ABSTRACT
OBJECTIVES: The term "mixed pain" has been established when a mixture of different pain components (e.g. nociceptive, neuropathic, and nociplastic) are present. It has gained more and more acceptance amongst pain experts worldwide, but many questions around the concept of mixed pain are still unsolved. The sensation of pain is very personal. Cultural, social, personal experiences, idiomatic, and taxonomic differences should be taken into account during pain assessment. Therefore, a Latin American consensus committee was formed to further elaborate the essentials of mixed pain, focusing on the specific characteristics of the Latin American population. METHODS: The current approach was based on a systematic literature search and review carried out in Medline. Eight topics about the definition, diagnosis, and treatment of mixed pain were discussed and voted for by a Latin American consensus committee and recommendations were expressed. RESULTS: At the end of the meeting a total of 14 voting sheets were collected. The full consensus was obtained for 21 of 25 recommendations (15 strong agreement and 6 unanimous agreement) formulated for the above described 8 topics (7 of the 8 topics had for all questions at least a strong agreement - 1 topic had no agreement for all 4 questions). CONCLUSION: In a subject as complex as mixed pain, a consensus has been reached among Latin American specialists on points related to the definition and essence of this pain, its diagnosis and treatment. Recommendations for diagnosis and treatment of mixed pain in Latin America were raised.
Subject(s)
Pain , Humans , Consensus , Latin America/epidemiology , Pain/diagnosis , Pain/etiology , Pain/physiopathology , Pain Measurement , Analgesia/methodsABSTRACT
OBJECTIVE: To identify specific fractures risks of the following bones: distal femur, patella and tibia plateau, according to sex and age, with special interest in women >or= 50 y.o. MATERIAL AND METHODS: An epidemiologic case-control study was done between January 2002 and December 2005. The incidence rate for fractures were got by year, sex and age. The group exposed to the risk factors, was represented by female patients >or=50 y.o. The cases with fracture's worst prognosis were: distal femur (supracondylar, supraintercondylar or condylar), tibial plateau (Schatzker IV-VI); the control group was made with patients which fractures were in: proximal femur (Subtrocantheric, diaphysis), tibial plateau (Schatzker I-III). Descriptive and inferential analysis were done separately and together. RESULTS: 1578 Patients were studied. Incidence of fractures in the studied regions was of 5.9 per 10 000 persons/year (py), being of 5.7 and 4.9 per 10,000 py for men and women, respectively (p < 0.001). In subjects with age >or=50 y.o. the incidence rate was of 10.5 and 6.6 per 10 000 py for men and women, respectively. In the study patients less than 50 y.o. the incidence rate was of 1.6 per 10 000 py for both sexes (p < 0.001). The women >or=50 y.o. presented an OR of 5.1 (95% CI: 2.7-9.8, p < 0.001). CONCLUSIONS: In this study sample, the risk of fracture of the femur and the knee was greater in men than in women. In the >or= 50 y.o. age group, the ratio was inverted, with special interest in distal femur fractures. According to sex and age, no differences were identified in tibia plateau fractures.
