Effect of audiovisual eyeglasses on intraoperative pain, anxiety, and hemodynamic changes during mandibular third molar extraction: a randomized controlled clinical trial.

OBJECTIVES: To determine the effect of audiovisual eyeglasses in terms of anxiety relief, hemodynamic changes, and intraoperative pain in patients undergoing surgical removal of a mandibular third molar. METHOD AND MATERIALS: A randomized controlled clinical trial with two parallel groups was carried out in patients undergoing mandibular third molar extraction. Fifteen patients watched a video with multimedia eyeglasses during the surgical procedure, whereas 15 controls had their eyes covered during extraction. The patients completed anxiety questionnaires before and after surgery. Hemodynamic changes, intraoperative pain, duration of the surgery, and overall satisfaction were recorded. RESULTS: Thirty patients were analyzed. Intraoperative pain and the need for supplemental anesthesia were significantly more frequent in the control group (53.3% versus 13.3%; P < .05). The surgical procedure was also briefer when the eyeglasses were used (17.2 versus 28.1 minutes). Overall satisfaction was similar in both groups. No significant differences were found between the two study groups in terms of anxiety and hemodynamic parameters. CONCLUSIONS: The use audiovisual eyeglasses should be routinely considered during mandibular third molar extraction since these devices allow reduction of intraoperative pain and surgery time. However, patient anxiety level and hemodynamic parameters seem to remain unaltered.

Exploring Medication Adherence Using M-Health: A Study from Veterinary Medicine.

Background: Pharmacy practice includes the handling of human and animal medication. Amongst veterinary pharmaceutical treatments, the management of Canine Atopic Dermatitis (CAD), a chronic skin condition affecting 10%-15% of the canine population, is complex and demanding. Medication regimens are tailored to each animal and their owner or caregiver. The purpose of this study was to assess the impact of a mobile health (m-health) application (Petable®) to support the medication adherence in CAD treatment and clinical improvement. Methods: A total of 30 atopic dogs under treatment for CAD and their caregivers were enrolled. Both the dogs' and owners' background data were recorded as well as clinical and medication adherence information. This was accomplished by direct observation, clinical files consultation, mobile application, and medication adherence (Medida de Adesão aos Tratamentos-MAT questionnaire) feedback. Results: The overall non-adherence of the sample was 12.6% according to the mobile application, while 60% of caregivers self-scored as adherent according to the MAT. The only significant and positive correlation was between overall adherence and the caregiver's education. The average degree of pruritus decreased over time and during treatment, independently to the level of m-health app usage. Conclusions: The adherence to chronic treatments may be improved through m-health apps, although further studies are needed to gauge their actual usefulness in supplementing known adherence determinants.

Quality of life and depression in patients undergoing total and partial laryngectomy.

PURPOSE: The surgical treatment of head and neck cancer, primarily laryngeal cancer, causes sequelae and can change the patient's quality of life. The purpose of this study was to investigate the impact of laryngectomy on the quality of life regarding the functional, physical, psychological, and social aspects. METHODS: Fourteen patients underwent total laryngectomy and 16 underwent vertical partial laryngectomy. The Quality of Life Core Questionnaire (QLQ-C30) and Head and Neck (H&N35) questionnaire from the European Organization for Research and Treatment of Cancer (EORTC) were used for quality of life evaluation, while the Beck Depression Inventory questionnaire was used for the depression screen. RESULTS: In the total laryngectomy group, reported adverse effects were worsened, social and emotional function (21.3%), olfaction and taste changes (85.6%), cough (71.3%), speech difficulty (100%), and dysphagia (64.3%). Most of the patients (85.5%) judged their quality of life to be reasonable. In the partial laryngectomy group, reported adverse effects were worsened, emotional function (71.4%), speech difficulty (100%), and dysphagia (31.3%). However, most of the patients judged their quality of life to be above the general average. CONCLUSION: Despite being different surgeries, both groups experienced similar difficulties but at different levels. The quality of life was judged worse in the patients who underwent total laryngectomy.

Quality of life and depression in patients undergoing total and partial laryngectomy

OBJETIVO: O tratamento cirúrgico para o câncer de cabeça e pescoço, especificamente para o câncer de laringe, deixa seqüelas nos pacientes podendo alterar sua qualidade de vida. O objetivo deste estudo foi pesquisar o impacto na qualidade de vida, no que diz respeito aos aspectos funcionais, físicos, psicológicos, sociais e o rastreamento da depressão. MÉTODO: Foram estudados 14 pacientes submetidos a laringectomia total e 16 pacientes submetidos a laringectomia parcial vertical. Para a avaliação da qualidade de vida utilizamos os questionários da Organização Européia de Pesquisa e Tratamento do Câncer (EORTC), Quality of Life Core Questionnarie (QLQ-C30) e Head and Neck 35 (H&N35) e, para o rastreamento da depressão, o questionário Beck Depression. RESULTADOS: As funções social e emocional foram as mais afetadas no grupo de laringectomia total. 21,3% dos pacientes julgaram mediana sua qualidade de vida global. Dentro dos sintomas específicos, 85,5% referiram alteração no olfato e paladar, 71,3% tosse, 100% algum grau de dificuldade na fala e 64,3% dificuldades com a deglutição. No grupo de laringectomia parcial encontramos a função emocional afetada em 71,4%, a maioria julgou sua qualidade de vida global acima da média, 100% demonstraram algum grau de dificuldade com a fala e 31,3% referiram disfagia. CONCLUSAO: Embora sendo cirurgias diferentes, ambos os grupos passaram por dificuldades similares em maior ou menor grau. Os resultados demonstraram piora nos parâmetros de qualidade de vida dos pacientes submetidos a laringectomia total.