Frequency, severity, and impact on daily life of delayed and intercycle chemotherapy-induced nausea, vomiting, and retching

2021 ◽  
pp. 030089162199043
Author(s):  
Silvia Gonella ◽  
Dino S. Di Massimo ◽  
Marinella Mistrangelo ◽  
Gianmauro Numico ◽  
Paola Berchialla ◽  
...  

Introduction: Chemotherapy-induced nausea, vomiting, and retching (CINVR) remains a common side effect of treatment. Most previous studies have focused on vomiting control; nausea and retching have been less explored. This study aimed at describing the incidence, severity, and impact on daily life (IDL) of CINVR in the acute (0–24 hours), delayed (>24–120 hours), and overall (0–120 hours) postchemotherapy periods and beyond 120 hours (until next chemotherapy administration); and the pharmacologic and nonpharmacologic strategies adopted by patients to relieve symptoms. Methods: This was a single-center, cross-sectional study of 60 patients undergoing chemotherapy. Participants reported the frequency, severity, and IDL of CINVR from the day of chemotherapy administration up to 120 hours thereafter and nausea and vomiting that occurred beyond 120 hours, as well as pharmacologic and nonpharmacologic remedies used. Results: Forty-seven (78.3%, 95% confidence interval [CI] 66.4–86.9), 37 (61.7%, 95% CI 49.0–72.9), and 35 (58.3%, 95% CI 45.7–69.9) patients reported no nausea (Numeric Rating Scale ⩽1), vomiting, or retching in the acute, delayed, and overall periods, respectively. Nausea was more frequent, more severe, and had a greater IDL than did vomiting and retching across the overall observation period; beyond 120 hours, 11 (18.3%, 95% CI 10.6–29.9) patients reported nausea and none reported vomiting, with a median IDL of 1/10 (interquartile range: 0.75–5.00; 95% CI 0–7.6). Metoclopramide (n = 57 administrations), dexamethasone (n = 28), eating small servings of food (n = 13), and aloe (n = 11) were the most commonly used rescue therapies. Conclusions: Future studies should set hard outcomes, such as the absence of any symptoms, as a primary end point, and these should be assessed across and beyond the 120-hour period.

2021 ◽  
Vol 13 (3) ◽  
pp. 675-682
Author(s):  
Dyah Restuning Prihati ◽  
Maulidta Karunianingtyas Wirawati

Diabetes mellitus merupakan kondisi peningkatan kadar gula dalam darah yang berakibat munculnya komplikasi mikrovaskuler salah satunya luka kaki diabetes. Tindakan perawatan luka debridement untuk menghilangkan jaringan yang nekrosis. Proses pengangkatan balutan dan pembersihan luka, seringkali keluhan pasien yaitu nyeri dan cemas. Penelitian ini untuk mengetahui adanya hubungan tingkat nyeri dan kecemasan saat perawatan luka diabetik. Desain deskriptif analitik dengan cross sectional study, yaitu mencari hubungan antara variable tingkat cemas dan tingkat nyeri saat perawatan luka diabetik. Tehnik pengambilan sampel dengan accidental sampling, waktu penelitian selama 3 bulan. Lokasi penelitian di ruang rawat inap RSUD K.R.M.T. Wongsonegoro Semarang. Instrumen menggunakan skala nyeri Numeric Rating Scale menunjukkan realiabilitas > 0,95, uji validitas r=0,90 dan Depression Anxiety Stress Scales menilai kecemasan, uji reliabilitas r=0,60. Hasil penelitian ini menunjukkan responden yang dilakukan perawatan luka diabetik berjenis kelamin perempuan, sebagian besar responden dengan usia lebih dari 45 tahun, mengalami tingkat nyeri sedang dan tingkat kecemasan ringan, dengan nilai significancy 0,009. Nilai korelasi Sperman sebesar 0,454 menunjukkan hasil penenlitian ini kearah korelasi positif dengan kekuatan korelasi sedang.Terdapat hubungan antara tingkat nyeri dengan tingkat kecemasan, apabila pasien merasakan peningkatan keluhan nyeri saat dilakukan tindakan perawatan luka, maka kecemasan yang dirasakan pasien meningkat juga dengan kekuatan korelasi sedang.


2020 ◽  
Vol 35 (3) ◽  
pp. 162-166
Author(s):  
Martti Vastamäki ◽  
Heidi Vastamäki ◽  
Leena Ristolainen ◽  
Katrinas Laimi ◽  
Mikhail Saltychev

AIMS: Among musicians, string players have the highest prevalence for musculoskeletal overuse. Playing a violin or viola requires rapid, repetitive, and complicated movements of the hands and fingers. This cross-sectional study aimed to examine whether violin/viola, violin/cello, and violin/French horn players experience more intense musculoskeletal pain than other instrumentalists. METHODS: The study sample consisted of 590 orchestra musicians (354 male, 236 female, mean age 36 yrs). Self-administered questionnaires were used to assess pain of the back, neck, shoulder, face, jaw, and upper extremity. Pain intensity during the last 7 days was measured by an 11-point numeric rating scale (NRS) with a score from 0 to 10, as well as was disadvantage at work and leisure. RESULTS: Of the interviewed musicians, 20% presented playing-related musculoskeletal disorders at the time of the interview. Compared to other professional orchestra musicians, violin and viola players reported significantly more intense pain in the hand during the last week. Also, they had experienced more frequent neck pain ever and in 5 years than the others. During the past 30 days, violin and viola players had also perceived more harm in their upper limb joints. Violin/cello and violin/French horn players did not differ from the others. CONCLUSIONS: Our study showed that musicians playing the violin or viola have more intense hand pain and more frequent neck pain than other musicians, but these seem to disturb their daily tasks only a little.


2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e21-e21
Author(s):  
Karina Burke ◽  
Branka Vujcic ◽  
Jonathan Hamilton ◽  
Charlotte Mace ◽  
John Teefy ◽  
...  

Abstract Primary Subject area Emergency Medicine - Paediatric Background There is abundant evidence that provision of pharmacologic analgesia by prehospital providers to children is suboptimal. Most paediatric calls are performed by primary care paramedics (PCPs) who are unable to administer pharmacologic analgesia to children but can administer non-pharmacologic therapies. Objectives Our objective was to describe the provision of non-pharmacologic analgesia to children by prehospital providers. Design/Methods We reviewed all ambulance call reports (ACRs) of children 0-17 years with acutely painful conditions (headache, abdominal pain, injury, head/ears/eyes/nose/throat pain, and back pain) who were transported to a paediatric tertiary referral centre serving a catchment of > 1 million from 2017-2019. Data collection was recorded by two blinded assessors using a study-specific Excel™ sheet. The primary outcome was the proportion of children offered non-pharmacologic analgesia. We performed a stepwise logistic regression on the primary outcome using covariates defined a priori: age, sex, visible deformity, type of crew, complaint, pain score, call time, and prior analgesia. Results All 11,084 ACRs from January 1, 2017 to December 31, 2019 were reviewed. The sample included 5887/11084 (53.1%) males, ranging from 1 month to 17 years, with a mean (SD) age of 10.5 (5.6) years. Calls involved mainly PCPs [8576/11084 (77.4%)]. Non-trauma-related musculoskeletal injuries were most common, comprising 2743/11,084 (24.7%) of calls. Pain scores were documented in 6947/11084 (62.7%) of calls. The verbal numeric rating scale (0-10) was used in 5022/6947 (72.3%) of calls, with a mean (SD) score of 5.2 (3.2). Non-pharmacologic analgesia was provided in 2926/11084 (26.4%) of calls, most commonly splint (1115/2926, 38.1%) and ice (931/2926, 31.8%). Pharmacologic analgesia was provided in 458/11084 (4.1%) of calls. In the multivariate model, mild (OR: 3.2; 95% CI 2.3-4.4; p < 0 .001) and moderate pain (OR: 1.7; 95% CI 1.3-2.2) (versus no pain) were significant predictors of non-pharmacologic analgesia, whereas visible deformity (OR: 0.5; 95% CI 0.3-0.6; p < 0 .001) was a significant negative predictor. Conclusion The provision of non-pharmacologic analgesia to children in Southwestern Ontario by prehospital providers is suboptimal, despite moderate to severe pain. There is a clear need for education surrounding approaches to non-pharmacologic analgesia in children among prehospital providers.


2020 ◽  
Author(s):  
Jofrid Kollltveit ◽  
Malin Osaland ◽  
Marianne Reimers ◽  
Magnus Berle

BackgroundPain is a subjective sensation; self-reporting is important for quantifying pain intensity. There are several different validated tools for this, such as Visual Analog Scale and Numeric Rating Scale. In the clinic, these terms are often used as equivalent. The objective of this study was to examine correlation and agreement between the pain registration tools in triage in an emergency department.Materials and MethodsThe study was performed in the Department of Emergency Medicine at Haukeland University Hospital in the period June-August 2019. We registered the pain score with two tools in 200 unselected patients in emergency admission with pain. In addition, we registrered gender, age, triage and general department affiliation.ResultsWe found a strong correlation between the pain registration tools by Spearmans correlation test (rho=0,930, p<0,001). There were no significant difference between the pain registration tools within the subgroups. Bland-Altman analysis show agreement between the two pain registration tools.ConclusionsIn an Emergency Department triage is it acceptable to use Visual Analog Scale and Numeric Rating Scale as equivalent, as long as the correct terminology is used.


2019 ◽  
Vol 2 (1) ◽  
pp. 23
Author(s):  
Nur Masruroh ◽  
Nur Aini Fitri

Dismenore merupakan nyeri selama menstruasi yang disebabkan oleh adanya kejang pada otot rahim. Terdapat beberapa faktor yang mempengaruhi terjadinya dismenore, diantaranya yaitu asupan nutrisi yang terdiri dari Fe (zat Besi). Tujuan penelitian ini adalah untuk mengetahui hubungan kejadian dismenorea dengan asupan Fe (zat Besi) pada remaja putri .  Jenis penelitian ini adalah analitik observasional dengan rancangan cross sectional. Jumlah sampel sebanyak 112 yang diambil menggunakan teknik propostionate stratified random sampling. Data kejadian dismenore diperoleh dari kuesioner numeric rating scale dan data asupan zat gizi diperoleh dari form semi quantitative food frequency questionaire. Hasil penelitian menunjukkan bahwa sebagian remaja putri memiliki asupan Fe (zat Besi) kurang (50%). Sedangkan kejadian dismenorea yang dialami hampir setengahnya termasuk dalam kategori nyeri ringan (45,5%). Hasil analisis menggunakan uji rank sprearman menunjukkan bahwa ada hubungan kejadian dismenorea dengan asupan Fe (zat Besi) dengan nilai p-value = 0,014. Berdasarkan hasil penelitian tersebut dapat disimpulkan bahwa semakin tinggi asupan Fe (zat Besi), maka semakin rendah kejadian dismenorea yang dirasakan. Diharapkan remaja putri dapat mencegah dan mengurangi nyeri dengan mengkonsumsi makanan sumber Fe (zat Besi).


2021 ◽  
Author(s):  
Sarah Stephen ◽  
Corlia Brandt ◽  
Benita Olivier

Purpose: People with neck pain are likely to have negative respiratory findings. The purpose of this study was to investigate the relationship between neck pain and dysfunctional breathing and to examine their relationship to stress. Method: This cross-sectional study included 49 participants with neck pain and 49 age- and sex-matched controls. We measured neck pain using the numeric rating scale (NRS); neck disability using the Neck Disability Index (NDI); dysfunctional breathing using the Nijmegen Questionnaire (NQ), Self-Evaluation of Breathing Questionnaire (SEBQ), breath hold time, and respiratory rate (RR); and stress using the Perceived Stress Scale (PSS). Results:Participants with neck pain scored higher on the NQ ( p < 0.001) and the SEBQ ( p < 0.001) than controls. NQ and SEBQ scores correlated moderately with NDI scores ( r > 0.50; 95% CI: 0.25, 0.68 and 0.33, 0.73, respectively) and PSS scores ( r > 0.50; 95% CI: 0.29, 0.78 and 0.31, 0.73, respectively). SEBQ scores showed a fair correlation with NRS scores and RR a fair correlation with NDI scores. Conclusions: Participants with neck pain had more dysfunctional breathing symptoms than participants without neck pain, and dysfunctional breathing was correlated with increased neck disability and increased stress. The NQ and SEBQ can be useful in assessing dysfunctional breathing in patients with neck pain.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19646-19646
Author(s):  
S. Subongkot ◽  
S. Khounnikhom ◽  
N. Pratheepawanit Johns ◽  
A. Sookprasert

19646 Background: Pain is among the most common symptoms encountered in cancer patients and remains the first priority of care. Methods: This cross sectional study aimed to explore a pattern of pain management at KKU Hospital by utilizing a numeric rating scale (0–10). Cancer pain patients were categorized based on prior analgesic exposure into two groups; Naïve group, and Routine group. Treatments were defined according to WHO as 1) drug treatment relevant to pain severity, 2) analgesics being prescribed as around-the- clock and 3) analgesics used for break-through pain for patients receiving strong opioid. Results: From Dec 2005 to Jul 2006, 261 patients were enrolled. 93.1% (n=243) were in advanced stages and 88.5% (n=231) were in moderate to severe pain. This pain interfered with patient’s daily life activities mildly to moderately as each pain score increased (p-value<0.01). In Naive group (n=159), 32.7% (n=52) were given analgesics following the WHO on both days 1 and day 3 of admission whereas 40.2% (n=64) patients were not. A decreased pain score was greater (2.61, SD±1.5) in a group following the WHO on day 1. Additionally, a decreased pain score was greater (3.91, SD±1.8) in a group following the WHO on day 3 (p-value <0.0001). This pain score decreased was also clinically significant as pain score reduced more than 3 points. In Routine group (n=102), 32 (31.4%) were given analgesics following the WHO guideline on both day 1 and day 3 of admission. In contrast, 36 (35.3%) were not. A decreased pain score was greater (2.59, SD±1.8) in a routine group following the WHO on day 1. Moreover, a decreased pain score was greater (3.95, SD±1.8) in a group following the WHO on day 3. The clinical significance of pain score reduced was also found on day 3. Of the 261 evaluable patients, the pattern of analgesics usage following the WHO guideline was increased in both groups comparing to at the beginning of the study. Conclusions: The results demonstrated that patients who received pain management following the WHO guideline reported significantly lower pain intensity than those not following the WHO. No significant financial relationships to disclose.


2021 ◽  
Vol 19 (1) ◽  
pp. 175-178
Author(s):  
Anuj Jung Rayamajhi ◽  
Pawan Kumar Hamal ◽  
Rupesh Kumar Yadav ◽  
Nabin Pokhrel ◽  
Prashanta Paudel ◽  
...  

Background: Cooled Radiofrequency ablation is a newer technique for management of chronic knee pain in osteoarthritis. The aim of the study is to evaluate the clinical outcomes in patients with chronic osteoarthritis in terms of pain scores for first six months of cooled radiofrequency ablation using ultrasound guidance. Methods: A cross-sectional study with retrospective review of database was evaluated to analyze the change in the Numerical Rating Scale from baseline scores at 1 day, 1 month and 6 months after the Cooled Radiofrequency ablation of genicular nerves around knee in patients with chronic knee osteoarthritis. Results: Median age was 71 years [ 61-73 years (IQR: 25-75)] with more female preponderance. Numerical Rating Scale (Mean ± S.D.) was significantly less at 1 day (1.87 ± 1.22), 1 month (3.03 ± 0.99) and 6 months (3.37 ± 1.098) from baseline values (6.77 ± 1.00). No soreness and numbness were noted.Conclusions: Cooled Radiofrequency using Ultrasound guidance for management of knee pain in chronic osteoarthritis is promising and reduces Numerical Rating Score significantly from baseline at 1 month and 6 months respectively.Keywords: Cooled radiofrequency ablation; genicular nerve; numeric rating scale


2019 ◽  
Vol 2 (2) ◽  
pp. 71-76
Author(s):  
Yuni Tri Yustianti ◽  
Pusparini Pusparini

LATAR BELAKANG Dekade terakhir menunjukkan neck pain pada remaja semakin meningkat, bersamaan dengan meningkatnya penggunaan gawai (gadget). Seiring perkembangan zaman, gawai menjadi kebutuhan dan gaya hidup masyarakat luas. Pelajar menjadi pasar terbesar dalam penggunaan gawai sehubungan dengan kebutuhan belajar yang memerlukan akses Internet. Salah satu faktor penyebab neck pain pada pengguna gawai adalah intensitas penggunaan gawai yang mempengaruhi lamanya posisi fleksi pada otot leher. Tujuan penelitian ini adalah untuk mengetahui hubungan intensitas pemakaian gawai dengan neck pain pada usia 15-20 tahun. METODE Penelitian ini merupakan studi observasional dengan desain cross sectional yang mengikutsertakan 164 pelajar SMAN 28 Jakarta dan Fakultas Hukum Universitas Trisakti. Data dikumpulkan dengan cara pengisian kuesioner yang meliputi usia, jenis kelamin, intensitas pemakaian gawai dan keluhan neck pain. Penilaian neck pain menggunakan NRS (Numeric Rating Scale). Analisis data dilakukan dengan uji Chi-square dengan tingkat kemaknaan p<0.05. HASIL Subjek perempuan berjumlah 121 orang (73.8%). Paparan gawai dengan intensitas >56 jam/minggu dijumpai pada 109 subjek (66.5%). Keluhan neck pain dijumpai pada 138 subjek (84.1%). Uji Chi-square menunjukkan terdapat hubungan yang bermakna antara intensitas penggunaan gawai dengan neck pain pada usia 15-20 tahun dengan nilai p=0.004. KESIMPULAN Terdapat hubungan yang bermakna antara intensitas penggunaan gawai dengan neck pain pada usia 15-20 tahun.    


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