1
|
Inverardi N, Lekkala S, Serafim MF, Sekar A, Wannomae KK, Micheli B, Bedair H, Muratoglu OK, Oral E. Diffusion doping of analgesics into UHMWPE for prophylactic pain management. J Mater Chem B 2024. [PMID: 39192832 DOI: 10.1039/d4tb01050g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
Pain management after total joint arthroplasty is often addressed by systemic delivery of opioids. Local delivery of non-opioid analgesic drugs directly in the joint space from the UHMWPE component of the prosthesis would be highly beneficial to increase the efficacy of the drugs, decreasing the overall side effects and the risk of opioid addiction. It has been shown that effective concentrations of local analgesics can be achieved by eluting from analgesic-blended UHMWPE; however, this approach is limited by the decrease in mechanical properties resulting from the extent of phase separation of the blended drugs from the polymeric matrix. Here we hypothesized that mechanical properties could be maintained by incorporating analgesics into solid form UHMWPE by diffusion as an alternative method. Lidocaine or bupivacaine were diffused in solid form UHMWPE with or without radiation crosslinking. The loaded drug content, the spatial distribution of the drugs and their chemical stability after doping were characterized by FTIR and NMR spectroscopy, respectively. Drug release kinetics, tensile mechanical properties and wear rates were assessed. The results showed that diffusion doping could be used as a promising method to obtain a therapeutic implant material without compromising its mechanical and structural integrity.
Collapse
Affiliation(s)
- Nicoletta Inverardi
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts 02114, USA.
| | - Sashank Lekkala
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Maria F Serafim
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Amita Sekar
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts 02114, USA.
| | - Keith K Wannomae
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Brad Micheli
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Hany Bedair
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts 02114, USA.
| | - Orhun K Muratoglu
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts 02114, USA.
| | - Ebru Oral
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts 02114, USA.
| |
Collapse
|
2
|
Gao H, Dong G, Yao Y, Yang H. Identification and validation of aging-related genes in neuropathic pain using bioinformatics. Front Genet 2024; 15:1430275. [PMID: 39113685 PMCID: PMC11303200 DOI: 10.3389/fgene.2024.1430275] [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: 05/09/2024] [Accepted: 07/04/2024] [Indexed: 08/10/2024] Open
Abstract
Background Neuropathic pain (NP) is a debilitating and refractory chronic pain with a higher prevalence especially in elderly patients. Cell senescence considered a key pathogenic factor in NP. The objective of this research is to discover genes associated with aging in peripheral blood of individuals with NP using bioinformatics techniques. Methods Two cohorts (GSE124272 and GSE150408) containing peripheral blood samples of NP were downloaded from the GEO database. By merging the two cohorts, differentially expressed aging-related genes (DE-ARGs) were obtained by intersection with aging-related genes. The potential biological mechanisms of DE-ARGs were further analyzed through GO and KEGG. Three machine learning methods, namely, LASSO, SVM-RFE, and Random Forest, were utilized to identify diagnostic biomarkers. A Nomogram model was developed to assess their diagnostic accuracy. The validation of biomarker expression and diagnostic effectiveness was conducted in three distinct pain cohorts. The CIBERSORT algorithm was employed to evaluate the immune cell composition in the peripheral blood of patients with NP and investigate its association with the expression of diagnostic biomarkers. Results This study identified a total of 24 DE-ARGs, mainly enriched in "Chemokine signaling pathway," "Inflammatory mediator regulation of TRP channels," "HIF-1 signaling pathway" and "FOXO signaling pathway". Three machine learning algorithms identified a total of four diagnostic biomarkers (CEBPA, CEACAM1, BTG3 and IL-1R1) with good diagnostic performance and the similar expression difference trend in different types of pain cohorts. The expression levels of CEACAM1 and IL-1R1 exhibit a positive correlation with the percentage of neutrophils. Conclusion Using machine learning techniques, our research identified four diagnostic biomarkers related to aging in peripheral blood, providing innovative approaches for the diagnosis and treatment of NP.
Collapse
Affiliation(s)
| | | | | | - Huayuan Yang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
3
|
Kitada M, Yamamura S, Hori E. Subcutaneous edema as a potential cause of catheter failure in older inpatients receiving peripheral parenteral nutrition. Drug Discov Ther 2024; 18:160-166. [PMID: 38880602 DOI: 10.5582/ddt.2024.01029] [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: 06/18/2024]
Abstract
Malnutrition is a common problem among hospitalized older patients. Peripheral parenteral nutrition (PN) can improve patient outcomes but can also lead to complications that affect future treatment. Older inpatients, in particular, are expected to be prone to these catheter-related complications. However, the impact of peripheral PN on older inpatients has been rarely investigated. In the current study, the impact of PN on short peripheral catheters (SPCs) was evaluated by comparing signs and symptoms at the time of catheter removal between 22 patients with PN and 27 without. In addition to external clinical assessment, sonographic investigations of the SPC site were performed. The prevalence of external signs and symptoms of complications was similar between the patients (all P > 0.05). However, subcutaneous edema was found by ultrasound in > 80% of patients with PN, compared with 55.6% of those without PN (P = 0.051). Unlike cases without PN, all patients with PN who presented with external signs and symptoms developed subcutaneous edema (P = 0.022). Multivariate analysis demonstrated that administration of PN was independently associated with subcutaneous edema (adjusted odds ratio = 6.88, 95% confidence interval = 1.083-75.486, P = 0.040). For several decades, phlebitis has been the primary focus of complications related to peripheral PN in clinical settings. However, our results imply that peripheral PN causes subcutaneous edema, which can lead to catheter failure in older inpatients. This study contributes to understanding the etiology of catheter failure during peripheral PN in this population.
Collapse
Affiliation(s)
- Motoko Kitada
- Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan
| | - Shigeo Yamamura
- Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan
| | - Etsuro Hori
- Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| |
Collapse
|
4
|
Nogueira Carrer HC, Haik MN, Espósito G, Vasilceac FA, Melo CDS, Pedroso MG, Gramani Say K. What Predicts a Longer Period of Pain in Patients Referred to an Interdisciplinary Center for Pain Care? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:845. [PMID: 39063422 PMCID: PMC11276389 DOI: 10.3390/ijerph21070845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/07/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024]
Abstract
Chronic musculoskeletal pain (CMP) is a global health condition that affects thousands of people. CMP can substantially affect the functional capacity and quality of life of the people impacted, resulting in high costs for health care and social security systems. Sociodemographic factors may play a significant role in pain chronification prevention and control programs. Thus, current risk factors for CMP must be seriously considered as part of an interdisciplinary management strategy. The purpose of the study was to identify the primary sociodemographic characteristics of CMP patients at a multidisciplinary and specialized center for chronic pain. This is a retrospective investigation based on a review of medical records. Age, gender, income, and the time of onset of pain symptoms were among the variables included in the analyzed data. To analyze variables related to the duration of discomfort, a multiple regression model was utilized. Sociodemographic factors explained 37.94% of experiencing prolonged pain, according to the study's findings. Being female and having a family income above the minimum wage were variables that were directly proportional to discomfort duration. Age was not associated with a prolonged duration of pain perception.
Collapse
Affiliation(s)
- Helen Cristina Nogueira Carrer
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (M.N.H.); (C.d.S.M.); (M.G.P.)
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (M.N.H.); (C.d.S.M.); (M.G.P.)
| | - Gabriela Espósito
- Department of Gerontology, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (G.E.); (F.A.V.)
| | - Fernando Augusto Vasilceac
- Department of Gerontology, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (G.E.); (F.A.V.)
| | - Cristiane de Sousa Melo
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (M.N.H.); (C.d.S.M.); (M.G.P.)
| | - Maria Gabriela Pedroso
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (M.N.H.); (C.d.S.M.); (M.G.P.)
| | - Karina Gramani Say
- Department of Gerontology, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (G.E.); (F.A.V.)
| |
Collapse
|
5
|
Puto G, Repka I, Gniadek A. Gender differences in the quantitative and qualitative assessment of chronic pain among older people. Front Public Health 2024; 12:1344381. [PMID: 38915749 PMCID: PMC11194344 DOI: 10.3389/fpubh.2024.1344381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 05/28/2024] [Indexed: 06/26/2024] Open
Abstract
Background Pain, regardless of its causes, is a subjective and multidimensional experience that consists of sensory, emotional and cognitive factors that cannot be adequately captured by a single number on a pain scale. The aim of the study was to understand gender differences in the assessment of quantitative and qualitative chronic pain among older people. Methods The study used a questionnaire that included questions about demographic and social characteristics as well as the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Depression Scale (GDS-15), McGill Pain Questionnaire (MPQ). Results The pain rating index based on rank values of adjectives was higher among women than men (18.36 ± 7.81 vs. 17.17 ± 9.69, p = 0.04). The analysis of the frequency of selection of individual adjectives describing the sensory aspects of pain showed that men described the pain as "stabbing" more often than women (26.1% vs. 14.3%, p < 0.05). Women chose adjectives from the emotional category more often than men (59.8% vs. 75.4%, p < 0.05), describing the pain as "disgusting" (8.9% vs. 1.4%, p < 0.05), "unbearable" (19.6 vs. 4.3, p < 0.05). In the subjective category, there was a difference between women and men in terms of describing pain as "terrible" (23.2% vs. 7.2%, p < 0.05) and as "unpleasant" (11.6% vs. 23.3%, p < 0 0.05). Conclusion When referring to pain, women tend to employ more detailed and factual language, indicative of heightened emotional sensitivity. Men tend to use fewer words and focus on the sensory aspects of pain. Subjective aspects of pain were demonstrated by both women and men.
Collapse
Affiliation(s)
- Grażyna Puto
- Faculty of Health Sciences, Institute of Nursing and Midwifery, Jagiellonian University Medical College, Cracow, Poland
| | | | | |
Collapse
|
6
|
Vingan PS, Serafin J, Boe L, Zhang KK, Kim M, Sarraf L, Moo TA, Tadros AB, Allen R, Mehrara BJ, Tokita H, Nelson JA. Reducing Disparities: Regional Anesthesia Blocks for Mastectomy with Reconstruction Within Standardized Regional Anesthesia Pathways. Ann Surg Oncol 2024; 31:3684-3693. [PMID: 38388930 PMCID: PMC11267583 DOI: 10.1245/s10434-024-15094-2] [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: 10/30/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Recent data suggest disparities in receipt of regional anesthesia prior to breast reconstruction. We aimed to understand factors associated with block receipt for mastectomy with immediate tissue expander (TE) reconstruction in a high-volume ambulatory surgery practice with standardized regional anesthesia pathways. PATIENTS AND METHODS Patients who underwent mastectomy with immediate TE reconstruction from 2017 to 2022 were included. All patients were considered eligible for and were offered preoperative nerve blocks as part of routine anesthesia care. Interpreters were used for non-English speaking patients. Patients who declined a block were compared with those who opted for the procedure. RESULTS Of 4213 patients who underwent mastectomy with immediate TE reconstruction, 91% accepted and 9% declined a nerve block. On univariate analyses, patients with the lowest rate of block refusal were white, non-Hispanic, English speakers, patients with commercial insurance, and patients undergoing bilateral reconstruction. The rate of block refusal went down from 12 in 2017 to 6% in 2022. Multivariable logistic regression demonstrated that older age (p = 0.011), Hispanic ethnicity (versus non-Hispanic; p = 0.049), Medicaid status (versus commercial insurance; p < 0.001), unilateral surgery (versus bilateral; p = 0.045), and reconstruction in earlier study years (versus 2022; 2017, p < 0.001; 2018, p < 0.001; 2019, p = 0.001; 2020, p = 0.006) were associated with block refusal. CONCLUSIONS An established preoperative regional anesthesia program with blocks offered to all patients undergoing mastectomy with TE reconstruction can result in decreased racial disparities. However, continued differences in age, ethnicity, and insurance status justify future efforts to enhance preoperative educational efforts that address patient hesitancies in these subpopulations.
Collapse
Affiliation(s)
- Perri S Vingan
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joanna Serafin
- Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lillian Boe
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kevin K Zhang
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Minji Kim
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Leslie Sarraf
- Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tracy Ann Moo
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Audree B Tadros
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert Allen
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Babak J Mehrara
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hanae Tokita
- Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jonas A Nelson
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| |
Collapse
|
7
|
Miró Ò, Osorio GI, Alquézar-Arbé A, Aguiló S, Fernández C, Burillo G, Jacob J, Montero-Pérez FJ, García-Lamberechts EJ, Piñera P, Rodríguez Valles C, Carrasco Fernández E, Molina L, Ruescas E, Fernández Salgado F, Fernández-Simón Almela A, de Juan Gómez MÁ, Guiu Martí S, López-Laguna N, García Acosta J, Maza Vera MT, García García Á, Ezponda P, Martínez Lorenzo A, Ortega Liarte JV, Sánchez Ramón S, Ruiz Ramos J, González Del Castillo J. Sex- and age-related patterns in the use of analgesics in older patients in the emergency department. Eur J Emerg Med 2024; 31:108-117. [PMID: 37792526 DOI: 10.1097/mej.0000000000001096] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Treatment of acute pain in older patients is a common challenge faced in emergency departments (EDs). Despite many studies that have investigated chronic analgesic use in the elderly, data on patterns of acute use, especially in EDs, of analgesics according to patient characteristics is scarce. OBJECTIVE To investigate sex- and age-related patterns of analgesic use in the Spanish EDs and determine differences in age-related patterns according to patient sex. DESIGN A secondary analysis of the Emergency Department and Elderly Needs (EDEN) multipurpose cohort. SETTING Fifty-two Spanish EDs (17% of Spanish EDs covering 25% of Spanish population). PARTICIPANTS All patients' ≥65 years attending ED during 1 week (April 1-7, 2019). Patient characteristics recorded included age, sex, chronic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and opiates, comorbidity, dependence, dementia, depression, ability to walk and previous falls. Analgesics used in the ED were categorized in three groups: non-NSAID non-opioids (mainly paracetamol and metamizole, PM), NSAIDs, and opiates. OUTCOME MEASURES Frequency of analgesic use was quantified, and the relationship between sex and age and analgesic use (in general and for each analgesic group) was assessed by unadjusted and adjusted logistic regression and restricted cubic spline models. Interaction between sex and age was explored. MAIN RESULTS We included 24 573 patients, and 6678 (27.2%) received analgesics in the ED: 5551 (22.6%) PM, 1661 (6.8%) NSAIDs and 937 (3.8%) opiates (1312 received combinations). Analgesics were more frequently used in women (adjusted OR = 1.076, 95%CI = 1.014-1.142), as well as with NSAID (1.205, 1.083-1.341). Analgesic use increased with age, increasing PM and decreasing NSAIDs use. Opiate use remained quite constant across age and sex. Interaction of sex with age was present for the use of analgesics in general ( P = 0.006), for PM ( P < 0.001) and for opiates ( P = 0.033), with higher use of all these analgesics in women. CONCLUSION Use of analgesics in older individuals in EDs is mildly augmented in women and increases with age, with PM use increasing and NSAIDs decreasing with age. Conversely, opiate use is quite constant according to sex and age. Age-related patterns differ according to sex, with age-related curves of women showing higher probabilities than those of men to receive any analgesic, PM or opiates.
Collapse
Affiliation(s)
- Òscar Miró
- Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Gina I Osorio
- Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Aitor Alquézar-Arbé
- Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Catalonia
| | - Sira Aguiló
- Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona
| | - Cesáreo Fernández
- Emergency Department, Hospital Clínico San Carlos, IDISSC, Complutense University, Madrid
| | - Guillermo Burillo
- Emergency Department, Hospital Universitario de Canarias, University of La Laguna, Tenerife, Canary Islands
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Catalonia
| | | | | | - Pascual Piñera
- Emergency Department, Hospital Universitario Reina Sofia, Murcia
| | | | | | - Laura Molina
- Emergency Department, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo
| | - Esther Ruescas
- Emergency Department, Hospital Universitario Vinalopó, Elche, Alicante
| | | | | | | | | | | | | | | | | | - Patxi Ezponda
- Emergency Department, Hospital De Zumarraga, Gipuzkoa
| | | | | | | | - Jesús Ruiz Ramos
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | | |
Collapse
|
8
|
Mindlis I, Revenson TA, Erblich J, Fernández Sedano B. Multimorbidity and Depressive Symptoms in Older Adults: A Contextual Approach. THE GERONTOLOGIST 2023; 63:1365-1375. [PMID: 36516464 DOI: 10.1093/geront/gnac186] [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: 07/28/2022] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Among older adults, depressive symptoms increase with each chronic illness; however, specific disease-related stressors (e.g., pain) and contextual moderators (interpersonal, sociocultural, temporal) of this relationship remain understudied. We explored disease-related stressors associated with depressive symptoms and moderating effects of contextual factors on this relationship, guided by a social ecological framework. RESEARCH DESIGN AND METHODS Adults ≥62 years with multimorbidity (n = 366) completed validated scales assessing diagnoses, disease-related stressors (pain intensity, subjective cognitive function, physical function, somatic symptoms), and depressive symptoms. Moderators included age, expectations regarding aging, perceived social support, and difficulty affording medications. Data were analyzed using structural equation modeling. RESULTS Participants were 62-88 years old, with several comorbidities (M = 3.5; range: 2-9). As hypothesized, disease-related stressors were associated with depressive symptoms (b = 0.64, SE = 0.04, p < .001). The effect of disease-related stressors on depressive symptoms was greater among those reporting low social support (B = 0.70, SE = 0.06, p < .001) than for those reporting high social support (B = 0.46, SE = 0.06, p < .001). The negative effect of disease-related stressors on depressive symptoms was stronger for those with poorer expectations of aging (B = 0.68, SE = 0.07, p < .001), compared to those with more positive expectations (B = 0.47, SE = 0.06, p < .001). Age and difficulties affording medications were not significant moderators. DISCUSSION AND IMPLICATIONS Garnering social support and addressing low expectations for aging may prevent the detrimental effect of multimorbidity on mental health.
Collapse
Affiliation(s)
- Irina Mindlis
- Psychology Program, The Graduate Center, City University of New York, New York City, New York, USA
| | - Tracey A Revenson
- Psychology Program, The Graduate Center, City University of New York, New York City, New York, USA
- Psychology Department, Hunter College, City University of New York, New York City, New York, USA
| | - Joel Erblich
- Psychology Program, The Graduate Center, City University of New York, New York City, New York, USA
- Psychology Department, Hunter College, City University of New York, New York City, New York, USA
| | - Brandon Fernández Sedano
- Psychology Department, Hunter College, City University of New York, New York City, New York, USA
| |
Collapse
|
9
|
Alorfi NM. Pharmacological Methods of Pain Management: Narrative Review of Medication Used. Int J Gen Med 2023; 16:3247-3256. [PMID: 37546242 PMCID: PMC10402723 DOI: 10.2147/ijgm.s419239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/02/2023] [Indexed: 08/08/2023] Open
Abstract
Background Pain management is a critical aspect of healthcare, aimed at alleviating discomfort and improving the quality of life for individuals experiencing acute or chronic pain. Pharmacological methods constitute a primary approach to pain management, including a diverse array of drugs that work through different mechanisms. Aim Identifying medications commonly employed in pain management, focusing on their mechanism of actions, uses, efficacy and pharmacological applications. Methods The methodology involved a systematic search of scientific literature using various databases, including PubMed, Scopus, and Google Scholar. Relevant articles published between 2000 and 2023 were screened for inclusion. The selected studies encompassed original research, review articles, therapeutic guidelines and randomized controlled trials. Results The findings of this review suggest that a multimodal approach combining various analgesics can enhance pain relief while minimizing adverse effects. It emphasizes the importance of assessing pain intensity, determining the underlying etiology, and utilizing evidence-based guidelines to optimize pain management outcomes. Conclusion Pharmacological methods of pain management are an essential component of pain management strategies to achieve optimal pain relief while minimizing adverse effects. The article concludes with a discussion on emerging trends and future directions in pharmacological pain management, including novel drug targets and advances in drug delivery systems.
Collapse
Affiliation(s)
- Nasser M Alorfi
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| |
Collapse
|
10
|
Ferreira ACL, Pereira DS, da Silva SLA, Carvalho GA, Pereira LSM. Validity and reliability of the short form brief pain inventory in older adults with nociceptive, neuropathic and nociplastic pain. Geriatr Nurs 2023; 52:16-23. [PMID: 37192570 DOI: 10.1016/j.gerinurse.2023.04.011] [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: 02/12/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the validity and reliability of the Short Form Brief Pain Inventory (SF-BPI) for community-dwelling Brazilian older adults with chronic neuropathic, nociceptive and nociplastic pain. METHODS Cross-sectional psychometric testing was conducted in a convenience sample, n=114 (66.5 ± 4.9 years). RESULTS The 2-factor structure of the SF-BPI was ratified by confirmatory factor analysis. Convergent validity was found between the SF-BPI and the Present Pain Intensity (PPI). There was good overall internal consistency (Cronbach's α: 0.87). Test-retest reliability was excellent for pain intensity and interference scores of the SF-BPI (ICC: 0.90 and 0.96, respectively), as well as inter-rater reliability for both dimensions (ICC: 0.77). CONCLUSION The findings support the validity and reliability of the SF-BPI for community-dwelling older adults with chronic pain and may contribute to health professionals having a brief multidimensional assessment for more effective therapeutic approaches in this population.
Collapse
Affiliation(s)
- Ana Carolina Lopes Ferreira
- Department of Physiotherapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil; Sarah Network of Rehabilitation Hospitals, Avenida Amazonas, 5953, Gameleira, Belo Horizonte, Minas Gerais, CEP 30180-001, Brazil.
| | - Daniele Sirineu Pereira
- Department of Physiotherapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
| | - Silvia Lanziotti Azevedo da Silva
- Department of Collective Health/School of Medicine, Federal University of Juiz de Fora, Av. Eugênio do nascimento s/n°, Dom Bosco, Juiz de Fora, Minas Gerais, CEP 36038-330, Brazil
| | - Guilherme Almeida Carvalho
- Sarah Network of Rehabilitation Hospitals, Avenida Amazonas, 5953, Gameleira, Belo Horizonte, Minas Gerais, CEP 30180-001, Brazil
| | - Leani Souza Máximo Pereira
- Department of Physiotherapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
| |
Collapse
|
11
|
Mo N, Feng JY, Liu HX, Chen XY, Zhang H, Zeng H. Effects of Exergaming on Musculoskeletal Pain in Older Adults: Systematic Review and Meta-analysis. JMIR Serious Games 2023; 11:e42944. [PMID: 37097717 PMCID: PMC10170365 DOI: 10.2196/42944] [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: 09/25/2022] [Revised: 02/16/2023] [Accepted: 03/29/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Exercise is effective for musculoskeletal pain. However, physical, social, and environmental factors make it difficult for older adults to persist in exercising. Exergaming is a new pathway that combines exercise with gameplay and may be helpful for older adults to overcome these difficulties and engage in regular exercise. OBJECTIVE This systematic review aimed to determine the efficacy of exergaming to improve musculoskeletal pain in older adults. METHODS The search was performed in 5 databases (PubMed, Embase, CINAHL, Web of Science, and Cochrane Library). The risk of bias for randomized controlled studies was assessed using the revised Cochrane Risk of Bias tool in randomized trials (RoB 2), and the methodological quality was assessed using the Physiotherapy Evidence-Based Database scale. Standardized mean difference and 95% CI were calculated using fixed-effects model meta-analyses in the Review Manager version 5.3 (RevMan 5.3). RESULTS Seven randomized controlled studies were included, which contained 264 older adults. Three of the 7 studies reported significant improvements in pain after the exergaming intervention, but only 1 reported a significant difference between groups after adjustment for baseline (P<.05), and another reported a significant improvement in thermal pain between the 2 groups (P<.001). The results of the meta-analysis of the 7 studies showed no statistically significant improvement in pain compared to the control group (standardized mean difference -0.22; 95% CI -0.47 to 0.02; P=.07). CONCLUSIONS Although the effects of exergames on musculoskeletal pain in older adults are unknown, exergame training is generally safe, fun, and appealing to older adults. Unsupervised exercise at home is feasible and cost-effective. However, most of the current studies have used commercial exergames, and it is recommended that there should be more cooperation between industries in the future to develop professional rehabilitation exergames that are more suitable for older adults. The sample sizes of the studies included are small, the risk of bias is high, and the results should be interpreted with caution. Further randomized controlled studies with large sample sizes, high quality, and rigor are needed in the future. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022342325; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=342325.
Collapse
Affiliation(s)
- Nan Mo
- Xiangya Nursing School, Central South University, Changsha, China
| | - Jin Yu Feng
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hai Xia Liu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xiao Yu Chen
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hui Zhang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hui Zeng
- Xiangya Nursing School, Central South University, Changsha, China
| |
Collapse
|
12
|
Puto G, Repka I, Muszalik M. Factors Correlating with Functional Capacity in Older People with Chronic Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2748. [PMID: 36768110 PMCID: PMC9915534 DOI: 10.3390/ijerph20032748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Chronic pain in older people is a global health problem not only in terms of a negative subjective feeling, but also as a social and economic factor. Deterioration of functional capacity is one of the main symptoms of chronic pain; therefore, it should be assessed as a basic parameter in the life of older people. The aim of the study was to analyze the factors which have an impact on the functional capacity of older people with chronic pain. MATERIAL AND METHODS The study was conducted among 181 people over 65 suffering from chronic pain lasting more than 6 months. The study used a questionnaire that included questions about demographic and social characteristics and the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Pain Measure-24 (GPM-24). RESULTS In the study group, a positive correlation was found between: coexisting diseases and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A positive correlation was also found between the Geriatric Depression Scale (GDS) and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A significantly negative correlation was found between: AMTS, ADL, IADL performance and: withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of total GPM-24 score. CONCLUSIONS Chronic pain is more common in people with disabilities in basic and complex activities of daily living, with limited efficiency in cognitive functions and an increased sense of depression. The standard in everyday practice and clinical trials should be taking a history of chronic pain in every older person, monitoring the pain's intensity and accompanying characteristics by using a multidimensional scale for assessing pain in older people.
Collapse
Affiliation(s)
- Grażyna Puto
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Kopernika 25 Street, 31-501 Krakow, Poland
| | - Iwona Repka
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Kopernika 25 Street, 31-501 Krakow, Poland
| | - Marta Muszalik
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| |
Collapse
|