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1.
BMC Oral Health ; 22(1): 310, 2022 07 27.
Article in English | MEDLINE | ID: covidwho-1962806

ABSTRACT

BACKGROUND: Globally, with the COVID-19 pandemic, dental services were limited to emergency/ urgent conditions and were provided only after tele-triage referral for face-to-face management. However, no previous research explored whether the pain severity (PS) drives the tele-triage decisions. The current study examined the association between PS and tele-triage decision of whether to manage the condition remotely or refer the caller for face-to-face management. METHODS: This retrospective cross-sectional study analyzed the PS reported by hotline callers, using numerical rating scale (NRS-11), during the first wave of COVID-19 lockdown (23 March-31 August 2020) and its association with tele-triage decision controlling for age, sex, history of chronic illness, and dental discipline needed. Binomial logistic regression assessed the association between the PS (exposure) and tele-triage decision (outcome). ANOVA compared PS across tele-triage categories, dental history and tentative diagnosis. RESULTS: PS was significantly associated with tele-triage decisions (p < 0.05). An increase in pain score by 1 unit was associated with 1.4 times increased odds of face-face referral (95% CI: 1.26-1.54). Pediatric/ adolescent patients (9-18 years) (odds ratio (OR) = 2.07; 95% CI: 1.07-4.02), history of chronic illness (OR = 2.12; 95% CI:1.28-3.51), need for surgical specialty (OR = 1.93; 95% CI: 1.22-3.04) and orthodontic specialty (OR = 7.02; 95% CI: 3.54-13.87) were independently associated with tele-triage decision. PS was highest for the emergency triage category (8.00 ± 2.83, P < 0.0001), dental history of tooth with cavity or filling (6.65 ± 2.024, P < 0.0001), and the tentative tele-diagnosis of cellulitis (7.75 ± 2.872, P < 0.0001). CONCLUSIONS: During COVID-19 pandemic, tele-triage decisions were significantly influenced by patient-reported PS, adjusting for a range of variables. Despite this, referral for face-to-face management was individualized and driven by the tripartite considerations of the reported pain, clinical judgement, and the high transmission characteristics of COVID-19.


Subject(s)
COVID-19 , Triage , Adolescent , Child , Communicable Disease Control , Cross-Sectional Studies , Humans , Pain , Pain Measurement , Pandemics , Patient Reported Outcome Measures , Retrospective Studies
2.
BMJ Open ; 12(6): e060058, 2022 06 29.
Article in English | MEDLINE | ID: covidwho-1923250

ABSTRACT

INTRODUCTION: Chronic pain conditions are a leading cause of disease and disability. They are associated with symptoms such as fatigue, sleep and mood disturbances. Minimal evidence is available to support effective treatments and alternatives treatment approaches are called for. Photobiomodulation therapy has been highlighted as one promising option. A whole-body therapy device (NovoTHOR) has recently been developed with a number of potential advantages for people with chronic pain. Research is needed to consider the feasibility of this device. METHODS AND ANALYSIS: A single-centre single-armed (no placebo group) feasibility study with an embedded qualitative component will be conducted. The intervention will comprise 18 treatments over 6 weeks, with 6-month follow-up, in the whole-body photobiomodulation device. A non-probability sample of 20 adult participants with a clinician diagnosis of chronic axial pain, polyarthralgia, myofascial pain or widespread pain will be recruited (self-referral and clinician referral). Outcome measures will focus on acceptability of trial processes with a view to guiding a definitive randomised controlled trial. Analyses will use descriptive statistics for quantitative aspects. The qualitative element will be assessed by means of a participant-reported experience questionnaire postintervention and semistructured audio-recorded interviews at three stages; preintervention, midintervention and postintervention. The latter will be transcribed verbatim and a reflexive thematic analysis will be used to identify emerging themes. Exploratory outcomes (participant-reported and performance-based measures) will be analysed according to data distribution. ETHICS AND DISSEMINATION: The study has received ethical approval from the Leicester Central Research and Ethics Committee. Findings will be disseminated via local chronic pain groups, public register update, submission for presentation at scientific meetings and open-access peer-reviewed journals, and via academic social networks. TRIAL REGISTRATION NUMBER: NCT05069363.


Subject(s)
Chronic Pain , Low-Level Light Therapy , Adult , Chronic Disease , Chronic Pain/radiotherapy , Feasibility Studies , Humans , Pain Measurement , Randomized Controlled Trials as Topic
3.
Emerg Med J ; 39(7): 561-562, 2022 07.
Article in English | MEDLINE | ID: covidwho-1902035

Subject(s)
Triage , Humans , Pain Measurement
4.
Sensors (Basel) ; 22(8)2022 Apr 13.
Article in English | MEDLINE | ID: covidwho-1810111

ABSTRACT

With the development of robot technology, robot utilization is expanding in industrial fields and everyday life. To employ robots in various fields wherein humans and robots share the same space, human safety must be guaranteed in the event of a human-robot collision. Therefore, criteria and limitations of safety need to be defined and well clarified. In this study, we induced mechanical pain in humans through quasi-static contact by an algometric device (at 29 parts of the human body). A manual apparatus was developed to induce and monitor a force and pressure. Forty healthy men participated voluntarily in the study. Physical quantities were classified based on pain onset and maximum bearable pain. The overall results derived from the trials pertained to the subjective concept of pain, which led to considerable inter-individual variation in the onset and threshold of pain. Based on the results, a quasi-static contact pain evaluation method was established, and biomechanical safety limitations on forces and pressures were formulated. The pain threshold attributed to quasi-static contact can serve as a safety standard for the robots employed.


Subject(s)
Pain Threshold , Robotics , Humans , Industry , Male , Pain , Pain Measurement
5.
JAMA Intern Med ; 182(6): 687-688, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1801975
6.
J Pain ; 23(7): 1234-1244, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1796448

ABSTRACT

Recent studies suggest that the COVID-19 pandemic can serve as a unique psychosocial stressor that can negatively impact individuals with chronic pain. Using a large online sample in the U.S., the present study sought to investigate the impact of the pandemic on the trajectories of pain severity and interference, emotional distress (ie, anxiety and depressive symptoms), and opioid misuse behaviors across one year. Potential moderating effects of socio-demographic factors and individual differences in pain catastrophizing, pain acceptance, and sleep disturbance on outcome trajectories were also examined. Adults with chronic pain were surveyed three times across 1 year (April/May 2020 [N = 1,453]; June/July 2020 [N = 878], and May 2021 [N = 813]) via Amazon's Mechanical Turk online crowdsourcing platform. Mixed-effects growth models revealed that pain severity and interference, emotional distress, and opioid misuse behaviors did not significantly deteriorate across one year during the pandemic. None of the socio-demographic factors, pain catastrophizing, or sleep disturbance moderated outcome trajectories. However, individuals with higher pain acceptance reported greater improvement in pain severity (P< .008, 95% CI: -.0002, -.00004) and depressive symptoms (P< .001, 95% CI: -.001, -.0004) over time. Our findings suggest that the negative impact of the pandemic on pain, emotional distress, and opioid misuse behaviors is quite small overall. The outcome trajectories were also stable across different socio-demographic factors, as well as individual differences in pain catastrophizing and sleep disturbance. Nevertheless, interventions that target improvement of pain acceptance may help individuals with chronic pain be resilient during the pandemic. PERSPECTIVE: Individuals with chronic pain overall did not experience significant exacerbation of pain, emotional distress, and opioid misuse across one year during the COVID-19 pandemic. Individuals with higher pain acceptance showed greater improvement in pain severity and depressive symptoms over time during the pandemic.


Subject(s)
COVID-19 , Chronic Pain , Opioid-Related Disorders , Pain Measurement , Psychological Distress , Adult , Anxiety , COVID-19/psychology , Catastrophization , Chronic Pain/drug therapy , Chronic Pain/psychology , Depression , Female , Humans , Longitudinal Studies , Male , Middle Aged , Opioid-Related Disorders/psychology , Sleep Wake Disorders
7.
J Nerv Ment Dis ; 210(4): 270-275, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1764697

ABSTRACT

ABSTRACT: Limited data are available for real-world impact of the COVID-19 pandemic on chronic pain patients. This study aimed to evaluate pain intensity, depression, and anxiety status in chronic pain patients during the COVID-19 pandemic. A total of 110 patients with chronic pain participated on a voluntary basis in this questionnaire survey. The questionnaire form elicited information on sociodemographic characteristics and prepandemic and pandemic data on analgesic need, access to medication, visual analog scale (VAS) pain, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scores. The COVID-19 pandemic resulted in increased levels of depression (74.5%), anxiety (66.4%), increase in analgesic need (60%), and limited access to analgesic drugs (40.0%). In conclusion, our findings revealed significant increase in VAS pain intensity, BDI, and BAI scores during the COVID-19 pandemic compared with prepandemic period among chronic pain patients, particularly for patients with increased need of analgesics during pandemic.


Subject(s)
COVID-19 , Chronic Pain , Anxiety/epidemiology , COVID-19/epidemiology , Chronic Pain/epidemiology , Depression/epidemiology , Humans , Pain Measurement , Pandemics
8.
J Am Geriatr Soc ; 70(1): 296, 2022 01.
Article in English | MEDLINE | ID: covidwho-1685357
9.
Acta Orthop ; 93: 264-270, 2022 01 24.
Article in English | MEDLINE | ID: covidwho-1650526

ABSTRACT

BACKGROUND AND PURPOSE: Several studies have compared fast-track with conventional pathways for total hip arthroplasty (THA) patients, but none have compared different fast-track pathways. Due to COVID-19 restrictions, our department had to minimize patient-staff contact in the THA pathway. First, telephone consultations were implemented instead of an outpatient clinic visit and subsequently preoperative patient education was discontinued. This enabled us to compare patient-reported outcomes and satisfaction among 3 fast-track pathways. PATIENTS AND METHODS: We collected data from patients treated for hip osteoarthritis with THA at Gødstrup Hospital between 2018 and 2021. The patients had experienced 1 of 3 pathways and were interviewed via telephone between 2 and 6 months after discharge. We analyzed the influence of patient pathway on patient-reported pain and mobility level, self-perceived complications, and compliance using logistic regression. We then compared the pathway's effect on patient satisfaction both for the total sample and for the patients who experienced complications. RESULTS: The amount of patient-staff contact in the patient pathway did not have any influence on patientreported outcomes or the probability of self-perceived complications. For the full sample, patient-staff contact had no statistically significant influence on patient satisfaction either, but for the subgroup of patients experiencing complications, the pathways with less patient-staff contact reduced satisfaction. Patient satisfaction was primarily related to pain and mobility outcomes. INTERPRETATION: Our results indicate that reducing patient-staff contact in fast-track THA can be done without influencing mobility and pain outcomes, but the overall satisfaction among patients with self-perceived complications will be negatively affected.


Subject(s)
Arthroplasty, Replacement, Hip/methods , COVID-19/prevention & control , Patient Reported Outcome Measures , Patient Satisfaction , Telemedicine/methods , Humans , Pain Measurement , Pandemics , Postoperative Complications/psychology , SARS-CoV-2
10.
Neuromodulation ; 24(3): 441-447, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1593901

ABSTRACT

OBJECTIVES: Due to the impact of COVID-19 epidemic, face-to-face follow-up treatments for patients with chronic pain and implanted spinal cord stimulation (SCS) devices are forced to be delayed or stopped. This has led to more follow ups being done remotely. Meanwhile, with the development of 4G/5G networks, smartphones, and novel devices, remote programming has become possible. Here, we investigated the demand and utility of remote follow-ups including remote programming for SCS for patients with chronic pain. MATERIALS AND METHODS: A questionnaire including questions on demographic characteristics, pain history, postimplantation life quality, standard follow-up experience, remote follow-up, and remote programming experience was sent to patients diagnosed as chronic intractable pain and treated with SCS during January 2019 to January 2020. RESULTS: A total of 64 participants completed the questionnaire. About 70% of participants expressed demands for remote follow-ups due to the inconvenience, high costs, and time consumption of traditional follow-up visits. Nearly 97% of participants have attempted remote follow-ups, and about 81% of participants have further tried remote programming. Approximately, 96% of them recognized the benefits. CONCLUSIONS: The remote programming was in high demand among participants. Most of the participants have tried remote follow-ups or even remote programming. The remote programming appeared to be more efficient, economic and were widely recognized among participants.


Subject(s)
COVID-19/prevention & control , Chronic Pain/therapy , Disease Outbreaks/prevention & control , Implantable Neurostimulators , Remote Sensing Technology/methods , Spinal Cord Stimulation/methods , Adult , COVID-19/epidemiology , China/epidemiology , Chronic Pain/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pain Measurement/methods
11.
Pain Manag Nurs ; 23(3): 370-373, 2022 06.
Article in English | MEDLINE | ID: covidwho-1529770

ABSTRACT

AIMS: To examine the association between the type of mask worn by health care professionals and assessment of pain intensity in patients after orthopedic surgery using the visual analog scale (VAS). DESIGN: A nonrandomized controlled trial conducted among 176 patients hospitalized in an orthopedic department of a hospital located in northern-central Israel from January to March 2021. METHODS: In the intervention group (n = 83), pain assessment using the VAS was performed by a health care professional wearing a transparent face mask, while in the control group (n = 93), pain assessment was performed by a health care professional wearing a standard nontransparent face mask. The initial assessment was performed by a nurse, and 15 minutes later, an additional assessment was performed by a physician. RESULTS: Health care professionals wearing a standard non-transparent mask obtained higher VAS scores than health care professionals wearing a transparent mask. In addition, nurses obtained lower VAS scores than physicians. The discrepancy in VAS scores between nurses and physicians was found in 50% of cases. This discrepancy was more prevalent among female patients, patients after knee replacement or spinal surgery, and when health care professionals were wearing a standard nontransparent mask. CONCLUSIONS: This study supports the use of transparent face masks by health care professionals in an orthopedic department, particularly by nurses. In addition, this study supports the assumption of problems involving the reliability of VAS.


Subject(s)
Health Personnel , Masks , Female , Humans , Masks/adverse effects , Pain Measurement , Reproducibility of Results , Visual Analog Scale
13.
PLoS One ; 16(3): e0248589, 2021.
Article in English | MEDLINE | ID: covidwho-1456066

ABSTRACT

PURPOSE: To assess efficacy and safety of imaging-guided radiofrequency ablation (RFA) of Osteoid Osteoma (OO) in both typical and atypical sites. METHODS AND MATERIALS: Between January 2014 and March 2019, 102 consecutive percutaneous RFA were performed and retrospectively reviewed. The procedures were performed using a RFA bipolar ablation system (Covidien, exposed tip of 0.7-1cm), under Computed Tomography (CT) guidance or using a navigation system (Masmec) under CT and Cone Beam CT (CBCT) guidance. Patients were followed up over 24 months. Clinical success and recurrences were considered on the base of established criteria. In patients with clinical failure and/or imaging evidence of relapse, retreatment was considered. RESULTS: Administered power per-procedure was ≤8 W (mean temperature, 90°C). The pre-procedure average value of visual analog scale (VAS) was 8.33+/-0.91. Primary and secondary success rate 96.08% (98/102) and100% (102/102), respectively. No major complication was described. Technical success was proved in every patient by CT scan acquisition after needle positioning. Relapse and tumour location were significantly correlated (p-value = 0.0165). The mean dose-length product was 751.55 mGycm2. Advanced bone healing was noted in 68 lesions after 1y-follow up and in 86 lesions after 2y-follow up. CONCLUSION: Imaging-guided percutaneous RFA is a highly effective technique for OO, both in typical and atypical sites. CT or CBCT guidance, navigation systems and operator experience grant the technical success, which is the most crucial parameter affecting outcome.


Subject(s)
Bone Neoplasms/therapy , Cancer Pain/therapy , Neoplasm Recurrence, Local/epidemiology , Osteoma, Osteoid/therapy , Radiofrequency Ablation/methods , Adolescent , Adult , Bone Neoplasms/complications , Bone Neoplasms/diagnosis , Cancer Pain/diagnosis , Cancer Pain/etiology , Cone-Beam Computed Tomography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/prevention & control , Osteoma, Osteoid/complications , Osteoma, Osteoid/diagnosis , Pain Measurement/statistics & numerical data , Radiofrequency Ablation/statistics & numerical data , Retrospective Studies , Treatment Outcome , Young Adult
14.
Cochrane Database Syst Rev ; 6: CD008077, 2021 06 08.
Article in English | MEDLINE | ID: covidwho-1453524

ABSTRACT

BACKGROUND: Heparin is an anticoagulant medication that is usually injected subcutaneously. Subcutaneous administration of heparin may result in complications such as bruising, haematoma, and pain at the injection site. One of the factors that may affect pain, haematoma, and bruising is injection speed. Several studies have been carried out to determine if speed of injection affects the amount of pain and bruising where the injection is given; however, the results of these studies have differed, and study authors have not reached a clear final conclusion. This is the second update of a review first published in 2014. OBJECTIVES: To assess the effects of duration (speed) of subcutaneous heparin injection on pain and bruising at the injection site in people admitted to hospitals or clinics who require treatment with unfractionated heparin (UFH) or low molecular weight heparin (LMWH). We also looked at haematoma at the injection site. SEARCH METHODS: The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase, and CINAHL databases and the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 22 June 2020. We undertook reference checking of included studies to identify additional studies. SELECTION CRITERIA: We searched for randomised controlled trials (RCTs) comparing the effects of different durations of subcutaneous injection of heparin on pain, bruising, and haematoma at the injection site. DATA COLLECTION AND ANALYSIS: For this update, two review authors independently selected studies and extracted data via Covidence software and assessed methodological quality using Cochrane's risk of bias tool. The primary outcomes of interest were pain intensity at injection site and size and incidence of bruising. The secondary outcomes of interest were size and incidence of haematoma at injection site. We calculated the odds ratio (OR), mean difference (MD), or standardised mean difference (SMD) with corresponding 95% confidence intervals (CIs). We assessed the certainty of the evidence using GRADE criteria. MAIN RESULTS: We identified one new study for this update, resulting in a total of five included studies with 503 participants who received subcutaneous injections of LMWH into the abdomen. Given the nature of the intervention, it was not possible to blind participants and caregivers (personnel) in any of the included studies. Two studies described blinding of outcome assessors. Overall, the methodological quality of included studies was moderate. The duration of the fast injection was 10 seconds, and the duration of the slow injection was 30 seconds in all included studies. Four studies reported site pain intensity after each injection at different time points. Two studies assessed site pain intensity immediately after each injection; meta-analysis showed no evidence of a difference in site pain intensity immediately after slow injection when compared to fast injection (MD -1.52, 95% CI -3.56 to 0.53; 140 participants; low-certainty evidence). Meta-analysis of three studies indicated that site pain intensity may be slightly reduced 48 hours after the slow heparin injection compared to fast injection (MD -1.60, 95% CI -2.69 to -0.51; 103 participants; low-certainty evidence). Five studies assessed bruise size at 48 hours, and two studies assessed bruise size at 60 hours. Meta-analysis showed there may be a reduction in bruise size 48 hours (SMD -0.54, 95% CI -1.05 to -0.02; 503 participants; 5 studies; very low-certainty evidence) and 60 hours (SMD -0.49, 95% CI -0.93 to -0.06; 84 participants; 2 studies; low-certainty evidence) after slow injection compared to fast injection. There was no evidence of a difference in bruise size 72 hours after slow injection compared to fast injection (SMD -0.27, 95% CI -0.61 to 0.06; 140 participants; 2 studies; low-certainty evidence). Three studies evaluated incidence of bruising and showed there may be a reduction in bruise incidence 48 hours (OR 0.39, 95% CI 0.26 to 0.60; 444 participants; low-certainty evidence) and 60 hours (OR 0.25, 95% CI 0.10 to 0.65; 84 participants; 2 studies; low-certainty evidence) after slow injection compared to fast injection. We downgraded the certainty of the evidence due to risk of bias concerns, imprecision, and inconsistency. None of the included studies measured size or incidence of haematoma. AUTHORS' CONCLUSIONS: Administering medication safely and enhancing patient comfort are the main aims of clinical nurses. In this review, we identified five RCTs that evaluated the effect of subcutaneous heparin injection duration on pain intensity, bruise size and incidence. We found that pain may be slightly reduced 48 hours after slow injection. Similarly, there may be a reduction in bruise size and incidence after slow injection compared to fast injection 48 and 60 hours postinjection. We downgraded the certainty of the evidence for all outcomes to low or very low due to risk of bias concerns, imprecision, and inconsistency. Accordingly, new trials with a more robust design, more participants, and a focus on different injection speeds will be useful in strengthening the certainty of the available evidence.


Subject(s)
Anticoagulants/administration & dosage , Contusions/prevention & control , Heparin, Low-Molecular-Weight/administration & dosage , Injections, Subcutaneous/methods , Pain, Procedural/prevention & control , Anticoagulants/adverse effects , Bias , Contusions/chemically induced , Contusions/pathology , Hematoma/chemically induced , Hematoma/pathology , Heparin, Low-Molecular-Weight/adverse effects , Humans , Injections, Subcutaneous/adverse effects , Middle Aged , Pain Measurement/methods , Pain, Procedural/etiology , Randomized Controlled Trials as Topic , Time Factors
15.
Eur J Pain ; 25(7): 1564-1567, 2021 08.
Article in English | MEDLINE | ID: covidwho-1391565

ABSTRACT

In recent years, the delivery of health services has undergone a major paradigm shift towards expanded outpatient services and widespread use of telemedicine. Post-herpetic neuralgia (PHN) is a treatment recalcitrant neuropathic pain condition referring to pain persisting more than three months from the initial onset of an acute herpes zoster. QUTENZA® (capsaicin 8% patch) is a single 1-hr localized treatment for PHN and can provide several months of pain relief per application. However, patient access to capsaicin 8% patch is limited due to sensitive handling protocols that require the patch application to occur under physicians or healthcare professionals under the close supervision of a physician. Herein, we describe a successful treatment of PHN at-home, using capsaicin 8% patch, performed under full supervision and instruction from a physician using video telehealth services. SIGNIFICANCE: This is a case report of the successful treatment of post-herpetic neuralgia at-home using Capsaicin 8% patch. The procedure was performed under full supervision and instruction from a physician using video telehealth services. Not only did the patient tolerate the procedure and have significant efficacy, she voiced preference to repeat treatment in this manner versus going back to the office.


Subject(s)
Neuralgia, Postherpetic , Telemedicine , Capsaicin , Female , Humans , Neuralgia, Postherpetic/drug therapy , Pain Measurement , Sensory System Agents , Transdermal Patch
16.
Medicina (Kaunas) ; 57(8)2021 Jul 28.
Article in English | MEDLINE | ID: covidwho-1376896

ABSTRACT

Background and Objectives This systematic review aims to evaluate the efficacy of Tele-Rehabilitation for decreasing pain in patients with knee osteoarthritis (OA). Materials and Methods: Following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), three electronic databases (CINAHL, PubMed, PEDro), along with the addition of grey literature, were used to collect information. Randomized control trials (RCTs) comparing tele-rehabilitation (TR) to office-based-rehabilitation (OB) were critically appraised using the 2005 University of Oxford Standard. A total of 139 articles (PubMed = 132, CINAHL = 5, PEDro = 0, grey literature = 2) were acquired. Results: After the screening, three RCTs were included in our review. Their results show no statistically significant differences between TR and OB intervention. Furthermore, their results showed an overall reduction in pain in both groups from the baseline to the end of the study. However, each intervention's clinical efficiency was dependent on the exercise protocol itself and not on the method of delivery. There is a potential ceiling effect to the amount of therapy a patient can receive in which additional therapy would no longer lead to improved recovery. Conclusions: Our review suggests evidence that TR's efficacy is similar to that of OB for improvement of WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score parameters in patients suffering from knee OA.


Subject(s)
Osteoarthritis, Knee , Telerehabilitation , Exercise , Humans , Pain , Pain Measurement
17.
PLoS One ; 16(8): e0256433, 2021.
Article in English | MEDLINE | ID: covidwho-1372012

ABSTRACT

BACKGROUND: Endometriosis is a chronic pain condition in premenopausal women. Pain is mainly characterized by pain intensity and may induce disability in all areas of daily life. Nevertheless, pain is influenced by emotional and social factors as well. Social distancing measures or quarantine, as reaction to rapidly rising infections with the COVID-19 virus due to the SARS-CoV-2 pandemic, were implemented across Europe to prevent the spread of the virus and social distancing measures were imposed by the German government by beginning of March 2020 with initiation of the lockdown by the end of March 2020. The objective of this study was to assess, how social distancing measures during the lockdown impacted the various aspects of pain perception in a group of chronic pain patients, such as women suffering from endometriosis. METHODS: Between 6th to 27th April 2020, an online questionnaire was activated at internet platforms of endometriosis patients support groups. Participants were asked retrospectively at one time point about their visual pain intensity measured by the visual analogue scale (VAS) and pain disability via pain disability index (PDI) prior to initiation of social distancing measures in Germany (VASP, PDIP), as well as the pain intensity and pain disability since implementation of social distancing measures (VASI, PDII). Differences of VAS and PDI previous and after implementation of social distancing measures were displayed as ΔVAS and ΔPDI. Pain experience and social support were assessed by a 5-point Likert scale. RESULTS: 285 participants completed at least one question regarding pain intensity, disability, pain experience or social support. Dysmenorrhea, the symptom with the highest level of pain assessed by VAS, decreased significantly during the SARS-CoV-2 pandemic compared to the time period prior to social isolation (45.30% respondents experienced improvemenet vs 40.50% who experienced worsening; p = 0.025). The global physical impairment improved significantly (improvement of pain induced disability in 48.20% vs 40.90% with worsening of pain symptoms; p = 0.032) after the implementation of social distancing measures. Pain experience was negatively affected by social distancing measures, since frequency of pain awareness increased in 43.6% (p<0.001) of participants and 30.0% (p<0.001) more participants experienced pain as a threat. Verbalization of pain experience was reduced in 36.6% (p = 0.001) of participants and 14.6% (p = 0.91), 21.9% (p<0.001) and 31.5% (p<0.001) of participants reported less social support from their partner, family and friends. CONCLUSIONS: Physical pain and disability on one hand and emotional and social pain experience on the other were differentially affected by the emerged emotional, social and health care constraints related to the SARS-CoV-2 pandemic.


Subject(s)
COVID-19/epidemiology , Chronic Pain/etiology , Endometriosis/pathology , Social Support , Adult , COVID-19/virology , Cross-Sectional Studies , Disability Evaluation , Endometriosis/complications , Female , Germany/epidemiology , Humans , Internet , Pain Measurement , Pain Perception , Pandemics , Quarantine , Retrospective Studies , SARS-CoV-2/isolation & purification , Social Isolation , Surveys and Questionnaires
18.
Am J Phys Med Rehabil ; 100(4): 307-312, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1266237

ABSTRACT

OBJECTIVE: The clinical manifestations of COVID-19 range from mild symptoms to severe pneumonia and severe organ damage. When evaluated specifically for pain, the data so far have shown that myalgia, headache, and chest pain can be seen in patients at varying rates; myalgia and headache, especially, are among the initial symptoms. DESIGN: This retrospective chart review, followed by a descriptive survey design study, was carried out by examining patients afflicted with COVID-19. After discharge, patients were asked about the severity and the body region of their pain, their use of analgesics, their mood and mental health, and their overall quality of life. RESULTS: A total of 206 patients with a mean age of 56.24 ± 16.99 yrs were included in the study. Pain during COVID-19 was found to be higher compared with the preinfectious and postinfectious states. The most frequent painful areas were reported to be the neck and back before the infection, whereas the head and limbs during the infection. The most frequently used analgesic during infection was paracetamol. There was no relationship between the patients' pain and anxiety and depression; the quality of life was found to be worse in patients with persistent pain. CONCLUSIONS: This study showed that the head and limbs were the most common painful body regions during COVID-19. It was also found that pain can continue in the postinfection period.


Subject(s)
COVID-19/epidemiology , Myalgia/diagnosis , Pain Measurement/statistics & numerical data , Adult , Aged , COVID-19/complications , Female , Headache/diagnosis , Humans , Low Back Pain/diagnosis , Male , Middle Aged , Myalgia/etiology , Neck Pain/diagnosis , Physical Examination , Primary Health Care/methods , Retrospective Studies
19.
Acupunct Med ; 39(6): 612-618, 2021 12.
Article in English | MEDLINE | ID: covidwho-1255860

ABSTRACT

OBJECTIVE: Chronic pain is a common symptom experienced among patients with sickle cell disease (SCD). Our aims were to assess the feasibility and acceptability of performing acupuncture for the treatment of chronic pain in adults with SCD. METHODS: This was a single-arm, prospective pilot study of six adults with SCD. Participants reported ⩾ 3 months of chronic pain and were > 18 years of age. Per protocol, acupuncture was to be administered twice per week for 5 weeks, for 30 min per session. All treatments were performed in the acupuncture treatment laboratory at the University of Illinois Chicago College of Nursing. Pain intensity, pain interference, and other symptoms were measured at baseline and after the intervention. Participants completed a semi-structured interview and a protocol acceptability questionnaire after the acupuncture intervention. RESULTS: Six participants (mean age 52.5 years, six Black) were enrolled. Although the study was suspended due to COVID-19 and not all participants completed the 10-session protocol, completion rates were high with no missed appointments. One participant did not complete the study due to hospitalization unrelated to acupuncture. No adverse events were reported. At completion of the intervention at 4-5 weeks post-baseline, all participants had reduced pain intensity and pain interference. The mean acceptability score on the protocol acceptability questionnaire was 82%. CONCLUSION: It was feasible and acceptable to implement acupuncture in adults with SCD. This study can be used to guide a larger randomized controlled trial to evaluate the effect of acupuncture on reducing chronic pain in adults with SCD.Trial registration number: NCT04156399 (ClinicalTrials.gov).


Subject(s)
Acupuncture Therapy/methods , Anemia, Sickle Cell/psychology , Chronic Pain/therapy , Patient Acceptance of Health Care/psychology , Acupuncture Therapy/psychology , Adult , Anemia, Sickle Cell/complications , Chronic Pain/congenital , Chronic Pain/psychology , Feasibility Studies , Female , Humans , Male , Middle Aged , Pain Management/methods , Pain Management/psychology , Pain Measurement , Pilot Projects , Prospective Studies , Treatment Outcome
20.
Rev Bras Ter Intensiva ; 33(1): 48-67, 2021.
Article in Spanish, English | MEDLINE | ID: covidwho-1197640

ABSTRACT

OBJECTIVE: To propose agile strategies for a comprehensive approach to analgesia, sedation, delirium, early mobility and family engagement for patients with COVID-19-associated acute respiratory distress syndrome, considering the high risk of infection among health workers, the humanitarian treatment that we must provide to patients and the inclusion of patients' families, in a context lacking specific therapeutic strategies against the virus globally available to date and a potential lack of health resources. METHODS: A nonsystematic review of the scientific evidence in the main bibliographic databases was carried out, together with national and international clinical experience and judgment. Finally, a consensus of recommendations was made among the members of the Committee for Analgesia, Sedation and Delirium of the Sociedad Argentina de Terapia Intensiva. RESULTS: Recommendations were agreed upon, and tools were developed to ensure a comprehensive approach to analgesia, sedation, delirium, early mobility and family engagement for adult patients with acute respiratory distress syndrome due to COVID-19. DISCUSSION: Given the new order generated in intensive therapies due to the advancing COVID-19 pandemic, we propose to not leave aside the usual good practices but to adapt them to the particular context generated. Our consensus is supported by scientific evidence and national and international experience and will be an attractive consultation tool in intensive therapies.


OBJETIVO: Proponer estrategias agile para este abordaje integral de la analgesia, sedación, delirium, implementación de movilidad temprana e inclusión familiar del paciente con síndrome de dificultad respiratoria aguda por COVID-19, considerando el alto riesgo de infección que existe entre los trabajadores de salud, el tratamiento humanitario que debemos brindar al paciente y su familia, en un contexto de falta estrategias terapéuticas específicas contra el virus globalmente disponibles a la fecha y una potencial falta de recursos sanitarios. METODOS: Se llevó a cabo una revision no sistemática de la evidencia científica en las principales bases de datos bibliográficos, sumada a la experiencia y juicio clínico nacional e internacional. Finalmente, se realizó un consenso de recomendaciones entre los integrantes del Comité de Analgesia, Sedación y Delirium de la Sociedad Argentina de Terapia Intensiva. RESULTADOS: Se acordaron recomendaciones y se desarrollaron herramientas para asegurar un abordaje integral de analgesia, sedación, delirium, implementación de movilidad temprana e inclusión familiar del paciente adulto con síndrome de dificultad respiratoria aguda por COVID-19. DISCUSIÓN: Ante el nuevo orden generado en las terapias intensivas por la progresión de la pandemia de COVID-19, proponemos no dejar atrás las buenas prácticas habituales, sino adaptarlas al contexto particular generado. Nuestro consenso está respaldado en la evidencia científica, la experiencia nacional e internacional, y será una herramienta de consulta atractiva en las terapias intensivas.


Subject(s)
Analgesia/standards , COVID-19/complications , Consensus , Delirium/therapy , Pain Management/standards , Respiratory Distress Syndrome/therapy , Analgesia/methods , Analgesics/administration & dosage , COVID-19/drug therapy , Checklist , Delirium/diagnosis , Early Ambulation , Family , Humans , Intensive Care Units , Intubation, Intratracheal/methods , Neuromuscular Blockade/methods , Neuromuscular Blockade/standards , Pain Management/methods , Pain Measurement/methods , Pain Measurement/standards , Psychomotor Agitation/therapy
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