Effects of Kampo Medicine, Shishi-hakuhi-to, on Elderly Patients with Pruritic Skin Diseases Measured Using a Patient Diary with an Itching Visual Analog Scale

Abstract Objective: Because surgery in elderly patients should be minimally invasive, interspinous process distraction has been widely used in this group to treat lumbar canal stenosis. We developed a new interspinous process distraction spacer composed of hydroxyapatite ceramic. In this work, we demonstrate the usefulness of this novel device. Methods: Since 2003, we operated on 19 elderly patients with lumbar canal stenosis, including 14 men and five women. Their mean age was 70.1 years. We compared the intervertebral angle, posterior disc height, and interspinous process distance on midsagittal magnetic resonance images obtained before and after the surgery. We also assessed clinical outcomes by using the Visual Analog Scale and the Zurich Claudication Questionnaire. Results: The average operation time per level was 44.7 minutes. Postoperatively, there were significant changes in the angle (from 12.5 to 8.6 degrees, P < 0.0001), the posterior disc height (from 10.6 to 13.1 mm, P < 0.0001), and the interspinous process distance (from 9.7 to 14.1 mm, P < 0.0001). The clinical outcomes, which we assessed by using the Visual Analog Scale and the Zurich Claudication Questionnaire, were considered satisfactory. (Visual Analog Scale, from 6.88 to 3.00; Zurich Claudication Questionnaire, symptom severity domain from 2.94 to 1.92, physical function from 2.51 to 1.73.) Conclusion: Our ceramic spacer is useful in the treatment of elderly patients with lumbar canal stenosis. Treatment comprises an easy surgical procedure and produces no metal artifact on radiological evaluations, such as magnetic resonance imaging and computed tomographic scans.

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Postoperative Titration of Intravenous Morphine in the Elderly Patient

Anesthesiology ◽

10.1097/00000542-200201000-00009 ◽

2002 ◽

Vol 96 (1) ◽

pp. 17-23 ◽

Cited By ~ 115

Author(s):

Frédéric Aubrun ◽

Stéphanie Monsel ◽

Olivier Langeron ◽

Pierre Coriat ◽

Bruno Riou

Keyword(s):

Body Weight ◽

Pain Relief ◽

Elderly Patients ◽

Scale Score ◽

Visual Analog Scale ◽

Visual Analog Scale Score ◽

The Elderly ◽

Analog Scale ◽

Number Of Patients ◽

Intravenous Morphine

Background Intravenous morphine titration is used to obtain rapid and complete postoperative pain relief. Whether this titration can be safely administered in the elderly patients remains a matter for debate. Methods Intravenous morphine titration was administered as a bolus of 2 (body weight < or = 60 kg) or 3 (body weight > 60 kg) mg. The interval between each bolus was 5 min. There was no limitation in the number of boluses given until pain relief or severe adverse effect occurred. The visual analog scale threshold required to administer morphine was 30 mm, and pain relief was defined as a visual analog scale score of 30 mm or less. Patients were divided into two groups: young and elderly (age > or = 70 yr) patients. Data were expressed as mean +/- SD. Results Eight hundred seventy-five patients (83%) were young and 175 patients (17%) were elderly. At the end of morphine titration, the visual analog scale score and the number of patients with pain relief were not significantly different between groups. The total dose of morphine per kilograms of body weight administered was not significantly different between groups (0.15 +/- 0.10 vs. 0.14 +/- 0.09 mg/kg, not significant). No significant differences were observed in the incidence of morphine-related adverse effects (13 vs. 14%, not significant), the number of sedated patients (60 vs. 60%, not significant), and the number of patients whose titration had to be stopped (2 vs. 2%, not significant). Conclusion Intravenous morphine titration can be safely administered to elderly patients. Because titration is adapted to individual pain, the same protocol can be applied to young and elderly patients.

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Postoperative Morphine Consumption in the Elderly Patient

Anesthesiology ◽

10.1097/00000542-200307000-00026 ◽

2003 ◽

Vol 99 (1) ◽

pp. 160-165 ◽

Cited By ~ 66

Author(s):

Frédéric Aubrun ◽

Dorothea Bunge ◽

Olivier Langeron ◽

Gérard Saillant ◽

Pierre Coriat ◽

...

Keyword(s):

Elderly Patients ◽

Visual Analog Scale ◽

Severe Pain ◽

The Elderly ◽

Antiinflammatory Drug ◽

Postanesthesia Care Unit ◽

High Dose ◽

Analog Scale ◽

Old Patients ◽

Intravenous Morphine

Background It has been suggested that the dose of intravenous morphine used during postoperative titration is not modified by aging. The authors therefore studied morphine requirements in patients undergoing total hip replacement. Methods Intravenous morphine titration was administered as boluses, then subcutaneous morphine was administered every 4 h over 24 h. Pain was assessed by use of the visual analog scale (0 to 100), and the threshold required to administer morphine was 30. Young and elderly (> or =70 yr old) patients were compared. Data are mean +/- SD or odds ratio (OR) [95% CI]. Results Two hundred twenty-four patients (68%) were young and 105 (32%) were elderly. The initial visual analog scale was not significantly different between groups. The dose of intravenous morphine in the postanesthesia care unit was not significantly different between young and elderly patients (0.15 +/- 0.11 vs. 0.14 +/- 0.10 mg/kg, P = NS), in contrast to the dose of subcutaneous morphine (0.18 +/- 0.18 vs. 0.11 +/- 0.11 mg/kg, P < 0.001) in the ward. Only severe pain (visual analog scale of 70 or greater; OR, 10.5 [4.5-24.8]) was significantly associated with a high dose (greater than 0.15 mg/kg) of intravenous morphine, whereas severe pain (OR, 2.5 [1.6-4.0]), age less than 60 yr (OR, 2.3 [1.4-3.8]), and absence of a nonsteroidal antiinflammatory drug (OR, 1.9 [1.2-3.1]) were significantly associated with a high dose (greater than 0.12 mg/kg) of subcutaneous morphine. Conclusions The dose of intravenous morphine during titration is not modified in elderly patients, in contrast to the dose administered subcutaneously over a prolonged period.

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Dreierkombination (Thomapyrin®) ist wirksamer bei Kopfschmerzen als Monosubstanzen und Zweierkombination

Nervenheilkunde ◽

10.1055/s-0038-1629992 ◽

2005 ◽

Vol 24 (07) ◽

pp. 626-639 ◽

Cited By ~ 1

Author(s):

V. Pfaffenrath ◽

L. Pageler ◽

H. Peil ◽

B. Aicher ◽

H. C. Diener

Keyword(s):

Pain Intensity ◽

Visual Analog Scale ◽

A Priori ◽

Intensity Difference ◽

Visuelle Analogskala ◽

Analog Scale ◽

Pain Intensity Difference

ZusammenfassungDie Wirksamkeit, Sicherheit und Verträglichkeit einer Einzelgabe von zwei Tabletten der fixen Dreierkombination mit 250 mg Azetylsalizylsäure (ASS) plus 200 mg Paracetamol plus 50 mg Koffein (Thomapyrin®) gegenüber zwei Tabletten mit 500 mg ASS, oder zwei Tabletten mit 500 mg Paracetamol, oder zwei Tabletten mit 50 mg Koffein beziehungsweise Plazebo wurde in einer klinischen Studie an 1 743 Patienten geprüft, die ihre episodischen Kopfschmerzen vom Spannungstyp oder ihre Migräne mit und ohne Aura üblicherweise erfolgreich mit verschreibungsfreien Analgetika behandeln. Die Dreierkombination war im a priori definierten primären Endpunkt “Zeit bis zu 50% Schmerzreduktion” sowohl der Zweierkombination aus ASS plus Paracetamol (p = 0,0181), als auch den Monoanalgetika ASS (p = 0,0398) und Paracetamol (p = 0,0016), sowie auch der Monotherapie mit Koffein (p < 0,0001) und Plazebo (p < 0,0001) überlegen. Alle Behandlungen außer der Koffein-Monotherapie waren der Plazebobehandlung überlegen (p < 0,0001). Die überlegene Wirksamkeit der Dreierkombination gilt auch für alle sekundären Endpunkte wie beispielsweise der “Verringerung der Kopfschmerzen auf 10 mm VAS (visual analog scale = visuelle Analogskala zur Schmerzmessung), dem gewichteten % SPID (sum of pain intensity difference = aufsummierte Schmerzintensitätsdifferenz gegenüber dem Ausgangsschmerz in Prozent), dem Ausmaß der Beeinträchtigung der alltäglichen Aktivitäten und der globalen Beurteilung der Wirksamkeit durch die Patienten. Alle Behandlungen waren gut verträglich, die Inzidenz von unerwünschten Begleiterscheinungen war gering.

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Perceived Tension, Movement, and Pleasantness in Harmonic Musical Intervals and Noises

Music Perception An Interdisciplinary Journal ◽

10.1525/mp.2020.37.4.298 ◽

2020 ◽

Vol 37 (4) ◽

pp. 298-322 ◽

Cited By ~ 3

Author(s):

Marco Costa ◽

Mattia Nese

Keyword(s):

Visual Analog Scale ◽

Energy Content ◽

High Pitch ◽

Analog Scale ◽

Psychophysical Procedure ◽

Preliminary Study

Perceived valence, tension, and movement of harmonic musical intervals (from the unison to the octave presented in a low- and high-register) and standard noises (brown, pink, white, blue, purple) were assessed in two studies that differed in the crossmodal procedure by which tension and movement were rated: proprioceptive device or visual analog scale. Valence was evaluated in both studies with the visual analog scale. In a preliminary study, the proprioceptive device was calibrated with a psychophysical procedure. Roughness of the stimuli was included as covariate. Tension was perceived higher in dissonant intervals and in intervals presented in the high register. The higher the high-pitch energy content in the standard noise, the higher the perceived tension. The visual analog scale resulted in higher tension ratings than the proprioceptive device. Perception of movement was higher in dissonant intervals, in intervals in the high register, and in standard noises than in musical intervals. High-pitch spectrum noises were associated with more sense of movement than low-pitch spectrum noises. Consonant intervals and low-register intervals were evaluated as more pleasant than dissonant and high-register intervals. High-pitch spectrum purple and blue noises were evaluated as more unpleasant than low-pitch spectrum noises.

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Climical Trials of Incidal on Pruritic Skin Diseases

Nishi Nihon Hifuka ◽

10.2336/nishinihonhifu.31.620 ◽

1969 ◽

Vol 31 (6) ◽

pp. 620-624

Author(s):

Mutsuo YAMAGUCHI

Keyword(s):

Skin Diseases ◽

Pruritic Skin

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Management of cubital tunnel syndrome by anterior trans-muscular transposition of the ulnar nerve

Egyptian Journal of Neurosurgery ◽

10.1186/s41984-019-0067-2 ◽

2019 ◽

Vol 34 (1) ◽

Author(s):

Ahmed Shawky Ammar ◽

Mohamed Ahmed El Tabl ◽

Dalia Salah Saif

Keyword(s):

Clinical Outcome ◽

Ulnar Nerve ◽

Visual Analog Scale ◽

Electrophysiological Study ◽

Cubital Tunnel Syndrome ◽

Nerve Entrapment ◽

Cubital Tunnel ◽

Analog Scale ◽

Tunnel Syndrome ◽

Dash Questionnaire

Abstract Background Various surgical options are used for the treatment of ulnar nerve entrapment at the elbow. In this study, anterior trans-muscular transposition of the ulnar nerve was used for the treatment of cubital tunnel syndrome. Objectives To evaluate the surgical results of anterior trans-muscular transposition technique for the treatment of cubital tunnel syndrome with particular emphasis on clinical outcome. Methods Forty patients with cubital tunnel syndrome were operated using anterior trans-muscular transposition technique. Patients were classified into post-operative clinical outcome grades according to the Wilson & Krout criteria, and they were followed up by visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and post-operative clinical evaluation. Results Forty patients with cubital tunnel syndrome who underwent anterior trans-muscular transposition of the ulnar nerve show a significant clinical improvement at 24 months post-surgery regarding visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and the Wilson & Krout grading as 87.5% of the patients recorded excellent and good outcome. Conclusion Anterior transmuscular transposition of the ulnar nerve is a safe and effective treatment for ulnar nerve entrapment at the elbow.

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Treating traumatic thoracolumbar spine fractures using minimally invasive percutaneous stabilization plus balloon kyphoplasty: a 102-patient series

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2020-017238 ◽

2021 ◽

pp. neurintsurg-2020-017238

Author(s):

Henri Salle ◽

Alexandre Meynard ◽

Emilie Auditeau ◽

Clément Gantois ◽

Aymeric Rouchaud ◽

...

Keyword(s):

Visual Analog Scale ◽

Open Surgery ◽

Body Height ◽

Thoracolumbar Spine ◽

Visual Analog Scale Score ◽

Posterior Wall ◽

Balloon Kyphoplasty ◽

Expected Improvement ◽

Thoracolumbar Fractures ◽

Analog Scale

BackgroundThere is no consensus on the treatment for spinal injuries resulting in thoracolumbar fractures without neurological impairment. Many trauma centers are opting for open surgery rather than a neurointerventional approach combining posterior percutaneous short fixation (PPSF) plus balloon kyphoplasty (BK).ObjectiveTo assess the safety and efficacy of PPSF+BK and to estimate the expected improvement by clarifying the factors that influence improvement.MethodsWe retrospectively reviewed patients who underwent PPSF+BK for the treatment of single traumatic thoracolumbar fractures from 2007 to 2019. Kyphosis, loss of vertebral body height (VBH), clinical and functional outcomes including visual analog scale and Oswestry disability index were assessed. We examined the overall effects in all patients by constructing a linear statistical model, and then examined whether efficacy was dependent on the characteristics of the patients or the fractures.ResultsA total of 102 patients were included. No patient experienced neurological worsening or wound infections. The average rates of change were 74.4% (95% CI 72.6% to 76.1%) for kyphosis and 85.5% (95% CI 84.4% to 86.6%) for VBH (both p<0.0001). The kyphosis treatment was more effective on Magerl A3 and B2 fractures than on those classified as A2.3, as well as for fractures with slight posterior wall protrusion on the spinal canal. A higher postoperative visual analog scale score was predictive of poorer outcome at 1 year.ConclusionsThis is the largest series reported to date and confirms and validates this surgical treatment. All patients exhibited improved kyphosis and restoration of VBH. We advise opting for this technique rather than open surgery.

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Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis

Open Medicine ◽

10.1515/med-2021-0285 ◽

2021 ◽

Vol 16 (1) ◽

pp. 826-832

Author(s):

Jiarong Wang ◽

Liansheng Qiu ◽

Yimin Chen ◽

Minyun Chen

Keyword(s):

T Cells ◽

Allergic Rhinitis ◽

Retrospective Study ◽

Regulatory T Cells ◽

Visual Analog Scale ◽

Peripheral Blood ◽

Sublingual Immunotherapy ◽

Analog Scale ◽

Vas Score ◽

Medication Score

Abstract Background Few studies investigated the effects of sublingual immunotherapy (SLIT) on the peripheral regulatory T cells (Tregs)/Th17 ratio. Objective To investigate the effectiveness of SLIT in children with allergic rhinitis (AR) and the effects on the Tregs/Th17 ratio. Methods This was a retrospective study of children who were treated for AR between April 2017 and March 2018 at one hospital. The patients were grouped according to the treatments they received: SLIT + pharmacotherapy vs pharmacotherapy alone. Results Eighty children (51 boys and 29 girls; 40/group) were included. The visual analog scale (VAS) and medication scores at 1 year in the SLIT + pharmacotherapy group were 2.70 ± 1.08 and 1.1 ± 0.8, respectively, which were lower than at baseline (7.7 ± 1.2 and 3.6 ± 1.0, respectively) (both Ps < 0.05). For the pharmacotherapy group, the VAS score was decreased at 1 year vs baseline (3.3 ± 1.2 vs 7.4 ± 1.0; P < 0.05), but the medication score did not change (P > 0.05). In the SLIT + pharmacotherapy group, the Treg percentage increased, while the Th17 percentage decreased at 1 year (both Ps < 0.01). The percentages of Tregs and Th17s did not change in the pharmacotherapy group (both Ps > 0.05). Conclusions SLIT + pharmacotherapy can increase the Treg percentage and decrease the Th17 percentage in the peripheral blood of children with AR.

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The Prevalence of Pain in People With Chronic Ankle Instability: A Systematic Review

Journal of Athletic Training ◽

10.4085/1062-6050-531-17 ◽

2019 ◽

Vol 54 (6) ◽

pp. 662-670 ◽

Cited By ~ 4

Author(s):

Saeed Al Adal ◽

Fereshteh Pourkazemi ◽

Martin Mackey ◽

Claire E. Hiller

Keyword(s):

Physical Examination ◽

Visual Analog Scale ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Self Report ◽

Functional Impairments ◽

Ankle Pain ◽

Analog Scale ◽

Eligibility Criteria ◽

Prevalence Of Pain

ObjectiveTo identify the prevalence of pain in people with chronic ankle instability (CAI) and how pain is related to the impairments of CAI.Data SourcesWe searched the databases of AMED, CINAHL, EMBASE, MEDLINE, PubMed, Scopus, SPORTDiscus, and Web of Science from inception to March 2017.Study SelectionEligible studies were peer-reviewed research in which investigators reported the presence of ankle pain or assessed the effects of pain on impairments in participants with CAI. Age and language were not restricted. Studies that included only surgical interventions were excluded.Data ExtractionStudies identified by the search strategy were screened according to the eligibility criteria, and 2 independent reviewers extracted the data. Outcome measurements were (1) pain ratings using measures such as a visual analog scale and (2) other residual impairments, such as feelings of weakness, giving way, or deficits in functional performance.Data SynthesisOf the 5907 records identified through the database search, 14 studies were included in this review. All authors assessed ankle pain by self-report questionnaires or physical examination, or both. Pain was self-reported by 23% to 79% of participants and present on physical examination in 25% to 75% of participants, depending on the test applied. Among these studies, the highest reported pain level was 4.9 on the 11-point visual analog scale. Studies were heterogeneous for pain measures, participant groups, interventions, and follow-up periods. The relationship between pain and the structural and functional impairments associated with CAI was not investigated in the included studies.ConclusionsPain was present in a large proportion of people who had CAI, but pain levels were low. Information about the effects of pain was not reported, so researchers should examine the association between pain and function, balance, or other activities in people with CAI.

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