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1.
Hu Li Za Zhi ; 70(3): 26-36, 2023 Jun.
Article in Chinese | MEDLINE | ID: covidwho-20233980

ABSTRACT

BACKGROUND: Knee osteoarthritis is prevalent in older adults worldwide. Quality of life was negatively affected by the COVID-19 pandemic. PURPOSE: This study was designed to examine osteoarthritis severity and health-related quality of life (QOL) in older adults with knee osteoarthritis before total knee replacement during the COVID-19 pandemic and to identify the related predictors of QOL. METHODS: This cross-sectional correlation study involved convenience sampling in the orthopedic ward of a regional teaching hospital in central Taiwan from June 2020 to June 2021 using the Western Ontario and McMaster Universities Arthritis Index and the SF-36v2 Health Survey. The data were analyzed using Pearson's correlation coefficient analysis, independent samples t test, and one-way analysis of variance to determine correlations among demographic variables, osteoarthritis severity, and QOL. The predictors of QOL were examined using stepwise multiple linear regression analysis. RESULTS: A total of 60 older adults diagnosed with knee osteoarthritis were sampled. The average age was 70 years and the average osteoarthritis severity score was 70.45. Being male, having comorbidities, and having a relatively high level of monthly disposable income were associated with poorer QOL. Moreover, more severe knee pain, stiffness, and physical dysfunction were associated with better psychological QOL. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: During the COVID-19 pandemic, the severity of knee osteoarthritis affects preoperative quality of life in older adults. Clinicians should detect signs of pain and physical dysfunction in these patients in advance and intervene in a timely manner to improve their QOL before surgery.


Subject(s)
COVID-19 , Osteoarthritis, Knee , Humans , Male , Aged , Female , Osteoarthritis, Knee/surgery , Osteoarthritis, Knee/epidemiology , Quality of Life/psychology , Cross-Sectional Studies , Pandemics , Pain/psychology
2.
Sci Rep ; 13(1): 9336, 2023 Jun 08.
Article in English | MEDLINE | ID: covidwho-20239962

ABSTRACT

In the present work, we used daily diary methodology to investigate the influence of awe on stress, somatic health (e.g., pain symptoms), and well-being during the COVID-19 pandemic in 2020. We recruited a sample of community adults (N = 269) and a sample of healthcare professionals (N = 145) in the United States. Across both samples, we found that awe and well-being increased, and stress and somatic health symptoms decreased over the 22-day diary period. In daily level analyses, we found that the more daily awe people experienced, the less stress, less somatic health symptoms, and greater well-being they felt. Daily experiences of awe can benefit individuals during times of acute and chronic stress-such as the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Adult , Humans , United States , Longitudinal Studies , Emotions , Pain
3.
Womens Health (Lond) ; 19: 17455057231176751, 2023.
Article in English | MEDLINE | ID: covidwho-20239377

ABSTRACT

BACKGROUND: Vaccination can have an impact on menstruation, and this impact may be more notable in women with inflammatory gynecological pathologies such as endometriosis. OBJECTIVES: We aimed to investigate the impact of mRNA-based SARS-CoV-2 vaccines on menstrual cycle-related symptoms in women with endometriosis and assess the effect of hormonal therapy on potential SARS-CoV-2 vaccination-induced menstrual changes. DESIGN: A total of 848 women who received at least two doses of mRNA-based COVID-19 vaccines were prospectively recruited: 407 with endometriosis (endometriosis group) and 441 healthy controls (non-endometriosis group). METHODS: Data regarding demographics, clinical characteristics, hormonal treatment, and menstrual-associated symptoms in the first and second cycle after vaccination were collected through an online survey. RESULTS: A similar percentage of patients in both the endometriosis and the non-endometriosis group self-reported menstrual-associated changes the first (52.6% versus 48.8%, respectively) and second cycle after vaccination (29.0% versus 28.1%, respectively). Although the total symptoms recorded were not different between the two groups, several specific symptoms were statistically more frequent in the endometriosis group. These were pain disorders and fatigue in the first cycle after vaccination and pain disorders, menstrual headache and fatigue in the second cycle after vaccination. Bleeding frequency/regularity disorders were found to be more frequent in the non-endometriosis group in the first cycle after vaccination. Patients under hormonal treatment reported fewer changes in menstrual symptoms in the first and second cycle after vaccination compared with those not receiving this treatment. Similarly, patients in the endometriosis group receiving hormonal treatment reported fewer changes in menstrual-associated symptoms compared with those not following any hormonal treatment in the first and second menstrual cycle after the last vaccination. CONCLUSION: Women with endometriosis immunized with mRNA-based SARS-CoV-2 vaccines did not perceive greater worsening or new menstrual-associated symptoms after complete COVID-19 vaccination compared with healthy controls. Hormonal treatment may have a protective effect against worsened or new menstrual symptoms induced by COVID-19 vaccination.


Subject(s)
COVID-19 , Endometriosis , Humans , Female , COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , SARS-CoV-2 , Endometriosis/drug therapy , Fatigue , RNA, Messenger , Vaccination/adverse effects , Pain
4.
Sensors (Basel) ; 23(11)2023 May 26.
Article in English | MEDLINE | ID: covidwho-20239338

ABSTRACT

BACKGROUND: The COVID-19 pandemic has accelerated the demand for utilising telehealth as a major mode of healthcare delivery, with increasing interest in the use of tele-platforms for remote patient assessment. In this context, the use of smartphone technology to measure squat performance in people with and without femoroacetabular impingement (FAI) syndrome has not been reported yet. We developed a novel smartphone application, the TelePhysio app, which allows the clinician to remotely connect to the patient's device and measure their squat performance in real time using the smartphone inertial sensors. The aim of this study was to investigate the association and test-retest reliability of the TelePhysio app in measuring postural sway performance during a double-leg (DLS) and single-leg (SLS) squat task. In addition, the study investigated the ability of TelePhysio to detect differences in DLS and SLS performance between people with FAI and without hip pain. METHODS: A total of 30 healthy (nfemales = 12) young adults and 10 adults (nfemales = 2) with diagnosed FAI syndrome participated in the study. Healthy participants performed DLS and SLS on force plates in our laboratory, and remotely in their homes using the TelePhysio smartphone application. Sway measurements were compared using the centre of pressure (CoP) and smartphone inertial sensor data. A total of 10 participants with FAI (nfemales = 2) performed the squat assessments remotely. Four sway measurements in each axis (x, y, and z) were computed from the TelePhysio inertial sensors: (1) average acceleration magnitude from the mean (aam), (2) root-mean-square acceleration (rms), (3) range acceleration (r), and (4) approximate entropy (apen), with lower values indicating that the movement is more regular, repetitive, and predictable. Differences in TelePhysio squat sway data were compared between DLS and SLS, and between healthy and FAI adults, using analysis of variance with significance set at 0.05. RESULTS: The TelePhysio aam measurements on the x- and y-axes had significant large correlations with the CoP measurements (r = 0.56 and r = 0.71, respectively). The TelePhysio aam measurements demonstrated moderate to substantial between-session reliability values of 0.73 (95% CI 0.62-0.81), 0.85 (95% CI 0.79-0.91), and 0.73 (95% CI 0.62-0.82) for aamx, aamy, and aamz, respectively. The DLS of the FAI participants showed significantly lower aam and apen values in the medio-lateral direction compared to the healthy DLS, healthy SLS, and FAI SLS groups (aam = 0.13, 0.19, 0.29, and 0.29, respectively; and apen = 0.33, 0.45, 0.52, and 0.48, respectively). In the anterior-posterior direction, healthy DLS showed significantly greater aam values compared to the healthy SLS, FAI DLS, and FAI SLS groups (1.26, 0.61, 0.68, and 0.35, respectively). CONCLUSIONS: The TelePhysio app is a valid and reliable method of measuring postural control during DLS and SLS tasks. The application is capable of distinguishing performance levels between DLS and SLS tasks, and between healthy and FAI young adults. The DLS task is sufficient to distinguish the level of performance between healthy and FAI adults. This study validates the use of smartphone technology as a tele-assessment clinical tool for remote squat assessment.


Subject(s)
COVID-19 , Femoracetabular Impingement , Young Adult , Humans , Femoracetabular Impingement/diagnosis , Smartphone , Reproducibility of Results , Leg , Pandemics , Pain , Postural Balance
5.
BMJ Case Rep ; 16(5)2023 May 25.
Article in English | MEDLINE | ID: covidwho-20236167

ABSTRACT

Although SARS-CoV-2 syndrome primarily affects the lungs, systemic manifestations have been reported. New rheumatic immune-mediated inflammatory diseases have been reported following SARS-CoV-2 infection. We present a case of a woman in her mid-30s who developed inflammatory back pain due to bilateral sacroiliitis with erosions after contracting SARS-CoV-2 infection. Her inflammatory markers on presentation were normal. MRI of the sacroiliac joints demonstrated bone marrow oedema and erosive changes in both sacroiliac joints. As the patient was intolerant to non-steroidal anti-inflammatory drugs, adalimumab 40 mg subcutaneous (SC) injection was administered, which improved her symptoms in 8 weeks. However, due to the drug's side effects, SC adalimumab was switched to intravenous infliximab. The patient is currently tolerating her intravenous infliximab well and has experienced significant improvement in her symptoms. We reviewed the current literature on the prevalence of axial spondyloarthropathy after SARS-CoV-2 infection.


Subject(s)
COVID-19 , Rheumatic Diseases , Sacroiliitis , Spondylarthritis , Female , Humans , Spondylarthritis/complications , Spondylarthritis/drug therapy , Spondylarthritis/diagnosis , Infliximab/therapeutic use , Adalimumab/therapeutic use , COVID-19/complications , SARS-CoV-2 , Sacroiliac Joint , Sacroiliitis/drug therapy , Magnetic Resonance Imaging , Pain
7.
Lancet Neurol ; 22(6): 476-484, 2023 06.
Article in English | MEDLINE | ID: covidwho-20245121

ABSTRACT

BACKGROUND: No acute treatments targeting calcitonin gene-related peptide (CGRP) have been approved for use in China or South Korea. We aimed to compare the efficacy and safety of rimegepant-an orally administered small molecule CGRP antagonist-with placebo in the acute treatment of migraine among adults in these countries. METHODS: This double-blind, randomised, placebo-controlled, multicentre phase 3 trial was done at 86 outpatient clinics at hospitals and academic medical centres (73 in China and 13 in South Korea). Participants were adults (≥18 years) with at least a 1-year history of migraine who had two to eight moderate or severe attacks per month and fewer than 15 headache days per month within the 3 months before the screening visit. Participants were randomly assigned (1:1) to 75 mg rimegepant or placebo to treat a single migraine attack of moderate or severe pain intensity. Randomisation was stratified by the use of preventive medication and by country. The allocation sequence was generated and implemented by study personnel using an interactive web-response system accessed online from each study centre. All participants, investigators, and the sponsor were masked to treatment assignment. The coprimary endpoints of freedom from pain and freedom from the most bothersome symptom (nausea, phonophobia, or photophobia) 2 h after dosing were assessed in the modified intention-to-treat (mITT) population (randomly assigned participants who took study medication for a migraine attack of moderate or severe pain intensity, and provided at least one efficacy datapoint after treatment) using Cochran-Mantel Haenszel tests. Safety was assessed in all participants who received rimegepant or placebo. The study is registered with ClinicalTrials.gov, number NCT04574362, and is completed. FINDINGS: 1431 participants were randomly assigned (716 [50%] to rimegepant and 715 [50%] to placebo). 668 (93%) participants in the rimegepant group and 674 (94%) participants in the placebo group received treatment. 1340 participants were included in the mITT analysis (666 [93%] in the rimegepant group and 674 [94%] in the placebo group). 2 h after dosing, rimegepant was superior to placebo for pain freedom (132 [20%] of 666 vs 72 [11%] of 674, risk difference 9·2, 95% CI 5·4-13·0; p<0·0001) and freedom from the most bothersome symptom (336 [50%] of 666 participants vs 241 [36%] of 674 participants, 14·8, 9·6-20·0; p<0·0001). The most common (≥1%) adverse events were protein in urine (8 [1%] of 668 participants in the rimepegant group vs 7 [1%] of 674 participants in the placebo group), nausea (7 [1%] of 668 vs 18 [3%] of 674), and urinary tract infection (5 [1%] of 668 vs 8 [1%] of 674). There were no rimegepant-related serious adverse events. INTERPRETATION: Among adults living in China or South Korea, a single dose of 75 mg rimegepant was effective for the acute treatment of migraine. Safety and tolerability were similar to placebo. Our findings suggest that rimegepant might be a useful new addition to the range of medications for the acute treatment of migraine in China and South Korea, but further studies are needed to support long-term efficacy and safety and to compare rimegepant with other medications for the acute treatment of migraine in this population. FUNDING: BioShin Limited. TRANSLATIONS: For the Chinese and Korean translations of the abstract see Supplementary Materials section.


Subject(s)
Calcitonin Gene-Related Peptide , Migraine Disorders , Adult , Humans , Migraine Disorders/diagnosis , Nausea , Pain , Double-Blind Method , Tablets/therapeutic use , China , Treatment Outcome
8.
J Pain ; 24(6): 1080-1093, 2023 Jun.
Article in English | MEDLINE | ID: covidwho-20244382

ABSTRACT

Animal-assisted interventions (AAIs) is a promising treatment approach for pain, but possible mechanisms still need to be elucidated. This study set out to investigate the analgesic effects of an animal provided with a treatment rationale in a randomized controlled trial employing a standardized experimental heat-pain paradigm. We randomly assigned 128 healthy participants to: dog treatment (DT), placebo treatment (PT), dog and placebo treatment (DPT), and no treatment (NT). Primary outcomes were heat-pain tolerance and the corresponding self-reported ratings of pain unpleasantness and intensity. Results revealed no differences in heat-pain tolerance between the conditions. However, participants in the DT condition experienced heat-pain as significantly less unpleasant at the limit of their tolerance compared to participants in the NT condition (estimate = -0.96, CI = -1.58 to 0.34, P = .010). Participants in the DT condition also showed lower ratings of pain intensity at the limit of their tolerance compared to participants in the NT condition (estimate = -0.44, CI = -0.89 to 0.02, P = .060). This study indicates that a dog has analgesic effects on pain perception when integrated into the treatment rationale. We assume that providing a treatment rationale regarding the animal is important in AAIs for pain. PERSPECTIVE: This study shows that the presence of an animal is not sufficient for animal-assisted interventions (AAIs) to have an analgesic effect on pain unless they are provided with a treatment rationale. This could imply that not only the animal but also contextual factors are important in AAIs. TRIAL REGISTRATION: Clinical Trials NCT04361968.


Subject(s)
Pain Threshold , Pain , Humans , Animals , Dogs , Healthy Volunteers , Pain/drug therapy , Pain Perception , Analgesics/therapeutic use
9.
Int J Environ Res Public Health ; 20(10)2023 05 10.
Article in English | MEDLINE | ID: covidwho-20242389

ABSTRACT

Musculoskeletal disorders are responsible for the most prevalent form of pain, and necessitate a comprehensive approach to rehabilitation [...].


Subject(s)
Musculoskeletal Diseases , Musculoskeletal Pain , Humans , Psychosocial Intervention , Musculoskeletal Diseases/therapy , Pain , Musculoskeletal Pain/therapy , Exercise Therapy
10.
Front Public Health ; 11: 1153820, 2023.
Article in English | MEDLINE | ID: covidwho-2327164

ABSTRACT

Background: Since the end of 2019, Corona Virus Disease 2019, also known as COVID-19, has broken out in various countries. However, the change of China's COVID-19 prevention and control policy and the sharp increase in the number of infected people are making the teenagers have post-traumatic reactions. Negative post-traumatic reactions include: post-traumatic stress disorder (PTSD), depression, anxiety. Positive post-traumatic reaction mainly refers to post-traumatic growth (PTG). The purpose of this study is to explore the post-traumatic reaction, which refers to PTSD, depression, anxiety and the co-occurrence pattern of growth after trauma and to further explore the influence of family function on different categories of Post-traumatic Reactions. Methods: Latent profile analysis (LPA) was used to explore the co-occurrence of PTSD, depression, anxiety, and PTG. Multiple logistics regression was used to analyze the influence of family function on different categories of post-traumatic response. Results: There were three categories of post-traumatic reactions in adolescents infected with COVID-19 adolescents infected with COVID-19, namely: growth class, struggling class, and pain class. Multivariate Logistic regression showed that the growth class and struggling class were affected by problem solving and behavior control in family function, while the growth class and pain class were affected by problem solving, roles, behavior control, and general functioning. Multiple logistic regression showed that the growth class and struggling class were affected by problem solving and roles. Conclusions: The findings of this study provide evidence for the identification of high-risk individuals and the provision of effective interventions in clinical practice, as well as the influence of family functioning on the different categories of PTSD among adolescents infected with COVID-19.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , Adolescent , COVID-19/epidemiology , East Asian People , Stress Disorders, Post-Traumatic/epidemiology , Anxiety Disorders , Pain
11.
Otolaryngol Pol ; 77(1): 1-5, 2022 Nov 24.
Article in English | MEDLINE | ID: covidwho-2326462

ABSTRACT

BACKGROUND: Acute rhinosinusitis (ARS) is a common and well-defined disorder, primarily of viral aetiology, with rhinovirus and coronavirus accounting for more than 50% of viral ARS. The fight with COVID-19 pandemic resulted in an increased availability viral testing, which in turn allowed testing for presence of SARS-Cov-2 in all patients presenting common cold (or ARS) symptoms. The aim of this study was to assess the clinical characteristics of acute rhinosinusitis in patients diagnosed with COVID-19. METHODOLOGY/PRINCIPAL: This study is a post-hoc analysis. Patients symptoms were evaluated using a structured questionnaire twice: directly after a positive SARS-Cov-2 result and 7-12 days following the first evaluation. Subjects were asked about presence of nasal and systemic symptoms as well as headache. RESULTS: A total of 130 COVID-19 symptomatic patients were recruited into the study, 58 (45%) patients met EPOS2020 diagnostic criteria for ARS. Of all ARS patients, 72% presented with rhinorrhoea, 69% with pain perceived over paranasal sinuses, 62% with nasal congestion, 52% with cough, 45% with olfactory dysfunction, 38% with fever, 33% with facial pressure and in 22% pain was exacerbated by sinus palpation. CONCLUSIONS: Half of COVID-19 subjects has ARS. The course of SARS-Cov-2 ARS does not seem to differ significantly from ARS of other aetiologies. Since ARS in the course of COVID-19 seems to meet the definition of ARS proposed by EPOS 2020, we hypothesize that substances validated for ARS treatment, such as intranasal corticosteroids could be effective in SARS-Cov-2 ARS.


Subject(s)
COVID-19 , Sinusitis , Humans , COVID-19/complications , COVID-19/diagnosis , SARS-CoV-2 , Longitudinal Studies , Pandemics , Sinusitis/diagnosis , Sinusitis/epidemiology , Acute Disease , Pain
12.
Pain ; 164(6): 1258-1263, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-2323362

Subject(s)
Pain , Triamcinolone , Humans
13.
Clin Infect Dis ; 75(Supplement_1): S98-S109, 2022 Aug 15.
Article in English | MEDLINE | ID: covidwho-2320399

ABSTRACT

BACKGROUND: The opioid epidemic worsened during the coronavirus disease 2019 (COVID-19) pandemic. Synthetic opioids (primarily fentanyl) comprise the most common drugs involved in overdose (OD) death. A vaccine that blocks fentanyl from reaching the brain to prevent OD is under development, and insight is needed into its acceptability. METHODS: Using a semi-structured interview guide, persons with opioid use disorder (OUD), family, professionals, and the public were interviewed about attitudes and concerns regarding a fentanyl vaccine. Reactions to fictional clinical vignettes of persons at risk of OUD because of pain and/or substance use histories were collected, analyzed, and quantified for favorability. Interviews were transcribed, coded, and analyzed thematically. RESULTS: Among N = 64 participants, (70.3% female, average age 32.4 years), attitudes were favorable toward a fentanyl vaccine, with preference for lifelong durability (76% of n = 55 asked). Perceived benefits centered on the potential for a life-saving intervention, suffering averted, healthcare dollars saved, and the utility of a passive harm reduction strategy. Concerns centered on uncertainty regarding vaccine safety, questions about efficacy, worry about implications for future pain management, stigma, and need for supportive counseling and guidance to personalize decision making. Reactions to vignettes revealed complex attitudes toward fentanyl vaccination when considering recipient age, health history, and future risks for addiction and pain. CONCLUSIONS: Positive responses to a fentanyl vaccine were found along with appreciation for the complexity of a vaccine strategy to prevent OD in the setting of pain and uncertain durability. Further research is needed to elucidate operational, ethical, and communications strategies to advance the model.


Subject(s)
COVID-19 , Drug Overdose , Fentanyl , Opiate Overdose , Opioid-Related Disorders , Adult , Analgesics, Opioid/adverse effects , Drug Overdose/drug therapy , Drug Overdose/epidemiology , Drug Overdose/prevention & control , Female , Fentanyl/adverse effects , Humans , Male , Opioid-Related Disorders/complications , Opioid-Related Disorders/epidemiology , Opioid-Related Disorders/prevention & control , Pain , Vaccines
14.
Trials ; 23(1): 768, 2022 Sep 11.
Article in English | MEDLINE | ID: covidwho-2313320

ABSTRACT

BACKGROUND: There is an unmet need for treatments for knee osteoarthritis (OA). Effusion-synovitis is a common inflammatory phenotype of knee OA and predicts knee pain and structural degradation. Anti-inflammatory therapies, such as diacerein, may be effective for this phenotype. While diacerein is recommended for alleviating pain in OA patients, evidence for its effectiveness is inconsistent, possibly because studies have not targeted patients with an inflammatory phenotype. Therefore, we will conduct a multi-centre, randomised, placebo-controlled double-blind trial to determine the effect of diacerein on changes in knee pain and effusion-synovitis over 24 weeks in patients with knee OA and magnetic resonance imaging (MRI)-defined effusion-synovitis. METHODS: We will recruit 260 patients with clinical knee OA, significant knee pain, and MRI-detected effusion-synovitis in Hobart, Melbourne, Adelaide, and Perth, Australia. They will be randomly allocated to receive either diacerein (50mg twice daily) or identical placebo for 24 weeks. MRI of the study knee will be performed at screening and after 24 weeks of intervention. The primary outcome is improvement in knee pain at 24 weeks as assessed by a 100-mm visual analogue scale (VAS). Secondary outcomes include improvement in volumetric (ml) and semi-quantitative (Whole-Organ Magnetic Resonance Imaging Score, 0-3) measurements of effusion-synovitis using MRI over 24 weeks, and improvement in knee pain (VAS) at 4, 8, 12, 16, and 20 weeks. Intention-to-treat analyses of primary and secondary outcomes will be performed as the primary analyses. Per protocol analyses will be performed as the secondary analyses. DISCUSSION: This study will provide high-quality evidence to determine whether diacerein improves pain, changes disease trajectory, and slows disease progression in OA patients with effusion-synovitis. If diacerein proves effective, this has the potential to significantly benefit the substantial proportion (up to 60%) of knee OA patients with an inflammatory phenotype. TRIAL REGISTRATION: Australian and New Zealand Clinical Trial Registry ACTRN12618001656224 . Registered on 08 October 2018.


Subject(s)
Osteoarthritis, Knee , Synovitis , Anthraquinones , Australia , Humans , Multicenter Studies as Topic , Osteoarthritis, Knee/diagnostic imaging , Osteoarthritis, Knee/drug therapy , Pain/drug therapy , Randomized Controlled Trials as Topic , Synovitis/diagnostic imaging , Synovitis/drug therapy , Treatment Outcome
15.
Am J Emerg Med ; 68: 64-67, 2023 06.
Article in English | MEDLINE | ID: covidwho-2319708

ABSTRACT

INTRODUCTION: Asking patients about pain in the Emergency Department (ED) when deriving a pain score may aggravate perception of pain due to the nocebo-effect. A strategy for diminishing this nocebo-effect is cognitive reframing. Cognitive reframing of the frequently used pain score (PS) in the ED could theoretically be obtained by using the comfort score (CS). The aim of this study was to evaluate whether or not the CS and PS are interchangeable and therefore, whether or not the CS could safely be used in ED patients. METHODS: In this prospective pilot study we enrolled patients with pain visiting the ED. Participants were asked for both PS and CS in randomized order. CS were inverted (ICS) and compared with PS using the using the Wilcoxon signed rank test. Secondarily we evaluated for patient score preference. RESULTS: In total 100 patients were enrolled. The median PS in these participants was 6 (IQR 4-7) and median ICS was 5 (IQR 3-6). In total, 15 (15%) of the PS and ICS were identical Medians did not differ significantly (p = .115). In 33% of the participants the total difference between the PS and ICS was >2. Participants preferred to be asked for PS over CS (43 vs 15%, p < .00). CONCLUSION: This proof of concept study suggest interchangeability of the PS and the ICS in patients with pain in the ED. However, while not statistically significant, 33% of the patients had a possible clinical significant difference in score outcome, potentially over- or underestimating the patients pain. Whether or not this can be used as a tool for cognitive reframing to reduce perception of pain and medication consumption has yet to be studied.


Subject(s)
Emergency Service, Hospital , Pain , Humans , Pilot Projects , Prospective Studies , Proof of Concept Study , Pain/diagnosis , Pain/drug therapy
16.
BMJ Open ; 13(2): e068877, 2023 02 27.
Article in English | MEDLINE | ID: covidwho-2317984

ABSTRACT

OBJECTIVES: Infectious mononucleosis (IM) is a clinical syndrome that is characterised by lymphadenopathy, fever and sore throat. Although generally not considered a serious illness, IM can lead to significant loss of time from school or work due to profound fatigue, or the development of chronic illness. This study aimed to derive and externally validate clinical prediction rules (CPRs) for IM caused by Epstein-Barr virus (EBV). DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: 328 participants were recruited prospectively for the derivation cohort, from seven university-affiliated student health centres in Ireland. Participants were young adults (17-39 years old, mean age 20.6 years) with sore throat and one other additional symptom suggestive of IM. The validation cohort was a retrospective cohort of 1498 participants from a student health centre at the University of Georgia, USA. MAIN OUTCOME MEASURES: Regression analyses were used to develop four CPR models, internally validated in the derivation cohort. External validation was carried out in the geographically separate validation cohort. RESULTS: In the derivation cohort, there were 328 participants, of whom 42 (12.8%) had a positive EBV serology test result. Of 1498 participants in the validation cohort, 243 (16.2%) had positive heterophile antibody tests for IM. Four alternative CPR models were developed and compared. There was moderate discrimination and good calibration for all models. The sparsest CPR included presence of enlarged/tender posterior cervical lymph nodes and presence of exudate on the pharynx. This model had moderate discrimination (area under the receiver operating characteristic curve (AUC): 0.70; 95% CI: 0.62-0.79) and good calibration. On external validation, this model demonstrated reasonable discrimination (AUC: 0.69; 95% CI: 0.67-0.72) and good calibration. CONCLUSIONS: The alternative CPRs proposed can provide quantitative probability estimates of IM. Used in conjunction with serological testing for atypical lymphocytosis and immunoglobulin testing for viral capsid antigen, CPRs can enhance diagnostic decision-making for IM in community settings.


Subject(s)
Epstein-Barr Virus Infections , Infectious Mononucleosis , Pharyngitis , Young Adult , Humans , Adult , Adolescent , Infectious Mononucleosis/diagnosis , Herpesvirus 4, Human , Clinical Decision Rules , Prospective Studies , Retrospective Studies , Antigens, Viral , Pain
17.
J Korean Med Sci ; 38(18): e134, 2023 May 08.
Article in English | MEDLINE | ID: covidwho-2317680

ABSTRACT

There are many reports of subacute thyroiditis (SAT) that occurred after the coronavirus disease 2019 (COVID-19), but no such case has been reported in Korea. Moreover, the simultaneous occurrence of SAT and Graves' disease (GD) is rare. Here, we describe a patient who developed SAT and GD after the second episode of COVID-19. A 27-year-old woman with no known history of thyroid disease presented with fever, upper respiratory tract symptoms, and painful neck swelling. Thyroid function tests revealed thyrotoxicosis, and thyroid ultrasound showed heterogeneous echogenicity of enlarged thyroid glands. Her initial clinical presentation was consistent with SAT after viral infection, with typical neck tenderness and spontaneous improvement of thyrotoxicosis without antithyroid drug use. However, this case had some atypical features, such as an elevated thyroid-stimulating immunoglobulin level, relapse of thyrotoxicosis in short-term follow-up, and increased Tc-99m pertechnetate uptake, suggesting the coexistence of GD. About two months after methimazole (15 mg/day) was prescribed, she was lost to follow up again. We report the first case of unusual co-occurrence of SAT and GD following COVID-19.


Subject(s)
COVID-19 , Graves Disease , Thyroiditis, Subacute , Thyrotoxicosis , Humans , Female , Adult , Thyroiditis, Subacute/complications , Thyroiditis, Subacute/diagnosis , Thyroiditis, Subacute/drug therapy , COVID-19/complications , Graves Disease/complications , Graves Disease/diagnosis , Graves Disease/drug therapy , Thyrotoxicosis/complications , Thyrotoxicosis/diagnosis , Thyrotoxicosis/drug therapy , Fever , Pain
18.
J Nutr Sci ; 12: e56, 2023.
Article in English | MEDLINE | ID: covidwho-2315067

ABSTRACT

The coronavirus disease 2019 (COVID-19) has led to the implementation of restrictions to reduce transmission worldwide. The restrictions and measures have affected the psychological health and eating habits. The objective of the present study was to evaluate dietary habits, lifestyle changes, adherence to the Mediterranean diet (MD) and fear of COVID-19 in Turkey during the pandemic. A cross-sectional online survey of socio-demographic characteristics, anthropometric measurements, nutrition, physical activity and lifestyle habits was used for data collection. The fear of COVID-19 levels of the participants was determined by the fear of COVID-19 scale (FCV-19S). The Mediterranean Diet Adherence Screener (MEDAS) was used to evaluate participants' adherence to the MD. The differences between the FCV-19S and MEDAS according to gender were compared. Eight hundred and twenty subjects (76⋅6 % women and 28⋅4 % men) were evaluated within the study. The mean of MEDAS (ranged between 0 and 12) was 6⋅4 ± 2⋅1, and almost half of the participants moderately adhered to the MD. The mean of FCV-19S (ranged between 7 and 33) was 16⋅8 ± 5⋅7, while women's FCV-19S and MEDAS were significantly higher than men's (P < 0⋅001). The consumption of sweetened cereals, grains, pasta, homemade bread and pastries of the respondents with high FCV-19S were higher than in those with low FCV-19S. High FCV-19S was also characterized by decreased take-away food and fast food consumption in approximately 40 % of the respondents (P < 0⋅01). Similarly, women's fast food and take-away food consumption decreased more than men's (P < 0⋅05). In conclusion, the respondents' food consumption and eating habits varied according to the fear of COVID-19.


Subject(s)
COVID-19 , Diet, Mediterranean , Male , Humans , Female , Cross-Sectional Studies , Pandemics , Fear , Bread
19.
Am J Nurs ; 123(6): 26-36, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-2313147

ABSTRACT

PURPOSE: In this qualitative descriptive study, we sought to understand the professional experiences and perceptions of pain management nurses who cared for older adults in the United States during the height of the COVID-19 pandemic. METHODS: Data were collected between July 2020 and July 2021 through individual, semistructured interviews with a nonprobability sample of 18 pain management nurses. An inductive content analysis approach, in which categories were derived from a coding process based on a close reading of data extracts from the interview transcripts, was used to reveal the major theme related to the study aim. RESULTS: Notwithstanding the variable consequences of COVID-19 on patients' health, a single overarching theme was pronounced: "Pain management for older adults remained unchanged during the pandemic despite unpredictable survival, restrictions on human interactions, and communication challenges." This theme was supported by four categories that emerged from the data: unpredictable survival, restriction-induced isolation, perceived continuity and equality of pain management, and communication challenges. CONCLUSIONS: During the COVID-19 pandemic, pain management nurses stepped in and joined interdisciplinary teams providing general and specialized pain care to ensure that older adults, whether inpatient or outpatient, continued to receive quality care. These study findings highlight the many challenges pain management nurses faced during this unprecedented public health crisis, as well as opportunities to improve the health system and enhance nursing practice to meet the needs of older patients.


Subject(s)
COVID-19 , Pandemics , Humans , United States/epidemiology , Aged , Pain , Pain Management , Qualitative Research
20.
CMAJ ; 195(17): E625-E626, 2023 05 01.
Article in English | MEDLINE | ID: covidwho-2313002

Subject(s)
Pain , Humans , Pain Measurement
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