scholarly journals Pain Intensity and Sensory Perception of Tender Points in Female Patients with Fibromyalgia: A Pilot Study

Author(s):  
Edurne Úbeda-D'Ocasar ◽  
Juan Antonio Valera-Calero ◽  
Juan Pablo Hervás-Pérez ◽  
Mario Caballero-Corella ◽  
Cristina Ojedo-Martín ◽  
...  

Fibromyalgia syndrome (FMS) is a condition that courses with chronic pain, fatigue, sleep disturbance, impaired quality of life and daily function. Due to the lack of blood, imaging or histological confirmatory tests, the diagnosis of FMS is based on the presence of widespread pain and presence of tender points (TPs). Our aim was to assess the pain pressure thresholds (PPTs) and subjective pain perception (SPP) of all 18 TPs while applying a normalized pressure in female patients with fibromyalgia. An exploratory descriptive pilot study was conducted in 30 female patients with FMS. Sociodemographic data (e.g., age, height, weight, and body mass index), clinical characteristics (e.g., years with diagnosis and severity of FMS), PPTs (assessed with an algometer), and SPP (assessed with a visual analogue scale) of all 18 TPs were collected. A comparative analysis side-to-side (same TP, left and right sides) and between TPs was conducted. No side-to-side differences were found (p < 0.05). Significant differences between all 18 TPs were found for PPTs (p < 0.0001), and SPP (p < 0.005) scores were found. The most mechanosensitive points were located in the second costochondral junction, the occiput, the trochanteric prominence; the most painful while applying a normalized pressure considering the TP and side were those located in the gluteus, trochanteric prominence, and supraspinatus. The current study describes PPTs and SPP, as assessed with algometry and visual analogue scale, respectively, of all 18 TPs in female patients with FMS. TPs exhibited significant PPTs and SPP differences between TP locations with no side-to-side differences.

2012 ◽  
Vol 42 (2) ◽  
Author(s):  
Yuwan Pradana ◽  
Teti Madiadipoera ◽  
Melati Sudiro ◽  
Arif Dermawan

Background: Rhinosinusitis is one of major health problems which increased the economic burden. With symptoms include nasal congestion, rhinorrhea, facial pain, and sometimes reduced or loss of smell, this condition may impair work productivity and quality of life (QOL). Rhinosinusitis is one of the comorbidity of allergic rhinitis. Allergen specific immunotherapy provides protection against the occurence of allergic symptoms and inflammatory reactions due to allergen exposure, that results in improvement  of QOL of allergic rhinosinusitis patients.   To assess the effectiveness of immunotherapy in the  severity of the disease, nasal symptoms, nasoendoscopic findings, drugs intake, and the QOL in allergic rhinosinusitis patients treated with specific immunotherapy. Methods: A retrospective descriptive study conducted at the Rhinology-Allergy Clinic of ORL-HNS Department, Dr.Hasan Sadikin General Hospital, Bandung, on January - December 2011, towards 25 patients, by anamnesis, severity of the disease using Visual Analogue Scale (VAS), nasal symptoms from Weeke, Davis and Okuda, nasoendoscopic findings from Lund-Kennedy, drug intake score, and QOL assesment using Rhinoconjuctivitis Quality of Life Questionaire. Results: There was a significant correlation (p<0,05) between specific immunotherapy for 1 year observed by reduced disease severity, reduced nasal symptoms, nasoendoscopic findings improvement, reduced drug intake, and increased Quality of Life which shows significant results from 3 months after immunotherapy using Wilcoxon differential test (p<0,001). Conclusion: Immunotherapy for 1 year was significantly reduced disease severity, reduced nasal symptoms, improved nasoendoscopic findings, reduced drug intake, and improvement of QOL in patients with allergic rhinosinusitis began from 3 months after immunotherapy and maintained afterwards. Key words: allergic rhinosinusitis, nasal symptoms, nasoendoscopy, specific immunotherapy, quality of life    Abstrak :  Latar belakang: Rinosinusitis merupakan salah satu masalah kesehatan yang semakin meningkat sehingga menjadi beban besar terhadap perekonomian masyarakat. Dengan gejala berupa hidung tersumbat, rinore, nyeri pada wajah dan dapat disertai berkurang atau hilangnya penciuman, kondisi ini dapat menurunkan produktivitas kerja dan kualitas hidup. Rinosinusitis merupakan salah satu komorbiditas dari rinitis alergi. Imunoterapi alergen spesifik bertujuan untuk memberikan perlindungan terhadap timbulnya gejala alergi dan reaksi inflamasi akibat pajanan alergen, sehingga dapat meningkatkan kualitas hidup pasien rinosinusitis. Tujuan: Membuktikan efektivitas imunoterapi terhadap tingkat beratnya penyakit, gejala hidung, nasoendoskopi, penggunaan obat dan kualitas hidup pasien rinosinusitis alergi yang diberikan pengobatan imunoterapi selama 3, 6, dan 12 bulan. Metode: Dilakukan penelitian deskriptif retrospektif, di Poliklinik Rinologi Alergi Ilmu Kesehatan THT-KL RSHS Bandung, dalam periode JanuariDesember 2011 pada 25 pasien, menggunakan anamnesis, tingkat berat penyakit berdasarkan Visual Analogue Scale (VAS), gejala hidung  berdasarkan Weeke, Davis dan Okuda, pemeriksaan nasoendoskopi berdasarkan Lund-Kennedy, penggunaan obat dan penilaian kualitas hidup dengan Rhinoconjuctivitis Quality of Life Questionaire. Hasil: Didapatkan hubungan bermakna berdasarkan uji chi-kuadrat-Friedman   antara imunoterapi selama 1 tahun (p<0,05) terhadap penurunan tingkat berat penyakit, penurunan gejala hidung, perbaikan temuan nasoendoskopi, penurunan penggunaan obat, serta peningkatan kualitas hidup. Didapat perbaikan secara bermakna sejak 3 bulan pasca imunoterapi (p<0,001) berdasarkan uji beda Wilcoxon. Kesimpulan: Imunoterapi selama 1 tahun efektif terhadap penurunan tingkat berat penyakit, penurunan gejala hidung, perbaikan temuan nasoendoskopi, penurunan penggunaan obat, serta peningkatan kualitas hidup pada pasien rinosinusitis alergi, dengan perbaikan sejak 3 bulan dan bertahan hingga 1 tahun pasca-imunoterapi. Kata kunci: rinosinusitis alergi, gejala hidung, nasoendoskopi, imunoterapi, kualitas hidup 


Author(s):  
S. A. Lipman ◽  
V. T. Reckers-Droog ◽  
M. Karimi ◽  
M. Jakubczyk ◽  
A. E. Attema

Abstract Objectives EQ-5D-Y-3L health states are valued by adults taking the perspective of a 10-year-old child. Compared to valuation of adult EQ-5D instruments, this entails two changes to the perspective: (i) child health states are valued instead of adult health states and: (ii) health states are valued for someone else instead of for oneself. Although earlier work has shown that these combined changes yield different values for child and adult health states that are otherwise equal, it currently remains unclear why. Hence, we aimed to disentangle the effects of both changes. Methods A sample of 205 students (mean age: 19.48) was surveyed. Each respondent completed visual analogue scale (VAS) and time trade-off (TTO) tasks for five EQ-5D-Y-3L states, using four randomly ordered perspectives: (i) self-adult (themselves), (ii) other-adult (someone their age), (iii) self-child (themselves as a 10-year-old), (iv) other-child (a child of 10 years old). We compared how each perspective impacted outcomes, precision and quality of EQ-5D-Y-3L valuation. Results Overall, differences between perspectives were consistent, with their direction being dependent on the health states and respondents. For VAS, the effect on outcomes of valuation depended on severity, but variance was higher in valuation with child perspectives. For TTO, we observed that EQ-5D-Y-3L states valued on behalf of others (i.e., children or adults) received higher valuations, but lower variances. Conclusion The use of a different perspective appears to yield systematic differences in EQ-5D-Y-3L valuation, with considerable heterogeneity between health states and respondents. This may explain mixed findings in earlier work.


2018 ◽  
Vol 42 (6) ◽  
pp. 599-605 ◽  
Author(s):  
Halil Ekrem Akkurt ◽  
Hilal Kocabaş ◽  
Halim Yılmaz ◽  
Cemile Eser ◽  
Zafer Şen ◽  
...  

Background: Lateral epicondylitis is one of the most common causes of elbow pain. It is generally observed in people between the ages of 40 and 50 years, and the dominant extremity is more frequently affected. Various noninvasive methods are frequently used; however, studies investigating the effectiveness of the orthoses are limited and with controversial outcomes. Objective: To investigate the effectiveness of a hand-wrist resting orthosis and an epicondylitis bandage in lateral epicondylitis. Study design: Randomized controlled trial. Methods: In total, 82 patients diagnosed with unilateral lateral epicondylitis were enrolled into the study. Hand-wrist resting orthosis was applied to 45 patients and epicondylitis bandage was applied to 41 patients. Patients were evaluated before treatment and at 6 weeks after treatment with a Visual Analogue Scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form 36; and a determination of hand grasping force. Results: Both groups were similar in terms of age, body mass index, gender, frequency of lateral epicondylitis on the dominant side, dominant extremity, and duration of complaints ( p > 0.05). A statistically significant recovery was detected in both groups between the pre-therapy values and the values at the sixth week in terms of Visual Analogue Scale scores; Disabilities of the Arm, Shoulder, and Hand questionnarie scores; hand grasping forces; and the Short Form 36 mental and physical component scores ( p < 0.05). However, there were no significant differences detected between the two therapy methods before the therapy and at the sixth week of treatment in all parameter values ( p > 0.05). Conclusion: Our results suggest that both epicondylitis bandage and hand-wrist resting orthosis are effective treatment options for lateral epicondylitis–induced pain, functional status, muscle strength, and quality of life. Furthermore, neither treatment option was superior to the other. Large, randomized studies are necessary for more clear statements. Clinical relevance Epicondylitis bandage and hand-wrist resting orthosis are equally effective treatment options for lateral epicondylitis–induced pain, functional status, muscle strength, and quality of life.


2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Francesco Giacinto ◽  
Elisabetta Giacinto ◽  
Mario Giacinto ◽  
Filomena Casciani ◽  
Domenica Ciuffoletti

Il trattamento delle lesioni cutanee è complesso per la varietà delle eziologie, della presentazione della ferita, del decorso e delle elevate comorbidità associate. La risoluzione di un’eventuale infezione, che rappresenta la condizione indispensabile per la successiva guarigione della lesione, è da considerarsi l’obiettivo primario di qualsiasi intervento. Numerose sono le evidenze presenti in letteratura che attestano la superiorità di un trattamento antibiotico topico rispetto a una terapia antibiotica sistemica in presenza di una ferita infetta. È stato evidenziato come la sulfadiazina argentica 1% crema (SSD Ag 1%), un antibiotico chemioterapico topico, sia efficace nella prevenzione e cura delle lesioni cutanee acute e croniche infette e/o suscettibili di superinfezioni. Lo scopo di questo studio è quello di verificare l’efficacia della SSD nel migliorare la qualità di vita di pazienti affetti da lesioni. La ricerca è stata condotta presso l’Ambulatorio sperimentale di Vulnologia nel CAPT di Praia a Mare (ASP Cosenza, Italia); ha coinvolto 86 pazienti nell’arco di 4 mesi, trattati in parte in ambulatorio ed in parte in assistenza domiciliare, con età media di 69,6 anni, per la profilassi (50/86, 58%) o per il trattamento (36/86, 42%) di ulcere interessanti principalmente gli arti inferiori. I risultati ottenuti dall’utilizzo della SSD Ag 1% hanno evidenziato che, nei pazienti in cui il prodotto è stato applicato come trattamento, la percezione del dolore è diminuita in 18 su 24 pazienti, con un’aumentata qualità di vita valutata attraverso la Visual Analogue Scale-Quality of Life Scale. L’efficacia della SSD Ag 1% è stata dimostrata dai 23 casi di guarigione in 12 settimane e dai 5 casi in 4 settimane e dai 10 casi di risoluzione della sola infezione. La SSD Ag% si dimostra essere un ottimo prodotto sia per la profilassi (per prevenire l’insorgenza dell’infezione nelle ulcere a rischio) che per il trattamento dell’infezione delle ferite, coniugando efficacia e tollerabilità. Treating skin lesions is complex due to the variety of aetiologies, the presentation of the wound, the course of the injury and the high number of associated comorbidities. The main aim of any treatment is to resolve any infection, as this is the essential condition for the lesion to subsequently heal. There is a lot of evidence in literature that a topical antibiotic treatment is better than a systemic antibiotic therapy for infected wounds. Silver sulfadiazine 1% cream (SSD Ag 1%), a topical chemotherapy antibiotic, has been proved to be effective for the prevention and cure of acute and chronic skin lesions that are infected or susceptible to superinfection. The purpose of this study is to confirm the efficacy of SSD Ag 1%in improving the quality of life of patients with lesions. The study was conducted at the Experimental Wound Treatment Outpatients Department of the Praia a Mare Local Healthcare Centre (Cosenza Health Authority, Italy); it involved 86 patients during a 4-month period, some of whom were treated in the outpatients department and some at home, with an average age of 69.6, for prophylaxis (50/86, 58%) or to treat ulcers, primarily leg ulcers (36/86, 42%). The results of using SSD Ag 1% cream showed that for patients on whom the product was used as treatment, pain perception fell in 18 out of 24 patients, with improved quality of life assessed using the Visual Analogue Scale-Quality of Life Scale. The efficacy of SSD Ag 1% was shown by 23 cases of healing in 12 weeks and 5 cases in 4 weeks and by 10 cases of resolution of the infection only. SSD Ag 1% was shown to be an excellent product both for prophylaxis (to prevent infections in high-risk ulcers) and for treating wound infections, combining efficacy and tolerability.


2004 ◽  
Vol 13 (2) ◽  
pp. 311-320 ◽  
Author(s):  
A.G.E.M. de Boer ◽  
J.J.B. van Lanschot ◽  
P.F.M. Stalmeier ◽  
J.W. van Sandick ◽  
J.B.F. Hulscher ◽  
...  

2010 ◽  
Vol 28 (4) ◽  
pp. 200-204 ◽  
Author(s):  
Myeong Soo Lee ◽  
Jong-In Kim ◽  
Jae Cheol Kong ◽  
Dong-Hyo Lee ◽  
Byung-Cheul Shin

Objectives The aims of this study were to develop a sham cupping device and to validate its use as a placebo control for healthy volunteers. Methods A sham cupping device was developed by establishing a small hole to reduce the negative pressure after suction such that inner pressure could not be maintained in the cup. We enrolled 34 healthy participants to evaluate the validity of the sham cupping device as a placebo control. The participants were informed that they would receive either real or sham cupping and were asked which treatment they thought they had received. Other sensations and adverse events related to cupping therapy were investigated. Results 17 patients received real cupping therapy and 17 received sham cupping. The two groups felt similar sensations. There was a tendency for subjects to feel that real cupping created a stronger sensation than sham cupping (48.9±21.4 vs 33.3±20.3 on a 100mm visual analogue scale). There were only mild to moderate adverse events observed in both groups. Conclusion We developed a new sham cupping device that seems to provide a credible control for real cupping therapy by producing little or no negative pressure. This conclusion was supported by a pilot study, but more rigorous research is warranted regarding the use of this device.


2017 ◽  
Vol 2 (3) ◽  
pp. 244-249 ◽  
Author(s):  
Marjolein Geurts ◽  
Floor AS de Kort ◽  
Paul LM de Kort ◽  
Julia H van Tuijl ◽  
Ghislaine JMW van Thiel ◽  
...  

Introduction Treatment restrictions in the first 2 days after intracerebral haemorrhage have been independently associated with an increased risk of early death. It is unknown whether these restrictions also affect mortality if these are installed several days after stroke onset. Patients and methods Sixty patients with severe functional dependence at day 4 after ischaemic stroke or intracerebral haemorrhage were included in this prospective two-centre cohort study. The presence of treatment restrictions was assessed at the day of inclusion. Information about mortality, functional outcome (modified Rankin scale) score and quality of life (visual analogue scale) was recorded 6 months after stroke onset. Poor outcome was defined as modified Rankin scale >3. Satisfactory quality of life was defined as visual analogue scale ≥ 60. Results At 6 months, 30 patients had died, 19 survivors had a poor functional outcome and 9 patients had a poor quality of life. Treatment restrictions were independently associated with mortality at 6 months (adjusted relative risk, 1.30; 95% confidence interval, 1.06–1.59; p = 0.01), but not with functional outcome. Discussion Our findings were observed in 60 selected patients with severe stroke. Conclusion The instalment of treatment restrictions by itself may increase the risk of death after stroke, even if the first 4 days have passed. In future stroke studies, this potential confounder should be taken into account. Quality of life was satisfactory in the majority of the survivors, despite considerable disability.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Amit Khatri ◽  
Namita Kalra

Pain is the most common symptom of oral diseases. Pain perception in children is highly variable and unreliable due to poor communication. Therefore we designed a study to compare pain measurement techniques, that is, visual analogue scale (VAS) and Wong-Baker faces pain rating scale (WBFPS) among Delhi children aged 3 to 14 years undergoing dental extraction. Method. A cross-sectional study was conducted on 180 patients aged 3 to 14 years who had undergone dental extraction. Children were assessed for their pain sensitivity using visual analogue scale (VAS) and Wong-Baker faces pain rating scale (WBFPS ). Result and Conclusion. Pain threshold tends to decline, and the self-management of pain becomes more effective with increasing age. Genderwise result shows that communication ability of boys and girls is similar in all age groups.


2011 ◽  
Vol 101 (5) ◽  
pp. 385-389 ◽  
Author(s):  
Sarah Mahowald ◽  
Bradford S. Legge ◽  
John F. Grady

Background: The purpose of this study was to determine whether changes in plantar fascia thickness are a reliable gauge of efficacy of treatment protocols for plantar fasciitis. Methods: Thirty-nine feet (30 patients) with plantar fasciitis received an ultrasound examination to measure the thickness of the medial band of the plantar fascia. Each patient assessed his or her pain using the visual analogue scale. Following various treatments, a second ultrasound examination was performed and the thickness of the plantar fascia was again measured and subjective pain level assessed. Results: Twenty-nine feet (74.4%) showed a decrease in plantar fascia thickness and a decrease in pain. One foot (2.6%) experienced an increase in fascia thickness and reported an increase in pain. Four feet (10.3%) had an increase in thickness of the plantar fascia and reported no change in pain level. Three feet had minor increases in fascia thickness but reported a decrease in pain (7.7%). One foot (2.6%) had no change in fascia thickness but a decrease in pain and one foot (2.6%) had a decrease in the plantar fascia but no change in pain level. The average reduction in fascia thickness was 0.82 mm ±1.04 mm, correlating with an average improvement in pain of 3.64 ± 2.7 (P &lt; 0.005). Conclusions: This study provides evidence that changing thickness of the plantar fascia is a valid objective measurement to assess effectiveness of new or existing treatment protocols. (J Am Podiatr Med Assoc 101(5): 385–389, 2011)


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