scholarly journals AB0267 HOW EFFECTIVE IS PAIN MANAGEMENT IN THE PATIENTS’ OPINION? DATA FROM THE COMPAS STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1160.1-1160
Author(s):  
E. Pogozheva ◽  
A. Karateev ◽  
V. Amirdzhanova
Keyword(s):  
Pain Management ◽  
Pain Therapy ◽  
Significant Proportion ◽  
Connective Tissue Diseases ◽  
Underlying Disease ◽  
Additional Treatment ◽  
Results Of Treatment ◽  
Analgesic Therapy ◽  
Folk Remedies ◽  
Personalized Approach

Objectives:to evaluate the effectiveness and satisfaction of pain management in patients with rheumatic diseases (RD) according to a survey in the COMPAS (Quality of Pain Management according to Patients with Arthritis and Back pain) study.Methods:the survey involved 1040 patients with RD (rheumatoid arthritis-40.6%, osteoarthritis -32.1%, spondyloarthritis-10.6%, connective tissue diseases-8.6% of patients). 76.8% were women, the mean age was 55.8±14.0 years. 35.7% of patients continued to work in their specialty, 31.6% had various degrees of disability. The effectiveness of pain therapy was evaluated by the patient in the last month preceding the survey on a 5-point scale, where 1 - no effect and 5-excellent effect. Patients ‘ satisfaction with treatment, possible reasons for the lack of effectiveness of pain therapy and the use of additional treatment tools were also evaluated.Results:as therapy for the underlying disease, 40% of patients received conventional disease modifying antirheumatic drugs, 33.1% - glucocorticoids, 7.2% - biological agents and 15.2% - symptomatic slow-acting drugs in osteoarthritis. At the same time, 68% of patients needed additional analgesic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs). Slightly less than half of the surveyed patients (46.9%) noted a moderate effect of analgesic therapy, 22.7% - a low effect and 5% - no effect, 23.7% rated the effectiveness of therapy as good and only 1.7% - as excellent. At the same time, only 15.6% of patients were completely satisfied with the result of NSAIDs, 64% were partially satisfied with the treatment and 20.4% were completely dissatisfied. As the reason of insufficient effectiveness of NSAIDs, most often (34.3%) patients named fear of adverse events associated with taking drugs, 19.4% - weak drugs, 15.3% - insufficient attention of doctors to complaints, 6.6% - poor diagnosis of the causes of pain. Others found it difficult to answer or were completely satisfied with the treatment. 40% of patients used additional methods, most often chiropractic (12.3%), acupuncture (4.8%), physiotherapy (12.7%) and folk remedies (7.4%).Conclusion:A significant proportion of patients with RD don’t have adequate pain control. Only 25.4% of patients rate the result of treatment as good and excellent, and even fewer patients (15.6%) are completely satisfied with the results of therapy. Thus, a personalized approach to analgesic therapy is necessary, taking into account the expectations of patients regarding the results of treatment.Disclosure of Interests:None declared

scholarly journals Multimodal Pain Management in the Setting of Palliative Care

2021 ◽  
Author(s):  
Marija V. Sholjakova ◽  
Vesna M. Durnev
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Side Effects ◽  
Pain Relief ◽  
Additional Treatment ◽  
Therapeutic Approaches ◽  
Multimodal Pain Management ◽  
Addictive Drugs ◽  
Analgesic Therapy ◽  
Good Organization

Pain as an integral part of palliative care (PC) is often present at the end of the life. Today, many different analgesics from opioids and non- opioids origin are in use. The integration of their use is the most effective method for pain relief. The aim of this chapter is to discuss different therapeutic approaches to pain management in palliative care. Palliative care is being confronted between the expectations and the possibilities to provide an efficient relief from the symptoms, the pain and the stress. The possibility to use opioids for pain management, with all side effects, and non-addictive drugs as additional treatment, improves the quality and the duration of life for the patients in palliative care. Since the origin of the pain is different, the use of analgesic therapy should be individualized and adapted to the real need of every person. Finally, only a good organization and institutionalization of palliative care in the society could allow for better prevention of suffering at the end of the life.

scholarly journals Pain management in hemophilia: expert recommendations

2021 ◽  
Author(s):  
Waltraud Stromer ◽  
Ingrid Pabinger ◽  
Cihan Ay ◽  
Richard Crevenna ◽  
Josef Donnerer ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Patient Group ◽  
Pain Therapy ◽  
Psychological Intervention ◽  
Underlying Disease ◽  
Effective Manner ◽  
High Prevalence ◽  
Expert Meeting

Summary Introduction As a typical consequence of bleeding into muscles and joints, patients with severe hemophilia suffer from acute and chronic pain. In spite of its high prevalence, pain in this patient group is not always sufficiently considered or treated in an effective manner. Aim The recommendations presented in this paper address possible improvements in pain management in hemophilia patients and particularities that have to be taken into account in this patient group. Method The manifold aspects of pain management in hemophilia patients were discussed within the framework of an expert meeting. Based on the available literature and the experts’ clinical experience, the participants developed a set of recommendations presented in this paper. Results Pain management in patients with hemophilia is often insufficient, a fact that not only influences the patients’ quality of life but also implies the risk of difficult to manage chronic pain. Both the prevalent polypharmacy (due to comorbidities) as well as the underlying disease itself present special challenges to pain therapy in this patient group. The present review and recommendations are intended to support medical professionals in recognising the risks of pain chronicity, applying basic principles of multimodal pain therapy, including the options of psychological intervention and modalities of physical medicine in therapy concepts, and reaching a comprehensive understanding of the range of analgesic options available.

scholarly journals Personalized preoperative planning in children with recurrent patellar dislocation severe

2019 ◽  
Vol 26 (3) ◽  
pp. 31-36
Author(s):  
G. P Kotel’nikov ◽  
Yu. V Lartsev ◽  
A. K Povelihin ◽  
P. V Ryzhov ◽  
D. S Kudashev ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Postoperative Period ◽  
Patellar Dislocation ◽  
Preoperative Planning ◽  
Recurrent Dislocation ◽  
Knee Joints ◽  
Lateral Projection ◽  
Results Of Treatment ◽  
Personalized Approach ◽  
Severe Degree

The aim of the study: was to improve the results of treatment in children with recurrent severe patellar dislocation, through the development of a differentiated approach to preoperative planning. Material and Methods. In SLLP Clinics Samara state medical University from 2014 to 2018 was observed 54 patients with this disease. In 37 patients recurrent severe dislocation. The average age of patients is 14.2 years. The patients underwent postural radiography of the lower extremities, radiography of the knee joint in the lateral projection, computed tomography of the knee joints, computed tomography of the hip joints. Research patients measured parameters, confirming mnohopocetny dysplastic changes of the joint angle Q, the index Insall-Salvati, the congruence angle on Merchant and anticarsia of the femoral head. Because of the severe degree of the disease, bone plastic surgery is indicated. Patients underwent corrective supracondylar derotation-dialysisa osteotomy of the femur in combination with medialization and distalization of the tibial tuberosity. During this operation, it is possible to perform a correction in all three planes. Results. In the postoperative period, 32 patients have no complications, 1 patient has relapse, 4 patients have contracture. In the long-term postoperative period 86.5% of positive results and 13.5% of unsatisfactory results, which is much lower than 36.1% - the percentage of complications according to the medical literature. Conclusion. The proposed personalized approach in preoperative planning for recurrent dislocation of the patella of severe degree, allows you to choose the best option for surgery.

scholarly journals Subjective study on potts spine with therapeutic yoga intervention

2020 ◽  
Vol 1 (2) ◽  
pp. 32
Author(s):  
Amudha Rani Narayanan
Keyword(s):  
Pain Management ◽  
Complete Relief ◽  
Single Subject ◽  
Time Interval ◽  
Yoga Therapy ◽  
Yoga Intervention ◽  
Subjective Study ◽  
Personalized Approach ◽  
Reduced Time ◽  
Selection Of

This is a qualitative single subject intervention assessment involving the treatment of a 58 year old man, diagnosed with para-vertebral abscess due to tubercular pott’s spine with Diabetes since 2008, administered with neuro anaesthesia for pain management, which could not succeed in providing complete relief and hence a parallel attempt was made to treat the same through an integrative mind-body approach to resolving pain. Basic challenges in this process were to conceptualize a personalized approach based on the constitution and personality of the seeker and selection of specific tools of yoga therapy to suit the individual’s requirement. Adoption of yoga therapy involving synergized techniques resulted in holistic cure in a significantly reduced time interval. However, more studies are required to be adopted in the same manner to strengthen the line of the efficacy of such therapies in similar cases.

Pharmacologic and Technological Innovations in Pain Medicine

2016 ◽  
Author(s):  
Anita Gupta ◽  
Hawa Abubakar
Keyword(s):  
Pain Management ◽  
Disease Process ◽  
Multimodal Analgesia ◽  
Underlying Disease ◽  
Antiinflammatory Drug ◽  
Treatment Modalities ◽  
Technological Innovations ◽  
Duration Of Action ◽  
Key Words Pain ◽  
Opioid Receptor Antagonists

The experience of pain is subjective, and treatment modalities should aim at providing the greatest amount of pain relief while minimizing adverse effects. Pharmacologic and technological innovations are making this possible. By taking advantage of new manufacturing processes, the pharmaceutical industry is retooling old and effective drugs. SoluMatrix diclofenac uses nanotechnology to address the need for an effective nonsteroidal antiinflammatory drug at the lowest possible dose to minimize risks associated with cardiac, renal, and gastrointestinal side effects. Intravenous acetaminophen provides an additional alternative in multimodal analgesia in instances when the oral or rectal route of delivery is not desirable. Liposomal bupivacaine uses liposomal encapsulated, resulting in a local anesthetic with a prolonged duration of action that can be used effectively in the management of postoperative pain. With the recognition that opioid therapy still remains a mainstay in pain management, advances in science have allowed for the development of peripherally acting mu opioid receptor antagonists such as naloxegol, which minimize the bothersome side effect of opioid-induced constipation. In terms of interventional pain management, advances in radiofrequency ablation (RFA) technology have resulted in cooled RFA, which allows for the creation of larger spherical lesions, thereby alleviating pain by interfering with neurotransmission. Advances in stem cell research have led to the application of multipotent cells with the aim of treating the underlying disease process and thereby eliminating pain. Finally, pharmacogenetics testing and smart drugs provide an avenue via which issues surrounding how medication is consumed, determination of effectiveness, and ensuring compliance and adherence can be optimized. Key words: Pain, Pharmacology, Medications, Technology, Innovation, Smart Pills, Personalized Medicine, Biotechnology, Device, Surgery, Multimodal

Life-threatening conditions in pericarditis of different etiologies: diagnosis and treatment

2019 ◽  
pp. 40-45
Author(s):  
A. Ya. Kosonogov ◽  
S. V. Nemirova ◽  
V. I. Pozdishev ◽  
A. B. Nikolskiy ◽  
K. A. Kosonogov ◽  
...  
Keyword(s):  
Cardiac Tamponade ◽  
Postoperative Period ◽  
Underlying Disease ◽  
Electrolyte Balance ◽  
Symptomatic Therapy ◽  
Electrolyte Disorders ◽  
Results Of Treatment ◽  
Cardiac Compression ◽  
Pericardial Diseases ◽  
Life Threatening

Purpose of the study: to analyze the etiology, diagnostic criteria and results of treatment of life-threatening conditions in pericarditis of different etiologies (based on our clinic materials).Materials and methods. The study included cases of hospitalization of patients with a diagnosis of «Pericarditis» and ICD-10 codes for pericardial diseases for the period from 2009 to 2018. In the course of the work, the history and clinical picture of the disease, laboratory and radiation research methods were analyzed. All patients started treatment of the underlying disease and performed symptomatic therapy, including those aimed at restoring hemodynamics and normalizing water and electrolyte disorders, stopping inflammation and auto-aggression of the immune system. When signs of compression/cardiac tamponade were detected, pericardiocentesis was performed, according to indications, drainage/fenestration of the cardiac sac, pericardiotomy were performed. In the postoperative period was carried out antibacterial and symptomatic therapy.Results. Life-threatening diseases of the pericardium accounted for 32,03% of all patients treated in the hospital for pericarditis. The most frequently detected signs of a hemodynamically significant compression and cardiac tamponade, less often purulent and constrictive P. Isolated 25 patients underwent closed drainage with pericardiocentesis, in 1 case the drainage was supplemented with f ibrinolytic therapy. Sanitation of the cavity and fenestration of the pericardium were carried out in 11 patients, pericardiotomy with notched drainage in 2 patients, thoracotomy with pericardiectomy – 4. In the postoperative period, the symptoms of inflammation were reduced, the level of cardiac enzymes decreased, the electrolyte balance stabilized. Most patients noted a distinct regression of the symptoms of pericarditis and cardiac compression. Recurrent P was noted in 5 cases, deaths occurred in 4 cases (8,16%).Conclusion. Early verification of the diagnosis and timely decompression of the heart with fractional evacuation of the exudate or pericardectomy with respect to the sequence of release of the heart chambers from adhesions and adhesions against the background of complex therapy allows to achieve positive dynamics, and fenestration of the cardiac bag with the formation of a sufficiently sized opening during recurrent fluid accumulation or intrapericardial fibrin. development of severe complications of pericarditis even in patients with multiple concomitant diseases evanii and oncopathology.

Pain therapy in haemophilia in Germany

2015 ◽  
Vol 35 (02) ◽  
pp. 167-173 ◽  
Author(s):  
G. Schelle ◽  
K. Jost ◽  
W. Eberl ◽  
A. Tiede ◽  
W. Kalnins
Keyword(s):  
Pain Management ◽  
Children And Adolescents ◽  
Joint Pain ◽  
Pain Therapy ◽  
Long Term Care ◽  
Young Patients ◽  
Pharmacological Therapy ◽  
Common Type ◽  
Term Care

SummaryOne of many challenges in the treatment of persons with haemophilia is the selection and application of appropriate pain-relieving therapies. The current situation of pain management for persons with haemophilia in Germany was evaluated using a survey with the intention of identifying potential areas for improvement. Results of 685 respondents showed that 86% experienced episodes of pain and that pain was already present in 66% of children and adolescents. Joint pain was the most common type of pain (92%), remarkably so even in 80% of young patients. Half of the patients received pharmacological therapy for the pain and 46% of the patients received physiotherapy. Priority and sequence of the contacted physicians and therapists for diagnosis and therapy is described. Satisfaction with pain therapy was expressed by 56% of participants and 18% felt their pain not treated sufficiently.The results of the survey will be used to develop measures for improvement of long-term care of haemophilia patients regarding pain therapy.

scholarly journals A gyermekkori uveitis klinikai jellemzői és terápiája

2019 ◽  
Vol 160 (34) ◽  
pp. 1335-1339
Author(s):  
Judit Kiss ◽  
Valéria Gaál ◽  
Zoltán Nyul ◽  
Bernadett Mosdósi
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Autoimmune Diseases ◽  
Single Case ◽  
Severe Disease ◽  
Significant Proportion ◽  
Middle Layer ◽  
Underlying Disease ◽  
Posterior Uveitis ◽  
Study Data ◽  
Multidisciplinary Cooperation

Abstract: Introduction: Uveitis is characterized by inflammation of the middle layer of the eye. Its overall incidence is low. Autoimmune diseases and infections are the most common underlying diseases. Out of the autoimmune diseases, juvenile idiopathic arthritis is associated most frequently with uveitis. The topical ophthalmological treatment may fail in a significant proportion of the patients and immunomodulatory therapy may be required. Aim and method: In a retrospective study, data of 33 children diagnosed and treated with uveitis at the Department of Pediatrics and Ophthalmology, University of Pécs during the last 5 years were collected and analyzed. Results: The mean age of the patients was 9.3 (0.3–17.8) years. Boys and girls were equally affected with an exception of patients with juvenile idiopathic arthritis where female predominance was found. An underlying disease could be identified in 60% of the cases (20/33). Uveitis was associated in 12 patients with juvenile idiopathic arthritis, in 2 patients with Behcet’s disease and in a single case with inflammatory bowel disease. Infections have been proven in 5 patients. The autoimmune diseases caused an eye inflammation typically in anterior localization, in contrast to the infections that resulted in posterior uveitis. The majority of the patients required systemic treatment. 3 of them received systemic corticosteroid and 18 patients methotrexate as disease-modifying antirheumatic drug. 13 children with severe disease activity required biological therapy (adalimumab injection). Remission could be achieved in 1.45 (0.75–2.5) months. Conclusion: Pediatric uveitis is of great importance. Early diagnosis, adequate therapy and follow-up require multidisciplinary cooperation. Orv Hetil. 2019; 160(34): 1335–1339.

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