scholarly journals Impact of adolescent complex regional pain syndrome on the psychopathology of young men ahead of military service: a retrospective cohort analysis of Korean conscription data

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Shin-Heon Lee ◽  
Myeong-Jin Ko ◽  
Taek-Kyun Nam ◽  
Jeong-Taik Kwon ◽  
Yong-Sook Park
Keyword(s):  
Personality Disorder ◽  
Complex Regional Pain Syndrome ◽  
Military Service ◽  
Cohort Analysis ◽  
Pain Syndrome ◽  
Related Data ◽  
Retrospective Cohort Analysis ◽  
Paranoid Personality Disorder ◽  
Pain Duration ◽  
History Of

Abstract Background The relationship between physical and psychopathological features in complex regional pain syndrome (CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service. Methods We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory (MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS (19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at < 15 months (n = 30) versus ≥15 months (n = 33). Binary MPI results (normal-abnormal) were also compared between the two groups. Results In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio (OR) at 1.05 for every 1-month increase (95% confidence interval (CI) 1.02–1.08; P = 0.002). Subjects with pain duration at ≥15 months have lower faking good response score (P < 0.001 vs. those with pain duration at < 15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores (P < 0.05). Pain duration was significantly associated with the MPI variables. Conclusions Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.

scholarly journals Venipuncture Induced Complex Regional Pain Syndrome Presenting as Inflammatory Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Punit Pruthi ◽  
Pramod Arora ◽  
Manoj Mittal ◽  
Anugrah Nair ◽  
Waqia Sultana
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Inflammatory Arthritis ◽  
Young Male ◽  
Pain Syndrome ◽  
Poor Response ◽  
History Of ◽  
Diagnostic Modalities ◽  
Musculoskeletal Ultrasonography ◽  
The Right

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

scholarly journals Atypical presentation of complex regional pain syndrome: neuropathic itching - A case report -

2021 ◽  
Author(s):  
Syn-Hae Yoon ◽  
Woojong Cho ◽  
Juhan Mun ◽  
Wonyeong Jeong ◽  
Young Do Kim ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Treatment Modalities ◽  
Atypical Presentation ◽  
Foot And Ankle ◽  
Main Symptom ◽  
Hypoxic Brain Damage ◽  
Hypoxic Brain ◽  
History Of ◽  
Ankle Mobility

Background: In some patients with neuropathic pain (NP), such as complex regional pain syndrome (CRPS), itching rather than pain is the main symptom making diagnosis and treatment difficult.Case: We report a case of a 23-year-old man with a history of hypoxic brain damage who presented with pruritus of the left foot and ankle. His left foot was fractured, and he underwent surgery 6 months previously. After the operation and cast application, he developed uncontrolled pruritus, swelling, sweating, and flushing of the left foot skin with limping. On examination, he showed well-known features of CRPS without pain. He was diagnosed with an atypical CRPS with neuropathic itching (NI). With treatment modalities used for NP and CRPS, his pruritus subsided gradually, and the his ankle mobility improved.Conclusions: Unexplained itching can be the main symptom in some CRPS patients. Treatment according to NP can improve symptoms of NI in CRPS patients.

scholarly journals Impact of obesity on male urethral sling outcomes

2020 ◽  
Vol 12 ◽  
pp. 175628722092799
Author(s):  
M. Francesca Monn ◽  
Hannah V. Jarvis ◽  
Thomas A. Gardner ◽  
Matthew J. Mellon
Keyword(s):  
Operative Time ◽  
Cohort Analysis ◽  
Obese Patients ◽  
Retrospective Cohort Analysis ◽  
Surgical Complexity ◽  
History Of ◽  
Sling Placement ◽  
The Impact ◽  
Male Urethral Sling

Background: The impact of obesity on AdVance male urethral sling outcomes has been poorly evaluated. Anecdotally, male urethral sling placement can be more challenging due to body habitus in obese patients. The objective of this study was to evaluate the impact of obesity on surgical complexity using operative time as a surrogate and secondarily to evaluate the impact on postoperative pad use. Methods: A retrospective cohort analysis was performed using all men who underwent AdVance male urethral sling placement at a single institution between 2013 and 2019. Descriptive statistics comparing obese and non-obese patients were performed. Results: A total of 62 patients were identified with median (IQR) follow up of 14 (4–33) months. Of these, 40 were non-obese and 22 (35.5%) were obese. When excluding patients who underwent concurrent surgery, the mean operative times for the non-obese versus obese cohorts were 61.8 min versus 73.7 min ( p = 0.020). No Clavien 3–5 grade complications were noted. At follow up, 47.5% of the non-obese cohort and 63.6% of the obese cohort reported using one or more pads daily ( p = 0.290). Four of the five patients with a history of radiation were among the patients wearing pads following male urethral sling placement. Conclusion: Obese men undergoing AdVance male urethral sling placement required increased operative time, potentially related to operative complexity, and a higher proportion of obese compared with non-obese patients required postoperative pads for continued urinary incontinence. Further research is required to better delineate the full impact of obesity on male urethral sling outcomes.

scholarly journals Repeat Syphilis Is More Likely to Be Asymptomatic in HIV-Infected Individuals: A Retrospective Cohort Analysis With Important Implications for Screening

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Chris Kenyon ◽  
Kara Krista Osbak ◽  
Ludwig Apers
Keyword(s):  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Care Providers ◽  
Conflicting Evidence ◽  
Retrospective Cohort Analysis ◽  
History Of ◽  
Syphilis Screening ◽  
Multiple Episodes ◽  
Latent Syphilis

Abstract There is conflicting evidence as to whether repeat syphilis is more likely to present asymptomatically than initial syphilis. If it is, then this would motivate more frequent and long-term syphilis screening in persons with a history of multiple episodes of syphilis. We conducted detailed folder reviews of all individuals with 4 or more diagnoses of syphilis between 2000 and 2017 at the Institute of Tropical Medicine, Antwerp, and assessed if there was a difference in the proportion presenting with symptomatic (primary and secondary) vs asymptomatic (latent) syphilis in initial vs repeat syphilis. Forty-five clients with 4 or more episodes of syphilis were included in the study. All were HIV-infected. Repeat episodes of syphilis were less likely to be symptomatic than initial episodes (35/160 [21.9%] vs 28/45 [62.2%]; P &lt; .001). Frequent screening in those with HIV infection may be the only way to diagnose repeat episodes of syphilis. Care providers can use this information to motivate persons with multiple episodes of syphilis to be screened every 3 to 6 months.

scholarly journals 973. Inter-facility Patient Sharing and Clostridium difficile Incidence in the Ontario Hospital Network: A 13-Year Longitudinal Cohort Study of 116 Hospitals

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S38-S38
Author(s):  
Kevin Brown ◽  
Nick Daneman ◽  
Kevin Schwartz ◽  
Bradley Langford ◽  
Jennie Johnstone ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Discharge Abstract Database ◽  
Patient Transfers ◽  
Retrospective Cohort Analysis ◽  
High Incidence ◽  
Icd 10 ◽  
History Of ◽  
Facility Level ◽  
Acute Care Facilities ◽  
Healthcare Associated

Abstract Background Inter-facility patient movement plays an important role in the dissemination of antimicrobial resistance and C. difficile infection (CDI) throughout healthcare systems. However, the relative performance of different patient sharing metrics for predicting CDI incidence is not known. We compared 3 different measures of inter-facility patient sharing as they relate to CDI incidence in Ontario facilities. Methods A retrospective cohort analysis was used to predict incident CDI (ICD-10 = A04.7 identified from Discharge Abstract Database records) across Ontario hospitals (Nhospitals = 116) between April 1, 2003 to March 31, 2016. Patients with a stay of &lt;3 days and those with a history of CDI in the prior 90 days were excluded from the risk set but not from patient sharing metrics. Poisson regression models with facility-level random effects were used to predict facility CDI incidence (per 1,000 admissions) and measure the percent change in facility-level variance (PCV). The 3 metrics of inter-facility patient sharing included: (1) “importation”—the rate of patients with a discharge from another distinct facility in prior 90 days, (2) “incidence-weighted importation”—equal to importation weighted by the incidence of CDI in the previous facility, and (3) “case importation”—importation of patients with a history of CDI. Results Over the 13-year period, we observed 58,427 cases of healthcare-associated CDI among 12,750,000 admissions. Facility CDI incidence ranged from 2.9 to 19.6 per 1,000 admissions (6.8-fold range). Patient sharing metrics were strongly related to facility CDI incidence (figure). In models adjusting for facility risk factors, all 3 measures still explained an important portion of inter-facility variation in CDI incidence: importation (PCV = 5%, P = 0.01), incidence-weighted importation (PCV = 15%, P &lt; 0.001), and “case importation” (PCV = 48%, P &lt; 0.001). Conclusion We observed a substantial variation in facility CDI incidence that was explained by linkages between acute care facilities, especially linkage to other facilities with a high incidence of CDI. Facility infection prevention staff should consider incorporating the facility CDI incidence into risk stratification assessments of patient transfers. Disclosures All authors: No reported disclosures.

An exploration into the cortical reorganisation of the healthy hand in upper-limb complex regional pain syndrome

2016 ◽  
Vol 13 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Flavia Di Pietro ◽  
Tasha R. Stanton ◽  
G. Lorimer Moseley ◽  
Martin Lotze ◽  
James H. McAuley
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Functional Impairment ◽  
Self Efficacy ◽  
Control Sample ◽  
Pain Syndrome ◽  
Hemispheric Differences ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Pain Duration ◽  
The Relationship

AbstractBackground and aimsRecent evidence demonstrated that complex regional pain syndrome (CRPS) is associated with a larger than normal somatosensory (S1) representation of the healthy hand. The most intuitive mechanism for this apparent enlargement is increased, i.e. compensatory, use of the healthy hand. We investigated whether enlargement of the S1 representation of the healthy hand is associated with compensatory use in response to CRPS. Specifically, we were interested in whether the size of the S1 representation of the healthy hand is associated with the severity of functional impairment of the CRPS-affected hand. We were also interested in whether CRPS duration might be positively associated with the size of the representation of the healthy hand in S1.MethodsUsing functional magnetic resonance imaging (fMRI) data from our previous investigation, the size of the S1 representation of the healthy hand in CRPS patients (n = 12) was standardised to that of a healthy control sample (n = 10), according to hand dominance. Responses to questionnaires on hand function, overall function and self-efficacy were used to gather information on hand use in participants. Multiple regression analyses investigated whether the S1 representation was associated with compensatory use. We inferred compensatory use with the interaction between reported use of the CRPS-affected hand and (a) reported overall function, and (b) self-efficacy. We tested the correlation between pain duration and the size of the S1 representation of the healthy hand with Spearman’s rho.ResultsThe relationship between the size of the S1 representation of the healthyh and and the interaction between use of the affected hand and overall function was small and non-significant ( β =-5.488×10-5, 95% C.I. –0.001, 0.001). The relationship between the size of the S1 representation of the healthy hand and the interaction between use of the affected hand and self-efficacy was also small and non-significant (β =-6.027×10-6, 95% C.I. –0.001, 0.001). The S1 enlargement of the healthy hand was not associated with pain duration (Spearman’s rho = –0.14, p = 0.67).ConclusionOur exploration did not yield evidence of any relationship between the size of the healthy hand representation in S1 and the severity of functional impairment of the CRPS-affected hand, relative to overall hand use or to self-efficacy. There was also no evidence of an association between the size of the healthy hand representation in S1 and pain duration. The enlarged S1 representation of the healthy hand does not relate to self-reported function and impairment in CRPS.ImplicationsWhile this study had a hypothesis-generating nature and the sample was small, there were no trends to suggest compensatory use as the mechanism underlying the apparent enlargement of the healthy hand in S1. Further studies are needed to investigate the possibility that inter-hemispheric differences seen in S1 in CRPS may be present prior to the development of the disorder.

scholarly journals Familial Occurrence of Complex Regional Pain Syndrome

2010 ◽  
Vol 37 (3) ◽  
pp. 389-394 ◽  
Author(s):  
Peyman Shirani ◽  
Ali Jawaid ◽  
Paolo Moretti ◽  
Elham Lahijani ◽  
Alicia R. Salamone ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Clinical Features ◽  
Genetic Basis ◽  
Genetic Factors ◽  
Age At Onset ◽  
Pain Syndrome ◽  
Case Histories ◽  
Younger Age ◽  
History Of ◽  
Pain Symptoms

Background:The etiology of complex regional pain syndrome (CRPS) is unknown. Different environmental and genetic factors have been postulated to contribute to CRPS.Methods:We reviewed the clinical data from a cohort of 69 patients with CRPS. Four families were identified with two or more members affected with CRPS yielding a total of nine patients. Six more patients reported the presence of pain symptoms in their family members, however; this could not be clinically confirmed.Results:The case histories of the nine individuals with ‘familial’ CRPS suggested a younger age at onset and more frequent history of migraine versus the non-familial patients. A pattern of inheritance could not be ascertained.Conclusion:This data supports the hypothesis that CRPS can be familial and hence may have a genetic basis in some families. Larger studies will be needed to ascertain clearer patterns of inheritance and to determine whether the clinical features of ‘familial’ CRPS are the same as the sporadic form.

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