Pain Syndrome, Markers of Bone Metabolism in Patients with Osteoarthritis, Approaches to Drug Therapy and the Impact of Obesity

2016 ◽  
pp. 26-35
Author(s):  
Oleksandr Kuryata ◽  
Anna Cherkasova
Keyword(s):  
Neuropathic Pain ◽  
Bone Metabolism ◽  
Clinical Efficacy ◽  
Functional Ability ◽  
Analgesic Effect ◽  
Pain Syndrome ◽  
Knee Joints ◽  
Osteocalcin Level ◽  
Positive Effects ◽  
The Impact

The objective: to assess the nature of pain in patients with osteoarthritis, the impact of obesity on the clinical efficacy of treatment of osteoarthritis (OA) and dynamics of bone metabolism markers. Patients and methods. The research included 150 patients with OA, who were divided into two groups, according to the receiving therapy. Patients of the main group – received diacerein (drug «Flexirin» PC «Kyiv Vitamin Factory») and patients of control group – received only nonsteroidal anti1inflammatory drugs (NSAIDs). Results. The prevalence of neuropathic pain component in patients with OA was 64,7%, among which 80,7% use NSAIDs as an analgesic therapy. Obesity in patients with OA was associated with significantly higher levels of pain from the side of knee joints and higher degree of stiffness according to WOMAC index. The results of the study demonstrated a direct moderate correlation (R = 0,49; p = 0,04) between PICP level and the severity of pain at physical load from the side of hands and hip joints. The therapy by diacerein within 3 months resulted in a reliable decrease of pain syndrome intensity from the side of all articular zones, unlike to isolated NSAIDs use, where a reliable analgesic effect was demonstrated only from the side of knee joints. Obesity in patients with OA led to a significant decrease in clinical efficacy of therapy in point of functional status of the joints. Conclusions. Neuropathic pain is quite common among patients with OA, which at the same time is associated with the lack of patient’s awareness about possible risks during NSAID’s use. Medical treatment by diacerein (drug “Flexirin”) causes stability of osteocalcin level, in contrast to the isolated NSAIDs use, where priority changes have been demonstrated against osteocalcin level decrease. The use of diacerein also resulted to additional positive effects from the side of zonal prevalence of analgesic effect and improving of functional ability of joints. Obesity in patients with OA was associated with a reliable increase of pain level intensity from the side of knee joints and the higher degree of functional limitation, causing at the same time, reduction of clinical efficacy of therapy in point of achieving analgesic effect and improving functional ability of joints.

Comparative analysis of labile and stable high-frequency TENS in the treatment of neuropathic pain syndrome

2021 ◽  
pp. 40-46
Author(s):  
M. Kh. Al-Zamil
Keyword(s):  
Neuropathic Pain ◽  
Comparative Analysis ◽  
High Frequency ◽  
Analgesic Effect ◽  
Low Frequency ◽  
Lower Extremities ◽  
Pain Syndrome ◽  
Neuropathic Pain Syndrome ◽  
Reduction Of Pain

Introduction: There have been many works devoted to the comparative analysis of high-frequency and low-frequency TENS in the treatment of neuropathic pain syndrome. Meanwhile, the comparative analysis of the methods of labile and stable TENS has not been sufficiently studied to date. Purpose: To make a comparative analysis of labile and stable high-frequency TENS in the treatment of neuropathic pain syndrome in patients with distal polyneuropathy of the lower extremities (DPLE). Materials and methods: 64 patients (F: 34, M: 30) with severe neuropathic pain syndrome on the background of diabetic DPLE were studied. Depending on the method of high-frequency TENS, all patients were divided into 2groups: stable high-frequency TENS (n=31) and labile high-frequency TENS (n=33). TENS was carried out every other day for a month. The severity of pain was determined by the VAS before each procedure. Results: The reduction of pain syndrome with the use of labile stimulation was 76.9%, compared to stable stimulation — 41,6%. With daily registration of pain syndrome, a significant increase in pain syndrome was revealed in patients who underwent stable high-frequency TENS after the 7th procedure to 4,5±0,3points in comparison with the indicators of pain syndrome obtained after the 3rd procedure (3,2±0,14). Conclusions: The analgesic effect of the labile high-frequency TENS significantly exceeds the analgesic effect of the stable high-frequency TENS by 85.1%. Partial tolerance to high-frequency TENS is observed when applying stable stimulation, which develops after the 7th procedure and is not observed after labile TENS.

scholarly journals Mechanistic Rationale and Clinical Efficacy of Hyperbaric Oxygen Therapy in Chronic Neuropathic Pain: An Evidence-Based Narrative Review

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
Simone Schiavo ◽  
Julian DeBacker ◽  
Carine Djaiani ◽  
Anuj Bhatia ◽  
Marina Englesakis ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Hyperbaric Oxygen ◽  
Clinical Efficacy ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Pain Syndrome ◽  
Narrative Review ◽  
Human Studies ◽  
Current Evidence ◽  
Chronic Neuropathic Pain

Background. Chronic neuropathic pain is a condition affecting an increasing proportion of the general population and its management requires a comprehensive, multidisciplinary program. A growing body of evidence supports the use of hyperbaric oxygen therapy (HBOT) in several chronic neuropathic pain conditions; however, its role and efficacy remain unclear. Purpose. To summarize current evidence for the mechanistic rationale of HBOT in chronic neuropathic pain conditions and to evaluate its clinical efficacy. Methods. This narrative review was conducted after searching the following databases (Medline, Embase, Cochrane, PsycINFO, the Web of Science, Scopus, ClinicalTrials. gov, WHO ICTRP, and ProQuest Digital Dissertation) from January 1946 to March 2020. Articles published in English that involved either animal or human studies with acute or chronic neuropathic pain evaluating any HBOT-related intervention were included. Results. A total of 2971 citations were identified. A total of 29 studies were included in this review. The mechanisms of action for HBOT use in neuropathic conditions included the primary effects of hyperoxia and edema resolution, as well as the secondary effects pertinent to the production of oxygen and nitrogen reactive species (serving as pain signaling molecules), nitric oxide-dependent release of opioid peptides, and reduction of inflammatory mediators. A robust evidence for HBOT use in the clinical setting was associated with chronic regional pain syndrome and chronic primary bladder pain syndrome. Some evidence supported its use for chronic secondary (peripheral) neuropathic pain including radiation-induced plexus neuropathies, postherpetic neuralgia, and trigeminal neuralgia. Conclusions. HBOT has been shown to have antinociceptive and analgesic effects in animal models of inflammatory, neuropathic, and chronic pain. Human studies demonstrated beneficial effects of HBOT in improving clinical outcomes such as pain scores, pain-related symptoms, and quality of life. A systematic methodology of HBOT application is necessary to confirm its safety and efficacy.

scholarly journals Erratum to: Specific Features of Analgesic Effect of Docosahexaenoic Acid in Rats with Neuropathic Pain Syndrome

2014 ◽  
Vol 156 (6) ◽  
pp. 885-885
Author(s):  
I. V. Dyuizen ◽  
I. V. Manzhulo ◽  
O. S. Ogurtsova ◽  
N. E. Lamash ◽  
N. A. Latyshev ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Docosahexaenoic Acid ◽  
Analgesic Effect ◽  
Pain Syndrome ◽  
Neuropathic Pain Syndrome

Specific Features of Analgesic Effect of Docosahexaenoic Acid in Rats with Neuropathic Pain Syndrome

2014 ◽  
Vol 156 (5) ◽  
pp. 699-701 ◽  
Author(s):  
I. V. Dyuizen ◽  
I. V. Manzhulo ◽  
O. S. Ogurtsova ◽  
N. E. Lamash ◽  
N. A. Latyshev ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Docosahexaenoic Acid ◽  
Analgesic Effect ◽  
Pain Syndrome ◽  
Neuropathic Pain Syndrome

scholarly journals THE MARKERS OF BONE METABOLISM AND SYSTEM INFLAMMATION IN PATIENTS WITH OSTEOARTHRITIS DEPENDING ON BODY MASS, THE INFLUENCE OF SYMPTOMATIC SLOW ACTING DRUGS

2016 ◽  
Vol 5 ◽  
pp. 3-12
Author(s):  
Anna Cherkasova ◽  
Olexander Kuryata
Keyword(s):  
Body Weight ◽  
Bone Tissue ◽  
Body Mass ◽  
Clinical Efficacy ◽  
Pain Syndrome ◽  
Physical Load ◽  
Knee Joints ◽  
Enzyme Analysis ◽  
Normal Body ◽  
Normal Body Weight

Aim. To assess the levels of markers of the bone synthesis and system inflammation in patients with osteoarthritis (OA) in combination with obesity and their dynamic under the influence of basic treatment. Materials and methods. The research included 40 women with OA, 46–78 years old (mean age – 59,8±1,5 years). Duration of the disease varied from 3 to 36 years (mean duration – 10,0±1,1 years). Mean body mass index (BMI) among patients was 30,6±0,7 [22,3; 39,5]kg/m2, according to which patients were divided in 3 groups: patients with OA without obesity (n=17), patients with OA with 1 degree of obesity (n=14), patients with OA with 2 degree of obesity (n=9). The level of osteochondral metabolism was assessed using quantitative measuring of the levels of procollagen IC-terminal propeptide (РІСР), (Cloud-CloneCorp. “procollagen IC-Terminal Propeptide”, USA) and osteocalcin (Roche Diagnostics «N-MID Osteocalcin», Switzerland) on analyzer «ELECSYS 2010» by the method of immune-enzyme analysis; the level of the system inflammation was assessed by the level of C-reactive protein (CRP) by the method of immunoturbidimetry. The clinical efficacy was assessed by the dynamics of intensity levels of pain syndromes at physical load and at rest by the visual-analogue scale (VAS). The measuring of РІСР, osteocalcin and CRP levels and also the assessment of clinical efficacy as to the decrease of pain syndrome were carried out twice – at the beginning and at the end of observation. The period of observation is 2 months. Results. The presence of direct correlation between РІСР and BMI (r=0,62; р=0,008) among patients with OA in combination with the normal body weight was established at the research, whereas among patients with OA in combination with obesity the analogous correlation was demonstrated between SRP and BMI (r=0,43; р=0,04) on the background of correlation of PICP and OC levels (r=0,46; р=0,03). Obesity in patients with OA was associated with the reliably higher levels of pain at both rest and physical load from the side of knee joints, with maximal intensity of the pain syndrome among patients with OA and 1 degree of obesity. Statistical analysis did not reveal the reliable dependence of РІСР and OC in patients with OA from the initial CRP level on the background of tendency to the higher РІСР level and lower OC level among patients with initially increased CRP level comparing with ones with normal CRP level. The therapy with basic preparations at OA during 2 months among patients with OA with increased CRP level led to the reliable decrease of РІСР level (р=0,0076) and the tendency to increase of OC level (р˃0,05), without the reliably significant difference between the initial and final РІСР and OC levels among patients with OA and normal CRP level. At the end of observation period the maximal analgesic effect was demonstrated as to the articulate pain at rest from the side of knee joints (р˂0,001) among patients with OA, who received diacerein, with clinically comparable effect from the side of other aticulate zones (р˂0,05), that was associated with reliable decrease of CRP level (р=0,013). Discussion. The received results testify that the control of the system inflammation level at OA is a target not only relative to the decrease of pain syndrome but also conditions the stable state of subchondral bone (SCB), providing the compensation of processes of destruction and synthesis in bone tissue. The significance of procollagen IC-terminal propeptide (РІСР) and osteocalcin (OC) as the markers of bone synthesis that are able to reflect metabolic processes in SCB at OA, and also the discordant influence of CRP level on PICP level at the relative stability of OC level were demonstrated at the research. The received results allow consider the inflammatory process at OA as a target for preservance of the bone tissue, conditioning the expedience of taking into account the ability of OA basic preparations to realize the control influence on the level of system inflammation. Diacerein that in ESCEO recommendations (2014) is related to the preparations of the 1 step of treatment of patients with OA provides the control on inflammation and stability of osteocalcin level that testifies to the balance of catabolic processes in SCB. Conclusions. At OA the levels of procollagen IC-terminal propeptide (РІСР) and osteocalcin (OC) were not associated with obesity and did not depend on the initial CRP level at the presence of correlation between РІСР level and BMI among patients with OA with the normal body weight and BMI and CRP level among patients with OA in combination with obesity. The absence of reliable dynamics from РІСР side and maintenance of the stable OC level on the background of the reliable anti-inflammatory effect at using diacerein in patients with OA can testify to the compensatory adequacy of reparation processes in SCB.

Income Diversification and Bank Efficiency in Vietnam

2017 ◽  
pp. 52-67
Author(s):  
Sang Nguyen Minh
Keyword(s):  
Regression Model ◽  
Commercial Banks ◽  
Banking System ◽  
Operational Efficiency ◽  
Commercial Banking ◽  
Tobit Regression ◽  
Income Diversification ◽  
Positive Effects ◽  
Study Results ◽  
The Impact

This study uses the DEA (Data Envelopment Analysis) method to estimate the technical efficiency index of 34 Vietnamese commercial banks in the period 2007-2015, and then it analyzes the impact of income diversification on the operational efficiency of Vietnamese commercial banks through a censored regression model - the Tobit regression model. Research results indicate that income diversification has positive effects on the operational efficiency of Vietnamese commercial banks in the research period. Based on study results, in this research some recommendations forpolicy are given to enhance the operational efficiency of Vietnam’s commercial banking system.

Impact of Digitalization on Service Work in Knowledge-Intensive Business Services: An Empirical Study in Tax Consultancies

2019 ◽  
Vol 3 (4) ◽  
pp. 209-222
Author(s):  
Philipp K. Görs ◽  
Henning Hummert ◽  
Anne Traum ◽  
Friedemann W. Nerdinger
Keyword(s):  
Work Engagement ◽  
Service Work ◽  
Psychological Consequences ◽  
Business Services ◽  
Knowledge Intensive Business Services ◽  
Positive Effects ◽  
Knowledge Intensive ◽  
The Impact ◽  
Positive Effect ◽  
Special Case

Digitalization is a megatrend, but there is relatively little knowledge about its consequences for service work in general and specifically in knowledge-intensive business services (KIBS). We studied the impact of digitalization on psychological consequences for employees in tax consultancies as a special case of KIBS. We compare two tax consulting jobs with very different job demands, those of tax consultants (TCs) and assistant tax consultants (ATCs). The results show that the extent of digitalization at the workplace level for ATCs correlates significantly positively with their job satisfaction. For TCs, the same variable correlates positively with their work engagement. These positive effects of digitalization are mediated in the case of ATCs by the impact on important job characteristics. In the case of TCs, which already have very good working conditions, the impact is mediated by the positive effect on self-efficacy. Theoretical and practical consequences of these results are discussed.

HOW CLIMATE CHANGE CAN INFLUENCE THE AGRICULTURE IN UKRAINE: A REVIEW

2020 ◽  
Author(s):  
N. Maidanovych ◽  
Keyword(s):  
Climate Change ◽  
Crop Yields ◽  
Soil Surface ◽  
Winter Period ◽  
Negative Consequences ◽  
Resource Saving ◽  
Impact Of Climate Change ◽  
Positive Effects ◽  
Average Annual Temperature ◽  
The Impact

The purpose of this work is to review and analyze the main results of modern research on the impact of climate change on the agro-sphere of Ukraine. Results. Analysis of research has shown that the effects of climate change on the agro-sphere are already being felt today and will continue in the future. The observed climate changes in recent decades have already significantly affected the shift in the northern direction of all agro-climatic zones of Europe, including Ukraine. From the point of view of productivity of the agro-sphere of Ukraine, climate change will have both positive and negative consequences. The positives include: improving the conditions of formation and reducing the harvesting time of crop yields; the possibility of effective introduction of late varieties (hybrids), which require more thermal resources; improving the conditions for overwintering crops; increase the efficiency of fertilizer application. Model estimates of the impact of climate change on wheat yields in Ukraine mainly indicate the positive effects of global warming on yields in the medium term, but with an increase in the average annual temperature by 2 ° C above normal, grain yields are expected to decrease. The negative consequences of the impact of climate change on the agrosphere include: increased drought during the growing season; acceleration of humus decomposition in soils; deterioration of soil moisture in the southern regions; deterioration of grain quality and failure to ensure full vernalization of grain; increase in the number of pests, the spread of pathogens of plants and weeds due to favorable conditions for their overwintering; increase in wind and water erosion of the soil caused by an increase in droughts and extreme rainfall; increasing risks of freezing of winter crops due to lack of stable snow cover. Conclusions. Resource-saving agricultural technologies are of particular importance in the context of climate change. They include technologies such as no-till, strip-till, ridge-till, which make it possible to partially store and accumulate mulch on the soil surface, reduce the speed of the surface layer of air and contribute to better preservation of moisture accumulated during the autumn-winter period. And in determining the most effective ways and mechanisms to reduce weather risks for Ukrainian farmers, it is necessary to take into account the world practice of climate-smart technologies.

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