Trait-anxiety and pain intensity predict symptoms related to dysfunctional breathing (DB) in patients with chronic pain

2016 ◽  
Vol 12 (1) ◽  
pp. 123-123
Author(s):  
L.S. Nævestad ◽  
S. Halvorsen ◽  
G. Kvarstein

Abstract Aims The purpose of this cross-sectional study was to inves-tigate the occurrence of symptoms related to dysfunctional breathing (DB) in chronic pain patients and to examine factors associated with these symptoms. Methods A questionnaire was sent to 527 adults referred to out-patient pain clinics at Oslo university hospital. The questionnaire provided demographic data, Brief Pain Inventory, Spielberger state- trait anxiety inventory, and Nijmegen questionnaire (NQ). Multiple regression analyses were performed using SPSS. Results A total of 108 patients (20%) responded to the questionnaire and was included. Mean age was 49 years and two third of the participants were female. More than four out of ten had a NQ score ≥ 23 (a conservative cutoff value for DB). The median NQ score in the sample was 19. Trait-anxiety (Beta = .412, p < 0.001) and maximal pain intensity during the past week (Beta = .264, p = 0.004) predicted symptoms related to DB even when controlling for age and gender. Conclusions The study shows that a large portion of patients with chronic pain experiences symptoms that have been associated with hyperventilation and DB and at a higher level than previously reported. Although trait-anxiety is a strong predictor for symptoms related to DB, we find it interesting that maximal pain intensity during the last week also was associated with these symptoms. The cross-sectional design, low response rate, and lack of diagnoses limit our ability to draw conclusions about causal relationship and extrapolate to a larger populations of patients with chronic pain.

2020 ◽  
Author(s):  
Jessica Robinson-Papp ◽  
Gabriela Cedillo ◽  
Richa Deshpande ◽  
Mary Catherine George ◽  
Qiuchen Yang ◽  
...  

BACKGROUND Collecting patient-reported data needed by clinicians to adhere to opioid prescribing guidelines represents a significant time burden. OBJECTIVE We developed and tested an opioid management app (OM-App) to collect these data directly from patients. METHODS OM-App used a pre-existing digital health platform to deliver daily questions to patients via text-message and organize responses into a dashboard. We pilot tested OM-App over 9 months in 40 diverse participants with HIV who were prescribed opioids for chronic pain. Feasibility outcomes included: ability to export/integrate OM-App data with other research data; patient-reported barriers and adherence to OM-App use; capture of opioid-related harms, risk behaviors and pain intensity/interference; comparison of OM-App data to urine drug testing, prescription drug monitoring program data, and validated questionnaires. RESULTS OM-App data was exported/integrated into the research database after minor modifications. Thirty-nine of 40 participants were able to use OM-App, and over the study duration 70% of all OM-App questions were answered. Although the cross-sectional prevalence of opioid-related harms and risk behaviors reported via OM-App was low, some of these were not obtained via the other measures, and over the study duration all queried harms/risks were reported at least once via OM-App. Clinically meaningful changes in pain intensity/interference were captured. CONCLUSIONS OM-App was used by our diverse patient population to produce clinically relevant opioid- and pain-related data, which was successfully exported and integrated into a research database. These findings suggest that OM-App may be a useful tool for remote monitoring of patients prescribed opioids for chronic pain. CLINICALTRIAL NCT03669939 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1016/j.conctc.2019.100468


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Huailiang Wu ◽  
Weiwei Sun ◽  
Hanqing Chen ◽  
Yanxin Wu ◽  
Wenjing Ding ◽  
...  

Abstract Background Pregnant women experience physical, physiological, and mental changes. Health-related quality of life (HRQoL) is a relevant indicator of psychological and physical behaviours, changing over the course of pregnancy. This study aims to assess HRQoL of pregnant women during different stages of pregnancy. Methods This cross-sectional study was performed using the The EuroQoL Group’s five-dimension five-level questionnaire (EQ-5D-5L) to assess the HRQoL of pregnant women, and demographic data were collected. This study was conducted in a regional university hospital in Guangzhou, China. Results A total of 908 pregnant women were included in this study. Pregnant women in the early 2nd trimester had the highest HRQoL. The HRQoL of pregnant women rose from the 1st trimester to the early 2nd trimester, and dropped to the bottom at the late 3rd trimester due to some physical and mental changes. Reports of pain/discomfort problem were the most common (46.0%) while self-care were the least concern. More than 10% of pregnant women in the 1st trimester had health-related problems in at least one dimension of whole five dimensions. In the whole sample, the EuroQoL Group’s visual analog scale (EQ-VAS) was 87.86 ± 9.16. Across the gestational stages, the HRQoL remained stable during the pregnancy but the highest value was observed in the 1st trimester (89.65 ± 10.13) while the lowest was in the late 3rd trimester (87.28 ± 9.13). Conclusions During pregnancy, HRQoL were associated with gestational trimesters in a certain degree. HRQoL was the highest in the early 2nd trimester and then decreased to the lowest in the late 3rd trimester due to a series of physical and psychological changes. Therefore, obstetric doctors and medical institutions should give more attention and care to pregnant women in the late 3rd trimester.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Henrik Bjarke Vaegter ◽  
Mette Terp Høybye ◽  
Frederik Hjorth Bergen ◽  
Christine E. Parsons

Abstract Objectives Sleep disturbances are highly prevalent in patients with chronic pain. However, the majority of studies to date examining sleep disturbances in patients with chronic pain have been population-based cross-sectional studies. The aims of this study were to 1) examine the frequency of sleep disturbances in patients referred to two interdisciplinary chronic pain clinics in Denmark, 2) explore associations between sleep disturbances and pain intensity, disability and quality of life at baseline and follow-up, and 3) explore whether changes in sleep quality mediated the relationships between pain outcomes at baseline and pain outcomes at follow-up. Methods We carried out a longitudinal observational study, examining patients enrolled in two chronic pain clinics assessed at baseline (n=2,531) and post-treatment follow-up (n=657). Patients reported on their sleep disturbances using the sleep quality subscale of the Karolinska Sleep Questionnaire (KSQ), their pain intensity using 0–10 numerical rating scales, their pain-related disability using the Pain Disability Index (PDI), and quality of life using the EuroQol-VAS scale. The average time between baseline and follow-up was 207 days (SD=154). Results At baseline, the majority of patients reported frequent sleep disturbances. We found a significant association at baseline between self-reported sleep disturbances and pain intensity, pain-related disability, and quality of life, where greater sleep disturbance was associated with poorer outcomes. At follow-up, patients reported significant improvements across all pain and sleep outcomes. In two mediation models, we showed that changes in sleep disturbances from baseline to follow-up were significantly associated with (i) pain intensity at follow-up, and (ii) pain disability at follow-up. However, baseline pain intensity and disability scores were not associated with changes in sleep disturbances and, we did not find evidence for significant mediation of either pain outcome by changes in sleep disturbances. Conclusions Self-reported sleep disturbances were associated with pain outcomes at baseline and follow-up, with greater sleep disturbances associated with poorer pain outcomes. Changes in sleep quality did not mediate the relationships between baseline and follow-up scores for pain intensity and disability. These findings contribute to a growing body of evidence confirming an association between sleep and chronic pain experience, particularly suggestive of a sleep to pain link. Our data following patients after interdisciplinary treatment suggests that improved sleep is a marker for a better outcome after treatment.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Arturo Carta ◽  
Stefania Favilla ◽  
Giacomo Calzetti ◽  
Maria Cristina Casalini ◽  
Pier Francesco Ferrari ◽  
...  

Abstract Background The epidemiology of Moebius syndrome (MBS) is difficult to assess. In the present study, we investigated the epidemiology of MBS in a well-defined population within a precise geographical area. Materials and methods Our university hospital is the only national referral center for the diagnosis and treatment of MBS. Participants in this cross-sectional study were patients affected by MBS who had been periodically followed by our medical staff since 1998. Most of the patients were referred to our hospital by the Italian Association of Moebius Syndrome (AISMO). Demographic data necessary for study purposes were made available in the AISMO database, updated to April 2018. Subjects were assigned to geographical macroareas that are conventionally used in surveys and epidemiological investigations by the Italian National Institute of Statistics. The rates and prevalence of MBS cases were calculated on the basis of the last available survey of the Italian population. Each study parameter was then calculated with reference to the whole country and macroarea partition. The sex rate and the corresponding prevalence were calculated with respect to the weighted whole population and to the respective sex population. Chi-square analysis was adopted to investigate possible differences among geographical regions and/or sexes. A p value < 0.05 was considered statistically significant. Results One hundred and sixty-four out of 212 MBS patients fulfilled our inclusion criteria. All cases occurred in Caucasian patients and were sporadic. The median age at diagnosis was 3.6 years, ranging from 0 to 55 years; this range was significantly reduced to 0–5 years (median age at diagnosis: 2.2 years) in patients included after 2007. The calculated prevalence at birth was 0.06 cases per 10,000 live births, with an overall prevalence of 0.27/100,000, without any sex or geographical predominance. Conclusions The prevalence of MBS observed herein, rounded for possible underestimation, was 0.3/100,000 people, without any regional difference in the distribution of cases. Our data confirm the rarity of the disease on a national level.


Author(s):  
Silvana Marques e SILVA ◽  
Viviane Fernandes ROSA ◽  
Antônio Carlos Nóbrega dos SANTOS ◽  
Romulo Medeiros de ALMEIDA ◽  
Paulo Gonçalves de OLIVEIRA ◽  
...  

BACKGROUND: Colorectal cancer is a major cause of morbidity and mortality and can arise through the adenoma-carcinoma sequence. Colonoscopy is considered the method of choice for population-wide cancer screening. AIM: To assess the characteristics of endoscopically resected polyps in a consecutive series of patients who underwent colonoscopy at a university hospital and compare histopathology findings according to patient age and polyp size. METHODS: Retrospective, cross-sectional of 1950 colonoscopy reports from consecutively examined patients. The sample was restricted to reports that mentioned colorectal polyps. A chart review was carried out for collection of demographic data and histopathology results. Data were compared for polyps sized ≤0.5 cm and ≥0.6 cm and then for polyps sized ≤1.0 cm and ≥1.1 cm. Finally, all polyps resected from patients aged 49 years or younger were compared with those resected from patients aged 50 years or older. RESULTS: A total of 272 colorectal polyps were resected in 224 of the 1950 colonoscopies included in the sample (11.5%). Polyps >1 cm tended to be pedunculated (p=0.000) and were more likely to exhibit an adenomatous component (p=0.001), a villous component (p=0.000), and dysplasia (p=0.003). These findings held true when the size cutoff was set at 0.5 cm. Patients aged 50 years or older were more likely to have sessile polyps (p=0.023) and polyps located in the proximal colon (p=0.009). There were no significant differences between groups in histopathology or presence of dysplasia. CONCLUSION: Polyp size is associated with presence of adenomas, a villous component, and dysplasia, whereas patient age is more frequently associated with sessile polyps in the proximal colon.


2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Sidra Hameed ◽  
Faisal Faiyaz Zuberi ◽  
Sagheer Hussain ◽  
Syed Khalid Ali

Objective: To evaluate risk factors having significant effect on mortality of smear positive Pulmonary Tuberculosis (PTB) inpatients. Methods: A descriptive cross-sectional study was conducted at Ojha Institute of Chest Diseases, Dow University Hospital Ojha Campus, Karachi. One hundred and seventy (170) inpatients of smear positive PTB confirmed by Acid Fast Bacilli (AFB) smear, aged between 13-80 years were enrolled by using consecutive sampling technique while patients with drug resistant Tuberculosis (TB) and extra pulmonary TB were excluded from the study. Selected patients were interviewed for collecting demographic data and risk factor data by using a standard questionnaire. Results: Out of 170 PTB inpatients, mortality was observed in 23 (13.5%) patients among which male patients were 12 (52.2%), and female were 11 (47.8%). Mortality was significantly associated with increasing age (p=0.003), socioeconomic status (p=0.019), anemia (p=0.03), Chronic Liver Disease (CLD) (p=0.005), Diabetes Mellitus (DM) (p=0.001), Human Immunodeficiency Virus (HIV) (p=0.007), Hypertension (HTN) (p=0.006), recurrent TB (p=0.001), and smoking (p=0.001). Conclusion: Increasing age, poverty, smoking history, and presence of comorbidities like DM, CLD, HIV, hypertension, and anemia are associated with higher mortality in smear positive PTB cases. doi: https://doi.org/10.12669/pjms.35.5.919 How to cite this:Hameed S, Zuberi FF, Hussain S, Ali SK. Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.919 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Shaimaa S Yousef ◽  
Lamyaa S Al Bagoury ◽  
Sahar A Dewedar ◽  
Sahar M Sabbour ◽  
Wagida A Anwar

Abstract Background Patient satisfaction can be considered as an indirect measure of health outcomes and quality of provided services. Objectives To compare HCV patients' satisfaction regarding care and treatment in different selected Viral Hepatitis Outpatients Clinics in Cairo. Method: The current study is a cross sectional study. It recruited 300 HCV patients from Viral Hepatitis Outpatients Clinics in University, Ministry of Health (MOH) and Insurance Hospitals (100 HCV patients from each clinic). Recruited HCV patients attended at least 2 visits to the Viral Hepatitis Clinics. They completed an interview questionnaire about socio- demographic data, history of diagnosis of HCV, onset and type of treatment and Hepatitis Patients Satisfaction Questionnaire (HPSQ). Results Mean age of HCV patients were (48.9 ±13.5), (50.4 ± 10.4), and (54.8 ± 10.9) from University, MOH and Insurance Hospitals, respectively. Females accounted for (63%) of HCV patients in University Hospital sample however, males were (54%) and (57%) in MOH and Insurance Hospitals, respectively. Most of studied HCV patients were referred by specialists; (59%), (86%) and (87%) from University, MOH, and Insurance Hospitals, respectively. A statistically significant difference was found between the 3 Clinics as regards rating the quality of received HCV services, meeting patients’ needs, coping with HCV disease, and helping patients access to specialist services (p &lt; 0.01). The study revealed that the majority of health providers in the 3 Viral Hepatitis Clinics didn't involve HCV patients in making decisions about their treatment. Conclusion HPSQ findings identified University Hospital's patients more satisfied about their HCV treatment management than MOH and Insurance Hospitals' patients except for involvement of HCV patients in making decisions which was lacking in the 3 hospitals.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031483 ◽  
Author(s):  
Socheat Cheng ◽  
Tahreem Ghazal Siddiqui ◽  
Michael Gossop ◽  
Espen Saxhaug Kristoffersen ◽  
Christofer Lundqvist

ObjectivesTimely recognition of medication misuse and dependence is crucial to avoid both adverse drug events and increasing health expenditure. Yet the detection of these disorders in older people remains challenging due to the paucity of evidence on characteristics of patients at risk. This study investigates sociodemographic, pharmacological and clinical characteristics and factors associated with prolonged medication use, misuse and dependence in hospitalised older patients, focusing on three commonly prescribed central nervous system depressants (CNSDs): opioid analgesics, benzodiazepines and z-hypnotics.DesignA prospective, cross-sectional study complying with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.SettingSomatic departments of the Akershus University Hospital, Norway.Participants246 patients aged 65–90 were included.Outcome measuresProlonged use was defined as using CNSDs for ≥4 weeks. Misuse and dependence were assessed with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria for substance abuse and dependence. We used descriptive statistics to report patients’ characteristics and logistic regression to demonstrate factors associated with prolonged use, and misuse or dependence.ResultsForty per cent of participants reported using CNSDs for ≥4 weeks. The odds of prolonged use were higher for patients aged 75–84 (OR=2.32, 95% CI 1.16 to 4.65) and ≥85 (OR=3.33, 95% CI 1.25 to 8.87) vs <75 years, for pain intensity (OR=1.02, 95% CI 1.01 to 1.04), and polypharmacy versus no polypharmacy (OR=5.16, 95% CI 2.13 to 12.55). The odds were lower for patients who completed secondary education (OR=0.33, 95% CI 0.13 to 0.83) compared with those with only basic education. Factors associated with misuse or dependence were pain intensity (OR=1.02, 95% CI 1.01 to 1.04) and concurrent use of ≥2 CNSDs (OR=3.99, 95% CI 1.34 to 11.88).ConclusionCNSD overuse is prevalent among hospitalised older patients, despite clear guidelines and recommendations. Our findings underline a need for stronger focus on responsible prescribing, timely detection and prevention of this issue, with special attention towards older patients, those with enhanced pain, polypharmacy and/or concurrent use of several CNSDs.Trial registration numberNCT03162081.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Paulo Reis-Pina ◽  
Anand Acharya ◽  
Antonio Barbosa ◽  
Peter G. Lawlor

Background. Better understanding of the episodic cancer pain (CP) spectrum, including pains that occur in addition to its conventionally defined breakthrough CP (BTcP) and incident CP (IcP) components, may inform CP assessment and management. This study aimed to determine the prevalence of episodic patient-reported CP and the prevalence and associations of study-defined BTcP (S-BTcP) and IcP (S-IcP) in patients with CP. Methods. In a cross-sectional study at their first CP clinic attendance, participants with CP had the following assessments: Brief Pain Inventory (BPI); Pain Management Index (PMI), with PMI-negative status indicating undertreatment; standardized neuropathic pain component (NPC) status; S-BTcP (no trigger identified) and S-IcP (trigger identified) status, based on a preceding 7-day history of transitory pain flares distinct from background pain, and BPI-Worst or BPI-Now pain intensity ≥ 4. Clinicodemographic variables’ association with S-BTcP and S-IcP was examined in logistic regression analyses. Results. Of 371 participants, 308 (83%) had episodic CP by history alone; 140 (37.7%) and 181 (48.8%) had S-BTcP and S-IcP, respectively. Multivariable analyses demonstrated significant (p<0.05) associations (odds ratios: 95% CIs) for 6 variables with S-BTcP: head and neck pain location (2.53; 1.20–5.37), NPC (2.39; 1.34–4.26), BPI average pain (1.64; 1.36–1.99), abdominal pain (0.324; 0.120–0.873), S-IcP (0.207; 0.116–0.369), and PMI-negative status (0.443; 0.213–0.918). Similar independent associations (p<0.05) occurred for S-IcP with NPC, BPI average pain, and PMI-negative status, in addition to radiotherapy, S-BTcP, soft tissue pain, and sleep interference. Conclusions. Episodic or transient patient-reported CP flares often do not meet the more conventional criteria that define BTcP and IcP, the principal episodic CP types. Both BTcP and IcP occur frequently and both are associated with a NPC, higher pain intensity, and less opioid underuse in the management of CP. Further studies are warranted to both better understand the complex presentations of episodic CP and inform its classification.


2018 ◽  
Vol 84 (12) ◽  
pp. 1932-1937
Author(s):  
Anna-Maria ThÖLix ◽  
Jyrki Kössi ◽  
Veikko Remes ◽  
Tom Scheinin ◽  
Jukka Harju

Chronic groin pain after inguinal hernia mesh repair is a common problem. Mesh fixation without sutures has been suggested to have several advantages over the traditional suture fixation. The aim of this study was to compare two self-adhering meshes, the glued Adhesix® (AH) and the gripping Parietene ProGrip® (PP), and evaluate their impact on postoperative chronic pain and overall recovery. Two consultant surgeons performed altogether 393 open inguinal hernia operations at the Helsinki University Hospital during 2014 to 2015. The two groups, AH (n = 169) and PP (n = 224) were similar and comparable in terms of demographic data. The data were collected and analyzed from the patients’ medical records in the hospital's register. The patients were followed up for a period of 19 months (5-31 months). The number of patient contacts due to postoperative pain was significantly less common in the AH group than in the PP group, 4/169 (2.4%) versus 19/224 (8.5%) patients, respectively ( P = 0.011). The duration of pain was under three months for most patients, only two patients in the PP group had pain for over one year. The pain was treated most patients with anti-inflammatory painkillers, whereas injections of a local anesthetic and corticosteroid, and chronic pain medication was needed in some cases. It seems that the use of glue-coated mesh (Adhesix®) was associated with less postoperative visits due to pain compared with the self-fixating mesh with absorbable anchoring system (ProGrip®). Further studies with long-term follow-up are needed to confirm these results.


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