddalena Zampi
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Davide Sedda
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Giuseppe Servillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Maria Vargas
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
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14
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Gnall KE, Sinnott SM, Laumann LE, Park CL, David A, Emrich M. Changes in Interoception in Mind-body Therapies for Chronic Pain: A Systematic Review and Meta-Analysis. Int J Behav Med 2024:10.1007/s12529-023-10249-z. [PMID: 38169051 DOI: 10.1007/s12529-023-10249-z] [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] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Emerging literature has demonstrated deficits in interoception (i.e., the perception of physical sensations from inside the body) in individuals with chronic pain conditions. Mind-body therapies (MBTs) are purported to improve chronic pain in part through improving or restoring interoceptive abilities. The present systematic review and meta-analysis aimed to examine changes in interoception in MBTs for chronic pain conditions. METHODS A systematic search of PubMed, PsycINFO, Scopus, CINAHL, and ProQuest Dissertation and Theses was conducted from database inception to February 2023. English language intervention studies evaluating the effect of MBTs on interoception in adults with chronic pain conditions were examined. Changes in pain (severity and interference) following treatment were examined as secondary outcomes. RESULTS A total of 11 studies (10 unique samples) were identified. Meta-analytic results reveal significant improvements in total interoceptive awareness (Becker's d = 1.168, p < .01) as well as improvements in seven of eight subdomains of interoceptive awareness (ds = 0.28 to 0.81). MBTs were also associated with reductions in both pain intensity (d = -1.46, p = .01) and pain interference (d = -1.07, p < .001). CONCLUSIONS Preliminary research suggests that MBTs demonstrate improvements in interoceptive awareness and reduce pain in adults with chronic pain. Literature on changes in other domains of interoception, such as interoceptive accuracy, following MBTs is severely lacking. Although more rigorous studies are needed to corroborate results, the present findings lay an important foundation for future research to examine interoception as a possible underlying mechanism of MBTs to improve pain outcomes.
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Affiliation(s)
- Katherine E Gnall
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA.
| | - Sinead M Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Laura E Laumann
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Adam David
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Mariel Emrich
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
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15
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Buchwald D, Schmidt C, Buchwald D, Winter KI, Nielsen IB, Klostergaard K, Melgaard D, Fagerberg SK, Leutscher PDC. Impact of Low-Dose Dronabinol Therapy on Cognitive Function in Cancer Patients Receiving Palliative Care: A Case-Series Intervention Study. Palliat Med Rep 2023; 4:326-333. [PMID: 38098857 PMCID: PMC10719641 DOI: 10.1089/pmr.2023.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Background Cannabis may offer therapeutic benefits to patients with advanced cancer not responding adequately to conventional palliative treatment. However, tolerability is a major concern. Cognitive function is a potential adverse reaction to tetrahydrocannabinol containing regimens. The aim of this study was to test cognitive function in patients being prescribed dronabinol as an adjuvant palliative therapy. Methods Adult patients with advanced cancer and severe related pain refractory to conventional palliative treatment were included in this case-series study. Patients were examined at baseline in conjunction with initiation of dronabinol therapy and at a two-week follow-up using three selected Wechsler's adult intelligence scale III neurocognitive tests: Processing Speed Index (PSI), Perceptual Organization Index (POI), and Working Memory Index (WMI). Patients were also assessed using pain visual analog scale, Major Depression Inventory, and Brief Fatigue Inventory. Results Eight patients consented to take part in the study. Two patients discontinued dronabinol therapy, one due to a complaint of dizziness and another critical progression of cancer disease, respectively. The remaining six patients were successfully treated with a daily dosage of 12.5 mg dronabinol (p = 0.039). PSI (p = 0.020), POI (p = 0.034.), and WMI (p = 0.039). Conclusions Cognitive function improved in this group of patients with advanced cancer in conjunction with low-dose dronabinol therapy. The cause is likely multifactorial including reported relief of cancer-associated symptoms. Further clinical investigation is required.
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Affiliation(s)
- Ditte Buchwald
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Casper Schmidt
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Dorte Buchwald
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Palliative Care Team, Department of Gerontology, North Denmark Regional Hospital, Hjørring, Denmark
| | - Kristina Iris Winter
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Palliative Care Team, Department of Gerontology, North Denmark Regional Hospital, Hjørring, Denmark
| | - Ivan Bo Nielsen
- Palliative Care Team, Department of Gerontology, North Denmark Regional Hospital, Hjørring, Denmark
| | - Kirsten Klostergaard
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
| | - Dorte Melgaard
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Steen K. Fagerberg
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
| | - Peter Derek Christian Leutscher
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Palliative Care Team, Department of Gerontology, North Denmark Regional Hospital, Hjørring, Denmark
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16
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Zimmer Z, Zajacova A, Fraser K, Powers D, Grol-Prokopczyk H. A global comparative study of wealth-pain gradients: Investigating individual- and country-level associations. DIALOGUES IN HEALTH 2023; 2:100122. [PMID: 38099153 PMCID: PMC10718570 DOI: 10.1016/j.dialog.2023.100122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/27/2023] [Accepted: 03/05/2023] [Indexed: 12/17/2023]
Abstract
Pain is a significant yet underappreciated dimension of population health. Its associations with individual- and country-level wealth are not well characterized using global data. We estimate both individual- and country-level wealth inequalities in pain in 51 countries by combining data from the World Health Organization's World Health Survey with country-level contextual data. Our research concentrates on three questions: 1) Are inequalities in pain by individual-level wealth observed in countries worldwide? 2) Does country-level wealth also relate to pain prevalence? 3) Can variations in pain reporting also be explained by country-level contextual factors, such as income inequality? Analytical steps include logistic regressions conducted for separate countries, and multilevel models with random wealth slopes and resultant predicted probabilities using a dataset that pools information across countries. Findings show individual-level wealth negatively predicts pain almost universally, but the association strength differs across countries. Country-level contextual factors do not explain away these associations. Pain is generally less prevalent in wealthier countries, but the exact nature of the association between country-level wealth and pain depends on the moderating influence of country-level income inequality, measured by the Gini index. The lower the income inequality, the more likely it is that poor countries experience the highest and rich countries the lowest prevalence of pain. In contrast, the higher the income inequality, the more nonlinear the association between country-level wealth and pain reporting such that the highest prevalence is seen in highly nonegalitarian middle-income countries. Our findings help to characterize the global distribution of pain and pain inequalities, and to identify national-level factors that shape pain inequalities.
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Affiliation(s)
- Zachary Zimmer
- Department of Family Studies and Gerontology, Global Aging and Community Initiative, 166 Bedford Highway, McCain Centre 201C, Halifax, Nova Scotia B2M2J6, Canada
| | - Anna Zajacova
- Department of Sociology, Social Science Centre Room 5306, University of Western Ontario, London, Ontario N6A5C2, Canada
| | - Kathryn Fraser
- Global Aging and Community Initiative, 166 Bedford Highway, McCain Centre 201C, Halifax, Nova Scotia B2M2J6, Canada
| | - Daniel Powers
- Department of Sociology, RLP 2.622J, University of Texas at Austin, Austin, TX 78712-1086, USA
| | - Hanna Grol-Prokopczyk
- Department of Sociology, 430 Park Hall, University at Buffalo, Buffalo, NY 14260-4140, USA
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17
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Hector MS, Cheng JC, Hemington KS, Rogachov A, Kim JA, Osborne NR, Bosma RL, Fauchon C, Ayoub LJ, Inman R, Oh J, Anastakis DJ, Davis KD. Resilience is associated with cortical gray matter of the antinociceptive pathway in people with chronic pain. Biol Psychol 2023; 183:108658. [PMID: 37567549 DOI: 10.1016/j.biopsycho.2023.108658] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/12/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Resilience is an important personal characteristic that influences health and recovery. Previous studies of chronic pain suggest that highly resilient people may be more effective at modulating their pain. Since brain gray matter in the antinociceptive pathway has also been shown to be abnormal in people with chronic pain, we examined whether resilience is related to gray matter in regions of interest (ROIs) of the antinociceptive pathway (rostral and subgenual anterior cingulate cortex (rACC, sgACC), anterior insula (aINS), dorsolateral prefrontal cortex (dlPFC)) normally and in people who are experiencing chronic pain. We extracted gray matter volume (GMV) and cortical thickness (CT) from 3T MRIs of 88 people with chronic pain (half males/females) and 86 healthy controls (HCs), who completed The Resilience Scale and Brief Pain Inventory. We found that resilience scores were significantly lower in people with chronic pain compared to HCs, whereas ROI GMV and CT were not different between groups. Resilience negatively correlated with average pain scores and positively correlated with GMV in the bilateral rACC, sgACC, and left dlPFC of people with chronic pain. Mediation analyses revealed that GMV in the right rACC and left sgACC partially co-mediated the relationship between resilience and average pain in people with chronic pain. The resilience-pain and some resilience-GMV relationships were sex-dependent. These findings suggest that the antinociceptive pathway may play a role in the impact of resilience on one's ability to modulate chronic pain. A better understanding of the brain-resilience relationship may help advance evidence-based approaches to pain management.
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Affiliation(s)
- Melinda S Hector
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Joshua C Cheng
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Kasey S Hemington
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Anton Rogachov
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Junseok A Kim
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Natalie R Osborne
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Rachael L Bosma
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - Camille Fauchon
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - Lizbeth J Ayoub
- Centre for Multimodal Sensorimotor and Pain Research, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Division of Clinical and Computational Neuroscience, Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - Robert Inman
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada; Division of Immunology, University of Toronto, Toronto, ON, Canada
| | - Jiwon Oh
- Division of Neurology, Department of Medicine, St. Michael's Hospital, Toronto, ON, Canada
| | - Dimitri J Anastakis
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, Canada
| | - Karen D Davis
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, Canada.
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18
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Huber M, Larsson C, Lehmann J, Strigård K, Lindam A, Tunón K. Sonographic postpartum anal sphincter defects and the association with pelvic floor pain and dyspareunia. Acta Obstet Gynecol Scand 2023; 102:1290-1297. [PMID: 37350333 PMCID: PMC10540925 DOI: 10.1111/aogs.14606] [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: 12/30/2022] [Revised: 04/09/2023] [Accepted: 05/15/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION Pelvic floor pain and dyspareunia are both important entities of postpartum pelvic pain, often concomitant and associated with perineal tears during vaginal delivery. The association between postpartum sonographic anal sphincter defects, pelvic floor pain, and dyspareunia has not been fully established. We aimed to determine the prevalence of postpartum anal sphincter defects using three-dimensional endoanal ultrasonography (3D-EAUS) and evaluate their association with symptoms of pelvic floor pain and dyspareunia. MATERIAL AND METHODS This prospective cohort study followed 239 primiparas from birth to 12 months post delivery. Anal sphincters were assessed with 3D-EAUS 3 months postpartum, and self-reported pelvic floor function data were obtained using a web-based questionnaire distributed 1 year after delivery. Descriptive statistics were compared between the patients with and without sonographic defects, and the association between sonographic sphincter defects and outcomes were analyzed using logistic regression. RESULTS At 3 months postpartum, 48/239 (20%) patients had anal sphincter defects on 3D-EAUS, of which 43 (18%) were not clinically diagnosed with obstetric anal sphincter injury at the time of delivery. Patients with sonographic defects had higher fetal weight than those without defects, and a perineum <2 cm before the suture was a risk factor for defects (odds ratio [OR], 6.9). Patients with sonographic defects had a higher frequency of dyspareunia (OR, 2.4), and pelvic floor pain (OR, 2.3) than those without defects. CONCLUSIONS Our results suggest an association between postpartum sonographic anal sphincter defects, pelvic floor pain, and dyspareunia. A perineal height <2 cm, measured by bidigital palpation immediately postdelivery, was a risk factor for sonographic anal sphincter defect. We suggest offering pelvic floor sonography around 3 months postpartum to high- risk women to optimize diagnosis and treatment of perineal tears and include perineum <2 cm prior to primary repair as a proposed indication for postpartum follow-up sonography.
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Affiliation(s)
- Malin Huber
- Department of Clinical Sciences, Obstetrics and GynecologyUmeå UniversityUmeåSweden
| | - Charlotta Larsson
- Department of Surgical and Perioperative SciencesUmeå UniversityUmeåSweden
| | - Jan‐P Lehmann
- Department of SurgeryÖstersund HospitalÖstersundSweden
| | - Karin Strigård
- Department of Surgical and Perioperative SciencesUmeå UniversityUmeåSweden
| | - Anna Lindam
- Unit of Research, Education and Development, Department of Public Health and Clinical Medicine, Östersund HospitalUmeå UniversityUmeåSweden
| | - Katarina Tunón
- Department of Clinical Sciences, Obstetrics and GynecologyUmeå UniversityUmeåSweden
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Karimi R, Prego-Domínguez J, Takkouche B. Factors Contributing to the Link between Physical Well-Being and Chronic Pain in Young People from Galicia, Northwest Spain. J Clin Med 2023; 12:4228. [PMID: 37445263 DOI: 10.3390/jcm12134228] [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: 05/04/2023] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction: The relation between physical well-being and chronic pain is complex and involves several subjective and objective covariates. We aimed to assess the role of mediator, confounder, or interactor played by covariates, including sleep quality, physical activity, perceived stress, smoking, and alcohol drinking in the relation between physical well-being and chronic pain. Method: We used Poisson regression to obtain incidence rate ratios (IRR) of the association between physical well-being and chronic pain in a cohort study carried out among university students. We applied General Structural Equation Modeling (GSEM) to assess mediation and stratum-specific analyses to distinguish confounding from interaction. We computed Relative Excess Risks due to Interaction (RERI), Attributable Proportion (AP), and the Synergy index (S) to measure additive interaction. Results: High physical well-being is related to a large decrease in the risk of chronic pain (IRRTotal Effect = 0.58; 95% CI: 0.50-0.81). Perceived stress mediates 12.5% of the total effect of physical well-being on chronic pain. The stratum-specific IRRs of current smokers and non-current smokers were different from each other and were larger than the crude IRR (IRR = 1.49; 95% CI: 1.24-1.80), which indicates that smoking could be both confounder and interactor. Interaction analyses showed that physical activity could act as a potential interactor (RERI = 0.25; 95% CI: 0.13, 0.60). Conclusions: Perceived stress is an important mediator of the relation between physical well-being and chronic pain, while smoking is both a confounder and an interactor. Our findings may prove useful in distinguishing high-risk groups from low-risk groups, in the interventions aimed at reducing chronic pain.
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Affiliation(s)
- Roya Karimi
- Department of Preventive Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Jesús Prego-Domínguez
- Department of Preventive Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), 28029 Madrid, Spain
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Nemes B, László S, Zsidó BZ, Hetényi C, Feher A, Papp F, Varga Z, Szőke É, Sándor Z, Pintér E. Elucidation of the binding mode of organic polysulfides on the human TRPA1 receptor. Front Physiol 2023; 14:1180896. [PMID: 37351262 PMCID: PMC10282659 DOI: 10.3389/fphys.2023.1180896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction: Previous studies have established that endogenous inorganic polysulfides have significant biological actions activating the Transient Receptor Potential Ankyrin 1 (TRPA1) receptor. Organic polysulfides exert similar effects, but they are much more stable molecules, therefore these compounds are more suitable as drugs. In this study, we aimed to better understand the mechanism of action of organic polysulfides by identification of their binding site on the TRPA1 receptor. Methods: Polysulfides can readily interact with the thiol side chain of the cysteine residues of the protein. To investigate their role in the TRPA1 activation, we replaced several cysteine residues by alanine via site-directed mutagenesis. We searched for TRPA1 mutant variants with decreased or lost activating effect of the polysulfides, but with other functions remaining intact (such as the effects of non-electrophilic agonists and antagonists). The binding properties of the mutant receptors were analyzed by in silico molecular docking. Functional changes were tested by in vitro methods: calcium sensitive fluorescent flow cytometry, whole-cell patch-clamp and radioactive calcium-45 liquid scintillation counting. Results: The cysteines forming the conventional binding site of electrophilic agonists, namely C621, C641 and C665 also bind the organic polysulfides, with the key role of C621. However, only their combined mutation abolished completely the organic polysulfide-induced activation of the receptor. Discussion: Since previous papers provided evidence that organic polysulfides exert analgesic and anti-inflammatory actions in different in vivo animal models, we anticipate that the development of TRPA1-targeted, organic polysulfide-based drugs will be promoted by this identification of the binding site.
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Affiliation(s)
- Balázs Nemes
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Szabolcs László
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Department of Inorganic and Analytical Chemistry, Faculty of Chemical Technology and Biotechnology, Budapest University of Technology and Economics, Budapest, Hungary
| | - Balázs Zoltán Zsidó
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Csaba Hetényi
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Adam Feher
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ferenc Papp
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zoltan Varga
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Éva Szőke
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Zoltán Sándor
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Erika Pintér
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
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21
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Baik JS, Yang JH, Ko SH, Lee SJ, Shin YI. Exploring the Potential of Transcranial Direct Current Stimulation for Relieving Central Post-Stroke Pain: A Randomized Controlled Pilot Study. Life (Basel) 2023; 13:life13051172. [PMID: 37240817 DOI: 10.3390/life13051172] [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: 03/29/2023] [Revised: 05/08/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
The potential of transcranial direct current stimulation (tDCS) as a non-invasive brain stimulation technique for treating pain has been studied. However, its effectiveness in patients with central post-stroke pain (CPSP) and the impact of lesion location remain unclear. This study investigated tDCS's pain reduction effects in patients with CPSP. Twenty-two patients with CPSP were randomized into the tDCS or sham groups. The tDCS group received stimulation of the primary motor cortex (M1) for 20 min, five times weekly, for two weeks, and underwent evaluations at baseline, immediately after the intervention, and one week after the intervention. The tDCS group had no significant improvement compared to the sham group in pain, depression, and quality of life. Nevertheless, significant changes were identified within the tDCS group, and the pain trends appeared to be influenced by the lesion location. These findings provide important insights into the use of tDCS in patients with CPSP, which could inform further research and development of pain treatment options.
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Affiliation(s)
- Ji-Soo Baik
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Jung-Hyun Yang
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Sung-Hwa Ko
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Rehabilitation Medicine, The Graduate School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea
| | - So-Jung Lee
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Rehabilitation Medicine, The Graduate School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea
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22
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Raepsaet C, Alves P, Cullen B, Gefen A, Lázaro-Martínez JL, Lev-Tov H, Najafi B, Santamaria N, Sharpe A, Swanson T, Woo K, Beeckman D. The development of a core outcome set for clinical effectiveness studies of bordered foam dressings in the treatment of complex wounds. J Tissue Viability 2023:S0965-206X(23)00046-3. [PMID: 37127485 DOI: 10.1016/j.jtv.2023.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/05/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
AIM The aim of this project was to develop a core outcome set (COS) for clinical effectiveness studies of bordered foam dressings in the treatment of complex wounds. METHODS The research project followed the Core Outcome Measures in Effectiveness Trials (COMET) initiative and consisted of two phases. The first phase prepared the background and process, while the second phase had three steps: outcome list generation via systematic review and qualitative study, Delphi consensus study, and consensus meeting. The study has been registered in the Core Outcome Measures in Effectiveness Trials database. RESULTS The systematic review resulted in 82 outcomes and 20 additional outcomes were obtained during the interviews. After refinement, 111 panellists from 23 countries rated a list of 51 outcomes. In the following consensus meeting, six outcomes were prioritized to be included in the core outcome set. After the consensus meeting, a patient-reported outcome was added to the core outcome set. CONCLUSION The COS for evaluating the effectiveness of bordered foam dressings in treating complex wounds includes 7 outcomes: "ability to stay in place", "leakage", "pain", "dressing related periwound skin changes", "change in wound size over time", and "overall satisfaction". These identified outcomes are correlated with contemporary bioengineering testing and evaluation methods for dressing performance, which underpins the need for a close multidisciplinary collaboration to advance the field of wound dressings. The outcome 'overall satisfaction' reflects the impact of complex wounds and their treatment on a patient's daily life. The use of these outcomes is recommended to improve data synthesis and promote evidence-based practice. Future developments in COS development involve creating measurement instruments and relevant endpoints for these outcomes.
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Affiliation(s)
- Charlotte Raepsaet
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Paulo Alves
- Wounds Research Lab - Centre for Interdisciplinary Research in Health, Catholic University of Portugal, Porto, Portugal
| | | | - Amit Gefen
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | | | - Hadar Lev-Tov
- University of Miami Hospital Miller School of Medicine, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami, FL, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Nick Santamaria
- School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Sharpe
- Podiatry Department, Salford Royal NHS Foundation Trust, Salford Care Organisation, Salford, United Kingdom
| | | | - Kevin Woo
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Swedish Centre for Skin and Wound Research, Faculty of Health and Medicine, School of Health Sciences, Örebro University, Örebro, Sweden; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Odense, Denmark; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
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23
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Sun F, Zimmer Z, Zajacova A. Educational Differences in Life Expectancies With and Without Pain. J Gerontol B Psychol Sci Soc Sci 2023; 78:695-704. [PMID: 36242782 PMCID: PMC10066743 DOI: 10.1093/geronb/gbac169] [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: 04/13/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study computes years and proportion of life that older adults living in the United States can expect to live pain-free and in different pain states, by age, sex, and level of education. The analysis addresses challenges related to dynamics and mortality selection when studying associations between education and pain in older populations. METHODS Data are from National Health and Aging Trends Study, 2011-2020. The sample contains 10,180 respondents who are age 65 and older. Pain expectancy estimates are computed using the Interpolated Markov Chain software that applies probability transitions to multistate life tables. RESULTS Those with higher educational levels expect not only a longer life but also a higher proportion of life without pain. For example, a 65-year-old female with less than high school education expects 18.1 years in total and 5.8 years, or 32% of life, without pain compared with 23.7 years in total with 10.7 years, or 45% of life without pain if she completed college. The education gradient in pain expectancies is more salient for females than males and narrows at the oldest ages. There is no educational disparity in the percent of life with nonlimiting pain. DISCUSSION Education promotes longer life and more pain-free years, but the specific degree of improvement by education varies across demographic groups. More research is needed to explain associations between education and more and less severe and limiting aspects of pain.
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Affiliation(s)
- Feinuo Sun
- Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Zachary Zimmer
- Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Anna Zajacova
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
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24
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Zhang M, Zhu L, Lin SY, Herr K, Chi CL, Demir I, Dunn Lopez K, Chi NC. Using artificial intelligence to improve pain assessment and pain management: a scoping review. J Am Med Inform Assoc 2023; 30:570-587. [PMID: 36458955 PMCID: PMC9933069 DOI: 10.1093/jamia/ocac231] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022] Open
Abstract
CONTEXT Over 20% of US adults report they experience pain on most days or every day. Uncontrolled pain has led to increased healthcare utilization, hospitalization, emergency visits, and financial burden. Recognizing, assessing, understanding, and treating pain using artificial intelligence (AI) approaches may improve patient outcomes and healthcare resource utilization. A comprehensive synthesis of the current use and outcomes of AI-based interventions focused on pain assessment and management will guide the development of future research. OBJECTIVES This review aims to investigate the state of the research on AI-based interventions designed to improve pain assessment and management for adult patients. We also ascertain the actual outcomes of Al-based interventions for adult patients. METHODS The electronic databases searched include Web of Science, CINAHL, PsycINFO, Cochrane CENTRAL, Scopus, IEEE Xplore, and ACM Digital Library. The search initially identified 6946 studies. After screening, 30 studies met the inclusion criteria. The Critical Appraisals Skills Programme was used to assess study quality. RESULTS This review provides evidence that machine learning, data mining, and natural language processing were used to improve efficient pain recognition and pain assessment, analyze self-reported pain data, predict pain, and help clinicians and patients to manage chronic pain more effectively. CONCLUSIONS Findings from this review suggest that using AI-based interventions has a positive effect on pain recognition, pain prediction, and pain self-management; however, most reports are only pilot studies. More pilot studies with physiological pain measures are required before these approaches are ready for large clinical trial.
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Affiliation(s)
- Meina Zhang
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Linzee Zhu
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Shih-Yin Lin
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Keela Herr
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Chih-Lin Chi
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ibrahim Demir
- College of Engineering, University of Iowa, Iowa City, Iowa, USA
| | | | - Nai-Ching Chi
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
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25
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Falck J, Rolander B, Nygårdh A, Jonasson LL, Mårtensson J. Women with lipoedema: a national survey on their health, health-related quality of life, and sense of coherence. BMC Womens Health 2022; 22:457. [PMCID: PMC9673372 DOI: 10.1186/s12905-022-02022-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background Lipoedema is a chronic disease in adipose tissue that almost exclusively affects women during periods of hormonal alterations. Its main symptoms include an abnormal accumulation of subcutaneous fat in the buttock, hips, and legs, which is associated with pain, swelling, and easy bruising. Herein, a grading in three stages is used to determine disease progression. Problematically, lipoedema manifestations are often confused with lifestyle-induced obesity, which is why the various health problems among affected women often remain unrecognized. Overall, research on lipoedema is scarce. As such, this study examined the health, health-related quality of life (HRQOL), and sense of coherence (SOC) among women with lipoedema. Methods We conducted a national cross-sectional study using an online survey assessing sociodemographic data, lipoedema characteristics, symptom severity, comorbidities, HRQOL (RAND-36), and SOC (SOC-13). In total, 245 women with lipoedema, recruited from all Lipoedema Association groups in Sweden, participated. Data were compiled with descriptive statistics, and mean differences between groups were analysed by using parametric and non-parametric tests. Results Moderate and severe leg heaviness, pain, numbness, cold skin, feeling cold, easy bruising, and sleep problems were found to occur in all lipoedema stages. Moreover, almost all participants reported having comorbidities. Worse physical health and most substantial limitations in daily life were reported among women with the most progressive lipoedema (i.e., stage 3). Social and emotional functioning and SOC were found to be, on the other hand, primarily related to respondents’ sociodemographic data and their ages at lipoedema onset. Even though approximately 70% of the women had experienced lipoedema onset before age 30, only three (1.6%) had been diagnosed by a healthcare professional before that age. Conclusion Having lipoedema is associated with several health problems and a lower HRQOL. In addition, the extent of delay in diagnosis within this sample indicates that many women with lipoedema are often underdiagnosed and are left without support from healthcare. These findings call for the need for greater attention on lipoedema. Moreover, further studies on how women with lipoedema manage their health and symptoms, as well as on their experiences of healthcare services and lipoedema treatments, are needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-02022-3.
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Affiliation(s)
- Johanna Falck
- grid.118888.00000 0004 0414 7587Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bo Rolander
- grid.451698.7Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden ,grid.118888.00000 0004 0414 7587Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Annette Nygårdh
- grid.118888.00000 0004 0414 7587Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Lise-Lotte Jonasson
- grid.118888.00000 0004 0414 7587Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Jan Mårtensson
- grid.118888.00000 0004 0414 7587Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Bidirectional Associations Between Physical Activity and Pain Among Older Adults: An Ecological Momentary Assessment Study. J Aging Phys Act 2022; 31:240-248. [PMID: 35995422 DOI: 10.1123/japa.2022-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/08/2022] [Accepted: 07/07/2022] [Indexed: 11/18/2022]
Abstract
This paper examines the within-day, bidirectional associations between physical activity and self-reported pain among older adults. Older adults (N = 104; range: 60-98 years) participated in a 10-day Ecological Momentary Assessment (EMA) study. Participants received six EMA prompts/day with a single item assessing pain. Participants wore an activPAL monitor measuring step counts. At the within-person level, on occasions when participants took more steps than usual in the 30 min before the EMA prompt, they were more likely to experience pain at the prompt (β^02=0.0003, p < .03). At the between-person level, greater step counts in the 30 min before the EMA prompt, on average, were associated with less pain on occasions when pain was experienced (β^01=-0.0005, p < .04). Pain was not related to subsequent stepping. Bidirectional associations between physical activity and pain were not documented, but physical activity did appear to be related to subsequent pain.
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27
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Kashyap K, Singh V, Dwivedi SN, Gielen J, Bhatnagar S. Scrambler Therapy Enhances Quality of Life in Cancer Patients in a Palliative Care Setting: A Randomised Controlled Trial. Indian J Palliat Care 2022; 28:287-294. [PMID: 36072252 PMCID: PMC9443118 DOI: 10.25259/ijpc_94_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 04/03/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives: Given the known side effects of opioids and the negative impact of these side effects on quality of life (QOL), there is a need for therapies that can reduce opioid intake and improve QOL in patients suffering from cancer pain. Scrambler therapy (ST) is a neuromodulatory therapy that has been shown to reduce cancer pain, but its effect on QOL is not well understood. This study intended to evaluate the efficacy of ST for enhancing QOL in cancer patients through minimising pain and opioid intake. Material and Methods: This was a randomised controlled trial including 80 patients with head, neck and thoracic cancer. In both arms, patients were given pain management drugs following the WHO analgesic ladder for ten consecutive days. In the intervention arm each day ST was given. Pain, morphine intake, and QOL (WHOQOL-BREF) were assessed. Results: All domains of QOL improved significantly in the intervention arm in comparison to the control arm. In comparison to baseline, pain improved in both the intervention and the control arm on day 10 and at follow-up. However, QOL significantly improved in the intervention arm, while morphine intake decreased. In the control arm, QOL deteriorated, while morphine intake increased. Conclusion: ST significantly improved QOL. Since the increase in QOL took place along with a significantly lower morphine intake, the improvement in QOL may not only be explained by lower pain scores but, also, by a reduced intake of morphine, because the lower dosages of morphine will decrease the likelihood of side effects associated with the drug.
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Affiliation(s)
- Komal Kashyap
- Department of Oncoanaesthesia and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India,
| | - Vishwajeet Singh
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India,
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India,
| | - Joris Gielen
- Center for Global Health Ethics, Duquesne University, Pittsburgh, Pennsylvania, United States,
| | - Sushma Bhatnagar
- Department of Oncoanaesthesia and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India,
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Mende-Siedlecki P, Goharzad A, Tuerxuntuoheti A, Reyes PGM, Lin J, Drain A. Assessing the speed and spontaneity of racial bias in pain perception. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2022. [DOI: 10.1016/j.jesp.2022.104315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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29
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Agnus Tom A, Rajkumar E, John R, Joshua George A. Determinants of quality of life in individuals with chronic low back pain: a systematic review. Health Psychol Behav Med 2022; 10:124-144. [PMID: 35003902 PMCID: PMC8741254 DOI: 10.1080/21642850.2021.2022487] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 12/20/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Chronic low back pain (CLBP) is a prominent medical condition that can affect an individual at some point in their life time which could lead to poor quality of life (QOL). Low back pain has affected approximately 577 million individuals globally by 2017. The aim of the current systematic review is to synthesise the existing evidence on the factors influencing the QOL in individuals with CLBP and to identify strategies to improve their QOL. METHOD PubMed, ScienceDirect, PsychNet and Google Scholar were used to extract studies reporting quantitative relationships between QOL and its possible determinants in individuals having CLBP and the intervention strategies to improve QOL. RESULTS 10,851 studies were initially identified and twenty-six studies which met the inclusion criteria were selected for the review. 21 studies reported relationship between QOL and potential determinants and five studies assessed the influence of interventions on QOL. Determinants were classified as kinesiophobia, fear avoidance belief, or pain belief; occupation-related factors; pain and disability; activity; personal factors including age, gender, employment status; and other psychological factors including anxiety, quality of sleep, and health locus of control. Intervention strategies including MBSR, Pilates method and Back School Programme improved QOL in individuals with CLBP. CONCLUSION Psychosocial factors as well as the physical status of the individual contributed to the QOL in individuals having CLBP.
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Affiliation(s)
- Aleena Agnus Tom
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - Romate John
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - Allen Joshua George
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
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30
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Psychological variables associated with quality of life in patients with head and neck cancer: the role of body image distress. Support Care Cancer 2022; 30:9127-9139. [PMID: 35997811 PMCID: PMC9633472 DOI: 10.1007/s00520-022-07334-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 08/15/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The aim of this cross-sectional study was to explore the relationship between quality of life (QoL) and body image distress in patients with head and neck cancer (HNC), considering relevant psychological variables (i.e., coping strategies, social anxiety symptoms, self-esteem, intolerance of uncertainty, pain, and distress). We also aimed to explore gender differences in patients with HNC in terms of relevant psychological variables in HNC. METHODS Fifty-one HNC patients (37 males and 14 females) completed self-report questionnaires to assess body image distress, physical and mental QoL, and relevant psychological variables in HNC (coping strategies, social anxiety symptoms, self-esteem, intolerance of uncertainty, pain, and distress) before undergoing treatment. Pearson's correlations and four-step hierarchical regressions were performed to assess the relationship between body image distress, QoL, and the abovementioned psychological variables, while one-way analyses of variance and one-way analysis of covariance were employed to assess gender differences. RESULTS Physical QoL was associated with body image distress above and beyond disease duration, distress, coping strategies, pain, mental QoL, and self-esteem, while mental QoL was associated with pain above and beyond distress, coping strategies, physical QoL, self-esteem, and body image distress. Concerning gender differences, females scored higher than males on most of the explored psychological variables, except for physical QoL and intolerance of uncertainty, and showed lower mental QoL and self-esteem than males. CONCLUSION Body image distress and pain emerged as negatively associated with QoL, and almost all the explored psychological variables differed among genders. Psychological interventions targeting body image distress and pain should be promoted in patients with HNC to increase their QoL, while keeping gender differences in mind.
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Sheffler JL, Schmiege SJ, Sussman J, Bekelman DB. A longitudinal analysis of the relationships between depression, fatigue, and pain in patients with heart failure. Aging Ment Health 2021; 25:2272-2278. [PMID: 33287562 PMCID: PMC8796211 DOI: 10.1080/13607863.2020.1855626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 11/21/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Depression, pain, and fatigue are common and bothersome symptoms in heart failure, a serious illness in older adults. Understanding longitudinal pathways among depression, pain, and fatigue in heart failure could inform treatment and improve quality of life. METHODS We completed secondary, longitudinal data analyses of a sample of older adults with heart failure (baseline N = 317). Bootstrapped mediation was used to examine two longitudinal models of pain and depression, with fatigue at 6-months as the mediator. The outcome variables were 12-month pain and depression. RESULTS Depressive symptoms were associated with new onset of pain symptoms; however, this association was mediated by fatigue. Pain was not associated with new depression or fatigue symptoms in this sample. DISCUSSION In patients with heart-failure, worsening pain symptoms appear to be directly related to levels of depression and fatigue. These findings demonstrate that depression and fatigue may be key to reducing pain symptoms in this population.
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Affiliation(s)
- Julia L Sheffler
- Center for Translational Behavioral Science, Florida State University, Tallahassee, FL, USA
| | - Sarah J Schmiege
- Anschutz Medical Campus, University of Colorado, Denver, CO, USA
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Demircioğlu A, Özkal Ö, Dağ O. Multiple Factors Affecting Health-Related Quality of Life in Women With Chronic Multisite Musculoskeletal Pain: A Cross-Sectional Study in Ankara, Turkey. Eval Health Prof 2021; 45:115-125. [PMID: 34579589 DOI: 10.1177/01632787211049273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although chronic multi-site musculoskeletal pain is known to cause decreased physical function and impair work and social life, there is insufficient research about its impact on health-related quality of life (HRQoL) in women. The aim of this study was to investigate multiple factors affecting HRQoL in women with chronic multi-site musculoskeletal pain. This study included 227 women with two or more musculoskeletal areas which were painful during the last 3 months. The HRQoL and musculoskeletal system symptoms were evaluated with the Nottingham Health Profile (NHP) and the Nordic Musculoskeletal Questionnaire (NMQ), respectively. Physical activity level, social functionality and depressive symptoms were assessed with the International Physical Activity Questionnaire-Short Form (IPAQ- SF), Social Functioning Scale (SFS) and Beck Depression Inventory (BDI), respectively. Significant predictors for the total score on the NHP were found to be the number of children (p < 0.001), social engagement/withdrawal scale (p:0.094), the number of regions with musculoskeletal pain during the last year (p:0.002) and last 7 days (p:0.036), depressive symptoms (p < 0.001), current employment status (p:0.084), and the presence of chronic disease (p < 0.001). The results of this study demonstrated that both sociodemographic characteristics, and social and psychological factors may affect the HRQoL in women with chronic multi-site musculoskeletal pain.
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Affiliation(s)
- Arzu Demircioğlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Özden Özkal
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bursa Uludağ University, Bursa, Turkey
| | - Osman Dağ
- Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Lai YHE, Lascelles BDX, Nolan MW. Behavioral phenotyping of cancer pain in domesticated cats with naturally occurring squamous cell carcinoma of the tongue: initial validation studies provide evidence for regional and widespread algoplasticity. PeerJ 2021; 9:e11984. [PMID: 34458024 PMCID: PMC8375511 DOI: 10.7717/peerj.11984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 07/26/2021] [Indexed: 12/16/2022] Open
Abstract
Feline oral squamous cell carcinoma (FOSCC) is a common and naturally occurring condition that recapitulates many features of human head and neck cancer (HNC). In both species, there is need for improved strategies to reduce pain caused by HNC and its treatment. Research to benefit both species could be conducted using pet cats as a comparative model, but this prospect is limited by lack of validated methods for quantifying FOSCC-associated pain. A prospective non-randomized pilot study was performed for initial validation of: (1) a pet owner administered quality of life questionnaire and visual assessment scoring tool (FORQ/CLIENT); (2) a clinician assessment questionnaire (UFEPS/VET); (3) electronic von Frey testing [EVF]; and (4) Cochet-Bonnet (COBO) aesthesiometry. To assess intra-rater reliability, discriminatory ability, and responsiveness of each assay, 6 cats with sublingual SCC and 16 healthy control cats were enrolled. The intra-rater reliability was moderate-to-good for the clinical metrology instruments and EVF (intraclass correlation coefficient [ICC] ≥ 0.68), but poor for COBO (ICC = 0.21). FORQ/CLIENT scores were higher (worse quality of life) in FOSCC cats vs healthy controls. The internal reliability of FORQ/CLIENT scoring was high (Cronbach α = 0.92); sensitivity and specificity were excellent (100% when using cut-offs determined using receiver operating characteristic [ROC] curves). For the FORQ/CLIENT, there was strong and inverse correlation between scores from the questions and visual assessment (r = − 0.77, r2 = 0.6, P < 0.0001). For the UFEPS/VET, Cronbach’s α was 0.74 (high reliability). Sensitivity and specificity were 100% and 94%, respectively, when using a cut-off score (3.5) based on ROC curves (Youden index of 0.94). Total UFEPS/VET scores were positively correlated with FORQ/CLIENT scores (r2 = 0.72, P < 0.0001). Sensitivity of EVF and COBO ranged from 83 to 100% and specificity ranged from 56 to 94%. Cats with cancer were more sensitive around the face (lower response thresholds) and on the cornea (longer filament lengths) than control animals (P < 0.03). Reduced pressure response thresholds were also observed at a distant site (P = 0.0002) in cancer cats. After giving buprenorphine, EVF pressure response thresholds increased (P = 0.04) near the mandible of cats with OSCC; the length of filament required to elicit a response in the COBO assay also improved (shortened; P = 0.017). Based on these preliminary assessments, the assays described herein had reasonable inter-rater reliability, and they were able to both discriminate between cats with and without oral cancer, and respond in a predictable manner to analgesic therapy. In cats with tongue cancer, there was evidence for regional peripheral sensitization, and widespread somatosensory sensitization. These results provide a basis for multi-dimensional assessments of pain and sensitivity in cats with oral SCC.
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Affiliation(s)
- Yen-Hao Erik Lai
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States of America.,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America
| | - B Duncan X Lascelles
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States of America.,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America.,Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States of America
| | - Michael W Nolan
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States of America.,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America.,Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States of America
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Van Bogaert W, Putman K, Coppieters I, Goudman L, Nijs J, Moens M, Buyl R, Ickmans K, Huysmans E. Health-related quality of life deviations from population norms in patients with lumbar radiculopathy: associations with pain, pain cognitions, and endogenous nociceptive modulation. Qual Life Res 2021; 31:745-757. [PMID: 34342846 DOI: 10.1007/s11136-021-02964-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE The primary goal of this study was to compare the health-related quality of life (HRQoL) of people with lumbar radiculopathy to age- and sex-adjusted population norms. Additionally, it aimed to explore the associations between the HRQoL difference scores and measures related to pain cognitions, pain intensity, and endogenous nociceptive modulation. METHODS Using answers from the Short Form 36-item Health Survey and UK population norms, SF-6D difference scores were calculated. A one-sample t test was used to assess the SF-6D difference scores. Univariate and multivariate regression analyses were used to assess the associations between SF-6D difference scores and pain intensity [Visual Analogue Scale (VAS) for back and leg pain], pain cognitions [Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Pain Vigilance and Awareness Questionnaire (PVAQ)], and correlates for endogenous nociceptive modulation using quantitative sensory testing. RESULTS One hundred and twenty people with lumbar radiculopathy scheduled for surgery were included in this study. The mean SF-6D difference score of - 0.26 [SD = 0.09] was found to be significantly less than 0 [95%CI: - 0.27 to - 0.24]. Univariate analyses showed a significant influence from PCS, TSK, and PVAQ on the SF-6D difference scores. The final multivariate regression model included PCS and PVAQ, with only PCS maintaining a statistically significant regression coefficient [b = - 0.002; 95% CI: - 0.004 to - 0.001]. CONCLUSION People diagnosed with lumbar radiculopathy report significantly lower HRQoL scores when compared with age- and sex-adjusted UK norm values. Even though all examined pain cognitions were found to have a significant association, pain catastrophizing showed the most significant relation to the SF-6D difference scores. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier No. NCT02630732. Date of registration: November 25, 2015.
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Affiliation(s)
- Wouter Van Bogaert
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Interuniversity Center for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
- Research Foundation-Flanders (FWO), Brussels, Belgium.
| | - Koen Putman
- Interuniversity Center for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Coppieters
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Lisa Goudman
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Center for Neurosciences, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kelly Ickmans
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Eva Huysmans
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Interuniversity Center for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
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Marttinen MK, Kautiainen H, Vuorimaa H, Kauppi MJ. Pain experience in an aging adult population during a 10-year follow-up. Scand J Pain 2021; 21:716-723. [PMID: 34114388 DOI: 10.1515/sjpain-2021-0061] [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: 03/26/2021] [Accepted: 05/27/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This 10-year follow-up study aimed to examine the persistence of SF-36 pain intensity and pain-related interference and to identify baseline factors that may relate to pain experience among community-dwelling aging adults. METHODS Questionnaire and clinical data on a total of 1,954 participants (mean age at baseline 63 years) were collected in 2002, 2005, 2008, and 2012. Based on pain reports, four pain intensity, pain interference (PIPI) groups were formed at each time point: PIPI group I: none to mild pain intensity and interference; II: moderate to extreme pain intensity, none to mild pain-related interference; III: None to mild pain intensity, moderate to extreme pain-related interference, IV: Moderate to extreme pain intensity and interference. RESULTS Participants with the most pain at baseline improved their pain situation the most during the follow-up. Higher BMI was associated with pain interference, and metabolic syndrome (MetS) and musculoskeletal diseases with both pain intensity and interference (p<0.05, statistically significant interaction between pain intensity and pain interference) at baseline. According to multivariate logistic regression analysis the following baseline characteristics were associated with remaining in PIPI group I throughout the follow-up: presence of musculoskeletal disease (OR 0.22 [95% CI 0.16-0.30]), high BMI (OR 0.93 [95% CI 0.90-0.97]), high household income (OR 1.46 [95% CI 1.07-1.98]), good childhood home environment (OR 1.03 [95% CI 1.00-1.05]). CONCLUSIONS Multiple factors may affect pain persistence in late adulthood with varying effect on pain intensity and pain-related interference. Pain situation of even those with most pain may be improved.
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Affiliation(s)
- Maiju K Marttinen
- The Finnish Center for Pediatric and Adolescent Pain Management and Research, Helsinki University Hospital, Helsinki, Finland.,Department of Rheumatology, Päijät-Häme Central Hospital, Lahti, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Vuorimaa
- The Finnish Center for Pediatric and Adolescent Pain Management and Research, Helsinki University Hospital, Helsinki, Finland
| | - Markku J Kauppi
- Department of Rheumatology, Päijät-Häme Central Hospital, Lahti, Finland.,Clinicum, University of Helsinki, Helsinki, Finland
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Paz MGD, Souza LAFD, Tatagiba BDSF, Serra JRD, Moura LAD, Barbosa MA, Pereira LV. Factors associated with quality of life of older adults with chronic pain. Rev Bras Enferm 2021; 74:e20200554. [PMID: 34037193 DOI: 10.1590/0034-7167-2020-0554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 10/20/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the factors associated with quality of life of the older adults with chronic pain. METHOD Cross-sectional study conducted with 239 older adults in outpatient care in the state of Goiás, Brazil. The World Health Organization Quality of Life-Old (WHOQOL-OLD) instrument contains six domains and was applied to assess quality of life. Simple and multiple linear regressions were used in the statistical analysis. RESULTS The factors associated with Sensory Abilities were age (β = - 0.52), time spent together (β = - 14.35; - 17.86; - 15.57), and pain intensity (β = - 1, 70). Autonomy was associated with depression (β = - 5.99) and chest pain (β = - 6.17). Social participation related to schooling (β = - 0.64), diabetes mellitus (β = - 8.15), depression (β = - 14.53), pain intensity (β = - 1.43), and lower limb pain (β = - 5.94). Past, present and future activities related to depression (β = - 6.94). Death and dying related to hypertension (β = - 8.40), while Intimacy to depression (β = - 5.99) and headache/face pain (β = - 3.19). CONCLUSION The time experiencing chronic pain and the location of this experience, as well as depression, diabetes and systemic arterial hypertension were factors that had greater influence on the older adult's Quality of Life domains.
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Benz T, Lehmann S, Elfering A, Sandor PS, Angst F. Comprehensiveness and validity of a multidimensional assessment in patients with chronic low back pain: a prospective cohort study. BMC Musculoskelet Disord 2021; 22:291. [PMID: 33743669 PMCID: PMC7981999 DOI: 10.1186/s12891-021-04130-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 03/02/2021] [Indexed: 12/19/2022] Open
Abstract
Background Chronic low back pain is a multidimensional syndrome affecting physical activity and function, health-related quality of life and employment status. The aim of the study was to quantify the cross-sectional and longitudinal validity of single measurement scales in specific construct domains and to examine how they combine to build a comprehensive outcome, covering the complex construct of chronic low back pain before and after a standardized interdisciplinary pain program. Methods This prospective cohort study assessed 177 patients using the Short Form 36 (SF-36), the Multidimensional Pain Inventory (MPI), the Symptom Checklist-90-Revised (SCL-90-R), the Oswestry Disability Index (ODI), and 2 functional performance tests, the Back Performance Scale (BPS) and the 6-Minute Walking Distance (6MWD). The comprehensiveness and overlap of the constructs used were quantified cross-sectionally and longitudinally by bivariate correlations, exploratory factor analysis, and effect sizes. Results The mean age of the participants was 48.0 years (+/− 12.7); 59.3% were female. Correlations of baseline scores ranged from r = − 0.01 (BPS with MPI Life control) to r = 0.76 (SF-36 Mental health with MPI Negative mood). SF-36 Physical functioning correlated highest with the functional performance tests (r = 0.58 BPS, 0.67 6MWD) and ODI (0.56). Correlations of change scores (difference of follow-up – baseline score) were consistent but weaker. Factor analysis revealed 2 factors: “psychosocial” and “pain & function” (totally explained variance 44.0–60.9%). Psychosocial factors loaded strongest (up to 0.89 SCL-90-R) on the first factor, covering 2/3 of the explained variance. Pain and function (ing) loaded more strongly on the second factor (up to 0.81 SF-36 Physical functioning at follow-up). All scales showed improvements, with effect sizes ranging from 0.16–0.67. Conclusions Our results confirm previous findings that the chronic low back pain syndrome is highly multifactorial and comprises many more dimensions of health and quality of life than merely back-related functioning. A comprehensive outcome measurement should include the predominant psychosocial domain and a broad spectrum of measurement constructs in order to assess the full complexity of the chronic low back syndrome. Convergence and divergence of the scales capture the overlapping contents and nuances within the constructs.
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Affiliation(s)
- Thomas Benz
- Research Department, Rehaklinik Bad Zurzach, Zurzach Care Group, Quellenstrasse 34, Bad Zurzach, Switzerland. .,Institute of Psychology, University of Bern, Fabrikstrasse 8, Bern, Switzerland. .,Graduate School for Health Sciences, University of Bern, Bern, Switzerland. .,Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.
| | - Susanne Lehmann
- Research Department, Rehaklinik Bad Zurzach, Zurzach Care Group, Quellenstrasse 34, Bad Zurzach, Switzerland
| | - Achim Elfering
- Institute of Psychology, University of Bern, Fabrikstrasse 8, Bern, Switzerland
| | - Peter S Sandor
- Research Department, Rehaklinik Bad Zurzach, Zurzach Care Group, Quellenstrasse 34, Bad Zurzach, Switzerland
| | - Felix Angst
- Research Department, Rehaklinik Bad Zurzach, Zurzach Care Group, Quellenstrasse 34, Bad Zurzach, Switzerland
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Keppler L, Keppler AM, Ihle C, Minzlaff P, Fürmetz J, Beck M, Saier T. Patients with complex proximal tibial fractures overestimate the prognosis of their injury. Eur J Trauma Emerg Surg 2021; 48:1479-1486. [PMID: 33721052 PMCID: PMC9001533 DOI: 10.1007/s00068-021-01644-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/08/2021] [Indexed: 12/13/2022]
Abstract
Purpose To investigate, if patients with complex proximal tibial fracture have realistic expectations on open reduction and internal fixation. Methods 114 patients (mean 49 years, SD ± 13) with closed AO-type B and C proximal tibial fracture were grouped (group B, respectively C). Prior to surgery expectations concerning knee function, pain, return to work/sports, and the risk for osteoarthritis was assessed with the Hospital for Special Surgery-Knee Surgery Expectations Survey (HFSS-KSE) and a non-validated ten-item survey. Results 92% of patients expected at least an almost natural knee postoperatively. All items regarding restoring knee function were ranked to be at least important in both groups. 65% in group B and 47% in group C expected at most occasional pain. 83% in group B and 67% in group C expected full return to work without any limitations. Patients with low physical work intensity expected significantly shorter incapacity to work in both groups (7.8, respectively 8.9 weeks). 71% in group B and 60% in group C expected to return to sports with at most small limitations. 33% in group B and 22% in group C assumed risk for osteoarthritis will be prevented by surgery. Conclusion Expectations on surgery for complex proximal tibial fracture are high regardless of fracture type. The prognosis of many health and lifestyle domains was overestimated. The risk for osteoarthritis was underestimated. This study should sensitize surgeons to discuss realistic expectations. This may help to improve patient comprehension what leads to sensible expectations, resulting in improved patients´ satisfaction. Level of evidence IV. Trial registration number 14104, Date of registration: 06/2015.
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Affiliation(s)
- Lena Keppler
- Department of Trauma Surgery, BG Trauma Center Murnau, Murnau, Germany
| | - Alexander Martin Keppler
- Department of General, Trauma and Reconstructive Surgery, LMU Munich University Hospital, Munich, Germany.
| | - Christoph Ihle
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Tuebingen, Germany
| | - Philipp Minzlaff
- Department of Trauma and Orthopedic Surgery, Hospital Agatharied, Hausham, Germany.,Department of Orthopedic Surgery, Klinikum Rechts der Isar, Munich, Germany
| | - Julian Fürmetz
- Department of General, Trauma and Reconstructive Surgery, LMU Munich University Hospital, Munich, Germany
| | - Markus Beck
- Department of Trauma Surgery, BG Trauma Center Murnau, Murnau, Germany
| | - Tim Saier
- Department of Trauma Surgery, BG Trauma Center Murnau, Murnau, Germany
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Pigozzi LB, Pereira DD, Pattussi MP, Moret-Tatay C, Irigaray TQ, Weber JBB, Grossi PK, Grossi ML. Quality of life in young and middle age adult temporomandibular disorders patients and asymptomatic subjects: a systematic review and meta-analysis. Health Qual Life Outcomes 2021; 19:83. [PMID: 33691709 PMCID: PMC7945303 DOI: 10.1186/s12955-021-01727-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 03/02/2021] [Indexed: 11/10/2022] Open
Abstract
AIMS To compare the difference in the quality of life between temporomandibular disorders (TMD) patients and non-TMD subjects diagnosed with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). METHODS Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE) and Latin American and Caribbean Health Sciences Literature (LILACS) databases were searched in studies published in English and Portuguese. The search was performed by two independent reviewers in duplicate. A manual search and the gray literature were also included. The inclusion criteria were clinical studies that used the RDC/TMD axis I and quality of life with standard questionnaires in young and middle-aged adult population (18-55 years). The data were analyzed quantitatively by combining the results in a meta-analysis using forest plots. The measure of effect used was the standardized mean difference (SMD) in depression levels. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the studies. The publication bias was assessed by funnel plots. The initial search included 806 articles without duplications. RESULTS Twenty-four articles were included in the final systematic review. Of these, 9 were included in the meta-analysis, where it was shown a statistically significant in all axis I groups: (a) global TMD-groups I, II and III combined, N = 3829, SMD (95% CI) = 1.06 (0.65-1.51), p = 0.000; (b) group I-muscle disorders, N = 3,056, SMD (95% CI) = 0.82 (0.45-1.18), p = 0.000; (c) group II-disc displacements, N = 3,184, SMD (95% CI) = 0.59 (0.26-0.91), p = 0.000; and (d) group III-arthralgia/arthritis/arthrosis, N = 2781, SMD (95% CI) = 0.98 (0.59-1.36), p = 0.000. When compared to controls. CONCLUSIONS Quality of life is affected in all axis I TMD patients, especially in groups I and III with higher pain intensity and disability as compared to group II.
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Affiliation(s)
- Lucas Bozzetti Pigozzi
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Avenida Ipiranga 6681 Prédio 6, Building 11, 9th Floor, Porto Alegre, RS, 90619-900, Brazil
| | - Duziene Denardini Pereira
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Avenida Ipiranga 6681 Prédio 6, Building 11, 9th Floor, Porto Alegre, RS, 90619-900, Brazil
| | - Marcos Pascoal Pattussi
- Public Health, Vale Do Rio Dos Sinos University (UNISINOS), Av. Unisinos, 950 - Cristo Rei, São Leopoldo, RS, 93020-190, Brazil
| | - Carmen Moret-Tatay
- Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de La Ilustración 4, 46100, Burjassot, Valencia, Spain.,Dipartimento Di Neuroscienze Salute Mentale E Organi Di Senso (NESMOS), Università Sapienza Di Roma, Rome, Italy
| | - Tatiana Quarti Irigaray
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Avenida Ipiranga 6681 Prédio 6, Building 11, 9th Floor, Porto Alegre, RS, 90619-900, Brazil
| | - João Batista Blessmann Weber
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Avenida Ipiranga 6681 Prédio 6, Building 11, 9th Floor, Porto Alegre, RS, 90619-900, Brazil
| | - Patrícia Krieger Grossi
- School of Humanities, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Avenida Ipiranga 6681 Prédio 9, Porto Alegre, RS, 90619-900, Brazil
| | - Márcio Lima Grossi
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Avenida Ipiranga 6681 Prédio 6, Building 11, 9th Floor, Porto Alegre, RS, 90619-900, Brazil.
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Ataiants J, Fedorova EV, Wong CF, Iverson E, Gold JI, Lankenau SE. Pain Profiles among Young Adult Cannabis Users: An Analysis of Antecedent Factors and Distal Outcomes. Subst Use Misuse 2021; 56:1144-1154. [PMID: 33882778 PMCID: PMC8249053 DOI: 10.1080/10826084.2021.1910707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Pain is a primary reason for medical cannabis use among young adults, however little is known about the patterns of pain in this group. This study identified pain profiles among young adult cannabis users and examined related antecedents and distal outcomes. METHODS Past 30-day cannabis users aged 18-26, both medical cannabis patients and non-patients, were enrolled in Los Angeles in 2014-2015. A latent class analysis was used to identify pain classes based on history of chronic pain conditions and recent non-minor pain. The study assessed the predictors of membership in pain classes and examined the association of classes with recent mental health characteristics, cannabis use motives and practices. RESULTS Three classes were identified: Low pain (56.3%), Multiple pain (27.3%), and Nonspecific pain (16.4%). In adjusted models, lifetime insomnia was associated with membership in Multiple pain and Nonspecific pain classes versus the Low pain class. Medical cannabis patients and Hispanics/Latinos were more likely to belong to the Multiple pain class than the other classes. Regarding recent outcomes, the Multiple pain and Nonspecific pain classes were more likely than the Low pain class to use cannabis to relieve physical pain. Additionally, the Multiple pain class had a higher probability of psychological distress, self-reported medical cannabis use, consuming edibles, and using cannabis to sleep compared to one or both other classes. CONCLUSION Findings suggest that young adult cannabis users can be separated into distinct groups with different pain profiles. The Multiple pain profile was associated with medically-oriented cannabis use motives and practices.
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Affiliation(s)
- Janna Ataiants
- Dornsife School of Public Health, Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ekaterina V Fedorova
- Dornsife School of Public Health, Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, USA
| | - Carolyn F Wong
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Ellen Iverson
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Jeffrey I Gold
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Anesthesiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Psychiatry & Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Anesthesiology Critical Care Medicine, The Saban Research Institute at Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Stephen E Lankenau
- Dornsife School of Public Health, Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, USA
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Ilgen MA, Coughlin LN, Bohnert ASB, Chermack S, Price A, Kim HM, Jannausch M, Blow FC. Efficacy of a Psychosocial Pain Management Intervention for Men and Women With Substance Use Disorders and Chronic Pain: A Randomized Clinical Trial. JAMA Psychiatry 2020; 77:1225-1234. [PMID: 32725178 PMCID: PMC7391182 DOI: 10.1001/jamapsychiatry.2020.2369] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Chronic pain is common in those with substance use disorders (SUDs) and predicts poorer addiction treatment outcomes. A critical challenge for addiction treatment is to develop effective methods to improve pain-related and substance use-related outcomes for those in treatment for SUDs. OBJECTIVE To examine the efficacy of an integrated behavioral pain management intervention (Improving Pain During Addiction Treatment [ImPAT]) for men and women with SUDs to treat pain, functioning, and substance use. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial, 8 sessions of ImPAT were compared with 8 sessions of a supportive psychoeducational control (SPC) condition for adults with pain treated at a large residential SUD treatment program. Follow-up occurred at 3, 6, and 12 months postbaseline. A total of 1372 adults were screened, including 960 men and 412 women, and 510 adults were randomized, including 264 men and 246 women. The goal was to recruit approximately equal numbers of men and women to examine results separately in men and women. A total of 470 of 510 participants (92.2%) completed at least 1 follow-up assessment. Data were collected from October 3, 2011, to January 14, 2016. Data were analyzed from February 1, 2016, to May 1, 2020. INTERVENTIONS ImPAT focused on how a psychosocial model of pain was associated with functioning and relapse prevention and provides skills to manage pain. SPC served as the active control condition and involved discussions of topics like nutrition and the course of addiction, which were intended to be relevant to the patient population and to have face validity but be distinct from the content of ImPAT. MAIN OUTCOMES AND MEASUREMENTS The primary outcomes were pain intensity, pain-related functioning, and behavioral pain tolerance at 12 months. Secondary outcomes were frequency of alcohol and drug use over 12 months. RESULTS Of the 510 included participants, the mean (SD) age was 34.8 (10.3) years. A total of 133 men and 122 women were assigned to ImPAT, and a total of 131 men and 124 women were assigned to the SPC condition. Over 12 months of follow-up, randomization to the ImPAT intervention was associated with higher tolerance of pain among men, higher by a mean score of 0.11 (95% CI, 0.03 to 0.18; P = .004; Cohen d = 0.40) at 3 months and by 0.07 (95% CI, -0.01 to 0.19; P = .11; Cohen d = 0.25) at 12 months. Women receiving the ImPAT intervention experienced a reduction in pain intensity from 3 to 12 months, while women receiving the SPC condition experienced an increase in pain intensity, resulting in lower pain in the ImPAT condition by a mean score of 0.58 (95% CI, -0.07 to 1.22; P = .08; Cohen d = -0.22) at 12 months. No differences were found between the ImPAT and SPC conditions on alcohol or drug use. CONCLUSIONS AND RELEVANCE Behavioral pain management is not typically included in addiction treatment, but the present results indicate that this type of intervention was associated with better pain-related outcomes, including pain tolerance in men and pain intensity in women. Improvements in substance use-related outcomes beyond that achieved by treatment as usual were not observed. Treatment programs should consider providing psychosocial pain management services to augment standard addiction treatment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01372267.
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Affiliation(s)
- Mark A. Ilgen
- VA Center for Clinical Management Research (CCMR), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Lara N. Coughlin
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Amy S. B. Bohnert
- VA Center for Clinical Management Research (CCMR), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Stephen Chermack
- VA Center for Clinical Management Research (CCMR), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Amanda Price
- VA Center for Clinical Management Research (CCMR), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - H. Myra Kim
- VA Center for Clinical Management Research (CCMR), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor
| | - Mary Jannausch
- VA Center for Clinical Management Research (CCMR), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Frederic C. Blow
- VA Center for Clinical Management Research (CCMR), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan Medical School, Ann Arbor
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TROIANO GIANMARCO, LAZZERI GIACOMO. A review of quality of life of patients suffering from ichthyosis. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E374-E378. [PMID: 33150225 PMCID: PMC7595076 DOI: 10.15167/2421-4248/jpmh2020.61.3.1450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/24/2020] [Indexed: 11/16/2022]
Abstract
Introduction Ichthyoses include a heterogeneous group of skin diseases often characterized by persistent scaling and hyperkeratosis with variable erythema, pruritus, and sweating impairment. The aim of our review was to assess the quality of life in patients with ichthyosis. Methods In July 2018 we performed a systematic search in the electronic database PubMed (MEDLINE). The MESH term “quality of life” was combined, through the Boolean operator AND with the key word “ichthyosis”. We considered eligible for the systematic review studies written in English. Results The literature search yielded 63 publications, but 7 studies were included in the review. Studies were published in 2003-2014 and involved a minimum of 10 and a maximum of 235 patients. Authors used 5 types of tools: Dermatology Life Quality Index (DLQI), Dermatitis Family Impact Questionnaire (DFI), Nottingham Health Profile (NHP) questionnaire, Short Form Questionnaire 36 and 12 (SF-36, SF-12). Many patients reported worse scores than general population. Patients referred physical problems related to pain (which negatively influenced the mobility). Conclusions Ichthyosis considerably impaired the QoL, especially for paediatric patients. Further studies and efforts should be done to manage and treat the pain.
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Affiliation(s)
- GIANMARCO TROIANO
- Correspondence: Gianmarco Troiano, Department of Molecular & Developmental Medicine, University of Siena, Italy - E-mail:
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The Delaware Pain Database: a set of painful expressions and corresponding norming data. Pain Rep 2020; 5:e853. [PMID: 33134750 PMCID: PMC7587421 DOI: 10.1097/pr9.0000000000000853] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Facial expressions of pain serve an essential social function by communicating suffering and soliciting aid. Accurate visual perception of painful expressions is critical because the misperception of pain signals can have serious clinical and social consequences. Therefore, it is essential that researchers have access to high-quality, diverse databases of painful expressions to better understand accuracy and bias in pain perception. Objectives This article describes the development of a large-scale face stimulus database focusing on expressions of pain. Methods We collected and normed a database of images of models posing painful facial expressions. We also characterized these stimuli in terms of the presence of a series of pain-relevant facial action units. In addition to our primary database of posed expressions, we provide a separate database of computer-rendered expressions of pain that may be applied to any neutral face photograph. Results The resulting database comprises 229 unique (and now publicly available) painful expressions. To the best of our knowledge, there are no existing databases of this size, quality, or diversity in terms of race, gender, and expression intensity. We provide evidence for the reliability of expressions and evaluations of pain within these stimuli, as well as a full characterization of this set along dimensions relevant to pain such as perceived status, strength, and dominance. Moreover, our second database complements the primary set in terms of experimental control and precision. Conclusion These stimuli will facilitate reproducible research in both experimental and clinical domains into the mechanisms supporting accuracy and bias in pain perception and care.
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Makovski TT, Le Coroller G, Putrik P, Choi YH, Zeegers MP, Stranges S, Ruiz Castell M, Huiart L, van den Akker M. Role of clinical, functional and social factors in the association between multimorbidity and quality of life: Findings from the Survey of Health, Ageing and Retirement in Europe (SHARE). PLoS One 2020; 15:e0240024. [PMID: 33079931 PMCID: PMC7575102 DOI: 10.1371/journal.pone.0240024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/17/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE An increasing number of diseases is linked to deterioration of quality of life (QoL). Part of this association can be explained by socio-economic factors, which are most commonly accounted for. Our aim was to explore the potential contribution of other factors related to clinical burden, social interaction and functioning. METHODS A cross-sectional analysis was conducted on wave 6 of the population-based Survey of Health, Ageing and Retirement in Europe (SHARE), among participants aged 50+ (n = 67 179). The Control, Autonomy, Self-Realization and Pleasure (CASP-12v1) questionnaire measured QoL. The association between number of diseases and QoL was tested in a mixed-effects linear regression model. The base model controlled for socio-economic characteristics. Factors of interest (symptoms, polypharmacy, unmet care needs, utilisation of care, social network, personal and financial help, loneliness and activities of daily living (ADL) with instrumental activities (IADL)) were added to the base model one at a time and tested for relevance (i.e. change in the β-coefficient of the number of conditions of 15% or more). RESULTS Symptoms, polypharmacy, loneliness and ADL/IADL appeared relevant and were retained in the final model. The association between number of conditions and QoL in the base model was -2.44 [95% CI: -2.72; -2.16], while this association was -0.76 [95%CI: -0.97; -0.54] after all relevant factors were included. CONCLUSION Factors beyond the socio-economic circumstances play an important role in explaining the association between number of conditions and QoL. These factors should be considered to better estimate the impact of chronic diseases on QoL, and for improving patient care.
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Affiliation(s)
- Tatjana T Makovski
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.,Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Chairgroup of Complex Genetics and Epidemiology, Nutrition and Metabolism in Translational Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Gwenaëlle Le Coroller
- Competence Centre for Methodology and Statistics, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Polina Putrik
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Yun Hee Choi
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Maurice P Zeegers
- Chairgroup of Complex Genetics and Epidemiology, Nutrition and Metabolism in Translational Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Saverio Stranges
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.,Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.,Department of Family Medicine, Western University, London, Ontario, Canada
| | - Maria Ruiz Castell
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Laetitia Huiart
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Marjan van den Akker
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Academic Centre for General Practice / Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.,Institute of General Practice, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
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Park BY, Lee JJ, Kim HJ, Woo CW, Park H. A neuroimaging marker for predicting longitudinal changes in pain intensity of subacute back pain based on large-scale brain network interactions. Sci Rep 2020; 10:17392. [PMID: 33060726 PMCID: PMC7567066 DOI: 10.1038/s41598-020-74217-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/28/2020] [Indexed: 12/28/2022] Open
Abstract
Identification of predictive neuroimaging markers of pain intensity changes is a crucial issue to better understand macroscopic neural mechanisms of pain. Although a single connection between the medial prefrontal cortex and nucleus accumbens has been suggested as a powerful marker, how the complex interactions on a large-scale brain network can serve as the markers is underexplored. Here, we aimed to identify a set of functional connections predictive of longitudinal changes in pain intensity using large-scale brain networks. We re-analyzed previously published resting-state functional magnetic resonance imaging data of 49 subacute back pain (SBP) patients. We built a network-level model that predicts changes in pain intensity over one year by combining independent component analysis and a penalized regression framework. Connections involving top-down pain modulation, multisensory integration, and mesocorticolimbic circuits were identified as predictive markers for pain intensity changes. Pearson’s correlations between actual and predicted pain scores were r = 0.33–0.72, and group classification results between SBP patients with persisting pain and recovering patients, in terms of area under the curve (AUC), were 0.89/0.75/0.75 for visits four/three/two, thus outperforming the previous work (AUC 0.83/0.73/0.67). This study identified functional connections important for longitudinal changes in pain intensity in SBP patients, providing provisional markers to predict future pain using large-scale brain networks.
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Affiliation(s)
- Bo-Yong Park
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jae-Joong Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Hong Ji Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Choong-Wan Woo
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Hyunjin Park
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, South Korea. .,School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, South Korea.
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Aminde JA, Aminde LN, Bija MD, Lekpa FK, Kwedi FM, Yenshu EV, Chichom AM. Health-related quality of life and its determinants in patients with chronic low back pain at a tertiary hospital in Cameroon: a cross-sectional study. BMJ Open 2020; 10:e035445. [PMID: 33028543 PMCID: PMC7539580 DOI: 10.1136/bmjopen-2019-035445] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 07/24/2020] [Accepted: 07/29/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate health-related quality of life (HRQoL) and its determinants in chronic low back pain (CLBP) patients in Cameroon. DESIGN Observational cross-sectional study. SETTING Tertiary hospital. PARTICIPANTS There were 150 eligible adults with low back pain of at least 12 weeks who provided informed consent. Of these, 136 with complete questionnaires were analysed. OUTCOMES HRQoL was measured using the WHO Quality of Life questionnaire (WHOQOL-BREF). Outcome measures included its four domain (physical health, psychological, social relationships and environmental) scores and two independent scores for overall quality of life (OQOL) and general health satisfaction (GH). RESULTS Participants had a median age of 52 years, and median pain duration of 33 (IQR: 69) months. The median OQOL score was 50 (IQR: 25). After multivariable adjustment, tertiary education (β=11.43, 95% CI 3.12 to 19.75), age (β=0.49, 95% CI 0.12 to 0.87) and being a student (β=23.07, 95% CI 0.28 to 45.86) contributed to better OQOL. Age (β=0.57, 95% CI 0.10 to 1.04) and physical-type employment (β=-14.57, 95% CI -25.83 to -3.31) affected GH. Smoking (β=-20.49, 95% CI -35.49 to -5.48) and radiological anomalies (β=-7.57, 95% CI -14.64 to -0.49) affected the physical health domain, while disability (β=-0.67, 95% CI -1.14 to -0.20) and duration of pain (β=-0.13, 95% CI -0.20 to -0.05) affected the psychological domain. Income (β=14.94, 95% CI 4.06 to 25.81) affected the social domain, while education (β=9.96, 95% CI 1.41 to 18.50) and disability (β=-0.75, 95% CI -1.26 to -0.24) affected the environmental domain. CONCLUSIONS Our findings suggest that CLBP affects HRQoL and multiple socioeconomic and clinical factors influence its impact on different domains of HRQoL. Multipronged management programmes, especially those that reduce disability, could improve HRQoL in patients with CLBP.
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Affiliation(s)
- Jeannine Anyingu Aminde
- Cameroon Baptist Convention Health Service, Bamenda, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Leopold Ndemnge Aminde
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
- Non-communicable diseases Unit, Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon
| | - Marie Doualla Bija
- Rheumatology Unit, Douala General Hospital, Douala, Cameroon
- Department of Internal Medicine & Specialties, Faculty of Medicine & Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
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Mansuri B, Torabinezhad F, Jamshidi AA, Dabirmoghadam P, Vasaghi-Gharamaleki B, Ghelichi L. Application of High-Frequency Transcutaneous Electrical Nerve Stimulation in Muscle Tension Dysphonia Patients With the Pain Complaint: The Immediate Effect. J Voice 2020; 34:657-666. [DOI: 10.1016/j.jvoice.2019.02.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/09/2019] [Accepted: 02/19/2019] [Indexed: 11/26/2022]
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Mahgoub MY, Elnady BM, Abdelkader HS, Abdelhalem RA, Hassan WA. Comorbidity of Fibromyalgia in Primary Knee Osteoarthritis: Potential Impact on Functional Status and Quality of Life. Open Access Rheumatol 2020; 12:55-63. [PMID: 32440236 PMCID: PMC7212986 DOI: 10.2147/oarrr.s252748] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/17/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a painful condition with peripheral and central pain transmission. Fibromyalgia (FM) is the role model of central sensitization of pain perception. AIM To assess the frequency of FM in knee OA patients and evaluate the impact of FM on mental health and the quality of life in knee OA patients. PATIENTS AND METHODS A total of 121 female patients were recruited and divided into 3 groups: group I of 59 patients with knee OA only, group II of 32 patients with knee OA and FM, and group III of 30 FM patients. Patients underwent history taking, examination, investigations, and radiological evaluation of both knees. The assessment of visual analog scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Pain Anxiety Symptom Scale Short Form 20 (PASS20), Beck Depression Inventory (BDI-II), and PCASEE questionnaire were done for all patients. Lequesne index of knee OA and radiological Kellgren and Lawrence score severity were done for all OA patients. Fibromyalgia Impact Questionnaire (FIQ) was assessed for all FM patients. RESULTS FM was diagnosed in 35.5% of knee OA patients. Group II patients had higher VAS, PASS-20, PSQI, and lower quality of life than either groups I and III, elevated Lequesne index score than group I, significant correlation between VAS and BMI (p=0.002), Lequesne index score (p<0.001), PASS20 (p=0.006), BDI-II score (p=0.002), and FIQ (P<0.001), and a negative correlation was found between VAS and physical (p<0.001), anxiety (p=0.046), and social (p=0.026) QoL parameters. Univariable regression analysis showed a higher age, VAS, PSQI, PASS20, and FIQ were associated with lower QoL in group II. A higher PASS20 was the only predictor of lower QoL in multivariable analysis. CONCLUSION Fibromyalgia coexists frequently in knee OA patients and has implications on their mental health, functional activity, and quality of life.
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Affiliation(s)
- Marwa Yahia Mahgoub
- Rheumatology, Rehabilitation and Physical Medicine Department, Benha University, Benha, Egypt
| | - Basant Mohamed Elnady
- Rheumatology, Rehabilitation and Physical Medicine Department, Benha University, Benha, Egypt
| | | | | | - Waleed Ahmed Hassan
- Rheumatology, Rehabilitation and Physical Medicine Department, Benha University, Benha, Egypt
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Transcutaneous Electrical Nerve Stimulation Combined With Voice Therapy in Women With Muscle Tension Dysphonia. J Voice 2020; 34:490.e11-490.e21. [DOI: 10.1016/j.jvoice.2018.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 11/03/2018] [Accepted: 11/05/2018] [Indexed: 11/24/2022]
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van Doorn LP, Sijberden JP, Brouwers JJWM, Goossens LD, Hamming JF. Validation of the Dutch translation of the Cardiff wound impact schedule for evaluation of the health‐related quality of life of patients with chronic wounds. Int Wound J 2020; 17:1225-1230. [PMID: 32350991 PMCID: PMC7540679 DOI: 10.1111/iwj.13388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/02/2020] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to validate a Dutch translation of the Cardiff wound impact schedule (CWIS), a disease‐specific instrument to measure the health‐related quality of life (HRQoL) in patients with chronic leg ulcers. To achieve this, the original instrument was translated. A total of 83 patients with chronic lower leg ulcers were included and completed the translated instrument and SF36 at baseline after assessment of their wound severity. Follow‐up was performed 1 week after inclusion. The psychometric properties of the instrument were assessed. Construct validity was positively evaluated by an expert panel. Face validity was positively evaluated in a cognitive debriefing of a pilot group. Discriminant validity was assessed by correlating 1‐year amputation risk according to the Wound, Ischaemia, foot Infection classification system with the instrument scores. Significant correlation could not be proven. Criterion validity was assessed by correlating domain scores of the instrument with domain scores of the gold standard: SF36. Moderate to high correlation was calculated for most domains of the instrument. Test‐retest reliability and internal consistency were evaluated as acceptable. In conclusion, the Dutch translation of the CWIS is a valid and reliable disease‐specific instrument to assess the HRQoL in patients with chronic lower leg ulcers.
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Affiliation(s)
- Louk P. van Doorn
- Deparment of Surgery, Leiden University Medical Center Leiden The Netherlands
| | - Jasper P. Sijberden
- Deparment of Surgery, Leiden University Medical Center Leiden The Netherlands
| | | | | | - Jaap F. Hamming
- Deparment of Surgery, Leiden University Medical Center Leiden The Netherlands
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