scholarly journals Lichen Planus Activity and Damage Index (LiPADI)–Creation of the Questionnaire

2021 ◽  
Vol 11 (1) ◽  
pp. 23
Author(s):  
Katarzyna Stępień ◽  
Ewa Żabska ◽  
Mansur Rahnama-Hezavah ◽  
Adam Reich
Keyword(s):  
Lichen Planus ◽  
Hair Loss ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Damage Index ◽  
Life Quality ◽  
Skin Lesions ◽  
Disease Assessment ◽  
Physician Global Assessment ◽  
Evaluation Tool

Introduction: Lichen planus (LP) is a chronic autoimmune disease that affects skin, oral and genital mucosa, and other sites. Basic difficulties in assessment of LP are multitude of disease forms and diverse locations of lesions. Moreover, there is lack of objective and consolidated tool for assessment of disease severity and LP progression. Objective: The aim of the study was to develop a valid evaluation tool of LP severity, which will enable disease assessment in a repetitive way. Materials and methods: A combined tool called Lichen Planus Activity and Damage Index (LiPADI) was developed to assess the severity of LP skin, mucosal, and nail lesions as well as hair loss/scaring alopecia to provide an integrative scoring for LP activity and damage caused by the disease. Skin lesions were assessed in nine locations: scalp, face, chest, abdomen, back and buttocks, arms, hands, legs, and feet. The assessment of lesion activity included erythema, hypertrophy, and scaling, while the damage was reflected by the assessment of hyperpigmentation and scaring/atrophy. In addition, mucosal lesions, nail abnormalities, hair loss, and scarring alopecia were evaluated as well. LiPADI scoring was compared with quality of life assessed with the Dermatology Life Quality Index, EQ-5D calculator, pain and pruritus intensity assessed with the Numerical Rating Scale as well as with the patient and physician global assessment. Results: Our results show that LiPADI well reflects the LP patient’s clinical condition. The obtained results were in line with other indicators assessed. In addition, it was possible to evaluate patients with various forms and locations of LP, what indicates its versatility. Conclusions: LiPADI seems to be a useful tool for measurement the severity of the LP and its progress over time, which could help to monitor the effectiveness of the patients’ treatment.

Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section II: Tools for Assessing the Severity of Atopic Dermatitis

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 10S-16S ◽  
Author(s):  
Melinda J. Gooderham ◽  
Robert Bissonnette ◽  
Parbeer Grewal ◽  
Perla Lansang ◽  
Kim A. Papp ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Disease Severity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Life Quality ◽  
Severity Index ◽  
Adult Patients ◽  
Physician Global Assessment ◽  
Atopic Dermatitis Severity ◽  
Patient Reported

Clinicians rely on clinical measures to define the severity of atopic dermatitis and assess outcomes of therapy. These measures can be objective (ie, physician assessments of disease severity) or subjective (ie, patient-reported symptoms and quality of life outcomes). In this review, the most commonly used tools for assessing atopic dermatitis severity in adult patients are presented and compared. These include Eczema Area and Severity Index (EASI); SCORing Atopic Dermatitis (SCORAD); Physician Global Assessment (PGA); body surface area (BSA); Atopic Dermatitis Severity Index (ADSI); Six Area, Six Sign Atopic Dermatitis (SASSAD); Patient Oriented Eczema Measure (POEM); Dermatology Life Quality Index (DLQI); and pruritus Numerical Rating Scale (NRS). Available severity strata for the tools are summarized, although the use of severity strata in clinical practice is not recommended. Since both objective and subjective assessments of disease severity are important to assess, consideration of clinical characteristics such as disease recurrence or persistence, as well as location of the affected areas, should be considered in the overall judgement of disease severity and consideration of therapy choice.

scholarly journals Argonoperitoneum Effect on Pain Syndrome Intensity in Laparoscopic Cholecystectomy

2019 ◽  
Vol 25 (2) ◽  
Author(s):  
Oleh Tkachuk ◽  
Rostyslav Parakhoniak ◽  
Svitlana Melnyk ◽  
Olesia Tkachuk-Hryhorchuk
Keyword(s):  
Stress Intensity ◽  
Rating Scale ◽  
Surgical Stress ◽  
Numerical Rating Scale ◽  
Gallstone Disease ◽  
Life Quality ◽  
Pain Syndrome ◽  
Serum Cortisol ◽  
Study Groups ◽  
Numerical Rating

The objective of the research was to compare the objective and subjective indicators of intra- and postoperative pain and surgical stress intensity.          Materials and Methods. There were examined 360 patients suffering from gallstone disease. There were used the intraoperative monitoring of nociception index by means of Analgesia Nociception Index  - monitor, the determination of serum cortisol concentration, the assessment of pain syndrome in the postoperative period by means of the Numerical Rating Scale in accordance with life quality assessment and the number of injections at the patient’s request. Results. The analysis conducted indicated the reduction in pain irritation, low indices of pain syndrome and postoperative stress intensity under the effect of argonperitoneum. Considerable reduction in the need for analgesics in the study groups served as evidence to this predicted pattern. The assumption that the noticed phenomenon can be explained by the absence of acid irritation of the peritoneum due to argon chemical neutrality being distinct from carbon dioxide was substantiated.          Conclusions. The results proved the effectiveness of argonperitoneum application in laparoscopic surgeries.

scholarly journals Effect of minocycline on lumbar radicular pain: a prospective pilot study

2020 ◽  
Vol 24 (3) ◽  
pp. 197-201
Author(s):  
Sanaz Sha'abani ◽  
◽  
Sasan Gazerani ◽  
Maryam Ragheb ◽  
Amir-Hossein Mirgalou-Bayat ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Emotional Experience ◽  
Life Quality ◽  
Radicular Pain ◽  
Lumbar Pain ◽  
Controlled Clinical Trial ◽  
Before And After

Introduction: Pain is an unpleasant sensory and emotional experience. Evidence suggests a role for microglia in chronic pain and inhibition of microglia leads to decrease of chronic pain intensity in animal models. Minocycline, a semisynthetic tetracycline derivative, is a selective inhibitor of microglia. Several studies have shown pain intensity improvement by minocycline in animal model of pain, but a few studies showed effectiveness on chronic pain improvement in humans. This prospective, self-controlled clinical trial investigated whether minocycline is effective for chronic pain management. Methods: Twenty-two patients, between the ages of 20 and 80 years with radicular lumbar pain with a numerical rating scale >4, who were unresponsive to other medications and had pain duration of >6 weeks were included in the trial. Results: Pain intensity, neuropathic pain and life quality scores assessed before and after treatment. All scores showed significant improvement after 2 weeks of treatment: 56%, 74% and 14%, respectively. Conclusion: Findings of this study suggest minocycline can effectively improve patients’ pain scores and quality of life, even in those with long-term duration of chronic pain and warrants further study.

scholarly journals THU0280 IMPACT ON PHYSICIAN GLOBAL ASSESSMENT ON REMISSION RATES IN SLE. ANALYSIS FROM A GERMAN SLE-COHORT.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 367.2-367
Author(s):  
J. Mucke ◽  
C. Duesing ◽  
M. Schneider ◽  
G. Chehab
Keyword(s):  
Immunosuppressive Therapy ◽  
Global Assessment ◽  
Rating Scale ◽  
Task Force ◽  
Damage Index ◽  
Depression Scale ◽  
Added Value ◽  
Physician Global Assessment ◽  
Research Support ◽  
Number Of Patients

Background:Defining remission for SLE as a suitable target for a treat to target (T2T) approach has been a major challenge in the past years. A few years back, four definitions of remission were presented by the international DORIS task force.[1] Parameters included in the definition are clinical activity (cSLEDAI), steroid dose, immunosuppressive therapy, serology and physician global assessment (PGA). In particular the PGA, its threshold and general utility have been and still are discussed controversially.Objectives:It was our aim to evaluate the added value of PGA in remission assessment.Methods:In this monocentric cross-sectional study, patients with SLE according to the 1997 American College of Rheumatology (ACR) criteria were enrolled and assessed between September 2016 and December 2017. Two different definitions of remission were applied. The internationally accepted DORIS remission and a modified DORIS remission excluding PGA. Factors influencing PGA were assessed in the entire cohort. Regression analyses were used to assess differences between patients in DORIS and modified DORIS remission.Results:A total of 233 patients were included (87.6% female). 98 patients (41.9%) fulfilled any of the four DORIS remission definitions, while 154 patients (66.1%) were in any modified remission in which PGA was excluded. In general, PGA rating was associated with disease activity (clinical SLEDAI; p=<0.0001), depression (Center for Epidemiological Studies Depression Scale; p=0.049), pain reported by the patient (numeric rating scale; p=<0.0001) and hypocomplementemia (p=<0.0001). Damage (SLICC damage index, SDI) did not influence PGA (p=0.98). Both, DORIS and modified DORIS remission were associated with lower damage (p=0.026; p=0.003), lower pain on NRS (p=0.001; p=0.013), normal complement (p=0.0005; p=0.005) and better illness perception (p=0.006; p=0.023). Patients in modified DORIS remission had a tendency for more immunosuppressive therapy (p=0.046).Conclusion:Exclusion of PGA in remission assessment led to an increased number of patients in remission. Clinical parameters and factors associated with DORIS remission vs. modified DORIS remission were similar, hence the added value of PGA in our cohort regarding remission assessment is questionable. The use and especially the correct threshold of PGA for remission still has to be discussed.References:[1]van Vollenhoven, Ronald; Voskuyl, Alexandre; Bertsias, George; Aranow, Cynthia; Aringer, Martin; Arnaud, Laurent et al. (2017): A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). In:Annals of the rheumatic diseases76 (3), S. 554–561. DOI: 10.1136/annrheumdis-2016-209519.Disclosure of Interests:Johanna Mucke: None declared, Christina Duesing: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Gamal Chehab Grant/research support from: Grant/research support from: GlaxoSmithKline and UCB Pharma for performing the LuLa-study.

scholarly journals The 12-Item Pruritus Severity Scale – Determining the Severity Bands

2020 ◽  
Vol 7 ◽  
Author(s):  
Katarzyna Stępień ◽  
Adam Reich
Keyword(s):  
Dermatology Life Quality Index ◽  
Quality Index ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Life Quality ◽  
Verbal Rating Scale ◽  
Severity Scale ◽  
Subjective Character ◽  
Numerical Rating ◽  
The Mean

Introduction: Assessment of pruritus still remains a challenge due to its subjective character. Various itch questionnaires are widely used to evaluate the severity of pruritus. The aim of the current study was to define the cut off values for the 12-Item Pruritus Severity Scale (12-PSS).Methods: A total of 240 patients (86 males and 154 females) in the age between 19 and 87 years (mean 52.9 ± 20.7 years) suffering from pruritic dermatological conditions were asked to assess their maximal pruritus with the 12-PSS, the Verbal Rating Scale (VRS) and the Numerical Rating Scale (NRS). All subjects also completed the Dermatology Life Quality Index (DLQI). VRS, NRS, and DLQI scorings were used as anchor measures to define cut-offs of 12-PSS.Results: According to VRS, 43 (17.9%) patients suffered from mild, 96 (40%) from moderate, 65 (27.1%) from severe and 36 (15%) from very severe pruritus. Mean 12-PSS scoring for each VRS category was 7.6 ± 3.9, 10.4 ± 3.9, 13.0 ± 3.8, and 13.9 ± 3.8 points, respectively (p &lt; 0.001). Each VRS category significantly differed from the others regarding the mean 12-PSS scoring, except the mean scoring of severe and very severe pruritus (p = 0.72). Thus, three pruritus severity categories of 12-PSS were defined with following score ranges: mild pruritus−3–6 points of 12-PSS, moderate pruritus−7–11 points of 12-PSS and severe pruritus−12–22 points of 12-PSS based on calculation of weighted κ coefficient against VRS, NRS, and DLQI as anchor measures.Conclusions: The 12-PSS is able to differentiate between patients suffering from mild, moderate, and severe pruritus.

scholarly journals Efficacy of Dupilumab on Different Phenotypes of Atopic Dermatitis: One-Year Experience of 221 Patients

2020 ◽  
Vol 9 (9) ◽  
pp. 2684
Author(s):  
Simona Tavecchio ◽  
Luisa Angileri ◽  
Francesco Pozzo Giuffrida ◽  
Francesca Germiniasi ◽  
Angelo Valerio Marzano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Clinical Manifestations ◽  
Life Quality ◽  
Daily Practice ◽  
Severity Index ◽  
Efficacy And Safety

Background: The clinical features of adult-onset atopic dermatitis (AD) are heterogeneous and the diagnosis can be a challenge. A new biologic drug (dupilumab) has been approved for moderate to severe AD in adult patients. The efficacy and safety have been demonstrated in clinical trials, but these studies do not reflect conditions in daily practice and do not consider the different clinical manifestations of AD. Objectives: Analyzing the dupilumab activity in a real-world setting and comparing its efficacy on different AD phenotypes. Methods: We retrospectively evaluated 221 AD patients treated with dupilumab, stratified into six clinical phenotypes: classic, generalized eczema inflammatory and lichenoid patterns, prurigo, nummular eczema, and erythroderma. At baseline and at weeks 4, 16, and 52, the disease severity was assessed through the Eczema Area and Severity Index (EASI) and the quality of life was assessed through the Dermatology Life Quality Index (DLQI) questionnaire, Peak Pruritus Numerical Rating Scale (itch NRS), and Peak Sleep NRS. Results: We found a significant improvement after 16 weeks of treatment (p < 0.0001) in all six phenotypes for all the assessed scores mentioned above, persisting up to week 52. The best improvement was seen in the more severe phenotypes, particularly the erythrodermic one. Conclusions: The present study confirmed the efficacy and safety of dupilumab in the treatment of severe AD. Its strength was in the stratification of AD patients in six different phenotypes based on their clinical presentation, all of whom markedly improved in terms of both clinically evident and reported symptoms, as well as their quality of life.

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

2020 ◽  
Vol 8 (1) ◽  
pp. 21-21
Author(s):  
Mani Mofidi ◽  
Ali Dashti ◽  
Mahdi Rezai ◽  
Niloufar Ghodrati ◽  
Hoorolnesa Ameli ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Relief ◽  
Musculoskeletal Pain ◽  
Normal Saline ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Vital Signs ◽  
Categorical Variables ◽  
Intravenous Morphine ◽  
Numerical Rating

Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.

Comparison of Analgesic Effect of Levobupivacaine with Dexmedetomidine and Levobupivacaine for Scalp Block before Supratentorial Craniotomy: A Randomized Controlled Trial

2020 ◽  
Vol 103 (10) ◽  
pp. 1028-1035
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
Study Group ◽  
Analgesic Requirement ◽  
Supratentorial Craniotomy ◽  
Numerical Rating ◽  
Fentanyl Consumption ◽  
Scalp Block

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine

scholarly journals Ultrasound-guided superficial cervical plexus block for analgesia in patients undergoing craniotomy via suboccipital retrosigmoid approach: study protocol of a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034003
Author(s):  
Kun Peng ◽  
Min Zeng ◽  
Jia Dong ◽  
Xiang Yan ◽  
Dexiang Wang ◽  
...  
Keyword(s):  
Nerve Block ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
Cervical Plexus ◽  
Ethics Review ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Plexus Block

IntroductionScalp nerve block has been proven to be an alternative choice to opioids in multimodal analgesia. However, for the infratentorial space-occupying craniotomy, especially the suboccipital retrosigmoid craniotomy, scalp nerve block is insufficient.Methods and analysisThe study is a prospective, single-centre, randomised, paralleled-group controlled trial. Patients scheduled to receive elective suboccipital retrosigmoid craniotomy will be randomly assigned to the superficial cervical plexus block group or the control group. After anaesthesia induction, superficial cervical plexus nerve block will be performed under the guidance of ultrasound. The primary outcome is the cumulative consumption of sufentanil by the patient-controlled intravenous analgesia pump within 24 hours after surgery. Secondary outcomes include the cumulative consumption of sufentanil at other four time points and numerical rating scale pain severity score.Ethics and disseminationThe protocol (version number: 2.0, 10 April 2019) has been approved by the Ethics Review Committee of China Registered Clinical Trials (Ethics Review No. ChiECRCT-20190047). The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04036812

scholarly journals Application of 3D printing and framework internal fixation technology for high complex rib fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xuetao Zhou ◽  
Dongsheng Zhang ◽  
Zexin Xie ◽  
Yang Yang ◽  
Menghui Chen ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Fixation ◽  
Locking Plate ◽  
Rating Scale ◽  
Preoperative Planning ◽  
Numerical Rating Scale ◽  
Chest Ct ◽  
Rib Fractures ◽  
X Rays ◽  
With Screws

Abstract Objective To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures. Methods Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS). Results The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to 10 months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape. Conclusion The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.

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