scholarly journals Mental State Can Influence the Degree of Postoperative Axial Neck Pain Following Cervical Laminoplasty

2018 ◽  
Vol 9 (3) ◽  
pp. 292-297
Author(s):  
Yasushi Oshima ◽  
Yoshitaka Matsubayashi ◽  
Yuki Taniguchi ◽  
Kentaro Hayakawa ◽  
Masayoshi Fukushima ◽  
...  
Keyword(s):  
Neck Pain ◽  
Mental State ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Short Form ◽  
Statistical Significance ◽  
Multivariable Logistic Regression Analysis ◽  
Cervical Laminoplasty ◽  
Imaging Parameters ◽  
Axial Neck Pain

Study design: A retrospective cohort study. Objective: To investigate factors influencing the incidence of moderate to severe postoperative axial neck pain following cervical laminoplasty. Methods: We reviewed 125 patients with cervical myelopathy who underwent double-door laminoplasty. The primary outcomes were the Numerical Rating Scale score (NRS score, 0-10) for neck pain, the Short Form 36 (SF-36) Health Survey score (Physical and Mental Component Summary scores [PCS and MCS, respectively]), and satisfaction. Imaging parameters on plain radiographs and magnetic resonance imaging were also evaluated. Patients with moderate to severe postoperative neck pain (NRS ≥ 5) were compared with those with no or mild neck pain (NRS ≤ 4). Results: One hundred and three patients (82%) with complete data were eligible for inclusion. There were 67 men and 36 women, with a mean age of 65 years (32-89 years). Twenty-five patients (23%) had moderate to severe postoperative axial pain (NRS ≥ 5) and were compared with the other 78 patients (NRS ≤ 4), which revealed several predictive factors, including female sex, the presence of preoperative neck pain, low postoperative PCS, low preoperative and postoperative MCS, and satisfaction with the treatment. Multivariable logistic regression analysis revealed that the postoperative MCS ( P = .002) was a risk factor for postoperative neck pain, although the preoperative MCS did not reach statistical significance ( P = .06). Conclusions: Patients with a low mental state, possibly before surgery, are at a high risk for postoperative axial neck pain. None of the imaging parameters were statistically different.

scholarly journals Axial Neck Pain after Cervical Laminoplasty

2010 ◽  
Vol 47 (2) ◽  
pp. 107 ◽  
Author(s):  
Chul Bum Cho ◽  
Chung Kee Chough ◽  
Jong Yang Oh ◽  
Hae Kwan Park ◽  
Kyung Jin Lee ◽  
...  
Keyword(s):  
Neck Pain ◽  
Cervical Laminoplasty ◽  
Axial Neck Pain

scholarly journals Preliminary investigation into the identification and management of catatonia in patients admitted to adult inpatient units

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S336-S336
Author(s):  
Joanna Moore ◽  
Amy Kunicki ◽  
Georgina Latcham ◽  
Eleanor Perkins ◽  
Emma Vaccari
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Mental State ◽  
Rating Scale ◽  
Statistical Significance ◽  
Preliminary Investigation ◽  
Psychiatric Inpatients ◽  
Service Evaluation ◽  
Improvement Project ◽  
Adult Inpatient ◽  
Inpatient Units

AimsThe prevalence of catatonia is considered to be approximately 10% in psychiatric inpatients. Clinical experience suggests a lower documented prevalence. This could cause longer admissions and complications, such as Neuroleptic Malignant Syndrome (NMS). We carried out a service evaluation to investigate the recognition and management of catatonia on inpatient units in Southern Health Foundation Trust (SHFT). We reviewed the local documented prevalence of catatonia, treatment offered and prevalence of complications.MethodWe retrospectively reviewed the electronic records of 95 consecutive admissions to four adult inpatient units in SHFT, starting on 1st August 2020. We reviewed notes for the admission to establish whether catatonia was suspected and identified. We applied the screening questions from the Bush-Francis Catatonia Rating Scale (BFCRS) to the documented mental state examinations (MSE) prior to, and shortly after, admission. We also recorded the prescriptions issued during the first 72 hours of admission, and whether patients developed neuroleptic malignant syndrome (NMS), serotonin syndrome or required admission to a general hospital during admission.ResultCatatonia was documented as a possibility for 2 patients (2.1%). One showed possible posturing and stupor, while there were no documented symptoms for the other. In both cases the possibility was discounted by the clinical team. Twelve patients (12.6%) showed one or more possible or confirmed signs of catatonia. Eleven of these were prescribed regular antipsychotic medication on admission, but only 3 were prescribed regular benzodiazepines. NMS was more likely to be suspected in patients with a BFCRS of 1 or more compared with those with a score of 0, with an odds ratio of 8.1 (95% CI [1.03-64.0], Fisher's exact test = 7.79, p = .076).ConclusionCatatonia is likely under-recognised and under-treated locally among psychiatric inpatients. Although only approaching statistical significance, the higher rate of suspected NMS in patients showing possible catatonia is noteworthy and needs further investigation. Regular benzodiazepines were not frequently prescribed in this group, while antipsychotics, prescribed in all of these patients, can precipitate NMS. Alternatively, this finding could reflect the overlap in clinical presentation between NMS and catatonia. Data collection was limited by the frequent use of “remote clerking”, in the context of the COVID-19 pandemic. Additionally, the quality of mental state examinations was often not sufficient to draw any conclusions on the possible presence or absence of catatonic symptoms. This project has highlighted practice in need of improvement, which will be further prospectively investigated and improved via a Quality Improvement Project.

scholarly journals Minimal Clinically Important Change of the Neck Disability Index and the Numerical Rating Scale for Patients With Neck Pain

Spine ◽  
2007 ◽  
Vol 32 (26) ◽  
pp. 3047-3051 ◽  
Author(s):  
Jan J. M. Pool ◽  
Raymond W. J. G. Ostelo ◽  
Jan L. Hoving ◽  
Lex M. Bouter ◽  
Henrica C. W. de Vet
Keyword(s):  
Neck Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Important Change ◽  
Numerical Rating ◽  
Neck Disability ◽  
Clinically Important Change

Nebulized morphine for analgesia in an emergency setting

2018 ◽  
Vol 5 (1) ◽  
pp. 23 ◽  
Author(s):  
Vincent Bounes, MD ◽  
Jean Louis Ducassé, MD ◽  
Annie Momo Bona, MD ◽  
Florent Battefort, MD ◽  
Charles-Henri Houze-Cerfon, MD ◽  
...  
Keyword(s):  
Pain Relief ◽  
Acute Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Statistical Significance ◽  
A Priori ◽  
Primary Outcome Measure ◽  
Point Estimate ◽  
Emergency Setting ◽  
Significant Difference

Objective: To evaluate the efficacy and safety of inhaled morphine delivered in patients experiencing severe acute pain in an emergency setting.Patients and Methods: Patients were eligible for inclusion if they were aged 18 years or older, with a severe acute pain defined by a numerical rating scale (NRS) score of 60/100 or higher. The intervention involved administering a single dose of 0.2 mg/kg morphine nebulized using a Misty-Neb nebulizer system. NRSs were recorded and were repeated at 1, 3, 5, and 10 minute after the end of inhalation (T10). The protocol-defined primary outcome measure was pain relief (defined by an NRS score of 30/100 or lower) at T10. Secondary outcomes included differences between pain scores at baseline and at T10 and incidence of adverse events.Results: A total of 28 patients were included in this study. No patient experienced pain relief 10 minutes after the end of inhalation, and no adverse effects were recorded. Respective initial and final median NRS scores were 80 (70-90) and 70 (60-80), p < 0.0001. Despite achieving statistical significance, the value of this point estimate is less than the 14 NRS difference that was defined a priori as representing a minimum clinically significant difference in pain severity.Conclusion: 0.2 mg/kg nebulized morphine is not effective in managing acute pain in an emergency setting. In spite of the potential advantages of the pulmonary route of administration, opioids should be intravenous prescribed at short fixed intervals to control severe acute pain in an emergency setting.

scholarly journals Traditional Acupuncture and Laser Acupuncture in Chronic Nonspecific Neck Pain: Study Protocol for a Randomized Controlled Trial

2021 ◽  
Author(s):  
RAFAELA PERON ◽  
Érika Patrícia Rampazo ◽  
Richard Eloin Liebano
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Acupuncture Treatment ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Pressure Pain Threshold ◽  
Pain Modulation ◽  
Laser Acupuncture ◽  
Acupuncture Points

Abstract Background: Nonspecific neck pain is a multifactorial and very common condition in adult individuals. No reports were found in the literature comparing the effectiveness of Traditional Acupuncture (TA) and Laser Acupuncture (LA) in cases of chronic nonspecific neck pain. Therefore, the aim of the present study is to investigate the effectiveness of TA and LA therapies in individuals with chronic nonspecific neck pain.Methods/design: This study will be a controlled and randomized clinical trial. A total of 60 individuals will be randomized into two groups (30 each). The TA group will receive the acupuncture treatment using needles, while the LA group will receive the laser acupuncture treatment. The acupuncture points (Tianzhu, Fengchi, Jianjing, and Jianzhongshu) will be stimulated bilaterally with needles or laser. The primary outcome will be pain intensity, determined using the numerical rating scale. The secondary outcomes will be pressure pain threshold, temporal summation of pain, conditioned pain modulation, use of analgesic drugs after treatment, and the global perceived effect scale. The assessments will be performed immediately before and after treatment. At the follow-up, 1 months after the end of the treatments, evaluation will be made of the pain intensity and the global perceived effect. Statistical analysis of the data obtained will consider a significance level of p < 0.05.Discussion: This study will provide evidence concerning the effects of LA treatment, in comparison to TA, leading to benefits for individuals suffering from chronic nonspecific neck pain.Trial registration: RBR-7vbw5gd (Brazilian Registry of Clinical Trials - ​ReBEC)

scholarly journals O33 Towards personalised weaning of sedatives and analgesics using mechanism-based modelling of iatrogenic withdrawal in critically ill children

2019 ◽  
Vol 104 (6) ◽  
pp. e14.3-e15
Author(s):  
S Goulooze ◽  
E Krekels ◽  
M van Dijk ◽  
T Hankemeier ◽  
D Tibboel ◽  
...  
Keyword(s):  
Critically Ill ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Statistical Significance ◽  
Prolonged Treatment ◽  
Morphine Dependence ◽  
Critically Ill Children ◽  
Population Pharmacokinetic ◽  
List Type ◽  
Over Time

BackgroundProlonged treatment with analgesics and sedatives can result in iatrogenic withdrawal syndrome (IWS) in children being weaned from these drugs.1Personalized weaning strategies might lower the incidence of IWS, but this requires a quantitative understanding of withdrawal over time in individual patients.MethodsData from 81 children (aged 1 month to 17 years) collected during an observational clinical study on IWS2 were used, including a total of 1782 withdrawal assessments performed by PICU nurses, on a numerical rating scale (NRSwithdrawal) from 0 (no withdrawal) to 10 (worst withdrawal possible). Population pharmacokinetic models from literature were used to generate concentration-time profiles in each patient of all key analgesics and sedatives: morphine, fentanyl, methadone, midazolam, lorazepam, propofol, esketamine and clonidine. A mechanism-based withdrawal model was developed using NONMEM 7.3 to quantify IWS over time. The final model was used to perform simulations in which different weaning strategies were compared.ResultsA novel mechanism-based withdrawal model structure was developed with a hypothetical compartment, which equilibrates with the central pharmacokinetic compartment, and which characterizes the development and disappearance of drug dependence over time. With this model and available data, withdrawal dynamics could be established with statistical significance for fentanyl (p< 10-6), morphine (p=0.043) and esketamine (p=0.002), and not for any of the other drugs. Compared with fentanyl, development and disappearance of esketamine and morphine dependence is slower.ConclusionsGiven the patient‘s use of fentanyl, morphine and esketamine, the developed model can dynamically predict IWS from these substances under different weaning strategies. The results show that the optimal strategy for weaning of drug dependent children depends on both the type of drug and the drug levels prior to weaning. In this study, there was insufficient information to characterise midazolam withdrawal dynamics, potentially because of slow midazolam weaning with insufficiently high NRSwithdrawal scores.ReferencesBest KM, Boullata JI, Curley MAQ. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: A Systematic Review and Conceptual Model. Pediatr Crit Care Med ( 2015) 16(2): 175–183.Ista E, de Hoog M, Tibboel D, Duivenvoorden HJ, van Dijk M. Psychometric evaluation of the sophia observation withdrawal symptoms scale in critically ill children. Pediatr Crit Care Med ( 2013).14(8): 761–769.Disclosure(s)Nothing to disclose

RELATION OF NECK PAIN, FORWARD HEAD POSITION AND PROTRACTED SHOULDERS IN STUDENTS WITH CHRONIC NECK PAIN.

2021 ◽  
pp. 28-30
Author(s):  
Ritika Save ◽  
Annamma Varghese (PT)
Keyword(s):  
Neck Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Chronic Neck Pain ◽  
Correlation Study ◽  
Exclusion Criteria ◽  
Forward Head Posture ◽  
Head Posture ◽  
Numerical Rating ◽  
Written Informed Consent

Aim of the study: To study the correlation between neck pain, forward head posture and protracted shoulders in students aged 18-25yrs with chronic neck pain. 36 subjects, male and female were included in this cross s Material and Method: ectional, correlation study as per the inclusion and exclusion criteria. A written informed consent was signed by the subjects in their own language. Neck pain was measured using Numerical Rating Scale (NRS), Forward Head Posture (FHP) was measured using CVA angle by photogrammetry and Protracted Shoulders were measured using a Double Square Instrument. The results were compared and correlated using appropriate statistical tools. There was no signicant Results: correlation between CVA and protracted shoulders with severity of neck pain (p=0.54 and p= 1.64 respectively) in students aged 18-25 years. The comparison of CVA values in students with and without pain was signicant (p<0.00). The comparison of protracted shoulders in students with and without pain was signicant. (p=0.00). The correlation between CVA and protracted shoulders in students with chronic neck pain was found to be signicant (p= 0.01) but the correlation between the same in students without chronic neck pain was found to be not signicant (p= 0.24). Conclusion: The correlation between neck pain and CVA and neck pain and protracted shoulders was not signicant, but there was a signicant difference between the CVA and protracted shoulder values of students with and without neck pain suggesting an association, but not a linear relationship.

Feasibility of Patient-Created Orff Chant as a Music-Based Intervention in Supportive Cancer Care

2020 ◽  
Vol 57 (4) ◽  
pp. e1-e31
Author(s):  
Cynthia M Colwell ◽  
Jennifer Fiore
Keyword(s):  
Supportive Care ◽  
Standard Care ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Short Form ◽  
Subsequent Treatment ◽  
Supportive Cancer Care ◽  
Pain Anxiety ◽  
Distress Symptoms ◽  
Numerical Rating

Abstract A cancer diagnosis and subsequent treatment can produce distress symptoms, including pain, anxiety, fatigue, and altered mood. These symptoms can have a negative psychological and physiological impact on patients. Patients may need to engage in supportive care with opportunities for emotional responses associated with the disease and chemotherapy treatment to ameliorate distress symptoms. The purpose of the current study was to assess the feasibility of 2 music-based interventions, 1 traditional and 1 novel, and explore the preliminary efficacy of these interventions as supportive care of cancer patients in outpatient treatment rooms. Supportive care options were: standard care (control), patient-selected singing with accompaniment (traditional), and patient-created chant using the Orff process (novel). Distress outcomes measured were: pain and fatigue using a 0–10 numerical rating scale, the State-Trait Anxiety Inventory (state form), and the Profile of Mood States 2 Short Form (for mood and fatigue). After obtaining consent, participants engaged in a single-session of 1 of 3 conditions lasting approximately 30 min. Feasibility measures indicated that the traditional and novel interventions were appropriate for the setting. Results indicated that although not always statistically significant, there were positive changes in pain, fatigue, anxiety, and mood for the 2 music-based conditions over standard care. Conclusions indicate the patient-selected condition was more impactful for pain, anxiety, and mood, while the patient-created chant using the Orff process was more impactful for fatigue. These conclusions might be clinically relevant for therapists pending cancer-related symptoms present during the assessment.

scholarly journals Evaluation of Post-operative Pain after Irrigation Using End-vented NaviTip Tips versus Vibringe Sonic Irrigating System in Teeth with Acute Pulpitis with Apical Periodontitis: A Randomized Clinical Trial

2020 ◽  
Vol 8 (D) ◽  
pp. 130-133
Author(s):  
Mohamed Elsaeed Mohamed Ali ◽  
A. Magdy ◽  
W. Hussien
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Statistical Significance ◽  
Demographic Data ◽  
Apical Periodontitis ◽  
Radiographic Findings ◽  
Post Operative Pain ◽  
Working Length ◽  
Time Periods

AIM: This clinical study was conducted to evaluate and compare the post-operative pain after the using of two different irrigating techniques: Vibringe sonic irrigating system with end-vented NaviTip and conventional needle with end-vented NaviTip immediate postoperatively and 4, 12, 24, 48, and 72 h and 7 days utilizing a numerical rating scale (NRS). METHODS: Thirty-eight patients with acute pulpitis with apical periodontitis were involved in this study. Root canals were prepared using NiTi ProTaper Universal rotary system then randomized into two equal groups according to the technique used for irrigation Group A, Vibringe sonic irrigating system with end-vented NaviTip and Group B, conventional syringe with end-vented NaviTip® irrigating tip. The needles of irrigation were penetrated 2 mm shorter than the working length. The trial design of this study is a parallel randomized controlled trial. RESULTS: All demographic data, clinical and radiographic findings, and modified NRS scores obtained from patients were statistically analyzed. Results showed that there was no statistically difference between the two groups regarding the demographic data, prevalence of pre-operative pain, after 4 h, 12 h, 24 h, and 48 h and 7 days, while in both groups, there was a statistically significant decrease in pain intensity preoperatively compared with all other time periods. CONCLUSION: There is no statistical significance difference between Vibringe sonic irrigating syringe with endvented needle and conventional syringe with end-vented NaviTip, while in both groups, there was a statistically significant decrease in pain intensity preoperatively compared with all other time periods.

scholarly journals Need for Palliative Care in Patient with Rheumatoid Arthritis: A Cross-sectional Observational Study

2021 ◽  
Vol 27 ◽  
pp. 275-280
Author(s):  
Kiran Mahendru ◽  
Nishkarsh Gupta ◽  
Manish Soneja ◽  
Rajeev Kumar Malhotra ◽  
Vinod Kumar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Palliative Care ◽  
Observational Study ◽  
Disease Activity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Short Form ◽  
Emotional Problem ◽  
Well Being ◽  
Cross Sectional

Objectives: Rheumatoid arthritis (RA) is a chronic disorder causing inflammation in the joints and achieving remission is often the primary goal of physicians. We evaluated the suffering from RA and assessed the need for palliative care services in these patients. Materials and Methods: This cross-sectional observational study was done in 100 adult RA cases who attended the outpatient department. The Disease Activity Score 28 (DAS28), Health Assessment Questionnaire Disability Index, depression, anxiety and stress score, Short Form 36 Health Survey and numeric rating scale were assessed. The relationship between DAS28 with the other parameters and scores was assessed using Spearman’s rho correlation coefficient. Results: About 90% of patients in our study were female and majority (50%) had a moderate disease activity. The DAS28 showed a positive correlation with the degree of depression (r = 0.671, P = 0.000), anxiety (r = 0.609, P = 0.000) and stress levels (r = 0.474, P = 0.000). The patients with severe disease had a poor quality of life (QoL) [physical functioning (r = –0.737, P = 0.000); role limitation (r = –0.662, P = 0.000); emotional problem (r = –0.676, P = 0.000); energy/fatigue (r = –0.638, P = 0.000); social functioning (r = –0.658, P = 0.000); emotional well-being (r = –0.605, P = 0.000); general health (r = –0.643, P = 0.000); health change (r = –0.376, P = 0.000) and numerical rating scale score for pain (r = 0.656, P = 0.000)]. Conclusion: RA patients with high disease activity suffer from depression, anxiety, stress and poor QoL. Palliative care physicians and rheumatologists must be vested with the power to provide comprehensive care to these patients.

Sign in / Sign up

Export Citation Format

Share Document