scholarly journals The Impact of Expectation for Pain Relief on Orofacial Pain Treatment Outcomes

2021 ◽  
Vol 12 ◽  
Author(s):  
Yaron Haviv ◽  
Sigal Mazor ◽  
Margolis Shani ◽  
Robert Yanko ◽  
Doron J. Aframian ◽  
...  
Keyword(s):  
Pain Relief ◽  
Treatment Outcomes ◽  
Orofacial Pain ◽  
Pain Treatment ◽  
Treatment Success ◽  
Inverse Correlation ◽  
Pain Clinic ◽  
Complete Relief ◽  
Subjective Outcome ◽  
The Impact

Aims: To examine the effects of expectations for pain relief on the objective and subjective outcome of chronic orofacial pain (OFP) treatment.Materials and Methods: Sixty individuals referred to the Orofacial Pain Clinic at the Hebrew University-Hadassah School of Dental Medicine between 2015 and 2017 with OFP reported their expectation for pain relief upon initial consultation. They were also interviewed by telephone after treatment and asked to recall their expectations, referred to as “recalled expectations” (RE). Correlations between RE and treatment success were calculated from pain diaries, and from subjective pain improvement rates (PIR) reported by the patients.Results: 21 males (35.0%) and 39 females (65%), mean age of 46.90 ± 15.77 years and mean pain duration of 49.07 ± 51.95 months participated in the study. All participants rated their expectations as “10” on a 0 to 10 scale during their first visit. RE did not correlate with diary ratings, (P = 0.773) but inversely correlated (−0.3) with PIR (P = 0.020) treatment outcomes.Conclusions: Expectations for pain relief, reported as 10 on a 0–10 scale during the first appointment, may reflect the patient's desire for complete relief of their pain rather than their expectations. Clinicians should therefore be aware of the need for clear communication and wording when examining for expectations. Inverse correlation between recalled expectations and subjective outcome may be due to the nature of recalled expectations when patients already knew their treatment outcomes, and may be explained by the concept of cognitive dissonance.

The impact of immediate in-brace 3D corrections on curve evolution after two years of treatment: preliminary results

2021 ◽  
Author(s):  
A Guy ◽  
H Labelle ◽  
S Barchi ◽  
CÉ Aubin
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Treatment Outcomes ◽  
Lumbar Lordosis ◽  
Treatment Success ◽  
Curve Evolution ◽  
Preliminary Results ◽  
Coronal Correction ◽  
The Impact

For the brace treatment of adolescent idiopathic scoliosis (AIS), in-brace correction and brace-wear compliance are well-documented parameters associated with a greater chance of treatment success. However, the number of studies on the impact of sagittal and transverse correction on curve evolution in the context of bracing is limited. The objective of this work was to evaluate how immediate inbrace correction in the three anatomical planes is related to long-term curve evolution after two years of bracing. We performed a retrospective analysis on 94 AIS patients followed for a minimum of two years. We analyzed correlations between in-brace correction and two-year out-of-brace evolution for Cobb and apical axial rotations (ARs) in the medial thoracic and thoraco-lumbar/lumbar regions (MT & TL/L). We also studied the association between the braces’ kyphosing and lordosing effect and the evolution of thoracic kyphosis (TK) and lumbar lordosis (LL) after two years. Finally, we separated the patients into three groups based on their curve progression results after two years (corrected, stable and progressed) and compared the 3D in-brace corrections and compliance for each group. Coefficients were statistically significant for all correlations. They were weak for Cobb angles (MT: -0.242; TL/L: -0.275), low for ARs (MT: -0.423; TL/L: -0.417) and moderate for sagittal curves (TK: 0.549; LL: 0.482). In-brace coronal correction was significantly higher in corrected vs stable patients (p=0.004) while compliance was significantly higher in stable vs progressed patients (p=0.026). This study highlights the importance of initial in-brace correction in all three planes for successful treatment outcomes.

scholarly journals One-Year Results of an Algorithmic Approach to Managing Failed Back Surgery Syndrome

2014 ◽  
Vol 19 (6) ◽  
pp. 313-316 ◽  
Author(s):  
Martín Avellanal ◽  
Gonzalo Diaz-Reganon ◽  
Alejandro Orts ◽  
Silvia Soto
Keyword(s):  
Pain Relief ◽  
Treatment Success ◽  
Clinical Problem ◽  
Failed Back Surgery Syndrome ◽  
Incidence Rates ◽  
Pain Clinic ◽  
Foraminal Stenosis ◽  
Common Diagnosis ◽  
Failed Back Surgery ◽  
Back Surgery

BACKGROUND: Failed back surgery syndrome (FBSS) is a major clinical problem. Different etiologies with different incidence rates have been proposed. There are currently no standards regarding the management of these patients. Epiduroscopy is an endoscopic technique that may play a role in the management of FBSS.OBJECTIVE: To evaluate an algorithm for management of severe FBSS including epiduroscopy as a diagnostic and therapeutic tool.METHODS: A total of 133 patients with severe symptoms of FBSS (visual analogue scale score ≥7) and no response to pharmacological treatment and physical therapy were included. A six-step management algorithm was applied. Data, including patient demographics, pain and surgical procedure, were analyzed. In all cases, one or more objective causes of pain were established. Treatment success was defined as ≥50% long-term pain relief maintained during the first year of follow-up. Final allocation of patients was registered: good outcome with conservative treatment, surgical reintervention and palliative treatment with implantable devices.RESULTS: Of 122 patients enrolled, 59.84% underwent instrumented surgery and 40.16% a noninstrumented procedure. Most (64.75%) experienced significant pain relief with conventional pain clinic treatments; 15.57% required surgical treatment. Palliative spinal cord stimulation and spinal analgesia were applied in 9.84% and 2.46% of the cases, respectively. The most common diagnosis was epidural fibrosis, followed by disc herniation, global or lateral stenosis, and foraminal stenosis.CONCLUSIONS: A new six-step ladder approach to severe FBSS management that includes epiduroscopy was analyzed. Etiologies are accurately described and a useful role of epiduroscopy was confirmed.

scholarly journals Impact of family DOTS on tuberculosis treatment outcomes and associated factors in tribal and hard to reach areas in the state of Chhattisgarh: an implementation research

2021 ◽  
Vol 8 (6) ◽  
pp. 2847
Author(s):  
Fidius Kerketta ◽  
Ashish Sinha ◽  
Narayan Tripathi ◽  
Arti Borkar ◽  
Shashank Gupta ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Implementation Research ◽  
Treatment Success ◽  
Intervention Group ◽  
Control Programme ◽  
National Tuberculosis ◽  
Poor Treatment ◽  
Sputum Conversion ◽  
Negative Sputum ◽  
The Impact

 Background: Tuberculosis (TB) remains a worldwide healthcare problem and it is one of the major public health concerns in India including Chhattisgarh state. National tuberculosis elimination program (NTEP) has adopted direct observed treatment (DOTS) strategy for elimination of TB. Due to inaccessibility and difficult to reach areas in the tribal areas, monitoring of treatment adherence and treatment completion remains a challenge leading to poor treatment outcomes among TB cases. This implementation research was aimed to assess the impact of family DOTS on the TB treatment outcomes in a tribal district of Chhattisgarh.Methods: A prospective cohort study of all new smear positive sputum, new smear negative sputum and extra-pulmonary TB patients who were newly diagnosed and registered for treatment under the revised national tuberculosis control programme (RNTCP) in hard to reach district was implemented between November 2016 to January 2018. They were followed till the completion of the treatment.Results: Total 305 tuberculosis new patients (218 intervention and 87 in comparison blocks) were registered for treatment at health facilities in study area. The treatment success rate in the comparison group was better (72.41%) compared to the intervention group (68.35%). Similar results have been observed in terms of non-adherence to treatment and death rate. Sputum conversion rate was observed to have 94% in intervention group in comparison to 95% comparison group.Conclusions: Family DOTS may not be effective unless there is involvement from the RNTCP by regular monitoring and follow up.

scholarly journals Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone

2021 ◽  
Vol 6 (3) ◽  
pp. 154
Author(s):  
Sulaiman Lakoh ◽  
Darlinda F. Jiba ◽  
Mamadu Baldeh ◽  
Olukemi Adekanmbi ◽  
Umu Barrie ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Sierra Leone ◽  
Negative Impact ◽  
Care Delivery ◽  
Treatment Success ◽  
Multivariate Logistic Regression Analysis ◽  
Policy Implications ◽  
Case Detection ◽  
Self Administration ◽  
The Impact

The COVID-19 pandemic has adversely affected tuberculosis (TB) care delivery in high burden countries. We therefore conducted a retrospective study to assess the impact of COVID-19 on TB case detection and treatment outcomes at the Chest Clinic at Connaught Hospital in Freetown, Sierra Leone. Overall, 2300 presumptive cases were tested during the first three quarters of 2020 (intra-COVID-19) versus 2636 in 2019 (baseline), representing a 12.7% decline. Testing declined by 25% in women, 20% in children and 81% in community-initiated referrals. Notwithstanding, laboratory-confirmed TB cases increased by 37.0% and treatment success rate was higher in 2020 (55.6% vs. 46.7%, p = 0.002). Multivariate logistic regression analysis found that age < 55 years (aOR 1.74, 95% CI (1.80, 2.56); p = 0.005), new diagnosis (aOR 1.69, 95% CI (1.16, 2.47); p = 0.007), pulmonary TB (aOR 3.17, 95% CI (1.67, 6.04); p < 0.001), HIV negative status (aOR 1.60, 95%CI (1.24, 2.06); p < 0.001) and self-administration of anti-TB drugs through monthly dispensing versus directly observed therapy (DOT) (aOR 1.56, 95% CI (1.21, 2.03); p = 0.001) independently predicted treatment success. These findings may have policy implications for DOTS in this setting and suggest that more resources are needed to reverse the negative impact of the COVID-19 pandemic on TB program activities in Sierra Leone.

scholarly journals Impact of a mobile phone-based interactive voice response software on tuberculosis treatment outcomes in Uganda (CFL-TB): a protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Dathan Mirembe Byonanebye ◽  
Hope Mackline ◽  
Christine Sekaggya-Wiltshire ◽  
Agnes N. Kiragga ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Treatment Outcomes ◽  
Interactive Voice Response ◽  
Controlled Trial ◽  
Treatment Success ◽  
Treatment Completion ◽  
Randomized Controlled ◽  
Tb Treatment ◽  
The Impact ◽  
Voice Response

Abstract Background Throughout the last decade, tuberculosis (TB) treatment success has not surpassed 90%, the global target. The impact of mobile health interventions (MHIs) on TB treatment outcomes is unknown, especially in low- and middle-income countries (LMICs). MHIs, including interactive voice response technology (IVRT), may enhance adherence and retention in the care of patients with tuberculosis and improve TB treatment outcomes. This study seeks to determine the impact of IVRT-based MHI on TB treatment success (treatment completion and cure rates) in patients with TB receiving care at five public health facilities in Uganda. Methods We used a theory-based and human-centered design (HCD) to adapt an already piloted software to design “Call for life-TB” (CFL-TB), an MHI that utilizes IVRT to deliver adherence and appointment reminders and allows remote symptom reporting. This open-label, multicenter, randomized controlled trial (RCT), with nested qualitative and economic evaluation studies, will determine the impact of CFL-TB on TB treatment success in patients with drug-susceptible TB in Uganda. Participants (n = 274) at the five study sites will be randomized (1:1 ratio) to either control (standard of care) or intervention (adherence and appointment reminders, and health tips) arms. Multivariable regression models will be used to compare treatment success, adherence to treatment and clinic appointments, and treatment completion at 6 months post-enrolment. Additionally, we will determine the cost-effectiveness, acceptability, and perceptions of stakeholders. The study received national ethical approval and was conducted in accordance with the international ethical guidelines. Discussion This randomized controlled trial aims to evaluate interactive voice response technology in the context of resource-limited settings with a high burden of TB and high illiteracy rates. The software to be evaluated was developed using HCD and the intervention was based on the IMB model. The software is tailored to the local context and is interoperable with the MHI ecosystem. The HCD approach ensures higher usability of the MHI by integrating human factors in the prototype development. This research will contribute towards the understanding of the implementation and impact of the MHI on TB treatment outcomes and the health system, especially in LMICs. Trial registration ClinicalTrials.govNCT04709159. Registered on January 14, 2021.

scholarly journals Reasons for failure to perform interventional pain procedures in cancer patients: an analysis of pain clinic consultations

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052095755
Author(s):  
Ki Wook Kim ◽  
Shin Hyung Kim ◽  
Ji Yeon Won ◽  
Hun Jang ◽  
Sang Jun Park
Keyword(s):  
Pain Relief ◽  
Conservative Treatment ◽  
Cancer Patients ◽  
Pain Treatment ◽  
Pain Clinic ◽  
Common Reason ◽  
Medical Resource ◽  
Patient Refusal ◽  
Pain Characteristics ◽  
Effective Pain Relief

Background Interventional pain procedures (IPPs) may be necessary for some cancer patients when conservative treatment fails. However, many IPPs are often delayed or cancelled for cancer patients who are referred to the pain clinic. Methods We retrospectively analyzed the reasons for such cancellations to identify clinically avoidable causes of the delay in IPP. Results We enrolled 350 cancer patients who were referred to our pain clinic for an IPP between March 2016 and February 2018. There were 213 (60.9%) cases that were cancelled, among which 115 (54%) cases were potentially avoidable and 98 (46%) were unavoidable. The most common reasons for cancellation were patient-derived factors, which accounted for 85 (39.9%) cases. Patient refusal was a common reason for cancellation, with 33 (15.5%) cases attributed to this cause. The primary avoidable causes of cancellation were a recommendation that the patient continue with their current pharmacological pain treatment, conflict with another planned treatment, and pain characteristics that were not suitable for an IPP. Together, these accounted for 76.5% of all avoidable cancellations. Conclusions Comprehensive and accurate pain assessments before IPP may result in more favorable outcomes for the efficient use of medical resource and effective pain relief in cancer patients.

scholarly journals Patients with Chronic Pain Prefer Maintenance of Pain Treatment Despite COVID-19 Pandemic Restrictions

2021 ◽  
pp. 165-173
Keyword(s):  
Chronic Pain ◽  
Pain Therapy ◽  
Pain Treatment ◽  
Mental Illnesses ◽  
Pain Clinic ◽  
Pain Clinics ◽  
Number Of Patients ◽  
Hygiene Measures ◽  
Short Period ◽  
The Impact

BACKGROUND: Worldwide, the COVID-19 pandemic has a significant impact on daily life. First studies describe a negative impact of pandemic stressors even on individuals without previous mental illnesses. The home lockdown and the shutdown of pain clinics make it difficult for all patients to get the healthcare they need. OBJECTIVES: The aim of this study was to investigate to what extent patients with chronic pain felt affected by the pandemic and its consequences on pain treatments, focussing on the beginning of the outbreak. STUDY DESIGN: A prospective noninterventional study. SETTING: Medical University Center . METHODS: One-hundred and forty-nine patients, suffering from chronic pain, treated at a large German interdisciplinary pain center, were studied over a period of 2 months at the beginning of the pandemic. Data from patient charts and questionnaires were evaluated. Patients were asked about postponements or cancellations of pain therapy, the possible effect on pain levels, depression, anxiety and stress, and the impact of intensified hygiene measures. Results were compared to those from standardized and validated questionnaires from the same patients (German version of the depression, anxiety, and stress scale = DASS) at the time of the first contact in the pain clinic. RESULTS: Eighty-four (56.4%) patients reported cancelled or postponed treatments during the pandemic. Those chronic pain patients with delayed or cancelled treatments reported significantly more pain and psychological distress. The delay or discontinuation of treatments resulted in a deterioration of symptoms. From the patients’ point of view this deterioration was unrelated to the timing of treatment and not secondary to increased hygiene measures. In both groups, patients showed a significant amelioration of the DASS values compared to the values they had at the beginning of treatment, despite the negative effects of the COVID-19 pandemic on care structures. The majority of the patients do not think that the quality of pain treatment was significantly affected by the intensified hygiene requirements. LIMITATIONS: The limitations of the study are the small number of patients because of the limitation to a short period of time at the beginning of the pandemic and the return rate of 40.2% of the study consents. CONCLUSIONS: Even in the event of a pandemic-related restriction of the care structures, patients with chronic pain benefit from pain therapy. Limitations such as the increased hygiene measures caused by the pandemic were not considered detrimental to the therapeutic measures. KEY WORDS: COVID-19 pandemic, hygiene measures, chronic pain, anxiety, depression, stress

Why does the impact of multidisciplinary pain management on quality of life differ so much between chronic pain patients?

2013 ◽  
Vol 4 (4) ◽  
pp. 255-255
Author(s):  
P. Vartiainen ◽  
T. Heiskanen ◽  
R.P. Roine ◽  
E. Kalso
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Treatment Success ◽  
Severe Depression ◽  
Pain Clinic ◽  
Hrqol Questionnaire ◽  
Chronic Pain Patients ◽  
The Impact ◽  
Pain Patients

Abstract Aims To assess the change in quality of life and factors predicting this change in 1425 chronic pain patients treated in a multidisciplinary pain clinic. Methods This is an observational follow-up study using the 15D generic health-related quality of life (HRQoL) instrument. Patients filled in the HRQoL questionnaire at baseline, and 6 and 12 months after discharge. To assess if mental factors predicted treatment success, the changes in the overall 15D score were compared and related to the baseline variables of depression and distress. The group of patients, who scored 4 or 5 on the 1–5 scale for the depression and distress dimensions of the 15D instrument, were considered mentally distressed (N =199). They were compared with the non-distressed patients (i.e. those who scored 1; N = 401). Results Pain was associated to depression and distress: 85.4% of mentally distressed patients scored 4 or 5 also on the discomfort and symptoms dimension, vs. 51.4% of the non-distressed (p < 0.001). The mean 15D score of the mentally distressed patients improved statistically significantly more (from 0.572 to 0.636, N =141) during the first six months after treatment compared with the 15D of those who were not mentally distressed, who improved only marginally (0.790–0.803, N = 294; p < 0.001). Conclusions Patients with more severe depression or distress at baseline appear to gain more from the treatment than those who have less mental distress. In our ongoing study more baseline factors will be evaluated to assess their effect on the success of treatment.

scholarly journals Mycobacterium abscessus pulmonary disease: individual patient data meta-analysis

2019 ◽  
Vol 54 (1) ◽  
pp. 1801991 ◽  
Author(s):  
Nakwon Kwak ◽  
Margareth Pretti Dalcolmo ◽  
Charles L. Daley ◽  
Geoffrey Eather ◽  
Regina Gayoso ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Pulmonary Disease ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Treatment Success ◽  
Specific Treatment ◽  
Mycobacterium Abscessus ◽  
Patient Data ◽  
The Impact ◽  
Culture Conversion

Treatment of Mycobacterium abscessus pulmonary disease (MAB-PD), caused by M. abscessus subsp. abscessus, M. abscessus subsp. massiliense or M. abscessus subsp. bolletii, is challenging.We conducted an individual patient data meta-analysis based on studies reporting treatment outcomes for MAB-PD to clarify treatment outcomes for MAB-PD and the impact of each drug on treatment outcomes. Treatment success was defined as culture conversion for ≥12 months while on treatment or sustained culture conversion without relapse until the end of treatment.Among 14 eligible studies, datasets from eight studies were provided and a total of 303 patients with MAB-PD were included in the analysis. The treatment success rate across all patients with MAB-PD was 45.6%. The specific treatment success rates were 33.0% for M. abscessus subsp. abscessus and 56.7% for M. abscessus subsp. massiliense. For MAB-PD overall, the use of imipenem was associated with treatment success (adjusted odds ratio (aOR) 2.65, 95% CI 1.36–5.10). For patients with M. abscessus subsp. abscessus, the use of azithromycin (aOR 3.29, 95% CI 1.26–8.62), parenteral amikacin (aOR 1.44, 95% CI 1.05–1.99) or imipenem (aOR 7.96, 95% CI 1.52–41.6) was related to treatment success. For patients with M. abscessus subsp. massiliense, the choice among these drugs was not associated with treatment outcomes.Treatment outcomes for MAB-PD are unsatisfactory. The use of azithromycin, amikacin or imipenem was associated with better outcomes for patients with M. abscessus subsp. abscessus.

تأثير الاستثمار الاجنبي المباشر في القيمة السوقية للشركة (دراسة تطبيقية في شركة بترو جانيا الصينية في عقود التراخيص النفطية للجولة الاولى والثانية في الحقول النفطية في العراق للمدة من 2017-2010)

2020 ◽  
Vol 2020 (66) ◽  
pp. 65-85
Author(s):  
هيثم عبد النبي موسى ◽  
أ .د حيدر نعمة غالي الفريجي
Keyword(s):  
Foreign Direct Investment ◽  
Stock Prices ◽  
Return On Investment ◽  
Direct Investment ◽  
Inverse Correlation ◽  
Market Value ◽  
Political Stability ◽  
Coefficient Of Determination ◽  
Independent Variable ◽  
The Impact

This study dealt with the effect of foreign direct investment on the market value of the company during the period of time (2010-2017). This issue was studied through a sample of oil fields in southern Iraq in which the company operates within the first and second licensing contracts rounds and according to the circumstances and variables of the investment environment as it is. Although this investment often achieves high returns, it is also characterized by a high degree of risk and for the purpose of evaluating the impact of foreign direct investment on the market value of the company's stock prices for the period (2010-2017). The statistical scale (T-TEST) was used to indicate the significance of the correlation hypotheses. Between the return on investment as the independent variable and the market value as the dependent variable, and the use of the coefficient of determination (R2) that measures the effect of the independent variable (foreign direct investment) on the dependent variable (market value) and the F-Test to demonstrate acceptance or rejection of the hypothesis of the return on investing in the market value of the oil company, and if the company achieves a high return in foreign direct investment, the market value of it will be affected positively. The study was based on a set of goals, including determining the attractiveness of Iraq to foreign investments, especially the oil sector, and the study reached a number of conclusions, the most prominent of which is the existence of a strong inverse correlation between the return on investment and the market value of the company. And the existence of a slight impact of the return on investment on the market value of the company, and the study reached a number of recommendations, the most important of which is activating the investment climate through political stability and the clarity and stability of laws and legislation regulating investment, which is one of the most important factors affecting the investment decision.

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