Assessment of Pain Treatments in Disorders of Upper Limbs: A Qualitative Study Protocol Based on Patients' Experiences.

Chronic musculoskeletal pain (CMP) is one of the most common symptoms of musculoskeletal disorders. Carpal tunnel syndrome (CTS) and subacromial syndrome (SAS) are the most prevalent musculoskeletal disorders of the upper limbs. By collecting the opinions of patients with CTS and SAS, we aim to identify variables that could be introduced in the follow-up of CMP, and to detect barriers and facilitators of its treatments to improve their acceptance. This qualitative study is being conducted in Lleida, Spain, and explores the experiences and feelings of patients, and their acceptance of the standard of care. It follows the consolidated criteria for reporting qualitative research (COREQ) through focus groups, addressing issues with rigor and representativeness. By collecting patients' opinions, we expect to obtain valuable information to complement the set of variables previously used by health professionals in the follow-up of CMP, and to understand treatment barriers and facilitators.

Higher Accuracy of Lung Ultrasound over Chest X-ray for Early Diagnosis of COVID-19 Pneumonia.

BACKGROUND: The COVID-19 pandemic rapidly strained healthcare systems worldwide. The reference standard for diagnosis is a positive reverse transcription polymerase chain reaction (RT-PCR) test, but results are not immediate and sensibility is variable. AIM: To evaluate the diagnostic accuracy of lung ultrasound compared to chest X-ray for COVID-19 pneumonia. DESIGN AND SETTING: A retrospective analysis of symptomatic patients admitted into one primary care centre in Spain between March and September 2020. METHOD: Patients' chest X-rays and lung ultrasounds were categorized as normal or pathologic. RT-PCR confirmed COVID-19 infection. Pathologic lung ultrasound images were further categorized as showing either local or diffuse interstitial disease. McNemar and Fisher tests were used to compare diagnostic accuracy. RESULTS: Most of the 212 patients presented fever at admission, either as a standalone symptom (37.74% of patients) or together with others (72.17% of patients). The positive predictive value of the lung ultrasound was 90% for the diffuse interstitial pattern and 46.92% for local pattern. The lung ultrasound had a significantly higher sensitivity (82.75%) (p < 0.001), but lower specificity (71%) than the chest X-ray (54.02% and 86%, respectively) (p = 0.008) for identifying interstitial lung disease. Moreover, sensitivity of the lung ultrasound for severe interstitial disease was 100%, and was significantly higher than the chest X-ray (58.33%) (p = 0.002). CONCLUSION: The lung ultrasound is more accurate than the chest X-ray for identifying patients with COVID-19 pneumonia and it is especially useful for those presenting diffuse interstitial disease.