Pain Following Endoscopic Foreheadplasty Surgery in Women

2021 ◽  
Author(s):  
Julia C Lassegard ◽  
Bruce J Dubin ◽  
Peggy Compton ◽  
Andrew C Charles ◽  
Paul M Macey
Keyword(s):  
Repeated Measures ◽  
Severe Pain ◽  
Short Form ◽  
Light Sensitivity ◽  
Moderate Pain ◽  
Common Procedure ◽  
Repeated Measures Design ◽  
Postoperative Headache ◽  
Headache Pain

Abstract Background Endoscopic foreheadplasty surgery (EFS) is a common procedure, however little evidence exists describing the nature or treatment of postoperative headache pain and associated symptoms. Objectives Our objective was to describe the intensity, quality, location, and duration of headache pain in women following EFS. We also compared post EFS symptoms with migraine, described medication use and efficacy, and measured emotional and functional outcomes. Methods This descriptive study used an observational repeated measures design. Forty-two women (age mean±std=59.0±7.9 years) undergoing EFS were prospectively recruited from twelve private cosmetic practices in three California counties. Phone interviews with the Acute Short-Form 12v2, and Headache Questionnaires were conducted on postoperative days (POD) 1, 3, 7, and 30. Results At POD#1, 93% reported at least moderate pain and 64% severe pain. Severe pain was characterized as throbbing (71%), sharp (53%), dull (76%), exploding (41%), imploding (53%), continuous (53%) or intermittent (41%) on POD#1. Moderate pain was most frequent on POD#3 (21%) compared to POD#1 (19%), POD#7 and #30 (12%). Mild pain predominated on POD#3 (40%) and POD#7 (40%), with (20%) remaining on POD#30. The majority (79%) of post EFS symptoms commonly included light sensitivity and nausea, and therefore met most International Classification of Headache Disorders criteria for migraine. Analgesic use provided inconsistent relief. Functional and emotional status did not return to baseline throughout the 30-day postoperative period. Conclusions Immediately following EFS, most women experience moderate to severe headache pain, despite use of medications. Pain persists in many patients for up to a month. Headache is associated with migraine symptoms, including light sensitivity and nausea.

Pain and Health-Related Quality of Life (HRQoL) in Patients with Relapsed and Plateau-Phase (PP) Multiple Myeloma (MM) Treated with Denosumab

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2388-2388 ◽  
Author(s):  
Karen C Chung ◽  
Arie Barlev ◽  
Yi Qian ◽  
Susie Jun
Keyword(s):  
Severe Pain ◽  
Short Form ◽  
Human Monoclonal Antibody ◽  
Moderate Pain ◽  
Mild Pain ◽  
Osteoclast Activity ◽  
The Past ◽  
Hrqol Data ◽  
The Impact

Abstract BACKGROUND: MM is the second most common hematalogical malignancy in the U.S. The expansion of myeloma cells in bone, which is characteristic of MM, results in increased osteoclast activity that cause osteolytic lesions, which can lead to spinal cord compression, pathologic fracture, surgery or radiation therapy to bone, and bone pain. Denosumab is a fully human monoclonal antibody that can inhibit bone resorption by reducing the number and activity of osteoclasts by inhibiting RANK ligand, a key mediator of osteoclast activity. The objective of this analysis was to evaluate the pain and HRQoL in patients with MM being treated with denosumab. METHODS: 96 patients with either ≥2 prior treatment regimens and relapsed following a response to any conventional MM therapy (relapsed) or response to the most recent MM therapy and stable M-protein for ≥3 months (PP) were enrolled in a phase 2, multicenter, open-label, single-arm study of denosumab. Patients received 120mg denosumab SC on days 1, 8, 15, and 29 then every 28 days thereafter until disease progression or discontinuation. The Brief Pain Inventory-Short Form (BPI) and Functional Assessment of Cancer Therapy-General (FACT) were assessed at baseline (BL) and prior to treatment on day 1 of each 28-day cycle. BPI “pain at worst in the past 24 hours” scores were categorized as no pain (BPI 0), mild pain (BPI 1–4), moderate pain (BPI 5–6) or severe pain (BPI 7–10). BL and month 3 (relapsed) and month 5 (PP) pain and HRQoL data were analyzed. Longitudinal data regarding pain and HRQoL data were reported at BL and the latest assessment timepoint where <30% of patients had dropped out. RESULTS: 45 patients with relapsed MM (Table 1) and 37 patients with PP MM (Table 2) had BL and ≥1 post-BL assessment. 30% or more patients dropped out after month 3 of treatment in relapsed patients and after month 5 in PP patients. In relapsed patients, 12 (27%), 21 (47%), 8 (18%), and 4 (9%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. In PP patients, 15 (41%), 13 (35%), 5 (14%), and 4 (11%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. 68% and 89% of relapsed and PP patients, respectively, demonstrated improvement or no categorical change in pain. At BL, mean (sd) FACT total scores (0–108, higher score indicating better HRQoL) for relapsed and PP patients were 77.4 (15.3) and 82.5 (11.2), respectively. FACT total scores remained relatively constant in relapsed and PP patients, 77.9 (19.4) and 83.6 (13.3), respectively. In addition, mean change from baseline in FACT domain scores varied between 1.2 to 0.2 in relapsed patients and between 0.3 to 1.1 in PP patients. CONCLUSION: The majority of patients with relapsed and PP MM demonstrated maintenance or improvement in pain and maintenance of HRQoL during treatment with denosumab. These results suggest denosumab may be associated with stabilization of pain and maintenance of HRQoL in patients with MM. Randomized trials are needed to further understand the impact of denosumab on pain and HRQoL in patients with MM. Table 1. “Pain at Worst in the past 24 hours” Category Shift between BL and month 3 in relapsed patients (n=45). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 7 2 2 1 12 Mild 4 10 4 3 21 Moderate 2 3 1 2 8 Severe 0 0 2 2 4 TOTAL 13 15 9 8 45 Table 2. “Pain at Worst in the past 24 hours” Category Shift between BL and month 5 in PP patients (n=37). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 13 2 0 0 15 Mild 4 7 1 1 13 Moderate 1 2 1 1 5 Severe 0 0 2 2 4 TOTAL 18 11 4 4 37

Effect of Sinus Surgery on Bodily Pain: A Metaanalysis

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P75-P75
Author(s):  
Alexander C Chester ◽  
Raj Sindwani ◽  
Timothy L Smith ◽  
Neil Bhattacharyya
Keyword(s):  
Repeated Measures ◽  
Short Form ◽  
Bodily Pain ◽  
Sinus Surgery ◽  
Web Based ◽  
Repeated Measures Design ◽  
Pain Scores ◽  
Sf 36 ◽  
Before And After ◽  
Pain Domain

Objective To determine by systematic review and metaanalysis if (1) bodily pain as measured by the 36-Item Short Form Health Survey (SF-36) is consistently increased in patient populations with chronic rhinosinusitis (CRS); and (2) if SF-36 bodily pain scores significantly and consistently improve following endoscopic sinus surgery (ESS). Methods Studies published in any language reporting SF-36 results before and after ESS were retrieved by searching MEDLINE, EMBASE, Web of Science, Cochrane databases, and additional Web-based sources (from 1980 to January 2008); by examining bibliographies of retrieved articles; and by contacting investigators in the field. Two authors independently evaluated studies for inclusion. Results After excluding 1 study reporting results as medians rather than as means, the remaining 10 observational ESS studies (909 patients) reported preoperative SF-36 bodily pain scores 0.95 SDs below the general population mean (more bodily pain) in average weighted by sample size. Using a repeated-measures design, all studies noted an improvement in SF-36 bodily pain domain scores following surgery, with a moderate-sized combined effect of 0.54 (95% confidence interval [CI], 040–0.69) and moderate heterogeneity (I2 = 50%). This pooled effect corresponds to a clinically and statistically significant mean improvement of 11.7 (95% CI, 7.1–16.3) units in the SF-36 bodily pain domain. Conclusions Bodily pain is consistently increased in patient populations with CRS. Using within-subject comparisons, a clinically and statistically significant improvement in bodily pain is noted after ESS, an improvement similar in size to that previously described for fatigue and other CRS symptoms.

scholarly journals ARTHROSCOPIC TREATMENT FOR LATERAL EPICONDYLITIS: OUTCOMES IN 104 CASES OF A SINGLE INSTITUTION

2019 ◽  
Vol 27 (3) ◽  
pp. 156-159
Author(s):  
Alexandre Tadeu do Nascimento ◽  
Gustavo Kogake Claudio ◽  
Pedro Bellei Rocha ◽  
Juan Pablo Zumárraga ◽  
Olavo Pires de Camargo
Keyword(s):  
Severe Pain ◽  
Short Form ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Lateral Epicondylitis ◽  
Dash Score ◽  
Moderate Pain ◽  
Duration Of Symptoms ◽  
Mild Pain ◽  
Sf 36

ABSTRACT Objective: To evaluate the outcomes of patients that underwent arthroscopic surgery for lateral epicondylitis (LE), after failed conservative treatment. Methods: One hundred four patients with LE treated with arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon were enrolled in this retrospective study. They were evaluated using Disabilities of the Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) and Short Form Health Survey (SF-36) scale. Mean age at surgery was 46.9 years. Duration of symptoms was 2.1 years (range: 6 m to 10 yrs.). Mean follow-up was 34.4 months (range: 6 to 68 m). Results: Mean postoperative scores were: 20.67 points on the DASH; 1.8 points on the VAS at rest, with 48 cases (46%) without pain, 40 (38%) with mild pain, 13 (13%) with moderate pain and 4 (4%) with severe pain; 4.7 points on the VAS in activity, with 21 (20%) without pain, 21 (20%) with mild pain, 35 (34%) with moderate pain and 27 (26%) with severe pain; and SF-36 was 66.8 points. Of the 23 patients who practiced sports regularly or with higher physical demand from the upper limbs, 17 (74%) were able to return to the same activity at the same level. No significant complications were observed postoperatively, except for 3 (2.8%) cases of postoperative superficial infection. Conclusion: Surgical treatment with arthroscopy for recalcitrant LE is effective and safe, presenting positive outcomes in the studied patients. Level of evidence IV, Case Series.

scholarly journals Potential Benefits of Nintendo Wii Fit Among People with Multiple Sclerosis

2011 ◽  
Vol 13 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Matthew Plow ◽  
Marcia Finlayson
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Repeated Measures ◽  
Short Form ◽  
Control Period ◽  
Exercise Program ◽  
Nintendo Wii ◽  
Repeated Measures Design ◽  
Wii Fit ◽  
Nintendo Wii Fit

We examined the potential of Nintendo Wii Fit (Nintendo Co, Ltd, Kyoto, Japan) to increase physical activity (PA) behavior and health among people with multiple sclerosis (MS). The study consisted of a repeated-measures design with a baseline control period and involved 30 people with MS who had the ability to walk 25 feet with or without a cane (26 individuals were included in the analyses). Nintendo Wii was set up in the homes of participants, who were prescribed a Wii Fit exercise program lasting 14 weeks, 3 days a week. The Physical Activity and Disability Survey, Modified Fatigue Impact Scale, and 36-item Short Form Health Status Survey were administered three times before participants gained access to Wii Fit (control period, at 2-week intervals), and three times after they received Wii Fit (posttest 1: immediately after; posttest 2: 7 weeks after; posttest 3: 14 weeks after). Mobility, balance, strength, and weight were assessed at the first pretest, immediately prior to obtaining access to Wii Fit, and 7 weeks after obtaining access to Wii Fit. Results from the questionnaires indicated that PA significantly improved at week 7, but at week 14, PA levels declined relative to week 7 and the difference was no longer significant compared with the control period. Physical assessments indicated that balance and strength significantly improved at week 7. One adverse event was reported (repetitive knee injury). Physical assessments indicated that people with MS may be able to improve their fitness levels by using Wii Fit. Future studies should incorporate behavior change strategies to promote long-term use of Wii Fit, and explore whether individuals with more severe symptoms of MS can safely use Wii Fit.

scholarly journals Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-16 ◽  
Author(s):  
Kathryn Curtis ◽  
Kerry Kuluski ◽  
Gitte Bechsgaard ◽  
Jennifer Ridgway ◽  
Joel Katz
Keyword(s):  
Repeated Measures ◽  
Pain Catastrophizing ◽  
Short Form ◽  
Depression Scale ◽  
Well Being ◽  
Continuing Care ◽  
Hatha Yoga ◽  
Care Hospital ◽  
Repeated Measures Design ◽  
Self Compassion

Introduction. The purpose of this study was to evaluate a specialized yoga intervention for inpatients in a rehabilitation and complex continuing care hospital.Design. Single-cohort repeated measures design.Methods. Participants (N=10) admitted to a rehabilitation and complex continuing care hospital were recruited to participate in a 50–60 min Hatha Yoga class (modified for wheelchair users/seated position) once a week for eight weeks, with assigned homework practice. Questionnaires on pain (pain, pain interference, and pain catastrophizing), psychological variables (depression, anxiety, and experiences with injustice), mindfulness, self-compassion, and spiritual well-being were collected at three intervals: pre-, mid-, and post-intervention.Results. Repeated measures ANOVAs revealed a significant main effect of time indicating improvements over the course of the yoga program on the (1) anxiety subscale of the Hospital Anxiety and Depression Scale,F(2,18)= 4.74,p<.05, andηp2= .35, (2) Self-Compassion Scale-Short Form,F(2,18)= 3.71,p<.05, andηp2= .29, and (3) Magnification subscale of the Pain Catastrophizing Scale,F(2,18)= 3. 66,p<.05, andηp2= .29.Discussion. The results suggest that an 8-week Hatha Yoga program improves pain-related factors and psychological experiences in individuals admitted to a rehabilitation and complex continuing care hospital.

scholarly journals Auricular Point Acupressure for Chronic Low Back Pain: A Feasibility Study for 1-Week Treatment

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Chao-Hsing Yeh ◽  
Lung-Chang Chien ◽  
Yi-Chien Chiang ◽  
Li-Chun Huang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Repeated Measures ◽  
Retention Rate ◽  
Short Form ◽  
Intensity Change ◽  
Low Back ◽  
Repeated Measures Design ◽  
Auricular Point

Objectives. The objective of this one-group, repeated-measures design was to explore the acceptance of auricular point acupressure (APA) to reduce chronic low back pain (CLBP) and estimate minimum clinically important differences (MCIDs) for pain intensity change.Methods. Subjects received 7-day APA treatment. After appropriate acupoints were identified, vaccaria seeds were carefully taped onto each selected auricular point for 7-day. The Brief Pain Inventory Short Form (BPI) was used to collect outcome data.Results. A total of 74 subjects participated in the study. Ten subjects dropped out and the retention rate was 87%. Subjects reported a 46% reduction in BPI worst pain, and over 50% reduction in BPI average pain, overall pain severity and pain interference by the end of study, and 62.5% subjects also reported less pain medication use. The MCIDs for the subscale of BPI ranged from .70 to 1.86 points. The percentage improvement of MCIDs from baseline was between 14.5–24.9%.Discussion. APA appears to be highly acceptable to patients with CLBP. A sham group is needed in order to differentiate the true effects of APA from the possible psychological effects of more frequent visits by the auricular therapist and patients’ expectation of the APA treatment.

scholarly journals A Study of Post Obturation Pain Following Single Visit Root Canal Treatment

2013 ◽  
Vol 12 (3) ◽  
pp. 16-19 ◽  
Author(s):  
Salma Jabeen ◽  
Dr Khurshiduzzaman
Keyword(s):  
Root Canal ◽  
Severe Pain ◽  
Root Canal Treatment ◽  
Moderate Pain ◽  
Treatment Procedure ◽  
Common Procedure ◽  
Single Visit ◽  
Medical College ◽  
Slight Pain

Introduction: Root canal treatment (RCT) is a common procedure in dentistry. In recent year, single visit RCT has gained increased acceptance as a treatment procedure of RCT. One of the problem of RCT is post obturation pain. Objectives: This study was conducted to determine the incidence of post obturation pain related to single visit RCT in asymptomatic non-vital single rooted teeth. Methods: A total 60 cases of endodontically involved asymptomatic non-vital single rooted teeth without any evidence of periapical radiolucency in radiograph, were selected for this study. The canals of all teeth were prepared and filled using the standarized preparation and lateral condensation filling technique. The frequency of post obturation pain was recorded as no pain, slight, moderate and severe pain and evaluated at the day l and at the day 7 after obturation. Result: Out of the 60 patients involved in the study, 37 patients had no pain, 12 patients had slight pain and 11 patients had moderate pain at the day 1 after post obturation. At the day 7 after post obturation, 50 patients had no pain, 8 patients had slight pain and 2 patients had moderate pain. No one showed severe pain in both follow up days. Conclusion: Statistically significant differences were found in the incidence and degree of pain between two follow up days. Incidence of pain was more in 1st post obturation day and decreased thereafter. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 16-19

Vestibular Function and Motion Sickness Susceptibility: Videonystagmographic Evidence From Oculomotor and Caloric Tests

2020 ◽  
Vol 29 (2) ◽  
pp. 188-198
Author(s):  
Cynthia G. Fowler ◽  
Margaret Dallapiazza ◽  
Kathleen Talbot Hadsell
Keyword(s):  
Phase Velocity ◽  
Motion Sickness ◽  
Repeated Measures ◽  
Short Form ◽  
Vestibular Function ◽  
Slow Phase ◽  
Test Results ◽  
Normal Range ◽  
Slow Phase Velocity ◽  
Caloric Tests

Purpose Motion sickness (MS) is a common condition that affects millions of individuals. Although the condition is common and can be debilitating, little research has focused on the vestibular function associated with susceptibility to MS. One causal theory of MS is an asymmetry of vestibular function within or between ears. The purposes of this study, therefore, were (a) to determine if the vestibular system (oculomotor and caloric tests) in videonystagmography (VNG) is associated with susceptibility to MS and (b) to determine if these tests support the theory of an asymmetry between ears associated with MS susceptibility. Method VNG was used to measure oculomotor and caloric responses. Fifty young adults were recruited; 50 completed the oculomotor tests, and 31 completed the four caloric irrigations. MS susceptibility was evaluated with the Motion Sickness Susceptibility Questionnaire–Short Form; in this study, percent susceptibility ranged from 0% to 100% in the participants. Participants were divided into three susceptibility groups (Low, Mid, and High). Repeated-measures analyses of variance and pairwise comparisons determined significance among the groups on the VNG test results. Results Oculomotor test results revealed no significant differences among the MS susceptibility groups. Caloric stimuli elicited responses that were correlated positively with susceptibility to MS. Slow-phase velocity was slowest in the Low MS group compared to the Mid and High groups. There was no significant asymmetry between ears in any of the groups. Conclusions MS susceptibility was significantly and positively correlated with caloric slow-phase velocity. Although asymmetries between ears are purported to be associated with MS, asymmetries were not evident. Susceptibility to MS may contribute to interindividual variability of caloric responses within the normal range.

Power of Modified Brown-Forsythe and Mixed-Model Approaches in Split-Plot Designs

Methodology ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Pablo Livacic-Rojas ◽  
Guillermo Vallejo ◽  
Paula Fernández ◽  
Ellián Tuero-Herrero
Keyword(s):  
Repeated Measures ◽  
Statistical Power ◽  
Mixed Model ◽  
Covariance Structure ◽  
Simulation Method ◽  
Future Research ◽  
Repeated Measures Design ◽  
Fixed And Random Effects ◽  
Split Plot ◽  
High Level

Abstract. Low precision of the inferences of data analyzed with univariate or multivariate models of the Analysis of Variance (ANOVA) in repeated-measures design is associated to the absence of normality distribution of data, nonspherical covariance structures and free variation of the variance and covariance, the lack of knowledge of the error structure underlying the data, and the wrong choice of covariance structure from different selectors. In this study, levels of statistical power presented the Modified Brown Forsythe (MBF) and two procedures with the Mixed-Model Approaches (the Akaike’s Criterion, the Correctly Identified Model [CIM]) are compared. The data were analyzed using Monte Carlo simulation method with the statistical package SAS 9.2, a split-plot design, and considering six manipulated variables. The results show that the procedures exhibit high statistical power levels for within and interactional effects, and moderate and low levels for the between-groups effects under the different conditions analyzed. For the latter, only the Modified Brown Forsythe shows high level of power mainly for groups with 30 cases and Unstructured (UN) and Autoregressive Heterogeneity (ARH) matrices. For this reason, we recommend using this procedure since it exhibits higher levels of power for all effects and does not require a matrix type that underlies the structure of the data. Future research needs to be done in order to compare the power with corrected selectors using single-level and multilevel designs for fixed and random effects.

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