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Karlsen APH, Tran TXM, Mathiesen O, Jakobsen JC, Meyhoff CS, Lunn TH, Olsen MH. The OPI•AID Zone Tool as a composite outcome for postoperative pain management quality-A protocol for an observational pilot study. Acta Anaesthesiol Scand 2024; 68:960-974. [PMID: 38629867 DOI: 10.1111/aas.14422] [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: 02/29/2024] [Accepted: 03/18/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Managing postoperative pain while minimizing opioid-related adverse drug events (ORADEs) remains a significant challenge. The OPI•AID Zone Tool is proposed as a novel clinical decision support tool that - both graphically and in a scoring-system - represents the relationship between pain management and the occurrence of ORADEs, aiming to enhance patient outcomes in postoperative care. The OPI•AID Zone Tool places pain score on the x-axis and an ORADE score on the y-axis, and stratifies patients into five zones to reflect the composite impact of pain severity and ORADEs on the quality of postoperative patient care. The study will have two key aims: (1) to explore whether the OPI•AID Zone Tool can function as a composite outcome measure for postoperative pain and ORADEs, and (2) to evaluate the use of the OPI•AID Zone Tool in visual presentations and for evaluation of patients' postoperative pain management quality. METHODS This prospective observational cohort study will include 200 adults undergoing various surgical procedures in general anesthesia with a subsequent stay in the post-anesthesia care unit (PACU) at Bispebjerg Hospital, Denmark. Substudy 1 primary outcome: To assess whether a zone score in the OPI•AID Zone Tool is associated with patient-perceived health (EQ VAS), quality of recovery (QoR-PACU), and time to discharge readiness in PACU, and if the zone score has a stronger association than pain and ORADE score in themselves. Substudy 2 primary outcome: To assess how the use of intraoperative non-opioid analgesics impact where patients are placed in the OPI•AID Zone Tool's XY scatterplot right after surgery. To assess if patients who receive more comprehensive non-opioid analgesic basic regimens, generally fall into lower zones. CONCLUSION The OPI•AID Zone Tool could potentially be a valuable clinical decision-making tool for optimizing postoperative care by simultaneously addressing pain management and the risk of ORADEs. By computing a composite measure of these two critical outcomes, the tool could guide more nuanced and patient-centered analgesic regimens, potentially improving patient satisfaction and operational efficiency in postoperative settings. The tool's applicability will be explored in this observational pilot and followed up in a planned series of studies (opiaid.dk).
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Affiliation(s)
- Anders Peder Højer Karlsen
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Trang Xuan Minh Tran
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Ole Mathiesen
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital Køge, Køge, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Janus Christian Jakobsen
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Christian S Meyhoff
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Troels Haxholdt Lunn
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Markus Harboe Olsen
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital Køge, Køge, Denmark
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Neuroanaesthesiology, Neuroscience Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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Zhang Y, Zhu Z, Jin X, Huang P. Association of Abdominal Aortic Calcification and Clinical Outcomes in LDH Patients Treated with Endoscopic Lumbar Discectomy. Pain Ther 2024:10.1007/s40122-024-00633-2. [PMID: 39028388 DOI: 10.1007/s40122-024-00633-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
INTRODUCTION To determine any significant associations between abdominal aortic calcification (AAC) and clinical manifestations of pain symptoms following endoscopic lumbar discectomy. METHODS Patients sequentially presenting with a history of unilateral radiculopathy with or without back pain, and with magnetic resonance imaging (MRI)-confirmed diagnosis of posterolateral disc herniation between August 2021 and December 2023 were eligible for inclusion in the study. All patients underwent endoscopic discectomy at our center during the study period. AAC stages were classified based on the Kauppila classification system using lateral lumbar radiographs. RESULTS Between August 2021 and December 2023 a total of 120 patients were included in the study for analysis, of whom 82 (68.3%) exhibited mild AAC and 38 (31.7%) had moderate-severe AAC. Analyses using the multivariate linear regression model revealed a significant correlation between AAC comorbidity and postoperative clinical outcomes. At 1 year post-surgery, the mean change in leg pain following endoscopic lumbar discectomy was significantly less for patients with moderate-severe AAC (5.0 points) than for patients with mild ACC (p < 0.001). Even after adjusting for relevant confounders, this difference remained significant. Similar results were also observed in the postoperative improvement of back pain, the Oswestry Disability Index score, and the physical functioning, role physical, and bodily pain components of the 36-item Short Form Health Survey questionnaire. There was no significant difference in the rate of repeat surgery or post-surgical new-onset back pain between patients with different levels of severity of AAC at 1 year post-surgery. CONCLUSIONS There is a significant association between the severity of AAC and clinical outcomes among patients with lumbar disk herniation who underwent endoscopic lumbar discectomy. AAC may serve as a prognostic factor in predicting surgical outcomes and guiding management strategies for patients with lumbar disk herniation following endoscopic lumbar discectomy.
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Affiliation(s)
- Ying Zhang
- Department of Pain, The First Affiliated Hospital of Soochow University, Pinghai Road NO. 899, Suzhou City, Jiangsu Province, China
| | - Zhaoji Zhu
- Department of General Practice, Changshu Hospital Affiliated to Soochow University, Suzhou, China
| | - Xiaohong Jin
- Department of Pain, The First Affiliated Hospital of Soochow University, Pinghai Road NO. 899, Suzhou City, Jiangsu Province, China.
| | - Peng Huang
- Department of Pain, The First Affiliated Hospital of Soochow University, Pinghai Road NO. 899, Suzhou City, Jiangsu Province, China.
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Latka K, Kolodziej W, Pawus D, Bielecki M, Latka D. Performance of successful ambulatory cervical spine surgery: safety, efficacy, and early experiences of first 100 cases in Poland. Br J Neurosurg 2024:1-6. [PMID: 39007749 DOI: 10.1080/02688697.2024.2378825] [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: 03/28/2024] [Accepted: 07/07/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Ambulatory anterior cervical discectomy and fusion (ACDF) is a promising method, but not common in Poland. OBJECTIVE That is why the purpose of this study was to demonstrate the experience of performing ACDF in patients with degenerative spinal diseases. METHODS This study at the Spine Centre involved a single-center, multi-surgeon evaluation of 100 patients undergoing ACDF. RESULTS Outcomes assessed included pain severity, measured by the visual analogue scale, which improved from 4.28 ± 0.76 preoperatively to 1.11 ± 0.59 one month postoperatively. The Core Outcome Measures Index-neck (COMI-neck) scale also showed significant improvement: before surgery, 30% of patients scored their condition severity between 4-6, and 70% scored 7-10; 6 months postoperatively, the scores were 0-3 for 55% of patients, 4-6 for 45%, and 7-10 for none. Only 2% of patients experienced moderate, temporary complications, with no serious complications or postoperative hematomas observed. CONCLUSION The study supports the feasibility, safety, and efficacy of performing ACDF in an ambulatory setting, suggesting that with appropriate patient selection and surgical protocols, ambulatory ACDF can be more broadly implemented.
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Affiliation(s)
- Kajetan Latka
- Department of Neurosurgery, University of Opole, Opole, Poland
- Center for Minimally Invasive Spine and Peripheral Nerve Surgery, Opole, Poland
| | - Waldemar Kolodziej
- Department of Neurosurgery, University of Opole, Opole, Poland
- Center for Minimally Invasive Spine and Peripheral Nerve Surgery, Opole, Poland
| | - Dawid Pawus
- Faculty of Electrical Engineering, Automatic Control and Informatics, Opole University of Technology, Opole, Poland
| | - Mateusz Bielecki
- Department of Neurosurgery, John Paul II Western Hospital in Grodzisk Mazowiecki, Grodzisk Mazowiecki, Poland
- Department of Neurosurgery, Lazarski University, Warsaw, Poland
| | - Dariusz Latka
- Center for Minimally Invasive Spine and Peripheral Nerve Surgery, Opole, Poland
- Department of Neurosurgery, Institute of Medical Sciences, University of Opole, Opole, Poland
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Than CA, Valiotis AK, Prottoy AR, Alexander KG, Alogakos M, Adra M, Smayra K, Curtis TJ, Kim GE, Nakanishi H, Dannawi Z. Discectomy for Lumbar Disc Herniation in Pediatric and Adolescent Populations: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e63880. [PMID: 39104990 PMCID: PMC11298768 DOI: 10.7759/cureus.63880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2024] [Indexed: 08/07/2024] Open
Abstract
Corroborative evidence for discectomy in pediatric or adolescent patients remains scarce, with this single-arm meta-analysis investigating discectomy for lumbar disc herniation (LDH) within this population. PubMed, Embase (Elsevier), CiNAHL, Cochrane Library, Scopus, and Web of Science were searched. Eligible studies reported pediatric patients under 21 years of age with a diagnosis of LDH that was treated surgically with discectomy. This review was registered in PROSPERO (ID: CRD42023463358). Twenty-two studies met the eligibility criteria (n=1182). Visual analog scale (VAS) scores for back pain at baseline were 5.34 (95% CI: 4.48, 6.20, I2=98.9%). Postoperative VAS back pain scores after 12 months were 0.88 (95% CI: 0.57, 1.19, I2=95.6%). VAS scores for leg pain at baseline were 7.03 (95% CI: 6.63, 7.43, I2=93.5%). Postoperative VAS leg pain scores after 12 months were 1.02 (95% CI: 0.68, 1.36, I2=97.0%). Oswestry disability index (ODI) scores at baseline were 55.46 (95% CI: 43.69, 67.24, I2=99.9%). Postoperative ODI scores after 12 months were 7.82 (95% CI: 4.95, 10.69, I2=99.4%). VAS back, VAS leg and ODI scores demonstrated a minimum clinically important difference (MCID) at all postoperative points. Perioperative outcomes demonstrated operative time as 85.71 mins (95% CI: 73.96, 97.46, I2=99.4%) and hospital length of stay as 3.81 days (95% CI: 3.20, 4.41, I2=98.5%). The postoperative reoperation rate at the same level was 0.01 (95% CI: <0.00, 0.02, I2=0%). Discectomy appears safe and effective in pediatric and adolescent patients suffering from LDH. The findings here provide groundwork for future randomized control trials against conservative measures to elaborate on optimal management and elucidate long-term outcomes.
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Affiliation(s)
- Christian A Than
- Biomedical Sciences, The University of Queensland, Brisbane, AUS
| | | | - Abid R Prottoy
- Neurosurgery, St George's University of London, London, GBR
| | | | - Marios Alogakos
- General Surgery, St George's University of London, London, GBR
| | - Maamoun Adra
- Orthopedics, St George's University of London, London, GBR
| | - Karen Smayra
- Radiology, St George's University of London, London, GBR
| | - Tom J Curtis
- Orthopedics, Frimley Health NHS Foundation Trust, Windsor, GBR
| | | | | | - Zaher Dannawi
- Spine Surgery, Mid and South Essex NHS Foundation Trust, London, GBR
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Du J, Wu X, Liu Y, Lei L, Zhao H, Chen Y, Nie C. Does enteral nutrition require continuity of management: a randomized controlled study. Ann Med Surg (Lond) 2024; 86:3998-4004. [PMID: 38989181 PMCID: PMC11230797 DOI: 10.1097/ms9.0000000000002180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/01/2024] [Indexed: 07/12/2024] Open
Abstract
Objective To explore a set of enteral nutrition therapy continuity management programs for intensive care unit patients based on the theoretical study of circadian rhythm mechanism. Methods The control group followed routine nursing management. Patients in the experimental group were implemented with an enteral nutrition continuity management program, and their eating behavior was adjusted 3 days before the end of tube feeding. Food intake was intermittent at 2, 3, and 4 h on the first day, the second day, and the third day of intervention, respectively, and all patients stopped eating at night. Abdominal distension assessment, appetite assessment, application of gastric motility drugs, and patient satisfaction were compared between the two groups after tube feeding. Results Three days after the end of tube feeding, abdominal distention assessment, bowel sound auscultation, and appetite assessment were statistically different (P<0.05) between the two groups. There were differences in the first day (15 vs. 6, P<0.05), the second day (9 vs. 3, P<0.05), and the cumulative number (17 vs. 7, P<0.05) of gastrointestinal drugs, but no differences in the third day (2 vs. 1, P>0.05). There was a statistical difference in nursing intervention (6.0 vs. 7.0, P<0.05) and psychological nursing (6.0 vs. 7.0, P<0.05), but no statistical difference in health education, medical environment, and nursing attitude (P>0.05). Conclusion Enteral nutrition continuity management program has a good preventive effect on the gastrointestinal symptoms of intensive care unit patients after the end of tube feeding.
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Affiliation(s)
| | | | | | | | | | | | - Chencong Nie
- Zigong Fourth People’s Hospital, Ziliujing District, Zigong, Sichuan, People’s Republic of China
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Jackman VA, Bajzak K, Rains A, Swab M, Miller ME, Logan GS, Gustafson DL. Physical Modalities for the Treatment of Localized Provoked Vulvodynia: A Scoping Review of the Literature from 2010 to 2023. Int J Womens Health 2024; 16:769-781. [PMID: 38737495 PMCID: PMC11086396 DOI: 10.2147/ijwh.s445167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/25/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction Localized provoked vulvodynia (LPV) is a prevalent sexual health condition with significant negative impacts on quality of life. There is a lack of consensus regarding effective management. Methods We used Arksey and O'Malley's five-step method to identify, collate, and evaluate literature published between 2010 and 2023. The scoping review investigated the efficacy or effectiveness of interventions in the management of LPV. The aim of this paper is to map the literature on the efficacy or effectiveness of physical interventions. Results The review produced 19 primary studies of physical interventions for LPV. These include acupuncture, laser therapy, physiotherapy, transcutaneous electrical nerve stimulation, low-intensity shockwave therapy, transcranial direct current stimulation, and vestibulectomy. Conclusion Published studies that investigated a range of physical treatments for LPV showed some positive effects, except for transcranial direct-current stimulation. The remaining modalities demonstrated improved sexual pain and treatment satisfaction, when measured. Findings were mixed for non-sexual pain. There was insufficient evidence to draw conclusions regarding other outcomes. Researchers are encouraged to conduct larger, high-quality studies that sample more diverse patient populations and use patient-oriented outcomes to assess effectiveness of physical modalities.
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Affiliation(s)
- Victoria A Jackman
- Faculty of Medicine, Memorial University, Newfoundland & Labrador, St. John’sCanada
| | - Krisztina Bajzak
- Discipline of Obstetrics and Gynecology, Memorial University, Newfoundland & Labrador, St. John’sCanada
| | - Alex Rains
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Michelle Swab
- Health Sciences Library, Faculty of Medicine, Memorial University, Newfoundland & Labrador, St. John’sCanada
| | - Michelle E Miller
- Discipline of Obstetrics and Gynecology, Memorial University, Newfoundland & Labrador, St. John’sCanada
| | - Gabrielle S Logan
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Diana L Gustafson
- Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University, Newfoundland & Labrador, St. John’sCanada
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Świder K, Moratti S, Bruña R. How to make calibration less painful-A proposition for an automatic, reliable and time-efficient procedure. Psychophysiology 2024; 61:e14505. [PMID: 38229548 DOI: 10.1111/psyp.14505] [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: 05/04/2023] [Revised: 08/30/2023] [Accepted: 12/04/2023] [Indexed: 01/18/2024]
Abstract
In behavioral and neurophysiological pain studies, multiple types of calibration methods are used to quantify the individual pain sensation stimuli. Often, studies lack a detailed calibration procedure description, data linearity, and quality quantification and omit required control for sex pain differences. This hampers study repetition and interexperimental comparisons. Moreover, typical calibration procedures require a high number of stimulations, which may cause discomfort and stimuli habituation among participants. To overcome those shortcomings, we present an automatic calibration procedure with a novel stimuli estimation method for intraepidermal stimulation. We provide an in-depth data analysis of the collected self-reports from 70 healthy volunteers (37 males) and propose a method based on a dynamic truncated linear regression model (tLRM). We compare its estimates for the sensation (t) and pain (T) thresholds and mid-pain stimulation (MP), with those calculated using traditional estimation methods and standard linear regression models. Compared to the other methods, tLRM exhibits higher R2 and requires 36% fewer stimuli applications and has significantly higher t intensity and lower T and MP intensities. Regarding sex differences, t and T were found to be lower for females compared to males, regardless of the estimation method. The proposed tLRM method quantifies the calibration procedure quality, minimizes its duration and invasiveness, and provides validation of linearity between stimuli intensity and subjective scores, making it an enabling technique for further studies. Moreover, our results highlight the importance of control for sex in pain studies.
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Affiliation(s)
- Karolina Świder
- Department of Experimental Psychology, Psychology Faculty, Universidad Complutense de Madrid, Madrid, Spain
- Centre for Cognitive and Computational Neuroscience (C3N), Universidad Complutense de Madrid, Madrid, Spain
| | - Stephan Moratti
- Department of Experimental Psychology, Psychology Faculty, Universidad Complutense de Madrid, Madrid, Spain
- Centre for Cognitive and Computational Neuroscience (C3N), Universidad Complutense de Madrid, Madrid, Spain
| | - Ricardo Bruña
- Centre for Cognitive and Computational Neuroscience (C3N), Universidad Complutense de Madrid, Madrid, Spain
- Department of Radiology, Universidad Complutense de Madrid, IdISSC, Madrid, Spain
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Wang JM, Pan YT, Yang CS, Liu MC, Ji SC, Han N, Liu F, Sun GX. Effect of inflammatory response on joint function after hip fracture in elderly patients: A clinical study. World J Orthop 2024; 15:337-345. [PMID: 38680675 PMCID: PMC11045470 DOI: 10.5312/wjo.v15.i4.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/27/2024] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival. This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management. AIM To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients. METHODS The elderly patients who had hip fracture surgery at our hospital between January 1, 2021, and December 31, 2022 were chosen for this retrospective clinical investigation. Patients with excellent and fair postoperative hip function had their clinical information and characteristics gathered and compared. Age, gender, fracture site, surgical technique, laboratory indices, and other variables that could have an impact on postoperative joint function were all included in a univariate study. To further identify independent risk factors affecting postoperative joint function in hip fractures, risk factors that showed statistical significance in the univariate analysis were then included in a multiple logistic regression analysis. In addition to this, we also compared other outcome variables such as visual analogue scale and length of hospital stay between the two groups. RESULTS A total of 119 elderly patients with hip fractures were included in this study, of whom 37 were male and 82 were female. The results of univariate logistic regression analysis after excluding the interaction of various factors showed that there was a statistically significant difference in interleukin (IL)-6, IL-8, IL-10, C-reactive protein (CRP), and complement C1q (C1q) between the fair and excellent joint function groups (P < 0.05). The results of multiple logistic regression analysis showed that IL-6 > 20 pg/mL [(Odds ratio (OR) 3.070, 95%CI: 1.243-7.579], IL-8 > 21.4 pg/ mL (OR 3.827, 95%CI: 1.498-9.773), CRP > 10 mg/L (OR 2.142, 95%CI: 1.020-4.498) and C1q > 233 mg/L (OR 2.339, 95%CI: 1.094-5.004) were independent risk factors for poor joint function after hip fracture surgery (all P < 0.05). CONCLUSION After hip fractures in older patients, inflammatory variables are risk factors for fair joint function; therefore, early intervention to address these markers is essential to enhance joint function and avoid consequences.
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Affiliation(s)
- Jia-Ming Wang
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Yu-Tao Pan
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Chen-Song Yang
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Ming-Chong Liu
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Sheng-Chao Ji
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Ning Han
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Fang Liu
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Gui-Xin Sun
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
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Bielewicz J, Daniluk B, Kamieniak P. Altered serum cytokines in patients with symptomatic disk herniation and depressive symptoms. Front Neurosci 2024; 18:1366559. [PMID: 38646609 PMCID: PMC11026593 DOI: 10.3389/fnins.2024.1366559] [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: 01/06/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Purpose An increasing number of studies have indicated the important role of cytokines in the development of depressive disturbances (DD). In medically ill patients, cytokines can provoked sickness behavior, the signs of which resemble DD. This results in alterations in behavior to limit energy expenditure and redirect it to cope with particular diseases. The aim of our study was to investigate the role of pro-inflammatory IL-6, TNF-α, and IL-1β and anti-inflammatory IL-10 and TGF-β in DD observed in patients suffering from pain caused by disk herniation (DH) qualified for surgery. Patients and methods The intensity of DD assessed by using Beck Depression Inventory, pain intensity, and functional impairment were evaluated in 70 patients with DH who were qualified for surgery. Pro-inflammatory serum levels of TNF-α, IL-1, IL-6, anti-inflammatory TGF-β, and IL-10 were measured. Results Elevated serum levels of TGF-β, IL-10, and IL-6 were found in the group with moderate and severe depressive symptoms (SD) compared with the groups with mild (MD) or no depressive symptoms (ND). TGF-β levels were negatively correlated with pain intensity, as assessed using the Present Pain Intensity scale in SD. Functional impairment measured using the Oswestry Disability Index was the most advanced in SD group. Conclusion Results of our study can suggest association between depressive disturbances and anti-inflammatory cytokines TGF-β and IL-10. Functional impairment of SD group is more severe but serum levels of TGF-β and IL-10, which are involved in the healing processes, are increased.
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Affiliation(s)
- Joanna Bielewicz
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Beata Daniluk
- Institute of Psychology, Maria Curie-Skłodowska University, Lublin, Poland
| | - Piotr Kamieniak
- Department of Neurosurgery, Medical University of Lublin, Lublin, Poland
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Herrero P, Val P, Lapuente-Hernández D, Cuenca-Zaldívar JN, Calvo S, Gómez-Trullén EM. Effects of Lifestyle Interventions on the Improvement of Chronic Non-Specific Low Back Pain: A Systematic Review and Network Meta-Analysis. Healthcare (Basel) 2024; 12:505. [PMID: 38470617 PMCID: PMC10931043 DOI: 10.3390/healthcare12050505] [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: 12/27/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Chronic non-specific low back pain (CNSLBP) is a highly prevalent musculoskeletal condition that has a great socioeconomic impact on health systems. Instead of focusing on mechanical causes and direct workload in the development of CNSLBP, genetics, psychosocial environment, lifestyle and quality of life are coming to the forefront in its approach. The main objective was to analyze whether interventions aimed at modifying lifestyle can be effective in improving pain intensity and functional disability in CNSLBP. A search in PubMed, Web of Science, Scopus and SportDiscus databases was performed. Both a univariate and a multivariate network meta-analysis were applied with the difference pre/post-treatment. A total of 20 studies were included for qualitative analysis, of which 16 were randomized clinical trials with a moderate-high methodological quality and were part of the quantitative analysis. The interventions that had the greatest effect in reducing pain intensity were cognitive therapy combined with functional exercise programs, lumbar stabilization exercise and resistance exercise; meanwhile, for functional disability, they were functional exercise programs, aerobic exercise and standard care. In conclusion, a multimodal intervention aimed at changing one's lifestyle that encompasses cognitive, behavioral, and physical aspects seems to be highly effective in improving pain intensity and functional disability caused by CNSLBP; however, it is not yet known if these improvements are maintained in the long term.
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Affiliation(s)
- Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
- iHealthy Research Group, University of Zaragoza, IIS Aragon, 50009 Zaragoza, Spain
| | - Paula Val
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
| | - Diego Lapuente-Hernández
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
- iHealthy Research Group, University of Zaragoza, IIS Aragon, 50009 Zaragoza, Spain
| | - Juan Nicolás Cuenca-Zaldívar
- Grupo de Investigación en Fisioterapia y Dolor, Departamento de Enfermería y Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, 28801 Alcalá de Henares, Spain;
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute–Segovia de Arana (IDIPHISA), 28222 Madrid, Spain
- Primary Health Center “El Abajón”, 28231 Las Rozas de Madrid, Spain
| | - Sandra Calvo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
- iHealthy Research Group, University of Zaragoza, IIS Aragon, 50009 Zaragoza, Spain
| | - Eva María Gómez-Trullén
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (P.H.); (P.V.); (D.L.-H.); (E.M.G.-T.)
- iHealthy Research Group, University of Zaragoza, IIS Aragon, 50009 Zaragoza, Spain
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11
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Goudman L, Pilitsis JG, Billet B, De Vos R, Hanssens K, Billot M, Roulaud M, Rigoard P, Moens M. The level of agreement between the numerical rating scale and visual analogue scale for assessing pain intensity in adults with chronic pain. Anaesthesia 2024; 79:128-138. [PMID: 38058100 DOI: 10.1111/anae.16151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 12/08/2023]
Abstract
The numerical rating scale and visual analogue scale are used to quantify pain intensity. However, it has not yet been explored whether these scores are interchangeable in adults with chronic pain. Data from the prospective multicentre cross-sectional INTERVAL study were used to evaluate the one-dimensionality and agreement between numerical rating scale scores and visual analogue scale scores in adults with chronic pain. Pain intensity scores using the numerical rating scale and visual analogue scale were provided by 366 patients with chronic pain for current, average, minimal and maximal pain. To evaluate whether pain intensity scales are completed in accordance with each other, the proportion of patients who satisfied the following condition was calculated: minimal pain intensity ≤ maximal pain intensity. A factor analysis confirmed the one-dimensionality of the pain measures. A significant difference was found between numerical rating scale and visual analogue scale scores for average, current, minimum and maximum pain. Intra-class correlation coefficient estimates ranged from 0.739 to 0.858 and all measures failed to show sufficient and acceptable agreement at the 95% level. The strength of agreement between pain severity categories was classified as 'moderate' for average and minimal pain and 'substantial' for current and maximal pain. The proportion of patients who scored minimal pain ≤ maximal pain was 97.5% for the numerical rating scale and 89.5% for the visual analogue scale. This study failed to show an acceptable agreement between the numerical rating scale and visual analogue scale when pain intensity was rated by adults with chronic pain, despite showing both scales measure the same information.
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Affiliation(s)
- L Goudman
- STIMULUS research group, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
| | - J G Pilitsis
- Florida Atlantic University, Boca Raton, FL, USA
| | - B Billet
- STIMULUS research group, Vrije Universiteit Brussel, Brussels, Belgium
- Pain Clinic, AZ Delta, Roeselare, Belgium
| | - R De Vos
- Pain Clinic, AZ Delta, Roeselare, Belgium
| | - K Hanssens
- Pain Clinic, AZ Delta, Roeselare, Belgium
| | - M Billot
- PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
| | - M Roulaud
- PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
| | - P Rigoard
- PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
- Department of Spine Surgery and Neuromodulation, Poitiers University Hospital, Poitiers, France
| | - M Moens
- STIMULUS research group, Vrije Universiteit Brussel, Brussels, Belgium
- Departments of Neurosurgery and Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
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12
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Cao X, Gui Q, Wei Y, Lan L, Xiao H, Wen S, Li X. The 50% effective dose of hydromorphone and morphine for epidural analgesia in the hemorrhoidectomy: a double-blind, sequential dose-finding study. BMC Anesthesiol 2024; 24:41. [PMID: 38291353 PMCID: PMC10826036 DOI: 10.1186/s12871-024-02420-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Although previous studies have showed that epidural morphine can be used as a complement to local anesthetics for analgesia after postcesarean delivery under spinal anesthesia, there is little known about the analgesic dosage of epidural morphine and hydromorphone for hemorrhoidectomy. Therefore, we conducted this study to examine the potency ratio of hydromorphone to epidural morphine as well as effective analgesic dose for 50% patients (ED50) undergoing elective hemorrhoidectomy. METHODS 80 patients under elective hemorrhoidectomy with combined spinal and epidural anesthesia(CSEA) in department of anesthesia, Dongguan Tungwah hospital. To assess the ED50, patients were treated with epidural morphine or epidural hydromorphone randomly using a biased coin method-determined dose with a sequential allocation procedure. Following surgery, standardized multimodal analgesia was administered to all patients. A pain response score of ≤ 3 (on a scale of 0-10) was determined to be the effective dose after 24 h following CSEA. The ED50 in both groups were determined using the probit regression and isotonic regression method. We also measured pain intensity by patient interview using a 10 point verbal numeric rating scale prospectively at 6, 12 and 24 h after CSEA, and adverse effects were also noted. RESULTS The ED50 was 0.350 mg (95% CI, 0.259-0.376 mg) in hydromorphone group and 1.129 mg (95% CI, 0.903-1.187 mg) in morphine group, respectively, estimated by isotonic regression method. Regression analysis with the probit, the ED50 of epidural hydromorphone was 0.366 mg (95% CI, 0.276-0.388 mg) and epidural morphine was 1.138 mg (95% CI, 0.910-1.201 mg). Exploratory findings showed that there was no difference between the most frequent dosages of epidural hydromorphone or epidural morphine in the occurrence of nausea, vomiting and pruritus. When administered with epidural opioids at ED50 doses or higher, 97.5% (39/40) of epidural morphine patients and 97.5% (39/40) epidural hydromorphone of patients were satisfied with their analgesia. CONCLUSION Effective hemorrhoidectomy analgesia requires a 3:1 ratio of epidural morphine to epidural hydromorphone. Both drugs provide excellent patient satisfaction.
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Affiliation(s)
- Xianghua Cao
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Qiangjun Gui
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Yujiao Wei
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Lanhui Lan
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Huiling Xiao
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Shihong Wen
- Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-Sen University, No 58, ZhongShan 2nd road, Guangzhou, China.
| | - Xueping Li
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China.
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13
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Ilharreborde B, Simon AL, Shadi M, Kotwicki T. Is scoliosis a source of pain? J Child Orthop 2023; 17:527-534. [PMID: 38050593 PMCID: PMC10693849 DOI: 10.1177/18632521231215861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/03/2023] [Indexed: 12/06/2023] Open
Abstract
Purpose Pain in scoliosis is definitely a hot topic with growing popularity. The literature remains very controversial, with a pain prevalence ranging from 23% to 90%, but this can be explained by the great heterogeneity of the numerous series. The aim of this review was to report results from the literature regarding pain in relation to scoliosis regardless of the etiology. Methods A bibliographic search in Medline and Google database from 2003 to March 2023 was performed. Relevant literature was analyzed, summarized, and discussed based on authors' experience. A 1-year prospective series of adolescent idiopathic scoliosis patients was also included to compare with the existing literature. Results A total of 126 adolescent idiopathic scoliosis patients were included, with a mean preoperative Cobb angle of 64.5° (range, 45°-112°). Reported pain prevalence was 34.1%. Pain and no-pain groups were very different in their self-reported experience, with a very low mean visual analogue scale score of 0.5 (± 0.6) in the no pain group, while visual analogue scale averaged 5.6 (± 1.2) in the pain group (p < 0.001). No significant difference was found between groups regarding the most relevant demographic and radiological parameters. Conclusion Evidence-based literature on "scoliosis as a source of pain" remains ambiguous. There seems to be a consensus on the lack of direct relationship between deformity magnitude and back pain intensity. A comprehensive evaluation of the patient is therefore necessary before any treatment, including medical history, clinical examination, and relevant imaging for any child with scoliosis and back pain. Level of evidence Level VI.
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Affiliation(s)
- Brice Ilharreborde
- Pediatric Orthopaedic Department, CHU Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Anne-Laure Simon
- Pediatric Orthopaedic Department, CHU Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris Cité University, Paris, France
| | - Milud Shadi
- Department of Spine Disorders and Paediatric Orthopaedics, University of Medical Sciences, Poznan, Poland
| | - Tomasz Kotwicki
- Department of Spine Disorders and Paediatric Orthopaedics, University of Medical Sciences, Poznan, Poland
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14
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Lin LH, Lin TY, Chang KV, Wu WT, Özçakar L. Neural Mobilization for Reducing Pain and Disability in Patients with Lumbar Radiculopathy: A Systematic Review and Meta-Analysis. Life (Basel) 2023; 13:2255. [PMID: 38137856 PMCID: PMC10744707 DOI: 10.3390/life13122255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Lumbar radiculopathy causes lower back and lower extremity pain that may be managed with neural mobilization (NM) techniques. This meta-analysis aims to evaluate the effectiveness of NM in alleviating pain and reducing disability in patients with lumbar radiculopathy. We hypothesized that NM would reduce pain and improve disability in the lumbar radiculopathy population, leveraging the statistical power of multiple studies. Electronic databases from their inception up to October 2023 were searched for randomized controlled trials (RCTs) that explored the impact of NM on lumbar radiculopathy. Our primary outcome measure was the alteration in pain intensity, while the secondary one was the improvement of disability, standardized using Hedges' g. To combine the data, we employed a random-effects model. A total of 20 RCTs comprising 877 participants were included. NM yielded a significant reduction in pain intensity (Hedges' g = -1.097, 95% CI = -1.482 to -0.712, p < 0.001, I2 = 85.338%). Subgroup analyses indicated that NM effectively reduced pain, whether employed alone or in conjunction with other treatments. Furthermore, NM significantly alleviated disability, with a notable effect size (Hedges' g = -0.964, 95% CI = -1.475 to -0.453, p < 0.001, I2 = 88.550%), particularly in chronic cases. The findings provide valuable insights for clinicians seeking evidence-based interventions for this patient population. This study has limitations, including heterogeneity, potential publication bias, varied causal factors in lumbar radiculopathy, overall study quality, and the inability to explore the impact of neural pathology on NM treatment effectiveness, suggesting opportunities for future research improvements.
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Affiliation(s)
- Long-Huei Lin
- Kaohsiung Rukang Physiotherapy Clinic, Kaohsiung 83050, Taiwan;
| | - Ting-Yu Lin
- Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Yilan 26546, Taiwan;
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10048, Taiwan;
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan
- Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10048, Taiwan;
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey;
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15
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Ma N, Yi P, Xiong Z, Ma H, Tan M, Tang X. Efficacy and safety of perioperative use of non-steroidal anti-inflammatory drugs for preemptive analgesia in lumbar spine surgery: a systematic review and meta-analysis. Perioper Med (Lond) 2023; 12:61. [PMID: 37996936 PMCID: PMC10668431 DOI: 10.1186/s13741-023-00347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/27/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE Lumbar spine disorders have become an increasingly common health problem in recent years. Modern clinical studies have shown that perioperative analgesia at certain doses can reduce postoperative pain by inhibiting the process of peripheral sensitization and central sensitization, which is also known as "preemptive analgesia," Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of drugs that achieve antipyretic and analgesic effects by inhibiting cyclooxygenase (COX) and affecting the production of prostaglandins. Our meta-analysis aimed to assess the efficacy and safety of perioperative preemptive analgesia with non-steroidal anti-inflammatory drugs in patients with lumbar spine surgery. METHODS We searched PubMed, ScienceDirect, the Cochrane Library, and the Web of Science for randomized controlled trials (RCTs) that met the inclusion criteria. A total of 12 clinical studies were included to assess the efficacy and safety of perioperative NSAIDs preemptive analgesia for lumbar spine surgery. RESULT Twelve studies, including 845 patients, met the inclusion criteria. The results showed that perioperative receipt of NSAIDs for preemptive analgesia was effective and safe. Patient's postoperative morphine consumption (P < 0.05), visual analog scale (P < 0.05), and numerical rating scale (P < 0.05) were not statistically associated with postoperative complications (P > 0.05). CONCLUSION Our findings suggest that NSAIDs are effective and safe for preemptive analgesia in the perioperative period of lumbar spine surgery and that more and better quality RCTs and more in-depth studies of pain mechanics are still needed.
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Affiliation(s)
- Nanshan Ma
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Ping Yi
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, 100029, People's Republic of China
| | - Zhencheng Xiong
- Department of Orthopaedic Surgery, West China Hospital, Chengdu, 610041, People's Republic of China
| | - Haoning Ma
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, 100029, People's Republic of China
| | - Mingsheng Tan
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, 100029, People's Republic of China
| | - Xiangsheng Tang
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, 100029, People's Republic of China.
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16
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Feenstra ML, Jansen S, Eshuis WJ, van Berge Henegouwen MI, Hollmann MW, Hermanides J. Opioid-free anesthesia: A systematic review and meta-analysis. J Clin Anesth 2023; 90:111215. [PMID: 37515877 DOI: 10.1016/j.jclinane.2023.111215] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/09/2023] [Accepted: 07/14/2023] [Indexed: 07/31/2023]
Abstract
STUDY OBJECTIVE To evaluate all available evidence thus far on opioid based versus opioid-free anesthesia and its effect on acute and chronic postoperative pain. DESIGN Systematic review and meta-analysis of randomized clinical trials. SETTING Operating room, postoperative recovery room and ward. PATIENTS Patients undergoing general anesthesia. INTERVENTIONS After consulting MEDLINE, EMBASE and Cochrane database, studies which compared opioid free anesthesia (OFA) with opioid based anesthesia (OBA) were included (last search April 15th 2022). MEASUREMENTS Primary outcomes were acute and chronic pain scores in NRS or VAS. Secondary outcomes were quality of recovery and postoperative opioid consumption. Risk of bias was assessed using the RoB2 tool and a random effects model for the meta-analysis was conducted. MAIN RESULTS We identified 1245 citations, of which 38 studies met our inclusion criteria. There is moderate quality evidence showing no clinically relevant difference of Numeric Rating Scale (NRS) scores or opioid consumption in the postoperative period (pooled mean difference of 0.39 points with a CI of 0.19-0.59 and 4.02 MME with a CI of 1.73-6.30). We found only one small-sized study reporting no effect of opioid-free anesthesia on chronic pain. The quality of recovery was superior in patients with opioid-free anesthesia (mean difference of 8.26 points), however, this pooled analysis was comprised of only two studies. Postoperative nausea and vomiting (PONV) occurred less in opioid-free anesthesia, but bradycardia was more frequent. CONCLUSIONS We concluded that we cannot recommend one strategy over the other. Future studies could focus on quality of recovery as outcome measure and adequately powered studies on the effects of opioid-free anesthesia on chronic pain are eagerly awaited.
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Affiliation(s)
- Minke L Feenstra
- Department of Anesthesiology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Department of Surgery, Amsterdam UMC location University of Amsterdam, AGEM, Cancer Center Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Simone Jansen
- Department of Anesthesiology, LUMC, Albinusdreef 2, Leiden, the Netherlands
| | - Wietse J Eshuis
- Department of Surgery, Amsterdam UMC location University of Amsterdam, AGEM, Cancer Center Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Mark I van Berge Henegouwen
- Department of Surgery, Amsterdam UMC location University of Amsterdam, AGEM, Cancer Center Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Markus W Hollmann
- Department of Anesthesiology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jeroen Hermanides
- Department of Anesthesiology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
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17
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Jin R, Zhang Z, Zheng Y, Niu Z, Sun S, Cao Y, Zhang Y, Abbas AE, Lerut T, Lin J, Li H. Health-Related Quality of Life Following Robotic-Assisted or Video-Assisted Lobectomy in Patients With Non-Small Cell Lung Cancer: Results From the RVlob Randomized Clinical Trial. Chest 2023; 163:1576-1588. [PMID: 36621757 DOI: 10.1016/j.chest.2022.12.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/05/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Robot-assisted lobectomy (RAL) is increasingly used as an alternative to video-assisted lobectomy (VAL) for resectable non-small cell lung cancer (NSCLC). However, there is little evidence of any difference in postoperative health-related quality of life (HRQoL) between these two approaches. RESEARCH QUESTION Is RAL superior to VAL in improving quality of life in patients with resectable NSCLC? STUDY DESIGN AND METHODS We performed a single-center, open-label randomized clinical trial from May 2017 to May 2020 with 320 enrolled patients undergoing RAL or VAL for resectable NSCLC (RVlob trial; NCT03134534). Postoperative pain was evaluated by visual analog score or numeric rating score on postoperative day 1 and at weeks 4, 24, and 48. The European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30), EORTC Quality of Life Questionnaire in Lung Cancer (QLQ-LC13), and the European Quality of Life 5 Dimensions (EQ-5D) questionnaire were also administered at weeks 4, 24, and 48 after surgery. RESULTS One hundred and fifty-seven patients underwent RAL and 163 underwent VAL. The mean pain score of patients after RAL was significantly lower at week 4 (2.097 ± 0.111 vs 2.431 ± 0.108; P = .032). QLQ-C30 and QLQ-LC13 summary scores (P > .05) were similar for both RAL and VAL during the first 48 weeks of follow-up. HRQoL scores assessed with the EQ-5D questionnaire were also comparable between the two groups (P > .05) during the whole study period. INTERPRETATION Both RAL and VAL showed satisfactory and comparable HRQoL and postoperative pain up to 48 weeks after surgery, despite some minor statistical differences at week 4. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT03134534; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Runsen Jin
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhengyuan Zhang
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuyan Zheng
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhenyi Niu
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Siying Sun
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuqin Cao
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yajie Zhang
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Abbas E Abbas
- Department of Thoracic Surgery, Brown Surgical Associates and Lifespan Hospitals, Warren Alpert Medical School of Brown University, Providence, RI
| | - Toni Lerut
- Department of Thoracic Surgery, University Hospital Leuven, Leuven, Belgium
| | - Jules Lin
- Section of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI
| | - Hecheng Li
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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18
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Tchetina E, Glemba K, Yunitskaya A, Markova G, Makarov M, Lila A. Cathepsin S Upregulation Measured in the Peripheral Blood Mononuclear Cells Prior to Surgery Points to Postoperative Pain Development in Patients with Hip Osteoarthritis. Diagnostics (Basel) 2023; 13:diagnostics13101739. [PMID: 37238223 DOI: 10.3390/diagnostics13101739] [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: 03/31/2023] [Revised: 04/28/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Disability caused by hip osteoarthritis has increased due to population aging, obesity, and lifestyle behaviors. Joint failure after conservative therapies results in total hip replacement, which is considered to be one of the most successful interventions. However, some patients experience long-term postoperative pain. Presently, there are no reliable clinical biomarkers for the prognosis of postoperative pain prior to surgery. Molecular biomarkers can be considered as intrinsic indicators of pathological processes and as links between clinical status and disease pathology, while recent innovative and sensitive approaches such as RT-PCR have extended the prognostic value of clinical traits. In light of this, we examined the importance of cathepsin S and proinflammatory cytokine gene expression in peripheral blood in addition to the clinical traits of patients with end-stage hip osteoarthritis (HOA) to predict postoperative pain development prior to surgery. This study included 31 patients with radiographic Kellgren and Lawrence grade III-IV HOA who underwent total hip arthroplasty (THA) and 26 healthy volunteers. Before surgery, a visual analog scale (VAS), DN4, PainDETECT, and the Western Ontario and McMaster Universities osteoarthritis index scores were used for pain and function assessment. Three and six months post-surgery, VAS pain scores of 30 mm and higher were reported. The intracellular protein levels of cathepsin S were measured using ELISA. The expression of the cathepsin S, tumor necrosis factor α, interleukin-1β, and cyclooxygenase-2 genes in peripheral blood mononuclear cells (PBMCs) was assessed using quantitative real-time RT-PCR. Pain persisted in 12 (38.7%) patients after THA. Patients who developed postoperative pain demonstrated significantly higher cathepsin S gene expression in the PBMCs and higher rates of neuropathic pain based on the DN4 testing compared to the other HOA subjects that were examined. No significant differences in proinflammatory cytokine gene expression were noted in either patient cohort prior to THA. The development of postoperative pain in patients with hip osteoarthritis might be associated with disturbances in pain perception, while increased expression of cathepsin S in the peripheral blood prior to surgery may serve as its prognostic biomarker and could be used in clinical settings to improve medical service for patients with end-stage hip OA.
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Affiliation(s)
- Elena Tchetina
- Immunology and Molecular Biology Department, Nasonova Research Institute of Rheumatology, 34A Kashirskoe Shosse, 115522 Moscow, Russia
| | - Kseniya Glemba
- Surgery Department, Nasonova Research Institute of Rheumatology, 34A Kashirskoe Shosse, 115522 Moscow, Russia
| | - Anna Yunitskaya
- Immunology and Molecular Biology Department, Nasonova Research Institute of Rheumatology, 34A Kashirskoe Shosse, 115522 Moscow, Russia
| | - Galina Markova
- Immunology and Molecular Biology Department, Nasonova Research Institute of Rheumatology, 34A Kashirskoe Shosse, 115522 Moscow, Russia
| | - Maksim Makarov
- Surgery Department, Nasonova Research Institute of Rheumatology, 34A Kashirskoe Shosse, 115522 Moscow, Russia
| | - Aleksandr Lila
- Osteoarthritis Laboratory, Nasonova Research Institute of Rheumatology, 34A Kashirskoe Shosse, 115522 Moscow, Russia
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19
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Janc M, Jozwiak Z, Jankowska A, Makowiec-Dabrowska T, Kujawa J, Polanska K. Ergonomics of E-Learning Workstations and the Prevalence of Musculoskeletal Disorders-Study among University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3309. [PMID: 36834004 PMCID: PMC9966283 DOI: 10.3390/ijerph20043309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
The prevalence of musculoskeletal disorders (MSD) has increased significantly in recent years. The COVID-19 pandemic has led to a fundamental change in the lifestyles, ways of learning and working patterns of the general population, which in turn, might lead to health consequences. The aim of this study was to evaluate the conditions of e-learning and the impact of the learning modality on the occurrence of musculoskeletal symptoms among university students in Poland. This cross-sectional study included 914 students who completed an anonymous questionnaire. The questions covered two time periods (before and during the COVID-19 pandemic) and were aimed at obtaining information about lifestyle (including physical activity using the modified International Physical Activity Questionnaire, 2007 (IPAQ), perceived stress and sleep patterns), the ergonomics of computer workstations (by Rapid Office Strain Assessment, 2012 (ROSA) method), the incidence and severity of musculoskeletal symptoms (by the Nordic Musculoskeletal Questionnaire, 2018 (NMQ)) and headaches. The main differences between the two periods were statistically significant according to the Wilcoxon test in terms of physical activity, computer use time, and severity of headaches. During the COVID-19 pandemic, there was a significant increase in MSD (68.2% vs. 74.6%) and their intensity (2.83 ± 2.36 vs. 3.50 ± 2.79 points) among the student population (p < 0.001). In the group of students with MSD, there was a high musculoskeletal load, due to the lack of ergonomic remote learning workstations. In future, a thorough study should be carried out, and there is an urgent need to raise students' awareness of arranging learning workstations according to ergonomic principles in order to prevent the occurrence of musculoskeletal problems.
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Affiliation(s)
- Magdalena Janc
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine (NIOM), 91-348 Lodz, Poland
| | - Zbigniew Jozwiak
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine (NIOM), 91-348 Lodz, Poland
| | - Agnieszka Jankowska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine (NIOM), 91-348 Lodz, Poland
| | - Teresa Makowiec-Dabrowska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine (NIOM), 91-348 Lodz, Poland
| | - Jolanta Kujawa
- Department of Medical Rehabilitation, Faculty of Health Sciences, Medical University of Lodz, 92-213 Lodz, Poland
| | - Kinga Polanska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine (NIOM), 91-348 Lodz, Poland
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Wada Y, Bizen Y, Inaba M. Exploring the effects of COVID-19 on motorcycle riding patterns and its importance. Front Psychol 2023; 14:994128. [PMID: 36794090 PMCID: PMC9923106 DOI: 10.3389/fpsyg.2023.994128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/04/2023] [Indexed: 01/31/2023] Open
Abstract
A motorcycle refers to a two-wheeled, personal mobility vehicle used for daily transportation and leisure activities. Leisure enables social interaction, and motorcycle riding could be an activity that facilitates social interactions and distancing. Therefore, grasping the importance of riding motorcycles during the pandemic-which involved social distancing and limited leisure activities-can be valuable. However, researchers have yet to examine its potential importance during the pandemic. Therefore, this study aimed to determine the importance of personal space and time spent with others in the context of motorcycle riding during the COVID-19 pandemic. We specifically explored the effects of COVID-19 on riding patterns and importance of riding motorcycle by examining whether these factors differed regarding changes in the frequency of motorcycle riding before and during the pandemic in daily and leisure-oriented transportation. Data were collected from 1,800 motorcycle users in Japan using a web-based survey conducted in November 2021. Respondents replied to questions concerning the importance of personal space and time spent with others attributed to motorcycle riding before and during the pandemic. Following the survey, we conducted a two-way repeated measures analysis of variance (two-factor ANOVA) and performed a simple main effect analysis using the SPSS syntax editor in case of interactions. The valid samples for motorcyclists with leisure motive (leisure-oriented users) and daily transportation motive (daily users) numbered n = 890 and n = 870, respectively (total n = 1,760, 95.5%). Each valid sample was divided into three groups based on the differences in motorcycle riding frequency before and during the pandemic: unchanged, increased frequency, and decreased frequency. The two-factor ANOVA results showed significant differences in the interaction effects for leisure-oriented and daily users regarding personal space and time spent with others. The mean value of the "increased frequency" group during the pandemic indicated significantly higher importance of personal space and time spent with others than the other groups. Motorcycle riding could enable daily transportation and leisure-oriented users to practice social distancing while simultaneously spending time with companions and alleviating loneliness and isolation during the pandemic.
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Affiliation(s)
- Yukako Wada
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan,*Correspondence: Yukako Wada,
| | - Yoshifumi Bizen
- Faculty of Human Development, Kokugakuin University, Yokohama, Kanagawa, Japan,Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Mitsuyuki Inaba
- College of Policy Science, Ritsumeikan University, Ibaraki, Osaka, Japan
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Bodmer NJ, Brodt JL, Neuburger PJ. Erector spinae plane blocks for cardiac surgery: Are we comparing apples to oranges? J Card Surg 2022; 37:5230-5232. [PMID: 36218007 DOI: 10.1111/jocs.17015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Natalie J Bodmer
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Jessica L Brodt
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Peter J Neuburger
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Grossman School of Medicine, New York, New York, USA
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22
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Wang B, Sun Y, Shi D, Han X, Liu N, Wang B. Impact of Alendronate Sodium plus Elcatonin on Postoperative Bone Pain in Patients with Osteoporotic Fractures. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1213278. [PMID: 36119926 PMCID: PMC9473873 DOI: 10.1155/2022/1213278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 11/21/2022]
Abstract
Objective This research aims to investigate and analyze the impact of alendronate sodium (ALN) plus elcatonin (EC) in treating postoperative bone pain (BP) in patients with osteoporotic fractures (OPFs). Methods One hundred and thirty-eight cases of OPFs admitted between July 2018 and July 2021 were selected, of which 68 cases receiving ALN were set as the control group and 70 cases receiving ALN plus EC were set as the research group. Intercomparisons were performed in terms of BP, curative effect, complication rate, and serum bone metabolism indexes such as bone Gla protein (BGP), parathyroid hormone (PTH), and bone alkaline phosphatase (BALP). Results Better postoperative BP relief, higher overall response rate, and lower complication rate were identified in the research group versus the control group. On the other hand, the research group presented with increased BGP and BALP after treatment, higher than those in the control group, while the posttreament PTH decreased obviously and was lower versus the control group. Conclusions For OPF patients, ALN plus EC contributes to significantly reduced postoperative BP, improved clinical efficacy, higher treatment safety, and better bone metabolism, which has high clinical application value.
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Affiliation(s)
- Baohui Wang
- Pain Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000 Shaanxi Province, China
| | - Yindi Sun
- Pain Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000 Shaanxi Province, China
| | - Da Shi
- Joint Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000 Shaanxi Province, China
| | - Xiuwei Han
- Joint Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000 Shaanxi Province, China
| | - Na Liu
- Pain Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000 Shaanxi Province, China
| | - Bo Wang
- Joint Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000 Shaanxi Province, China
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