scholarly journals The challenge of recognizing severe pain and autonomic abnormalities for early diagnosis of CRPS

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lars Kristian Lunden ◽  
Ellen Jorum
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Early Warning ◽  
Medical Records ◽  
Delayed Diagnosis ◽  
Warning Signs ◽  
Intense Pain ◽  
Early Warning Signs

Abstract Objectives Complex regional pain syndrome (CRPS) is a disabling usually post-traumatic pain condition. International guidelines emphasize early diagnosis for treatment and improved outcome. Early intense and persistent pain along with features of autonomic dysfunction in the first week’s post-injury are early warning signs for development of CRPS. We have previously reported a delayed diagnosis of CRPS. The main purpose of the present study was to investigate possible causes of a delayed diagnosis, with a special focus of recognition of risk factors. Methods A total of 52 CRPS 1 (without detectable nerve damage) and CRPS 2 (with evidence of nerve lesion) patients were included in the study. When examined at OUS-Rikshospitalet, we retrospectively asked the patients on the development of pain and autonomic abnormalities from the time of the eliciting injury, performed a thorough clinical investigation with an emphasis on signs of autonomic failure and compared symptoms and clinical findings with such information in previous medical records. We also evaluated symptoms and signs according to the type of injury they had suffered. Results Of a total of 52 patients (30 women and 22 men, mean age 39.0 years at the time of injury), 34 patients had CRPS type 1 (65.4%) and 18 CRPS type 2 (34.6%), 25 patients with pain in the upper and 27 in the lower extremity. A total of 35 patients (67.3%) were diagnosed with CRPS (following mean 2.1 years) prior to the investigation at OUS-Rikshospitalet (mean 4.86 years following injury). Mean time from injury to diagnosis was 33.5 months (SD 30.6) (2.8 years) for all patients. In retrospect, all 17 patients first diagnosed at OUS met the CRPS diagnosis at an earlier stage. All patients retrospectively reported intense pain (numeric rating scale > 7) from the time of injury with a large discrepancy to previous medical records which only stated intense pain in 29.4% of patients with CRPS type 1 and 44.4% of patients with CRPS type 2 within the first four months. While the patients reported an early onset of autonomic dysfunction, present in 67.3 and 94.2% of the patients within one week and one month, respectively, reports of autonomic abnormalities within the first four months was far less (maximum in 51.7% of patients with CRPS type 1 and in 60% in CRPS 2). In 10 patients with CRPS type 1, no symptom nor sign of autonomic abnormalities was reported. Conclusions We still find a significant delay in the diagnosis of CRPS. There is a large discrepancy between both self-reporting of intense, disproportionate pain, as well as symptoms of autonomic abnormalities from the time of injury, and documentation in previous medical records. Our findings suggest a lack of awareness of risk factors for the development of CRPS, such as early intense pain and autonomic abnormalities without recovery, contributing to delayed diagnosis. The present results suggest causes of delayed CRPS-diagnosis. An increased attention to early warning signs/risk factors may improve diagnosis of CRPS.

scholarly journals Knowledge about Cervical Cancer Early Warning Signs and Symptoms, Risk Factors and Vaccination among Students at a Medical School in Al-Ahsa, Kingdom of Saudi Arabia

2014 ◽  
Vol 15 (6) ◽  
pp. 2529-2532 ◽  
Author(s):  
Abdulaziz Ahmed Al-Darwish ◽  
Abdullah Fouad Al-Naim ◽  
Khalid Saleh Al-Mulhim ◽  
Nasser Khaled Al-Otaibi ◽  
Mohammed Saad Morsi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Saudi Arabia ◽  
Medical School ◽  
Early Warning ◽  
Signs And Symptoms ◽  
Warning Signs ◽  
Kingdom Of Saudi Arabia ◽  
Early Warning Signs

Knowledge and Awareness of Colorectal Cancer Early Warning Signs and Risk Factors among University Students in Jordan

2016 ◽  
Vol 33 (2) ◽  
pp. 448-456 ◽  
Author(s):  
Nizar M. Mhaidat ◽  
Belal A. Al-husein ◽  
Karem H. Alzoubi ◽  
Dima I. Hatamleh ◽  
Youcef Khader ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
University Students ◽  
Early Warning ◽  
Warning Signs ◽  
Early Warning Signs

scholarly journals Awareness Levels about Breast Cancer Risk Factors, Early Warning Signs, and Screening and Therapeutic Approaches among Iranian Adult Women: A large Population Based Study Using Latent Class Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Mahdi Tazhibi ◽  
Awat Feizi
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Early Warning ◽  
Latent Class ◽  
Warning Signs ◽  
Cancer Risk Factors ◽  
Early Warning Signs ◽  
Breast Cancer Risk Factors ◽  
Level Of Knowledge ◽  
Screening Approaches

Background and Objective. Breast cancer (BC) continues to be a major cause of morbidity and mortality among women throughout the world and in Iran. Lack of awareness and early detection program in developing country is a main reason for escalating the mortality. The present research was conducted to assess the Iranian women’s level of knowledge about breast cancer risk factors, early warning signs, and therapeutic and screening approaches, and their correlated determinants.Methods. In a cross-sectional study, 2250 women before participating at a community based screening and public educational program in an institute of cancer research in Isfahan, Iran, in 2012 were investigated using a self-administered questionnaire about risk factors, early warning signs, and therapeutic and screening approaches of BC. Latent class regression as a comprehensive statistical method was used for evaluating the level of knowledge and its correlated determinants.Results. Only 33.2%, 31.9%, 26.7%, and 35.8% of study participants had high awareness levels about screening approaches, risk factors, early warning signs and therapeutic modalities of breast cancer, respectively, and majority had poor to moderate knowledge levels. Most effective predictors of high level of awareness were higher educational qualifications, attending in screening and public educational programs, personal problem, and family history of BC, respectively.Conclusion. Results of current study indicated that the levels of awareness among study population about key elements of BC are low. These findings reenforce the continuing need for more BC education through conducting public and professional programs that are intended to raise awareness among younger, single women and those with low educational attainments and without family history.

scholarly journals Do Multiple Stroke-Related Educational Opportunities Enhance Stroke Knowledge among Students Enrolled in Communication Sciences and Disorders Programs?

2008 ◽  
Author(s):  
Kristen Lankford ◽  
E. Marshall ◽  
Amanda Pittman ◽  
Charles Ellis
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Early Warning ◽  
Stroke Risk ◽  
Warning Signs ◽  
Stroke Risk Factors ◽  
Early Warning Signs ◽  
Multiple Stroke ◽  
Level Of Instruction ◽  
Stroke Knowledge

Purpose: Stroke education modules have been added to medical school curriculums to improve stroke knowledge in graduate physicians, and this has resulted in positive outcomes. These findings suggest that similar strategies may be successful in graduate programs such as Communication Sciences and Disorders (CSD). The purpose of this study was to examine the impact of multiple stroke-related education opportunities on students enrolled in CSD programs. Methods: Seventy-six first and second year students enrolled in a Communication Sciences and Disorders program completed a survey of stroke risk factors and early warning signs of stroke. Results: Risk factor knowledge - 97% identified smoking as a risk factor; 61% identified diabetes; 90% identified high cholesterol; 84% identified age, and 90% identified physical inactivity. Students varied in their recognition of diabetes as a stroke risk factor based on their level of instruction. Early warning signs and first response knowledge - 83% recognized sudden confusion or trouble speaking; 100% recognized sudden facial, arm or leg weakness; 83% recognized sudden vision loss; 76% recognized sudden trouble walking; and 75% recognized sudden headache as early warning signs of stroke. Seventy-nine percent recognized calling 9-1-1 as the appropriate first action. Students varied in their recognition of sudden trouble walking and severe headache as an early warning sign of stroke based on their level of instruction. Conclusions: Most students recognized individual stroke risk factors and early warning signs, but few recognized multiple risk factors and warning signs. Multiple education opportunities appear to enhance student recognition of risk factors and warning signs.

Ten years after the stroke: Me talk slightly less funny

English Today ◽  
2018 ◽  
Vol 34 (2) ◽  
pp. 35-38
Author(s):  
Jürg R. Schwyter
Keyword(s):  
Risk Factors ◽  
Early Warning ◽  
Working Hours ◽  
Warning Signs ◽  
University Of Pennsylvania ◽  
English Department ◽  
Long Working Hours ◽  
University Of Cambridge ◽  
Early Warning Signs ◽  
The University

It is now ten years since I suffered a stroke. I continue to improve, albeit much more slowly than in the first one or two years. Readers of English Today may remember (Schwyter, 2011) that I was head of the English Department at the University of Lausanne, and a graduate of both the University of Pennsylvania and the University of Cambridge. My stroke came really out of the blue; I did not have any of the early warning signs. And the only possible risk factors I was aware of were very long working hours and stress in all its forms – though ‘stress’ is not very well defined medically, being not one symptom but rather a cluster of symptoms (Kivimäki et al., 2015).

POLIOMYELITIS IN CANADIAN ESKIMOS: LABORATORY STUDIES. V. TYPE 1 AND TYPE 3 POLIOMYELITIS ANTIBODY LEVELS IN BAFFIN ISLAND ESKIMOS

1954 ◽  
Vol 32 (1) ◽  
pp. 119-125
Author(s):  
W. Wood ◽  
Eina M. Clark ◽  
F. T. Shimada ◽  
A. J. Rhodes
Keyword(s):  
Medical Records ◽  
Baffin Island ◽  
Tissue Cultures ◽  
Laboratory Studies ◽  
Poliomyelitis Virus ◽  
Antibody Titers ◽  
Antibody Levels ◽  
Type 3

Studies on the basic immunology of poliomyelitis in Canadian Eskimos have been continued. Some 87 sera collected from Eskimos at Pangnirtung, Baffin Island, have been examined for the presence of Type 1 and Type 3 poliomyelitis antibody by quantitative tests in tissue cultures. The same sera were previously examined for Type 2 antibody by quantitative tests in mice. The results of the three determinations are now presented together for comparison. These sera came from Eskimos aged 2 to 72 years of age. None of the Eskimos showed any evidence of paralysis. Examination of the medical records did not suggest that any paralytic disease had been present in this part of Baffin Island. Very few of the sera showed the presence of poliomyelitis antibody; thus, Type 1 antibody was demonstrated in the sera of 8%, Type 2 antibody in the sera of 9%, and Type 3 antibody in the sera of 14%. No significant number of Eskimos below the age of 45 years had acquired poliomyelitis antibody. The antibody titers mostly ranged between 10−1.0 and 10−2.0, and were significantly lower than the titers customarily found in recently paralyzed cases. These findings suggest that poliomyelitis infection occurred in Pangnirtung Eskimos many years before the date on which the samples were taken (1951). These results point to the worldwide prevalence of the three types of poliomyelitis virus.

Sign in / Sign up

Export Citation Format

Share Document