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Prevalence of discomfort/pain complaints and related factors in dental professionals of the public health service in Araucária, Paraná state, Brazil.
This poster presents a study about the influence of gender related factors, age, body weight, time of service in the profession and practice of physical exercise on the prevalence of discomfort/pain complaints in dental professionals. The scope of this study was limited to 123 subjects, 84.24% of professionals in the public dental clinics, who answered the multidimensional analytical work questionnaire. The data suggest that the lack postural awareness can contribute to the maintenance of painful conditions and also the low commitment to self-care can perpetuate the state of musculoskeletal discomfort/pain, justifying the application of the ergonomics concepts in the workplace and systematic guidance to professionals to adopt a healthy lifestyle. PMID:22317662
Bitencourt, Rosimeire Sedrez; Ricardo, Maria Isabel
An epidemiological comparison of pain complaints in the general population of Catalonia (Spain)
Epidemiological studies help to establish the health status in a country and allow a better allocation of economic resources. This survey estimated pain prevalence in Catalonia (Spain), analysed its relationship with demographic variables and evaluated pain-associated disabilities. The study was carried out in 1964 adults via phone interviews asking about any pain complaint they experienced in the last 6 months,
Antňnia Bassols; Fčlix Bosch; Mercedes Campillo; Montserrat Cańellas; Josep-Eladi Bańos
Analysis of complaints to a tertiary care pain clinic over a nine-year period
BACKGROUND: The present study is the result of an internal audit and examines the profiles of complainants and the sources and nature of complaints toward the staff in a tertiary care pain clinic, the Comprehensive Pain Program of the Toronto Western Hospital in Toronto, Ontario. METHODS: All sources of complaints over a nine-year period were reviewed, which included the following: Toronto Western Hospital Patient Relations (PR) records, with a subset of the files qualitatively analyzed in depth regarding the nature of complaints and complainants; complaints that bypassed PR and were addressed directly to the program director against members of the staff; complaints to the College of Physicians and Surgeons of Ontario; and complaints recorded anonymously at rateMDs.com. RESULTS: Although the prevalence of PR complaints was very low (1.73 complaints per 1000 visits), several other sources of complaints were identified. The typical complainant was a Canadian-born woman acting on her behalf or on behalf of a family member. More than one-half of the complaints were directed against the physicians regarding their opinion of psychological factors augmenting the patient's presentation and/or inappropriate use of opioids. Defensive techniques instituted by the Comprehensive Pain Program staff in reaction to the complaints are discussed, and pertinent literature is reviewed. CONCLUSION: The present study is the first to examine the nature of complaints and complainants from a Canadian pain clinic. Further studies are needed to explore the complex issues of patient and staff interactions, and complaints in the era of 'patient-centred care'.
Mailis-Gagnon, Angela; Nicholson, Keith; Chaparro, Luis
The high prevalence of pain in emergency medical care
Although there is a widely held belief that pain is the number 1 complaint in emergency medical care, few studies have actually assessed the prevalence of pain in the emergency department (ED). We conducted an analysis of secondary data by using explicit data abstraction rules to determine the prevalence of pain in the ED and to classify the location, origin,
William H. Cordell; Kelly K. Keene; Beverly K. Giles; James B. Jones; James H. Jones; Edward J. Brizendine
FDA investigates complaint of pain in spermicidal condom user.
Currently, the US Food and Drug Administration (FDA) is investigating a complaint that the Ramses Extra spermicidal condom may have caused severe pain in a user. The condom, which received marketing approval from FDA in 1982, contains the spermicidal lubricant nonoxynol-9, which reduces the number of active sperm and consequently decreases the risk of pregnancy. Lee Mathews of the FDA's office of compliance is investigating the complaint, filed in August 1983. The man experienced "excruciating pain" on urination after using the spermicidal condom, according to FDA documents. The woman indicated in the complaint that the pain possibly resulted from the condom's spermicide entering her husband's urethra. The pain subsided after several hours. She reported that her husband had never used the spermicidal condom before and had no known allergies or sensitivities. A spokeswoman for the manufacturer, Schmid Products, Company, reported after investigating the complaint that the company saw "no reason to believe that there was a batch problem or a problem with that particular condom." Company records revealed no other complaints with that batch. No other samples were available for testing from the woman filing the complaint, but "the fact that the wife did not have a problem also indicates there wasn't anything particularly wrong with that condom." Company officials did not interview the man who used the condom in question, but they did reply to him in writing and have heard nothing more from the couple. The Schmid spokeswoman indicated that there have been isolated instances of sensitivity to this product. A key factor behind FDA approval of the spermicidal condom was a study completed for Schmid by Dr. Edwin Dale. Dale's study involved 30 men, 19-46, who used both regular condoms and condoms treated with nonoxynol-9. He concluded that decreased sperm motility with the treated condoms was caused by cell fragmentation due to cell membrane disruption. PMID:12312848
Prevalence of myofascial pain in general internal medicine practice.
Myofascial pain is a regional pain syndrome characterized in part by a trigger point in a taut band of skeletal muscle and its associated referred pain. We examined a series of 172 patients presenting to a university primary care general internal medicine practice. Of 54 patients whose reason for a visit included pain, 16 (30%) satisfied criteria for a clinical diagnosis of myofascial pain. These patients were similar in age and sex to other patients with pain, and the frequency of pain as a primary complaint was similar for myofascial pain as compared with other reasons for pain. The usual intensity of myofascial pain as assessed by a visual analog scale was high, comparable to or possibly greater than pain due to other causes. Patients with upper body pain were more likely to have myofascial pain than patients with pain located elsewhere. Physicians rarely recognized the myofascial pain syndrome. Commonly applied therapies for myofascial pain provided substantial abrupt reduction in pain intensity. The prevalence and severity of myofascial pain in this university internal medicine setting suggest that regional myofascial pain may be an important cause of pain complaints in the practice of general internal medicine.
Skootsky, S A; Jaeger, B; Oye, R K
Medically unexplained pain complaints are associated with underlying unrecognized mood disorders in primary care
Background Patients with chronic pain frequently display comorbid depression, but the impact of this concurrence is often underestimated and mistreated. The aim of this study was to determine the prevalence of unrecognized major depression and other mood disorders and comorbid unexplained chronic pain in primary care settings and to explore the associated factors. Also, to compare the use of health services by patients with unexplained chronic pain, both with and without mood disorder comorbidity. Methods A cross-sectional study was carried out in a sample of primary care centers. 3189 patients consulting for "unexplained chronic pain" were assessed by the Visual Analogue Scales (VAS) and the Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaire. Results We report: a) a high prevalence of unrecognized mood disorders in patients suffering from unexplained chronic pain complaints (80.4%: CI 95%: 79.0%; 81.8%); b) a greater susceptibility of women to mood disorders (OR adjusted = 1.48; CI 95%:1.22; 1.81); c) a direct relationship between the prevalence of mood disorders and the duration of pain (OR adjusted = 1.01; CI 95%: 1.01; 1.02) d) a higher comorbidity with depression if the pain etiology was unknown (OR adjusted = 1.74; CI 95%: 1.45; 2.10) and, e) an increased use of health care services in patients with such a comorbidity (p < 0.0001). Conclusions The prevalence of undiagnosed mood disorders in patients with unexplained chronic pain in primary care is very high, leading to dissatisfaction with treatment processes and poorer outcomes. Consequently, it seems necessary to explore this condition more regularly in general practice in order to reach accurate diagnoses and to select the appropriate treatment.
Chest Pain Associated With Cocaine: An Assessment of Prevalence in Suburban and Urban Emergency Departments
Study objective: Chest pain and myocardial infarction following the use of cocaine have been well documented. We assessed the prevalence of cocaine use in patients who presented to the emergency department with chest pain of possibly ischemic origin. Design: During times of research assistant availability, consecutive adults with the chief complaint of chest pain unexplained by trauma or radiographic abnormality
Judd E Hollander; Knox H Todd; Gary Green; Katherine L Heilpern; David J Karras; Adam J Singer; Gerard X Brogan; Joseph P Funk; Judy B Strahan
Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations.
Gastrointestinal problems are common, especially in endurance athletes, and often impair performance or subsequent recovery. Generally, studies suggest that 30-50% of athletes experience such complaints. Most gastrointestinal symptoms during exercise are mild and of no risk to health, but hemorrhagic gastritis, hematochezia, and ischemic bowel can present serious medical challenges. Three main causes of gastrointestinal symptoms have been identified, and these are either physiological, mechanical, or nutritional in nature. During intense exercise, and especially when hypohydrated, mesenteric blood flow is reduced; this is believed to be one of the main contributors to the development of gastrointestinal symptoms. Reduced splanchnic perfusion could result in compromised gut permeability in athletes. However, although evidence exists that this might occur, this has not yet been definitively linked to the prevalence of gastrointestinal symptoms. Nutritional training and appropriate nutrition choices can reduce the risk of gastrointestinal discomfort during exercise by ensuring rapid gastric emptying and the absorption of water and nutrients, and by maintaining adequate perfusion of the splanchnic vasculature. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates, and potentially the use of nutrients that stimulate the production of nitric oxide in the intestine and thereby improve splanchnic perfusion. However, at this stage, evidence for beneficial effects of such interventions is lacking, and more research needs to be conducted to obtain a better understanding of the etiology of the problems and to improve the recommendations to athletes. PMID:24791919
de Oliveira, Erick Prado; Burini, Roberto Carlos; Jeukendrup, Asker
The determinants of prevalence of health complaints among young competitive swimmers
Objectives: Chloramines, which are produced by the reaction of chlorine with the organic matter present in indoor pools, are potential airway irritants in swimmers. The objective of this study was to compare the prevalence of health complaints of young swimmers and young indoor soccer players and to evaluate the relationship between chloramine concentrations and the athletes' health complaints. Methods: Health
Benoit Lévesque; Jean-François Duchesne; Suzanne Gingras; Robert Lavoie; Denis Prud'Homme; Emmanuelle Bernard; Louis-Philippe Boulet; Pierre Ernst
Peripheral Nerve Blocks and Incidence of Post-operative Neurogenic Complaints and Pain Scores
Background Peripheral nerve blocks (PNB) are a common adjuvant for anesthesia. There is little orthopedic literature regarding the incidence of neurogenic complaints and quality of pain control. Methods We instituted a questionnaire to post-operative patients who would have potentially received a PNB at a single institution between 2008 and 2009 and asked them to rate their pain on a standardized pain scale at several points in the post-operative period. The survey queried whether patients experienced severe pain, went to the ER, or experienced neurogenic complaints. comparative data was also collected on patients who did not receive a PNB. We instituted a follow up survey several months later to investigate the persistence of these complaints. Results 268 patients completed the survey, 215 patients with PNb and 53 control patients. There was a 38.14% incidence of neurogenic complaints in patients who received PNB as compared to 9.43% incidence in patients who did not receive a PNB, p <0.001. There was 27.9% (PNB) versus 15.1% (control) incidence of severe pain (p 0.05). 24 patients that received PNB versus five control patients visited the ER or called the house officer (p = 0.71). Patients who received PNB had significantly better pain control immediately after surgery (p = 0.02) and improved pain control the same night (p = 0.04), but there was no difference in pain control the morning after surgery, 24 hours after surgery and at the one week post-operative period (p values 0.77, 0.28 and 0.69). At the several month follow-up, we found that 41 of the 80 (51%) patients had persistent complaints. Conclusions Patients who receive PNBs have more neurogenic complaints and severe pain. They have improved initial pain control, but the profile shows no difference after less than 24 hours. If patients experience initial neurogenic complaints, a significant percentage of these patients have persistent complaints several months after surgery. the relative benefit of PNBs must be weighed against the possibility of persistent neurogenic complaints. Level of Evidence Cohort study type III
Mellecker, Chloe; Albright, John; Clark, Randy
Incidence and prevalence of complaints of the neck and upper extremity in general practice
Objective: To study the incidence and prevalence of neck and upper extremity musculoskeletal complaints in Dutch general practice. Methods: Data were obtained from the second Dutch national survey of general practice. In all, 195 general practitioners (GPs) from 104 practices across the Netherlands recorded all contacts with patients during 12 consecutive months. Incidence densities and consultation rates were calculated. Results: The total number of contacts during the registration period of one year was 1 524 470. The most commonly reported complaint was neck symptoms (incidence 23.1 per 1000 person-years), followed by shoulder symptoms (incidence 19.0 per 1000 person-years). Sixty six GP consultations per 1000 person-years were attributable to a new complaint or new episode of complaint of the neck or upper extremity (incidence density). In all, the GPs were consulted 147 times per 1000 registered persons for complaints of the neck or upper extremity. For most complaints the incidence densities and consultation rates were higher for women than for men. Conclusions: Neck and upper extremity symptoms are common in Dutch general practice. The GP is consulted approximately seven times each week for a complaint relating to the neck or upper extremity; of these, three are new complaints or new episodes. Attention should be paid to training GPs to deal with neck and upper limb complaints, and to research on the prognosis and treatment of these common complaints in primary care.
Bot, S; van der Waal, J M; Terwee, C; van der Windt, D A W M; Schellevis, F; Bouter, L; Dekker, J
Prevalence of cold-related complaints, symptoms and injuries in the general population: the FINRISK 2002 cold substudy
NASA Astrophysics Data System (ADS)
The prevalence of cold-related complaints and symptoms in the general population has remained unknown. As part of the nationwide FINRISK 2002 health survey performed in Finland, 8,723 people aged 25 64 years filled in a questionnaire asking about the number of hours spent weekly in cold air, their sensations during cold exposure, cold-related complaints, symptoms of diseases, and degradation of performance. Cold thermal sensations at +5°C to -5°C were reported by 35% of men and 46% of women. Almost all subjects reported at least some cold-related complaints, most commonly musculoskeletal pain (men 30%, women 27%), followed by respiratory (25% / 29%), white finger (15% / 18%) and episodic peripheral circulation symptoms (12% / 15%). Decreased mental or physical performance in cold was reported by 75% of men and 70% of women, most commonly impairing manual dexterity and tactile sense. With declining temperature, the first symptom to emerge was pain in the elbow or the forearm (at -3°C), followed by increased excretion of mucus from the lungs (-5°C), while most other symptoms appeared only at lower temperatures of -15°C to -20°C. Most symptoms showed little or no association with the weekly duration of exposure, with the exception of cold-induced pain at most sites. Although, in general, Finns are well adapted to the cold climate, the high prevalence of cold-related complaints poses a challenge to the health care system in terms of decreased performance and the possibility that such symptoms predict more serious health effects, such as increased mortality.
Raatikka, Veli-Pekka; Rytkönen, Mika; Näyhä, Simo; Hassi, Juhani
Factors associated with pain complaints in a clinical sample of postmenopausal women.
The aims of this study were to evaluate the relationships occurring between pain complaints and postmenopausal status, and to look at the correlation between such complaints and other symptoms commonly related to the climacterium. A clinical sample of 99 consecutive postmenopausal patients requiring medical help were studied: 36 complained of muscle-skeletal pains whereas 33 presented with headache limiting daily activity. Climacteric syndrome, level of distress, coping style and bone mineral density were assessed with appropriate questionnaires and instruments. Neither bone mineral density, nor body mass index nor time since menopause were associated with either headaches or muscle-skeletal pains. According to the logistic regression being younger, being without a job, suffering from insomnia and having a lower ability in self-support by the means of comforting ideas predicts suffering from headache. A high level of distress and an avoidance behavior to problem facing predict the presence of pain complaints. In such cases the ineffectiveness of the coping mechanism (i.e. avoid the problem) could be the reason for the increased level of psychological distress. These findings indicate that complaining of pains or headache is not dependent upon postmenopausal status. Individual coping strategies and their effectiveness seem the main reasons for the presence of disabling musculoskeletal pains or headache. PMID:8528378
Bono, G; Neri, I; Granella, F; Genazzani, A R; Facchinetti, F
Children's Pain Threat Appraisal and Catastrophizing Moderate the Impact of Parent Verbal Behavior on Children's Symptom Complaints
Objective ?We tested the hypothesis that pain threat appraisal and catastrophizing by children with functional abdominal pain (FAP) will moderate the relation between parent verbal behavior and children's symptom complaints following experimentally induced visceral discomfort.?Methods ?Thirty-three pediatric patients with FAP and their parents participated. Children completed measures of pain threat appraisal and catastrophizing. Weeks later they completed the Water Load Symptom Provocation Test to induce visceral discomfort. Spontaneous parent–child interactions during child discomfort were audiotaped and coded for content.?Results ?Parent symptom-related talk was associated with more child symptom complaints and parent non-symptom-related talk with fewer child complaints. The relation between symptom talk and complaints was greater for children with high catastrophizing. Non-symptom talk was associated with fewer complaints for children with high threat appraisals.?Conclusions ?Child characteristics should be considered in research on the relation between parent behavior and children's symptom complaints.
Blount, Ronald L.; Walker, Lynn S.
Prevalence of menstrual pain in young women: what is dysmenorrhea?
Objectives This study aimed to determine the frequency of dysmenorrhea, as identified by different definitions, in a population of young women, and to investigate factors associated with this complaint. Materials and methods A final group of 408 young women completed a self-assessment questionnaire. This was a cross-sectional analytical study. Results Menstrual pain was reported by 84.1% of women, with 43.1% reporting that pain occurred during every period, and 41% reporting that pain occurred during some periods. Women with menstrual pain had an earlier menarche (P = 0.0002) and a longer menstrual flow (P = 0.006), and this group was characterized as having a higher prevalence of smokers (P = 0.031) and a lower prevalence of hormonal contraception users (P = 0.015). Pain intensity was correlated (r = 0.302, P < 0.0001) positively with menstrual flow length (CR = 0.336), history of abortions (CR = 3.640), and gynecological pathologies (CR = 0.948), and negatively with age at menarche (CR = ?0.225), use of hormonal contraception (CR = ?0.787), and history of gynecological surgery (CR = ?2.115). Considering the parameters of menstrual pain, a need for medication, and inability to function normally (absenteeism from study or social activities) alone or together, the prevalence of dysmenorrhea is 84.1% when considering only menstrual pain, 55.2% when considering the association between menstrual pain and need for medication, 31.9% when considering the association between menstrual pain and absenteeism, and 25.3% when considering the association between menstrual pain, need for medication, and absenteeism (P < 0.0001). The probability of having more severe dysmenorrhea is directly related to pain intensity as measured by a visual analog scale, but does not coincide with it. Conclusion Menstrual pain is a very common problem, but the need for medication and the inability to function normally occurs less frequently. Nevertheless, at least one in four women experiences distressing menstrual pain characterized by a need for medication and absenteeism from study or social activities.
Grandi, Giovanni; Ferrari, Serena; Xholli, Anjeza; Cannoletta, Marianna; Palma, Federica; Romani, Cecilia; Volpe, Annibale; Cagnacci, Angelo
Sleep and pain complaints in symptomatic traumatic brain injury and neurologic populations
Objective: To compare the incidence of sleep and pain complaints in symptomatic traumatic brain injury (TBI) (mild vs moderate\\/severe) and neurologic populations.Design: Case-control study.Setting: Outpatient neuropsychology service at a university-affiliated tertiary care center.Patients: A consecutive sample of mild (n = 127) and moderate to severe (n = 75) patients with TBI and a general neurologic (non-TBI) group (n = 123)
John T. Beetar; Thomas J. Guilmette; Francis R. Sparadeo
Chest Pain as a presenting complaint in patients with acute myocardial infarction (AMI)
Objective: To study various characteristics of chest pain in acute myocardial infarction patients. Methodology: A total of 331 patients of AMI admitted at Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology Multan, irrespective of the age and gender, were included in this study. The study duration was one year starting from June 2011 to June 2012. Non-probability purposive sampling technique was used in this descriptive study. Informed consent to participate in this study was taken. Data were entered and analyzed using SPSS-11. Results: A total number of 331 patients with AMI were included in the study. Mean age was 54.99±11.25 years with minimum age 20 years and maximum age 90 years. It included 264(79.8%) male and 67(20.2%) female patients with male to female ratio of 3.9:1. Out of these 331 patients 308 (93.1%) patients reported chest pain as the presenting complaint. Remaining 23(6.9%) presented with clinical features other than chest pain. There were 127(38.4%) patients with pre-cordial chest pain, 115(34.7%) had retrosternal chest pain, 58(17.5%) were having epigastric pain. Severe chest pain was seen in 281(84.9%) patients while 26(7.9%) had only mild chest discomfort. Radiation of the pain to shoulder, neck and jaw was seen in 75 (22.7%) patients. In 42(12.7%) patients, pain radiated to both sides of chest. Another 55(16.6%) patients had pain radiation to chest, shoulder, upper arm and ulnar side of left forearm. Chest pain radiation to interscapular region along with both sides of chest was present in 10(3.0%) patients. In 11(3.3%) patients' pain radiated only to left side of chest. Pain persisting for >20 minutes was reported by 298 (90%) patients while only 10(3.1%) had pain persisting for <20 minutes. Conclusion: There is considerable overlap in chest pain of cardiac as well as non cardiac causes. However, vigilant evaluation of characteristics of chest pain in history taking may help to overcome this dilemma. Severe and prolonged precordial chest pain in a male patient between the age of 41-70 years, with pain radiation to left shoulder, neck and jaw is highly suggestive of AMI.
Malik, Muhammad Ajmal; Alam Khan, Shahzad; Safdar, Sohail; Taseer, Ijaz-Ul-Haque
Parent attention versus distraction: Impact on symptom complaints by children with and without chronic functional abdominal pain
The objective of this study was to assess the impact of parent attention and distraction on symptom complaints by children with and without chronic functional abdominal pain. The water load symptom provocation task was used to induce visceral discomfort in pediatric patients with abdominal pain (N=104) and well children (N=119), ages 8–16 years. Parents were randomly assigned and trained to
Lynn S. Walker; Sara E. Williams; Craig A. Smith; Judy Garber; Deborah A. Van Slyke; Tricia A. Lipani
Objectives To assess the prevalence and correlates of regional pain and associated disability in four groups of Japanese workers. Methods As part of a large international survey of musculoskeletal symptoms (the CUPID study), samples of nurses, office workers, sales/marketing personnel and transportation operatives in Japan completed a self-administered questionnaire (response rate 83%). The questionnaire covered experience of pain in six anatomical regions, associated disability and sickness absence, and various possible occupational and psychosocial risk factors for these outcomes. Associations with risk factors were assessed by logistic regression. Results Analysis was based on 2290 subjects. Rates of regional pain were generally less than have been reported in the UK, with a particularly low prevalence of wrist/hand pain among office workers (6% in the past month). The strongest and most consistent risk factor for regional pain in the past month was tendency to somatise (odds ratios (95% confidence intervals) for report of ?2 v 0 distressing somatic symptoms 3.1 (2.4-4.0) for low back pain, 2.8 (2.1-3.8) for shoulder pain, and 2.5 (1.6-4.1) for wrist/hand pain). Sickness absence for regional pain complaints in the past year was reported by 5% of participants, the major risk factor for this outcome being absence during the same period for other medical reasons (OR 3.7, 95%CI 2.4-5.8). Conclusions Japanese office workers have markedly lower rates of wrist/hand pain than their UK counterparts. In Japan, as in Western Europe, somatising tendency is a major risk factor for regional pain. Sickness absence attributed to regional pain complaints appears to be much less common in Japan than in the UK, and to be driven principally by a general propensity to take sickness absence.
Matsudaira, Ko; Palmer, Keith T; Reading, Isabel; Hirai, Masami; Yoshimura, Noriko; Coggon, David
Pain in hemodialysis patients: prevalence, cause, severity, and management
Background: There is growing evidence that dialysis patients have a high burden of symptoms, including pain. However, the prevalence, cause, severity, and management of pain in dialysis patients have not been described. Methods: This prospective cohort study of 205 Canadian hemodialysis (HD) patients describes the prevalence, cause, severity, and management of pain in this population. A chart review for demographic
Sara N Davison
Prevalence of cold-related complaints, symptoms and injuries in the general population: the FINRISK 2002 cold substudy
The prevalence of cold-related complaints and symptoms in the general population has remained unknown. As part of the nationwide\\u000a FINRISK 2002 health survey performed in Finland, 8,723 people aged 25–64 years filled in a questionnaire asking about the\\u000a number of hours spent weekly in cold air, their sensations during cold exposure, cold-related complaints, symptoms of diseases,\\u000a and degradation of performance. Cold
Veli-Pekka Raatikka; Mika Rytkönen; Simo Näyhä; Juhani Hassi
Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions
BACKGROUND: Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. METHODS: Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The
Laxmaiah Manchikanti; Mark V Boswell; Vijay Singh; Vidyasagar Pampati; Kim S Damron; Carla D Beyer
Prevalence of complaints of arm, neck and shoulder among computer office workers and psychometric evaluation of a risk factor questionnaire
Background Complaints of Arm Neck and Shoulder (CANS) represent a wide range of complaints, which can differ in severity from mild, periodic symptoms to severe, chronic and debilitating conditions. They are thought to be associated with both physical and psychosocial risk factors. The measurement and identification of the various risk factors for these complaints is an important step towards recognizing (a) high risk subgroups that are relevant in profiling CANS; and (b) also for developing targeted and effective intervention plans for treatment. The purpose of the present study was to investigate the prevalence of CANS in a Dutch population of computer workers and to develop a questionnaire aimed at measuring workplace physical and psychosocial risk factors for the presence of these complaints. Methods To examine potential workplace risk factors for the presence of CANS, the Maastricht Upper Extremity Questionnaire (MUEQ), a structured questionnaire, was developed and tested among 264 computer office workers of a branch office of the national social security institution in the Netherlands. The MUEQ holds 95 items covering demographic characteristics, in addition to seven main domains assessing potential risk factors with regard to (1) work station, (2) posture during work, (3) quality of break time, (4) job demands, (5) job control, and (6) social support. The MUEQ further contained some additional questions about the quality of the work environment and the presence of complaints in the neck, shoulder, upper and lower arm, elbow, hand and wrist. The prevalence rates of CANS in the past year were computed. Further, we investigated the psychometric properties of the MUEQ (i.e. factor structure and reliability). Results The one-year prevalence rate of CANS indicated that 54% of the respondents reported at least one complaint in the arm, neck and/or shoulder. The highest prevalence rates were found for neck and shoulder symptoms (33% and 31% respectively), followed by hand and upper arm complaints (11% to 12%) and elbow, lower arm and wrist complaints (6% to 7%). The psychometric properties of the MUEQ were assessed using exploratory factor analysis which resulted in the identification of 12 factors. The calculation of internal consistency and cross validation provided evidence of reliability and lack of redundancy of items. Conclusion Neck and shoulder complaints are more frequently reported among Dutch computer workers than arm, elbow and hand complaints. The results further indicate that the MUEQ has satisfactory reliability and internal consistency when used to document CANS among computer workers in the Netherlands.
Eltayeb, Shahla; Staal, J Bart; Kennes, Janneke; Lamberts, Petra HG; de Bie, Rob A
Prevalence and tracking of back pain from childhood to adolescence
Background It is generally acknowledged that back pain (BP) is a common condition already in childhood. However, the development until\\u000a early adulthood is not well understood and, in particular, not the individual tracking pattern. The objectives of this paper\\u000a are to show the prevalence estimates of BP, low back pain (LBP), mid back pain (MBP), neck pain (NP), and care-seeking because
Per Kjaer; Niels Wedderkopp; Lars Korsholm; Charlotte Leboeuf-Yde
Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics
Objective. To assess (i) the relationship between forefoot joint damage and foot function (expressed as gait and pressure parameters), (ii) the relationship between foot function and pain, and (iii) the relationship between foot function and disability in patients with foot complaints secondary to rheumatoid arthritis (RA). Methods. Sixty-two patients with RA-related foot complaints were included. Measurements of joint damage, gait
M. van der Leeden; M. Steultjens; J. H. M. Dekker; A. P. A. Prins; J. Dekker
Pediatric pain: prevalence, assessment, and management in a teaching hospital
The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients' pain symptoms during the 24?h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child's pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.
Linhares, M.B.M.; Doca, F.N.P.; Martinez, F.E.; Carlotti, A.P.P.; Cassiano, R.G.M.; Pfeifer, L.I.; Funayama, C.A.; Rossi, L.R.G.; Finley, G.A.
Pressure ulcer related pain in community populations: a prevalence survey
Background Pressure ulcers are costly to the healthcare provider and can have a major impact on patient's quality of life. One of the most distressing symptoms reported is pain. There is very little published data on the prevalence and details of pain experienced by patients with pressure ulcers, particularly in community populations. The study was conducted in two community NHS sites in the North of England. Methods The aim was to estimate the prevalence of pressure area related pain within a community population. We also explored the type and severity of the pain and its association with pressure ulcer classification. A cross-sectional survey was performed of community nurses caseloads to identify adult patients with pressure ulcers and associated pain. Consenting patients then had a full pain assessment and verification of pressure ulcer grade. Results A total of 287 patients were identified with pressure ulcers (0.51 per 1000 adult population). Of the 176 patients who were asked, 133 (75.6%) reported pain. 37 patients consented to a detailed pain assessment. Painful pressure ulcers of all grades and on nearly all body sites were identified. Pain intensity was not related to number or severity of pressure ulcer. Both inflammatory and neuropathic pain were reported at all body sites however the proportion of neuropathic pain was greater in pressure ulcers on lower limbs. Conclusions This study has identified the extent and type of pain suffered by community patients with pressure ulcers and indicates the need for systematic and regular pain assessment and treatment.
Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions
Background Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. Methods Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The prevalence of facet joint pain was determined using controlled comparative local anesthetic blocks (1% lidocaine or 1% lidocaine followed by 0.25% bupivacaine), in accordance with the criteria established by the International Association for the Study of Pain (IASP). The study was performed in the United States in a non-university based ambulatory interventional pain management setting. Results The prevalence of facet joint pain in patients with chronic cervical spine pain was 55% 5(95% CI, 49% – 61%), with thoracic spine pain was 42% (95% CI, 30% – 53%), and in with lumbar spine pain was 31% (95% CI, 27% – 36%). The false-positive rate with single blocks with lidocaine was 63% (95% CI, 54% – 72%) in the cervical spine, 55% (95% CI, 39% – 78%) in the thoracic spine, and 27% (95% CI, 22% – 32%) in the lumbar spine. Conclusion This study demonstrated that in an interventional pain management setting, facet joints are clinically important spinal pain generators in a significant proportion of patients with chronic spinal pain. Because these patients typically have failed conservative management, including physical therapy, chiropractic treatment and analgesics, they may benefit from specific interventions designed to manage facet joint pain.
Manchikanti, Laxmaiah; Boswell, Mark V; Singh, Vijay; Pampati, Vidyasagar; Damron, Kim S; Beyer, Carla D
Attentional deficits in fibromyalgia and its relationships with pain, emotional distress and sleep dysfunction complaints
Cognitive complaints are common among subjects with fibromyalgia (FM). Yet, few studies have been able to document these deficits with cognitive tasks. A main limitation of existing studies is that attention has been broadly defined and the tasks used to measure attention are not designed to cover all the main components of the attentional system. Research on attention has identified
E. Miró; J. Lupiáńez; E. Hita; M. P. Martínez; A. I. Sánchez; G. Buela-Casal
The prevalence of painful incidents among young recreational gymnasts
BACKGROUND: Although children experience pain during their daily life, research has generally focused on medical pain. Sport-related pain has not been widely studied in children and research has not examined the occurrence of painful incidents in gymnastics. The prevalence of painful incidents among children in recreational gymnastics classes and accompanying coach responses were recorded. METHODS: Sixty-one children between five and 10 years of age were observed at a gymnastics club. A checklist was used to record painful incidents as well as coach and child responses. RESULTS: The rate of painful incidents was 0.17 per child per hour observed. The floor apparatus was the most common site of incidents, while bumping into equipment was the most common incident. Based on observer ratings, most incidents were mild to moderate in severity and, on average, the child's reaction to these mild to moderate incidents lasted for 8.5 s. Forty per cent of the children had a mild to moderate painful experience. Coaches reacted to more than 60% of the painful incidents, usually asking how the child was and what had happened. A significant difference was found between the mean severity ratings of painful incidents that were followed by coach response and incidents followed by no response. CONCLUSION: Most children who attend recreational gymnastics classes will likely experience at least one mild to moderate painful experience for every 6 h of class. Coaches are more inclined to react to a painful incident than not. Moreover, a difference was found that suggests coaches responded to more painful incidents.
Coates, Chrystal; McMurtry, C Meghan; Lingley-Pottie, Patricia; McGrath, Patrick J
A questionnaire study investigating the prevalence of chronic postoperative pain
Background Chronic postoperative pain (CPOP) is defined as pain of at least 2 months duration after a surgical procedure. Until recently, it has been a neglected topic, because it can occur after a wide spectrum of operations; however, little is known regarding its underlying mechanism, prevalence, risk factors, and treatments. We investigated characteristics of CPOP after various operations via a questionnaire. Methods Patients were contacted at > 2 months after surgery, irrespective of sex, type of operation or anesthesia method, and a follow-up pain questionnaire was administered by phone. Results One hundred forty-five of 400 patients (36.3%) described CPOP. The prevalence of CPOP was significantly lower in laparoscopic surgery (29/159, 18.2%) than open surgery (116/241, 48.1%). The prevalence of CPOP was higher with the use of PCA (patient controlled analgesia), (45.3%) than without PCA (24.6%). There were no significant differences regarding sex, anesthetic method, or duration of operation. Conclusions Our results indicate that the prevalence of CPOP may be related to use of an endoscope and PCA. However, it is difficult to completely explain the correlation, because this is a complex area of research. More research is needed to improve the quality of pain relief.
Kim, Young-Rok; Lee, Joon-Ho; Kim, Sang-Hyun; Chae, Won-Seok; Jin, Hee-Cheol; Lee, Jeong-Seok; Kim, Yong-Ik
Attentional deficits in fibromyalgia and its relationships with pain, emotional distress and sleep dysfunction complaints.
Cognitive complaints are common among subjects with fibromyalgia (FM). Yet, few studies have been able to document these deficits with cognitive tasks. A main limitation of existing studies is that attention has been broadly defined and the tasks used to measure attention are not designed to cover all the main components of the attentional system. Research on attention has identified three primary functions of attention, known as alerting, orienting and executive functioning. This study used the attentional network test-interactions task to explore whether and which of the three attentional networks are altered in FM. Results showed that FM patients have impaired executive control (greater interference), reduced vigilance (slower overall reaction time) and greater alertness (higher reduction in errors after a warning cue). Vigilance and alertness showed several relations with depression, anxiety and sleep quality. Sleep dysfunction was a significant predictor for alertness, whereas there were no significant predictors for vigilance. These findings highlight that the treatment of sleep difficulties in FM patients may help with some of their cognitive complaints. PMID:21391131
Miró, E; Lupiáńez, J; Hita, E; Martínez, M P; Sánchez, A I; Buela-Casal, G
Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation
ERIC Educational Resources Information Center
This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…
Desmond, Deirdre M.; MacLachlan, Malcolm
Prevalence of medication overuse headache in an interdisciplinary pain clinic
Background Medication overuse headache (MOH) has been recognized as an important problem in headache patients although the pathophysiological mechanisms remain unclear. The diagnosis of MOH is based on clinical characteristics defined by the International Headache Society. The aim was the evaluation of the diagnostic criteria of MOH in a mixed population of chronic pain patients to gain information about the prevalence and possible associations with MOH. Methods Data of all patients referred to the interdisciplinary pain clinic at the University Hospital of Zurich between September 2005 and December 2007 were retrospectively analyzed. Demographic data (age, sex, history of migration), as well as data about duration of pain disease, category of pain disease (neurological, psychiatric, rheumatologic, other), use of medication, history of trauma, and comorbidity of depression and anxiety have been collected. Results Totally 178 of 187 consecutive chronic pain patients were included in the study. A total of 138 patients (78%) used analgesics on 15 or more days per month. Chronic headache was more prevalent among patients with analgesic overuse (39.8%) than without analgesic overuse (18%). The prevalence of MOH was 29%. The odds ratio (OR) for a patient with medication overuse to have chronic headache was 13.1 if he had a history of primary headache, compared to a patient without a primary headache syndrome. Furthermore, history of headache (OR 2.5, CI [1.13;5.44]), history of migration (OR 2.9, CI [1.31;6.32]) and comorbid depression (OR 3.5, CI [1.46;8.52]) were associated with overuse of acute medication, in general. Conclusions Primary headaches have a high risk for chronification in patients overusing analgesics for other pain disorders. Whereas history of headache, history of migration and comorbidity of depression are independentely associated with analgesic overuse in this group of patients.
Prevalence and impact of pain in neurological inpatients of a German teaching hospital
ObjectivesThe authors sought to determine the prevalence of pain among neurological inpatients and the impact of pain on psychological and social variables depending on severity and chronicity of pain.
Kathrin Gerbershagen; Hans U. Gerbershagen; Gabriele U. Lindena; Lutz Lachenmayer; Rolf Lefering; Carsten O. Schmidt; Thomas Kohlmann
Anxiety and Somatic Complaints in Children with Recurrent Abdominal Pain and Anxiety Disorders
Objective?To compare anxiety symptoms and disorders in children and adolescents with recurrent abdominal pain (RAP), anxiety disorders, and healthy control children.?Methods?Twenty-one children with RAP (nine males, mean age = 11.05) were compared to 21 children with anxiety disorders (11 males, mean age = 12.29), and 21 children without pain or anxiety (nine males, mean age = 11.57) using diagnostic interviews and continuous measures of anxiety and other internalizing symptoms.?Results?Sixty-seven percent of children with RAP met criteria for an anxiety disorder. Children with RAP were higher than well children but not significantly different from children with anxiety on total internalizing and anxiety symptoms.?Conclusions?RAP and anxiety are closely related. Further understanding between these disorders is essential to understanding the development and progression of RAP, and to inform the prevention and treatment of the disorder.
Dunn, Madeleine J.; Compas, Bruce E.
The Prevalence of Fibromyalgia in Other Chronic Pain Conditions
Central sensitivity syndromes (CSS) include fibromyalgia syndrome (FMS), irritable bowel syndrome, temporomandibular disorder, restless legs syndrome, chronic fatigue syndrome, and other similar chronic painful conditions that are based on central sensitization (CS). CSS are mutually associated. In this paper, prevalence of FMS among other members of CSS has been described. An important recent recognition is an increased prevalence of FMS in other chronic pain conditions with structural pathology, for example, rheumatoid arthritis, systemic lupus, ankylosing spondylitis, osteoarthritis, diabetes mellitus, and inflammatory bowel disease. Diagnosis and proper management of FMS among these diseases are of crucial importance so that unwarranted use of such medications as corticosteroids can be avoided, since FMS often occurs when RA or SLE is relatively mild.
Yunus, Muhammad B.
Prevalence of Neuropathic Pain in Radiotherapy Oncology Units
Purpose: Neuropathic pain (NP) in cancer patients severely impacts quality of life. Radiotherapy (RT) may cause NP, and at the same time, cancer patients visit RT units for pain relief. NP prevalence at these sites and current analgesic treatment should be assessed to improve management. Methods and Materials: This epidemiological, prospective, multicenter study was undertaken to assess NP prevalence, according to Douleur Neuropathique 4 questions questtionaire (DN4) test results, and analgesic management in cancer pain patients visiting RT oncologic units. Secondary analyses assessed NP etiology and pain intensity (using the Brief Pain Inventory-Short Form) and impact (using the Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study [MOS] for Sleep, and the Health Survey Short Form-12). Results: A total of 1,098 patients with any kind of pain were registered. NP prevalence was 31.1% (95% confidence interval, 28.4%--33.9%); 291 NP patients (mean age, 62.2 {+-}12.5 years and 57.7% men) were eligible for study; 49% of patients were overweight. The most frequent tumors were those of breast and lung, and stage IIIB was the most common cancer stage. The tumors caused 75% of NP cases. Anxiety, sleepiness, and depression were common. At 8 weeks, pain intensity and interference with daily activities decreased significantly for 50.8% of responders. Depression and anxiety (p < 0.0001) scores on the Physical Component Summary and Mental Component Summary measures (p < 0.0001) and all MOS-Sleep subscales, except for snoring, improved significantly. The percentage of satisfied patients increased from 13.8% to 87.4% (p < 0.0001) with the current analgesic treatment, which meant a 1.2- and 6-fold increase (p < 0.0001) in narcotic analgesics and anticonvulsants, respectively, compared to previous treatment. Conclusions: NP is highly prevalent at RT oncology units, with sleepiness, anxiety, and depression as frequent comorbidities. There is a need to improve management of NP with increased use of more specific NP-targeting drugs.
Manas, Ana [Servicio de Oncologia Radioterapica, Hospital Universitario La Paz, Madrid (Spain); Monroy, Jose Luis [Servicio de Oncologia Radioterapica, Hospital Universitario de la Ribera, Valencia (Spain); Ramos, Avelino Alia [Servicio de Oncologia Radioterapica, Hospital Txagorritxu, Vitoria-Alava (Spain); Cano, Carmen [Servicio de Oncologia Radioterapica, Hospital de Torrecardenas, Almeria (Spain); Lopez-Gomez, Vanessa, E-mail: email@example.com [Medical Unit, Pfizer Espana, Alcobendas (Spain); Masramon, Xavier [Department of Biometrics, European Biometrics Institute, Barcelona (Spain); Perez, Maria [Medical Unit, Pfizer Espana, Alcobendas (Spain)
Prevalence and risk factor of neck pain in elderly Korean community residents.
Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact. PMID:23678258
Son, Kyeong Min; Cho, Nam H; Lim, Seung Hun; Kim, Hyun Ah
Pain originating from the sacroiliac joint is a common non-traumatic musculoskeletal complaint in elite inline-speedskaters - an observational study
Study design Observational study Objectives To investigate common non-traumatic musculoskeletal complaints of the low back in elite inline-speedskaters of the German national team. Summary of background data Traumatic injuries associated with falls or collisions are well documented in speedskaters but so far no studies have investigated non-traumatic low back pain. Previously, the sacroiliac joint was suspected as a frequent origin of complaint, we aimed to investigate this assumption. Methods Two chiropractors examined elite inline-speedskaters of the German national team during three sports events between summer 2010 and 2011. A test cluster of five provocative tests for the sacroiliac joint was selected based on reliability and validity. Results A total of 37 examinations were conducted on 34 athletes with low back pain during the three sport events. The reported pain intensities ranged from mild to moderate pain (VAS 23.4 ± 13.4 to 35.1 ± 19.2). About 90% of cases showed involvement of the SI joint of which again 90% presented with left sided symptoms. Conclusions Non-traumatic complaints of the low back originating from the left sacroiliac joint frequently occur in competitive inline speedskaters.
Facet Joint Pain in Chronic Spinal Pain: An Evaluation of Prevalence and False-positive Rate of Diagnostic Blocks
Study Design: A retrospective review. Objectives: Evaluation of the prevalence of facet or zygapophy- sial joint pain in chronic spinal pain of cervical, thoracic, and lumbar origin by using controlled, comparative local anesthetic blocks and evaluation of false-positive rates of single blocks in the diagnosis of chronic spinal pain of facet joint origin. Summary of Background Data: Facet or zygapophysial
Rajeev Manchukonda; Kavita N. Manchikanti; Kimberly A. Cash; Vidyasagar Pampati; Laxmaiah Manchikanti
Prevalence of chronic benign pain disorder among adults: a review of the literature
In this review epidemiological studies concerning chronic benign pain among adults are discussed. To this end, studies focusing on chronic pain, reporting prevalences at a population or primary health care level, including subjects aged between 18 and 75 years have been collected and analyzed. Focus of analysis was on research methods, definitions of chronic benign pain used, and reported prevalences.
PETER F. M. VERHAAK; JAN J. KERSSENS; Joost Dekker; MARJOLIJN J. SORBI; JOZIEN M. BENSING
A population based study of the prevalence of pain in Iceland
Prevalence estimates of pain differ depending on how it is defined and measured and on the populations studied. It has been estimated that on a given day, as many as 30–44% of the general population experience some kind of pain. Information about the prevalence of pain in Iceland is not available. The aims of this study were to evaluate the
Sigridur Gunnarsdottir; Sandra E. Ward; Ronald C. Serlin
The prevalence of OSA in snorers presenting with various chief complaints: a pilot study.
Aims: The incidence of obstructive sleep apnea (OSA) in snoring patients is reported in the literature to range from 20% to 70%. The aim of this study was to obtain exact data on the percent of snorers who have OSA, and to classify them as having normal, mild, moderate, or severe sleep apnea. Methodology: There were 273 patients who came into the senior author's office with sleep disorder breathing problems. They suffered with various sleep problems. All 273 patients also had a snoring problem. None of the 273 patients had ever had a sleep test, or polysomnograph (PSG). All 273 required a PSG for evaluation of their sleep problem. They were referred to a certified sleep lab local to them. When the results of the PSG came back, the authors were able to classify them as having normal, mild, moderate, or severe sleep apnea. Results: The results of the 273 PSGs showed the following: 12 patients (4%) had PSGs of apnoea-hypopnoea index (AHI)<5 (normal), 57 patients (21%) had PSGs with AHIs 5-<15 (mild), 79 patients (29%) had PSGs with AHIs 15-<30 (moderate), 119 patients (44%) had PSGs 30 or >30 (severe), and 6 patients (2%) had PSGs >100 (severe). Conclusions: Based on this study, of 273 patients who snored, the incidence of OSA is high. Ninety-six percent of the patients suffered with mild to severe sleep apnea. This malady, which can be very serious and degenerating, could be much more prevalent than previously believed. Additional research is needed to verify these figures. PMID:25000164
Keropian, Bryan; Murphy, Neal
Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain
OBJECTIVES--To determine the prevalence of pain arising from the zygapophysial joint in patients with chronic low back pain and to determine whether any clinical features could distinguish patients with and without such pain. METHODS--Sixty three patients with chronic low back pain were studied prospectively. All patients underwent a detailed history and physical examination as well as a series of intra-articular
A C Schwarzer; S C Wang; N Bogduk; P J McNaught; R Laurent
Chronic pain in the Republic of Ireland--community prevalence, psychosocial profile and predictors of pain-related disability: results from the Prevalence, Impact and Cost of Chronic Pain (PRIME) study, part 1.
The aims of the PRIME study (Prevalence, Impact and Cost of Chronic Pain) were 3-fold: (1) to determine the point prevalence of chronic pain in Ireland; (2) to compare the psychological and physical health profiles of those with and without chronic pain; and (3) to explore a predictive model of pain-related disability. A postal survey of 3136 people was conducted with a representative community-based sample of adults. Measures were obtained for sociodemographic variables, physical and psychological well-being, depressive symptoms, presence of pain, pain severity, pain-related disability, and illness perceptions. Responses were received from 1204 people. The prevalence of chronic pain was 35.5% (95% CI=32.8-38.2) (n=428). No gender difference in prevalence was found. Prevalence of pain increased with age and was associated with manual employment. The most commonly reported site of pain was the lower back (47.6%); however, multiple pain sites was the norm, with more than 80% of participants reporting more than 1 pain site. Approximately 12% of participants were unable to work or were on reduced work hours because of pain. Of those with chronic pain, 15% met the criteria for clinically relevant depression compared with 2.8% of those without pain. A multiple regression analysis, predicting 67% of variance, showed that pain intensity was the strongest predictor of pain-related disability. Depression and illness perceptions were also predictive of pain-related disability, after controlling for the effects of pain intensity. Chronic pain is a prevalent health problem in Ireland and is associated with significant psychological and functional disability. Psychological factors appear to influence the level of pain-related disability. PMID:21450402
Raftery, Miriam N; Sarma, Kiran; Murphy, Andrew W; De la Harpe, Davida; Normand, Charles; McGuire, Brian E
The prevalence of pain at pressure areas and pressure ulcers in hospitalised patients
Background Patients with pressure ulcers (PUs) report that pain is their most distressing symptom, but there are few PU pain prevalence studies. We sought to estimate the prevalence of unattributed pressure area related pain (UPAR pain) which was defined as pain, soreness or discomfort reported by patients, on an "at risk" or PU skin site, reported at a patient level. Methods We undertook pain prevalence surveys in 2 large UK teaching hospital NHS Trusts (6 hospitals) and a district general hospital NHS Trust (3 hospitals) during their routine annual PU prevalence audits. The hospitals provide secondary and tertiary care beds in acute and elective surgery, trauma and orthopaedics, burns, medicine, elderly medicine, oncology and rehabilitation. Anonymised individual patient data were recorded by the ward nurse and PU prevalence team. The analysis of this prevalence survey included data summaries; no inferential statistical testing was planned or undertaken. Percentages were calculated using the total number of patients from the relevant population as the denominator (i.e. including all patients with missing data for that variable). Results A total of 3,397 patients in 9 acute hospitals were included in routine PU prevalence audits and, of these, 2010 (59.2%) patients participated in the pain prevalence study. UPAR pain prevalence was 16.3% (327/2010). 1769 patients had no PUs and of these 223 patients reported UPAR pain, a prevalence of 12.6%. Of the 241 people with pressure ulcers, 104 patients reported pain, a UPAR pain prevalence of 43.2% (104/241). Conclusion One in six people in acute hospitals experience UPAR pain on 'at risk' or PU skin sites; one in every 8 people without PUs and, more than 2 out of every five people with PUs. The results provide a clear indication that all patients should be asked if they have pain at pressure areas even when they do not have a PU.
Role of allostatic load in socio-demographic patterns of pain prevalence in the US population
Persistent stressors associated with sociodemographic disadvantage exert a physiologic toll, labeled "allostatis load", that contributes to disparities in some health conditions. We investigated the contribution of allostatic load to pain prevalence in US adults. Interviews with 14,184 adults in the 1999–2004 National Health and Nutrition Examination Survey asked about severe headache, pain that lasted >24 hours, and widespread pain. Ten biomarkers of allostatic load were quantified from blood (glycated hemoglobin), serum (C-reactive protein, homocysteine, cholesterol, triglycerides), urine (creatinine, albumin) and physical measurements (body mass index, systolic and diastolic blood pressure). Log-binomial regression models estimated prevalence ratios (PR) and 95% confidence intervals (95%CIs). Prevalence ranged from 3.4% for widespread pain to 26.9% for pain >24 hours. After adjustment for demographic characteristics, low income was associated with greater prevalence of pain >24 hours (PR=1.65, 95%CI=1.49, 1.83), severe headache (PR=2.05, 95%CI=1.68, 2.50) and widespread pain (PR=3.67, 95%CI=2.56, 5.27). Racial/ethnic minorities had lower prevalence of all three pain conditions than non-Hispanic Whites. While greater allostatic load was associated with elevated prevalence of pain, allostatic load did not meaningfully attenuate prevalence ratios associated with income or race/ethnicity. We conclude that greater pain prevalence among low income groups is not explained by greater allostatic load.
Slade, Gary D.; Sanders, Anne E.; By, Kunthel
Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation.
This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence of phantom limb pain during the week preceding assessment was 42.6% (60 of 141). Prevalence of residual limb pain was 43.3% (61 of 141). More than one third of these had some pain constantly or most days. Phantom limb pain was commonly described as 'discomforting' (31 of 60) and associated with 'a little bit' of lifestyle interference (23 of 60). Residual limb pain was most often described as 'discomforting' (27 of 61) or 'distressing' (19 of 61) and was typically associated with low to moderate levels of lifestyle interference. Assessment of multiple dimensions of postamputation pain in the long term after upper limb amputation is warranted. PMID:20101187
Desmond, Deirdre M; Maclachlan, Malcolm
Prevalence and Correlates of Low Back Pain in Primary Care: What Are the Contributing Factors in a Rapidly Developing Country
Study Design Cross-sectional. Purpose The purpose of the study was to determine the prevalence of low back pain (LBP) in the primary care setting with emphasis on the socio-demographic contributing factors and impact of LBP on lifestyle habits. Overview of Literature LBP is one of the most common medical conditions seen in the Primary Health Care Clinic. Methods A representative sample of 2,600 patients were approached and 1,829 subjects agreed to participate in this study (70.0%). Data on socio-demographic characteristics, life style habits and type of treatment were collected through a questionnaire. Results The prevalence of LBP in the study sample was 56.5% (95% confidence interval, 54.2-58.8). LBP was more prevalent among women (53.9%) compared to men (46.1%). There was significant difference between male and female patients of LBP in terms of ethnicity (p<0.001), marital status (p=0.010), occupation (p<0.001), monthly household income (p=0.004), and cigarette/sheesha smokers (p<0.001). The percentages of different aspects of functional disabilities were statistically significantly higher among females compared to male patients with LBP. Almost a quarter of female patients with LBP (26%) and 18% male patients with LBP reported pain in the arms and legs (p=0.002). In addition, gastrointestinal complaints such as abdominal pain and food intolerance were significantly higher among female patients with LBP as compared to males (31% vs. 24.6%, p=0.018; and 25% vs. 18%, p=0.008, respectively). Complaints about headache and fainting were also significantly higher among female patients as compared to male LBP patients (43% vs. 36%, p=0.029; and 26% vs. 20%, p=0.016, respectively). The multivariate logistic regression revealed that being female, prolonged standing, prolonged sitting, heavy weight lifting, weakness in the legs, regular exercise, and cigarette/sheesh a smoking had a significant effect on the presence of LBP. Conclusions LBP is highly prevalent among both genders and in older age. Also, weakness in the legs, smoking, prolonged standing and sitting had a significant effect on LBP. Furthermore, the current study findings support the fact that LBP continues to be an important clinical, social and economic, burden and a public health problem affecting the population of the entire world.
Dafeeah, Elnour Elnaeim; Alnaqbi, Khalid
Subjective health complaints in patients with lumbar radicular pain and disc herniation are associated with a sex - OPRM1 A118G polymorphism interaction: a prospective 1-year observational study
Background Earlier observations show that development of persistent pain may be associated with the genetic variability in the gene encoding for the ?-opioid receptor 1, the OPRM1 A118G (rs1799971). The aim of this study was to investigate the association between OPRM1 genotype and subjective health complaints in patients with radicular pain and disc herniation. Methods A prospective, 1-year observational study was conducted at a hospital back clinic, including 118 Caucasian patients with lumbar radicular pain and MRI confirmed disc herniation. Single nucleotide polymorphism genotyping regarding the OPRM1 A118G was performed. The data of individuals with AA versus AG or GG were analysed separately by linear mixed models. The Subjective Health Complaints Inventory (0-81) including 27 common complaints experienced the previous month on a scale from not at all (0) to severe (3) was used as outcome. Pain, prior duration of leg pain, age, smoking status, and lumbar disc surgery were considered as covariates. Results In total 23 of 118 patients were carriers of the OPRM1 G-allele. All patients except female carriers of the G-allele reported a decrease in pain from baseline to 1 year. Female carriers of the G-allele reported significantly higher subjective health complaints score during the study time span than male carriers of the G-allele when controlling for pain and pain duration. Conclusion The present data indicate that, when controlling for pain intensity and duration, subjective health complaints are associated with a sex - OPRM1 A118G polymorphism interaction in patients with radicular pain.
Performance of Reperfusion Therapy and Hospital Mortality in ST-Elevation Myocardial Infarction Patients with Non-Chest Pain Complaints
Purpose ST-elevation myocardial infarction (STEMI) patients may visit the emergency department (ED) complaining of sensations of pain other than the chest. We investigated our performance of reperfusion therapy for STEMI patients presenting with non-chest pains. Materials and Methods This was a retrospective observational cohort study. STEMI patients who underwent primary percutaneous coronary intervention (PCI) were divided into a chest pain group and a non-chest pain group. Clinical differences between the two groups and the influence of presenting with non-chest pains on door-to-electrocardiograms (ECG) time, door-to-balloon time, and hospital mortality were evaluated. Results Of the 513 patients diagnosed with STEMI, 93 patients presented with non-chest pains. Patients in the non-chest pain group were older, more often female, and had a longer symptom onset to ED arrival time and higher Killip class than patients in the chest pain group. There was a statistically significant delay in door-to-ECG time (median, 2.0 min vs. 5.0 min; p<0.001) and door-to-balloon time (median, 57.5 min vs. 65.0 min; p<0.001) in patients without chest pain. In multivariate analysis, presenting with non-chest pains was an independent predictor for hospital mortality (odds ratio, 2.3; 95% confidence interval, 1.1-4.7). However, door-to-ECG time and door-to-balloon time were not factors related to hospital mortality. Conclusion STEMI patients presenting without chest pain showed higher baseline risk and hospital mortality than patients presenting with chest pain. ECG acquisition and primary PCI was delayed for patients presenting with non-chest pains, but not influencing hospital mortality. Efforts to reduce pre-hospital time delay for these patients are necessary.
Na, Jae Phil; Shin, Kyu Chul; Kim, Seunghwan; Park, Yoo Seok; Chung, Sung Phil; Park, In Cheol; Park, Joon Min
A Pilot Study of the Prevalence of Leg Pain Among Women with Endometriosis
Radiating leg pain is a common symptom presenting in manual therapy practices. Although this symptom has been reported as a complication of endometriosis, its prevalence and characteristics have not been studied. We surveyed members of a national endometriosis support group with endometriosis using a self-administered, mailed questionnaire. The main outcome measures were the prevalence and characteristics of leg pain. Of 94 respondents, leg pain was reported by 48 women (51%), and was bilateral in 59% of these symptomatic women. The likelihood of experiencing leg pain was related to weight gain since age 18, age, and height. The most common treatments tried included exercise, over-the-counter medications, and massage therapy, all with variable results. These data support leg pain as a prevalent complication of endometriosis, and that the disease may affect multiple peripheral nerves. Manual therapists should remain aware to this possible etiology for radiating pain.
Missmer, Stacey A.; Bove, Geoffrey M.
Gender Differences in the Incidence and Prevalence of Patellofemoral Pain Syndrome.
National Technical Information Service (NTIS)
The purpose of this investigation was to determine the association between gender and the prevalence and incidence of patellofemoral pain syndrome (PFPS). One thousand five hundred and twenty-five participants from the United States Naval Academy (USNA) w...
D. A. Padua K. Guskiewicz M. C. Boling S. Pyne S. W. Marshall
Prevalence of pain among residents in Japanese nursing homes: a descriptive study.
It is often observed that pain causes substantial problems for nursing home residents. However, there has been little research about the prevalence of pain for nursing home residents in Japan. This study aimed to examine the prevalence of pain in older adults living in nursing homes in Japan by using self-reporting and the Abbey Pain Scale-Japanese version (APS-J) and to explore factors related to pain. This is a descriptive study. Residents in two Special Nursing Homes for the Elderly in Tokyo, Japan, were asked to participate in this study, with the exclusion of short-term temporary residents. Data collected from participating residents included their demographics and the results from the Barthel Index, the Folstein Mini-Mental State Examination, the APS-J, and the Verbal Descriptor Scale for pain. The residents were divided into two groups: residents able to report their pain (self-report group) and residents not able to report their pain. The second group was assessed by using the APS-J (APS-J group). The Mann-Whitney U test, the ?2 test, and logistic analyses were performed to derive factors related to pain prevalence. Data were obtained from 171 residents. The prevalence of pain in the self-report group (n = 96) was 41.7%. For the 75 residents unable to report their pain, 52.0% were assessed by the APS-J to have pain. The overall pain prevalence of all residents was 46.2%. Age, Barthel Index score, and length of time of institutionalization were significantly associated with residents' pain in the APS-J group. Logistic regression analysis showed that contracture (odds ratio 3.8) and previous injury (odds ratio 3.4) were associated with residents' pain in the self-report group, whereas only the length of nursing home stay (odds ratio 1.03) was a predictor for pain in the APS-J group. Nearly one-half of residents had pain when they moved or were moved. Pain assessment and management is needed for residents. PMID:23688366
Takai, Yukari; Yamamoto-Mitani, Noriko; Chiba, Yumi; Nishikawa, Yuri; Sugai, Yuichi; Hayashi, Kunihiko
The prevalence of Helicobacter pylori serum antibodies in children with recurrent abdominal pain
As part of a large, prospective study we investigated the prevalenceHelicobacter pylori serum antibodies in children with recurrent abdominal pain (RAP). All patients suffered from recurrent bouts of abdominal pain for at least 6 months and ranged in age from 6 to 12 years.H. pylori antibodies were detected using an enzyme-linked immunosorbent assay. The prevalence ofH. pylori antibodies in the
S. B. van der Meer; P. P. Forget; R. J. L. F. Loffeld; E. Stobberingh; R. H. Kuijten; J. W. Arends
Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta: an upright, weightbearing MRI study
The purpose of this study is to determine if patellar maltracking is more prevalent among patellofemoral (PF) pain subjects with patella alta compared to subjects with normal patella height. We imaged 37 PF pain and 15 pain free subjects in an open-configuration magnetic resonance imaging scanner while they stood in a weightbearing posture. We measured patella height using the Caton-Deschamps, Blackburne-Peel, Insall-Salvati, Modified Insall-Salvati, and Patellotrochlear indices, and classified the subjects into patella alta and normal patella height groups. We measured patella tilt and bisect offset from oblique-axial plane images, and classified the subjects into maltracking and normal tracking groups. Patellar maltracking was more prevalent among PF pain subjects with patella alta compared to PF pain subjects with normal patella height (two-tailed Fisher's exact test, p < 0.050). Using the Caton-Deschamps index, 67% (8/12) of PF pain subjects with patella alta were maltrackers, whereas only 16% (4/25) of PF pain subjects with normal patella height were maltrackers. Patellofemoral pain subjects classified as maltrackers displayed a greater patella height compared to the pain free and PF pain subjects classified as normal trackers (two-tailed unpaired t-tests with Bonferroni correction, p < 0.017). This study adds to our understanding of PF pain in two ways - 1) we demonstrate that patellar maltracking is more prevalent in PF pain subjects with patella alta compared to subjects with normal patella height; and 2) we show greater patella height in PF pain subjects compared to pain free subjects using four indices commonly used in clinics.
Pal, Saikat; Besier, Thor F.; Beaupre, Gary S.; Fredericson, Michael; Delp, Scott L.; Gold, Garry E.
Prevalence of low back pain in the community: implications for service provision in Bradford, UK
STUDY OBJECTIVE: To assist a purchasing district in the planning of services for low back pain by assessing the prevalence of symptoms and the current involvement of primary, secondary, and complementary care in the treatment of low back pain. In the light of these findings, to assess further the potential impact of a new system of open access to physical
M Hillman; A Wright; G Rajaratnam; A Tennant; M A Chamberlain
Jaw Pain Prevalence Among French-speaking Canadians in Quebec and Related Symptoms of Temporomandibular Disorders
The purpose of this study was to assess the prevalence and pattern of self-reported TMD jaw pain in a randomized stratified sample from the general population living in the Province of Quebec, Canada. Through a telephone survey, standardized questions were asked to 897 French-speaking respondents, aged 18 years old and over, regarding frequency, severity, daily pattern of jaw pain, presence
J.-P. Goulet; G. J. Lavigne; J. P. Lund
Cervical Spinal Canal Stenosis and Central Disc Herniation C3/4 in a Man with Primary Complaint of Thigh Pain
Purpose?The purpose of this report is to describe the clinical course of a patient who had a primary complaint of isolated right lateral thigh pain 3 years prior that was nonresponsive to conservative measures. Hypoesthesia in the lateral side of the right forearm, deltoid and biceps, as well as triceps paresis, was also diagnosed. Results?Immediately after surgery, the patient reported substantial improvement in his right thigh symptoms. The signs and symptoms associated with the right C6 and C7 radiculopathy did improve. Conclusion?Although the presentation described in this case is somewhat unique, the eventual myelopathic signs and symptoms were not. It was these myelopathic signs and symptoms that led to cervical magnetic resonance imaging, the diagnosis of cervical cord compressive myelopathy, and surgical management.
Akhavan-Sigari, R.; Rohde, V.; Alaid, A.
Prevalence of Widespread Pain and Its Influence on Quality of Life: Population Study in Korea
The objective of this study was to examine the prevalence and risk factors for widespread pain and its influence on quality of life in residents of Korean communities. A rural and an urban community were selected, and 5,037 subjects were surveyed. Participants were asked if they had pain, aching, or stiffness in any of their joints on most days. Widespread pain was defined as pain above the waist, below the waist, on both sides of the body and in the axial region. The prevalence of widespread pain was 12% (16.2% and 5.5% in females and males, respectively). It was more frequent among females and increased with age in both genders. Age, female gender, and the presence of hand or knee arthritis were significantly associated with widespread pain after multivariate analysis. Except for mental health, all the items in the SF-12 were adversely affected in the widespread pain group after adjustment for confounding factors. Our findings show that the prevalence of widespread pain among residents of Korean communities is comparable to that reported among Caucasians. The significantly worse quality of life among subjects with widespread pain suggests that it may cause major health issues in the aging population.
Cho, Nam Han; Kim, Inje; Lim, Seung Hun
The postmastectomy pain syndrome: an epidemiological study on the prevalence of chronic pain after surgery for breast cancer
The prevalence of the postmastectomy pain syndrome (PMPS) and its clinical characteristics was assessed in a group of patients who had undergone surgery for breast cancer at the Department of Surgery, Odense University Hospital, within the period of 1 May 2003 to 30 April 2004. The study included 258 patients and a reference group of 774 women. A questionnaire was
O J Vilholm; S Cold; L Rasmussen; S H Sindrup
The nature and prevalence of chronic pain in homeless persons: an observational study.
Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs. Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant's reasons for homelessness, and whether they slept rough or in shelters. Findings: Of 168 shelter users approached, 150 (89.3%) participated: 93 participants (63%) reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs. Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable people's lives. PMID:24555079
Fisher, Rebecca; Ewing, Judith; Garrett, Alice; Harrison, E Katherine; Lwin, Kimberly Kt; Wheeler, Daniel W
Association of locomotor complaints and disability in the Rotterdam study
OBJECTIVE--To determine the association between joint complaints and locomotor disability. METHODS--During a home interview survey 1901 men and 3135 women aged 55 years and over (the Rotterdam Study) were asked about joint pain and morning stiffness in the past month, and locomotor disability was assessed by six questions from the Health Assessment Questionnaire (HAQ). RESULTS--The prevalence of locomotor disability was
E Odding; H A Valkenburg; D Algra; F A Vandenouweland; D E Grobbee; A Hofman
Complaints of the arm, neck and shoulder among computer office workers in Sudan: a prevalence study with validation of an Arabic risk factors questionnaire
Background Complaints of the arm, neck and/or shoulders (CANS) in general and computer-related disorders in particular affect millions of computer office workers in Western developed countries. However, with the widespread use of computer systems in developing countries, the associated musculoskeletal complaints are yet to be investigated. Aim To study the prevalence of work-related CANS, among computer office workers in Sudan, and to test the psychometric properties of a translated Dutch questionnaire in Arabic language. Methods In 2005 282 computer office workers at a mobile telecommunication company and three banks in Khartoum, Sudan, received an Arabic language version of the validated Maastricht upper extremity questionnaire (MUEQ). The questionnaire holds 109 items covering demographic characteristics, in addition to six main domains (i.e. work station, body posture, break time, job control, job demands and social support) assessing potential physical and psychosocial risk factors. Forward/backward translation of the MUQE was done independently by two different translators. Prevalence over the past year were computed for CANS. Further, the psychometric properties of the Arabic questionnaire were investigated (i.e. factor structure and reliability) and cross-validation was carried out. Results The response rate of the questionnaire was 88% (n = 250). The one-year prevalence of CANS showed that 53% of the respondents could be classified as mild cases. The highest incidences were found for neck and shoulder symptoms (64% and 41% respectively). The analysis of the psychometric properties of the scale resulted in the identification of 2 factors for each of the 6 domains (i.e. office equipment, computer position, head and body posture, awkward body posture, autonomy, quality of break time, skill discretion, decision authority, time pressure, task complexity, social support, and work flow). The calculation of internal consistency and cross validation provided evidence of reliability and lack of redundancy of items. Conclusion The prevalence of CANS among the targeted population seems to correspond strongly with prevalence of CANS in Western developed countries. The Arabic translation of the MUEQ has satisfactory psychometric properties to be used to assess work-related risk factors for the development of CANS among computer office workers in Sudan.
Eltayeb, Shahla M; Staal, J Bart; Hassan, Amar A; Awad, Salwa S; de Bie, Rob A
Prevalence and characteristics of chronic musculoskeletal pain in Japan
Background This cross-sectional study was conducted to obtain epidemiologic data on chronic musculoskeletal pain in the Japanese people,\\u000a and with it a better understanding of the actual conditions and problems involved.\\u000a \\u000a \\u000a \\u000a \\u000a Methods A questionnaire covering basic information, chronic musculoskeletal pain, daily life, quality of life, and social loss was\\u000a prepared and mailed to 11507 individuals aged 18 years or older. Subjects were selected
Masaya NakamuraYuji Nishiwaki; Yuji Nishiwaki; Takahiro Ushida; Yoshiaki Toyama
The Rising Prevalence of Chronic Low Back Pain
Background:Nationalorstate-levelestimatesontrends intheprevalenceofchroniclowbackpain(LBP)arelack- ing.Theobjectiveofthisstudywastodeterminewhether the prevalence of chronic LBP and the demographic, health-related,andhealthcare-seekingcharacteristicsof individualswiththeconditionhavechangedoverthelast 14 years. Methods: A cross-sectional, telephone survey of a rep- resentativesampleofNorthCarolinahouseholdswascon- ductedin1992andrepeatedin2006.Atotalof4437house- holdswerecontactedin1992and5357householdsin2006 toidentifynoninstitutionalizedadults21yearsorolderwith chronic(3months),impairingLBPorneckpainthatlim- its daily activities. These individuals were interviewed in more detail about their health and health care seeking. Results:The prevalence of chronic, impairing LBP rose significantly over the 14-year interval, from 3.9% (95%
Janet K. Freburger; George M. Holmes; Robert P. Agans; Anne M. Jackman; Jane D. Darter; Andrea S. Wallace; Liana D. Castel; William D. Kalsbeek; Timothy S. Carey
Prevalence of low back pain and lumbar spine degenerative disorders. Questionnaire survey and clinical-radiological analysis of a representative Hungarian population.
A cross-sectional epidemiological study via personal interviews was performed regarding low back pain and its related clinical aspects in a Hungarian sample of 10,000 people. Joining the international campaign of the "Bone and Joint Decade", our aim was to give data on low back pain prevalence and to explore the underlying possible clinical conditions in a Central European adult and adolescent population. Ten thousand people aged 14-65, selected randomly by the Hungarian central office of statistics from three counties of the south-western Hungarian region, were surveyed using a special questionnaire focusing on low back pain and other degenerative spinal symptoms. People with low back pain complaints and written consent were asked to participate in a further clinical investigation, where radiological and clinical assessment was performed. A total of 4,389 persons (44.1%) reported low back pain in the last month at the time of the survey. Work absenteeism due to low back pain affected 2,140 persons (21.5%). A total of 292 people (2.9%) had already undergone spinal surgery. Upon request 682 people came for a clinical follow-up, where thorough physical examination and radiological analysis was performed and results were statistically interpreted. The Oswestry disability index (ODI) in the examined group of patients averaged 35.1%; radiological degenerative signs were observed in 392/682 (57.5%). Individuals with signs of radiological degeneration had a statistically significant higher ODI value, age, and a higher, yet not significantly increased BMI value than radiographically negative patients (p?0.05). Co-existence of hip and knee osteoarthritis was also investigated. Higher osteoarthritis prevalence was found in individuals with radiographic signs of spinal degeneration. Details of the survey and clinical investigations are discussed. PMID:19997731
Horváth, Gábor; Koroknai, Gabriella; Acs, Barnabás; Than, Péter; Illés, Tamás
Pain and disability following fusion for idiopathic adolescent scoliosis: prevalence and associated factors
Study design:?Retrospective prognostic study. Objectives:?To describe the prevalence of pain following fusion for adolescent idiopathic scoliosis and to identify factors associated with pain and disability. Methods:?From 126 consecutive patients surgically treated for scoliosis between 1997 and 2007, 104 (82.5%) completed SRS-22 and ODI questionnaires at a last follow-up (mean, 4.8 years; range 1–11.2 years). Prevalence of pain and disability were determined from SRS questions 1 and 9 respectively, with "any" pain or decrease in activity considered clinically significant. SRS Pain Domain Scores (PDS) were also evaluated. Results:?Most participants reported "no pain" (38.5%) or "mild pain" (30.8%) and 72.1% of participants reported a current work/school activity level of 100% normal. An association between instrument type and the presence of any pain in the previous 6 months was noted (P?=?.022). Instrument type was the only factor that was significantly associated with the PDS (P?=?.0052). Conclusions:?The high percentage of patients reporting no pain or mild pain may suggest overall success of the procedures. Although an association between instrument type and pain was seen, unmeasured factors that contributed to the decision of what instrument to use may confound the relationship. From these data a causal inference cannot be made. Final class of evidence-prognosis Study design Prospective Cohort Retrospective Cohort • Case control Case series Methods Patients at similar point in course of treatment • F/U ? 85% Similarity of treatment protocols for patient groups Patients followed up long enough for outcomes to occur • Control for extraneous risk factors •* Overall class of evidence III The definiton of the different classes of evidence is available on page 55. *Potentially confounding factors were systematically explored and considered for stratified analysis as appropriate.
Bas, Teresa; Franco, Nuria; Bas, Paloma; Bas, Jose Luis
Randomized Controlled Trial of Physiotherapy and Feldenkrais Interventions in Female Workers with Neck-Shoulder Complaints
The present study aimed to investigate whether physiotherapy or Feldenkrais interventions resulted in a reduction of complaints from the neck and shoulders (prevalence, pain intensity, sick leave, and disability in leisure and work roles) in 97 female industrial workers (not on long-term sick leave). Range of motion of neck and shoulders, VO2, endurance score (i.e., summation of pain intensity ratings
Inga Lundblad; Jessica Elert; Björn Gerdle
Back pain prevalence in US industry and estimates of lost workdays.
OBJECTIVES: Back pain is the most common reason for filing workers' compensation claims and often causes lost workdays. Data from the 1988 National Health Interview Survey were analyzed to identify high-risk industries and to estimate the prevalence of work-related back pain and number of workdays lost. METHODS: Analyses included 30074 respondents who worked during the 12 months before the interview. A case patient was defined as a respondent who had back pain every day for a week or more during that period. RESULTS: The prevalence of lost-workday back pain was 4.6%, and individuals with work-related cases lost 101.8 million workdays owing to back pain. Male and female case patients lost about the same number of workdays. Industries in high-risk categories were also identified for future research and intervention, including those seldom studied. CONCLUSIONS: This study provides statistically reliable national estimates of the prevalence of back pain among workers and the enormous effect of this condition on American industry in terms of lost workdays.
Guo, H R; Tanaka, S; Halperin, W E; Cameron, L L
Neck/shoulder pain and low back pain among school teachers in China, prevalence and risk factors
Background School teachers represent an occupational group among which there appears to be a high prevalence of neck and/or shoulder pain (NSP) and low back pain (LBP). Epidemiological data on NSP and LBP in Chinese teachers are limited. The aim of this study was to investigate the prevalence of and risk factors for NSP and LBP among primary, secondary and high school teachers. Methods In a cross-sectional study of teachers from 7 schools, information on participant demographics, work characteristics, occupational factors and musculoskeletal symptoms and pain were collected. Results Among 893 teachers, the prevalence of NSP and LBP was 48.7% and 45.6% respectively. There was significant association between the level and prevalence of NSP and LBP among teachers in different schools. The prevalence of NSP among female teachers was much higher than that for males. Self-reported NSP was associated with physical exercise (OR 0.55, 95% CI 0.35 to 0.86), prolonged standing (1.74, 1.03 to 2.95), sitting (1.76, 1.23 to 2.52) and static posture (2.25, 1.56 to 3.24), and uncomfortable back support (1.77, 1.23 to 2.55). LBP was more consistently associated with twisting posture (1.93, 1.30 to 2.87), uncomfortable back support (1.62, 1.13 to 2.32) and prolonged sitting (1.42, 1.00 to 2.02) and static posture (1.60, 1.11 to 2.31). Conclusions NSP and LBP are common among teachers. There were strong associations with different individual, ergonomic, and occupational factors.
The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP)
Although pain is experienced at all ages, there is uncertainty about the pattern of its occurrence in older people. We have investigated the prevalence of three aspects of self-reported pain—occurrence of any recent pain, number and location of pain sites, and interference with daily life—to determine their association with age in older people. A cross-sectional postal survey of all adults
Elaine Thomas; George Peat; Lindsey Harris; Ross Wilkie; Peter R Croft
Cost-of-illness of neck pain in The Netherlands in 1996
The prevalence of neck pain in the general population ranges from 10 to 15%. The complaints can result in substantial medical consumption, absenteeism from work and disability. In this study we investigated the costs of neck pain in the Netherlands in 1996 to assess the financial burden to society. The study was based on prevalence data. Data sources included national
Jeroen A. J Borghouts; Bart W Koes; Hindrik Vondeling; Lex M Bouter
WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity
BACKGROUND: Health care planning for chronic pelvic pain (CPP), an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates. METHODS:
Pallavi Latthe; Manish Latthe; Lale Say; Metin Gülmezoglu; Khalid S Khan
The prevalence of neck pain in the world population: a systematic critical review of the literature
The objective of this study was to determine the prevalence of neck pain (NP) in the world population and to identify areas of methodological variation between studies. A systematic search was conducted in five databases (MEDLINE, EMBASE, CINAHL, OSH-ROM, and PsycINFO), followed by a screening of reference lists of relevant papers. Included papers were extracted for information and each paper
René Fejer; Kirsten Ohm Kyvik; Jan Hartvigsen
Pain, Work-related Characteristics, and Psychosocial Factors among Computer Workers at a University Center
[Purpose] Complaint of pain is common in computer workers, encouraging the investigation of pain-related workplace factors. This study investigated the relationship among work-related characteristics, psychosocial factors, and pain among computer workers from a university center. [Subjects and Methods] Fifteen subjects (median age, 32.0?years; interquartile range, 26.8–34.5?years) were subjected to measurement of bioelectrical impedance; photogrammetry; workplace measurements; and pain complaint, quality of life, and motivation questionnaires. [Results] The low back was the most prevalent region of complaint (76.9%). The number of body regions for which subjects complained of pain was greater in the no rest breaks group, which also presented higher prevalences of neck (62.5%) and low back (100%) pain. There were also observed associations between neck complaint and quality of life; neck complaint and head protrusion; wrist complaint and shoulder angle; and use of a chair back and thoracic pain. [Conclusion] Complaint of pain was associated with no short rest breaks, no use of a chair back, poor quality of life, high head protrusion, and shoulder angle while using the mouse of a computer.
Mainenti, Miriam Raquel Meira; Felicio, Lilian Ramiro; Rodrigues, Erika de Carvalho; Ribeiro da Silva, Dalila Terrinha; Vigario dos Santos, Patricia
Psychiatric disorders in children and adolescents presenting with unexplained chronic pain: what is the prevalence and clinical relevancy?
The prevalence of psychiatric disorders among children with unexplained chronic pain (UCP) is high in unselected populations\\u000a and pain clinics, yet the clinical relevance of these disorders in children referred for unexplained pain is not known. This\\u000a study assessed the prevalence of clinically relevant psychiatric disorders and their predictors in children referred to a\\u000a children's hospital for UCP. Psychiatry morbidity
Lidewij M. E. Knook; Antoinette Y. Konijnenberg; Joost van der Hoeven; Jan L. L. Kimpen; Jan K. Buitelaar; Herman van Engeland; Elisabeth R. de Graeff-Meeder
Increase of chronic low back pain prevalence in a medium-sized city of southern Brazil
Background Chronic low back pain (CLBP) is a highly disabling morbidity with high social, economic and individual effects. Demographic, occupational and behavioral changes that took place in Brazil over the last decade are related with an increasing burden of chronic conditions. Despite these changes, comparison studies on CLBP prevalence and associated factors, over time are scarce in the literature in general, and unknown in Brazil. The present study compared the CLBP prevalence in a medium sized city in Brazil between the years 2002 and 2010 and examined factors associated with prevalence in 2010. Methods Two cross-sectional studies with similar methodology were conducted in a medium-sized city in southern Brazil, in 2002 and 2010. 3182 individuals were interviewed in the first study and 2732 in the second one, all adults aged twenty years or more. Those who reported pain for seven weeks or more in the last three months in the lumbar region where considered cases of CLBP. Results The CLBP prevalence increased from 4.2% to 9.6% in 8 years. In most of the studied subgroups the CLBP prevalence has at least doubled and the increase was even larger among younger individuals with more years of education and higher economic status. Conclusions Increase in CLBP prevalence is worrisome because it is a condition responsible for substantial social impact, besides being an important source of demand for health services.
Prevalence of Radiographic Osteoarthritis of the Knee and Its Relationship to Self-Reported Pain
Background and Aim Osteoarthritis (OA) of the knee is one of the most common skeletal disorders, yet little data are available in Asian populations. We sought to assess the prevalence and pattern of radiographic OA of the knee, and its relationship to self-reported pain in a Vietnamese population. Methods The study was based on a sample of 170 men and 488 women aged ?40 years who were randomly sampled from the Ho Chi Minh City (Vietnam). Radiographs of the knee were graded from 0 to 4 according to the Kellgren and Lawrence scale. Osteoarthritis was defined as being present in a knee if radiographic grades of 2 or higher were detected. Knee pain and symptoms were ascertained by direct interview using a structured questionnaire. Results The point prevalence of radiographic OA of the knee was 34.2%, with women having higher rate than men (35.3% vs 31.2%). The prevalence of knee OA increased with advancing age: 8% among those aged 40–49 years, 30% in those aged 50–59 years, and 61.1% in those aged ?60 years. Greater BMI was associated with higher risk of knee OA. Self-reported knee pain was found in 35% of men and 62% of women. There was a statistically significant association between self-reported knee pain and knee OA (prevalence ratio 3.1; 95% CI 2.0 to 4.6). Conclusions These data indicate that approximately a third of Vietnamese men and women have radiographic OA in the knee, and that self-reported knee pain may be used as an indicator of knee osteoarthritis.
Ho-Pham, Lan T.; Lai, Thai Q.; Mai, Linh D.; Doan, Minh C.; Pham, Hoa N.; Nguyen, Tuan V.
Gender differences in the incidence and prevalence of patellofemoral pain syndrome
The purpose of this investigation was to determine the association between gender and the prevalence and incidence of patellofemoral pain syndrome (PFPS). One thousand five hundred and twenty-five participants from the United States Naval Academy (USNA) were followed for up to 2.5 years for the development of PFPS. Physicians and certified athletic trainers documented the cases of PFPS. PFPS was defined as retropatellar pain during at least two of the following activities: ascending/descending stairs, hopping/jogging, prolonged sitting, kneeling, and squatting, negative findings on examination of knee ligament, menisci, bursa, and synovial plica, and pain on palpation of either the patellar facets or femoral condyles. Poisson and logistic regressions were performed to determine the association between gender and the incidence and prevalence of PFPS, respectively. The incidence rate for PFPS was 22/1000 person-years. Females were 2.23 times (95% CI: 1.19, 4.20) more likely to develop PFPS compared with males. While not statistically significant, the prevalence of PFPS at study enrollment tended to be higher in females (15%) than in males (12%) (P50.09). Females at the USNA are significantly more likely to develop PFPS than males. Additionally, at the time of admission to the academy, the prevalence of PFPS was not significantly different between genders.
Boling, M.; Padua, D.; Marshall, S.; Guskiewicz, K.; Pyne, S.; Beutler, A.
Prevalence of chronic widespread pain and fibromyalgia syndrome: a Korean hospital-based study.
This study was conducted to estimate the point prevalence of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS) in a primary care center of a hospital in Korea. CWP was defined as pain lasting more than 3 months involving all the classified pain sites (axial, left and right, above and below waist). FMS was diagnosed by the American College of Rheumatology (ACR) criteria and also by clinical judgment of a physician. All 1,077 subjects were classified into three groups as no chronic pain (NCP), chronic regional pain (CRP), and CWP. CRP was defined as chronic pain with the exception of CWP. The point prevalence of CWP was 6.5% (95% confidence interval (CI) 0.2-12.8) and the point prevalence of FMS was 1.7% (95% CI 0.0-4.9) by ACR criteria and 2.3% (95% CI 0.0-6.1) by clinical judgment, respectively. We also analyzed the differential demographic characteristics among patients with NCP, CRP, and CWP. When compared to NCP, CWP was significantly associated with the female gender after adjusting for other variables (odds ratio 4.2; 95% CI 1.4-12.4, P = 0.009). Compared to NCP, CWP patients had lower levels of education (P = 0.018), a lower likelihood of a professional occupation (P = 0.014), infrequent alcohol intake (P = 0.014) and a lower proportion of current smokers (P = 0.003) based on a univariable analysis. In this Korean hospital-based study, CWP patients were common and had different demographic characteristics and life habits from NCP. PMID:22057141
Kim, Cheolhwan; Kim, Hyejin; Kim, Jongkwan
Prevalence of undertreatment in cancer pain. A review of published literature
Background: Pain is a major health care problem for patients with cancer: despite the existence of guidelines for cancer pain management, undertreatment is a widespread problem. Pain Management Indexes (PMIs) evaluate the congruence between the patient's reported level of pain and the intensity/strength of the analgesic therapy. Negative scores indicate inadequate prescriptions. Materials and methods: We conducted a Medline search using terms for 'pain management', 'index' or 'measure' to select studies which measured undertreatment in cancer settings. Univariate and multivariate logistic regression identified associations between independent predictors and high prevalence of undertreatment. Results: Among the 44 studies identified, 26 studies used the PMI as proposed by Cleeland. The range of negative PMI varied from 8% to 82% with a weighted mean value of 43%. In multivariate analyses, factors associated with negative PMI were date of publication before 2001, provenance from Europe or Asia and countries with a gross national income per capita <$40?000 per year and a care setting not specific for cancer. Age was not a significant predictor for undertreatment. Conclusion: Nearly one of two patients with cancer pain is undertreated. The percentage is high, but consists of a large variability of undertreatment across studies and settings.
Deandrea, S.; Montanari, M.; Moja, L.; Apolone, G.
Prevalence and risk factors for low back pain among professional cooks working in school lunch services
BACKGROUND: The prevalence of self-reported low back pain among professional cooks was estimated to examine the effects of daily life conditions, job-related factors, and psychological factors on this disorder. METHODS: Data was collected using a mailed self-administered questionnaire. RESULTS: Of 7100 cooks, 5835 (82%) replied to the questionnaire, including 1010 men and 4825 women. The mean age was 41.4 for
Miwako Nagasu; Kazuhiro Sakai; Akiyoshi Ito; Shigeru Tomita; Yoshiomi Temmyo; Mitsuo Ueno; Shigeji Miyagi
Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC 3-study
The objective of this paper was to present estimates on the prevalence of musculoskeletal pain of five different anatomical areas and ten anatomical sites, and their consequences and risk groups in the general Dutch population. Cross-sectional data from a population-based study of a sex-age stratified sample of Dutch inhabitants of 25 years and older were used. With a postal questionnaire
H. S. J. Picavet; J. S. A. G. Schouten
Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: a 2-year prospective multicentre study
Background: Persistent postoperative pain continues to be an underrecognized complication. We examined the prevalence of and risk factors for this type of pain after cardiac surgery. Methods: We enrolled patients scheduled for coronary artery bypass grafting or valve replacement, or both, from Feb. 8, 2005, to Sept. 1, 2009. Validated measures were used to assess (a) preoperative anxiety and depression, tendency to catastrophize in the face of pain, health-related quality of life and presence of persistent pain; (b) pain intensity and interference in the first postoperative week; and (c) presence and intensity of persistent postoperative pain at 3, 6, 12 and 24 months after surgery. The primary outcome was the presence of persistent postoperative pain during 24 months of follow-up. Results: A total of 1247 patients completed the preoperative assessment. Follow-up retention rates at 3 and 24 months were 84% and 78%, respectively. The prevalence of persistent postoperative pain decreased significantly over time, from 40.1% at 3 months to 22.1% at 6 months, 16.5% at 12 months and 9.5% at 24 months; the pain was rated as moderate to severe in 3.6% at 24 months. Acute postoperative pain predicted both the presence and severity of persistent postoperative pain. The more intense the pain during the first week after surgery and the more it interfered with functioning, the more likely the patients were to report persistent postoperative pain. Pre-existing persistent pain and increased preoperative anxiety also predicted the presence of persistent postoperative pain. Interpretation: Persistent postoperative pain of nonanginal origin after cardiac surgery affected a substantial proportion of the study population. Future research is needed to determine whether interventions to modify certain risk factors, such as preoperative anxiety and the severity of pain before and immediately after surgery, may help to minimize or prevent persistent postoperative pain.
Choiniere, Manon; Watt-Watson, Judy; Victor, J. Charles; Baskett, Roger J.F.; Bussieres, Jean S.; Carrier, Michel; Cogan, Jennifer; Costello, Judy; Feindel, Christopher; Guertin, Marie-Claude; Racine, Melanie; Taillefer, Marie-Christine
Breakthrough cancer pain: prevalence and characteristics in patients in Catalonia, Spain.
Breakthrough pain (BTP), a transitory exacerbation of pain superimposed on a background of persistent, usually adequately controlled pain, has been reported to occur in 50% to 75% of cancer patients. However, a 23% prevalence of BTP was recently reported in a study of Spanish patients with advanced cancers, showing probably a low detection rate of this clinical problem. The purpose of the present study was to determine the prevalence of BTP among oncology patients managed by palliative care teams in Catalonia, Spain, and to characterize the frequency, intensity, and treatment of BTP episodes. Sixty-two teams studied 397 patients on a predetermined index day. BTP was reported by 163 (41%) patients, with a total of 244 episodes (mean 1.5 episodes/patient/day). Mean (SD) intensity of BTP episodes was 7.3 (2.0), compared with 2.9 (2.7) for persistent pain (both 0-10 scales). Morphine was used to treat 52% of BTP episodes, while 25% were untreated. These findings indicate that BTP remains underrecognized and undertreated in Spain. PMID:12183094
Gómez-Batiste, Xavier; Madrid, Federico; Moreno, Francisco; Gracia, Albert; Trelis, Jordi; Nabal, Maria; Alcalde, Ramón; Planas, Josep; Camell, Helena
Prevalence of low back pain in children and adolescents: a meta-analysis
Background Low back pain (LBP) is common in children and adolescents, and it is becoming a public health concern. In recent years there has been a considerable increase in research studies that examine the prevalence of LBP in this population, but studies exhibit great variability in the prevalence rates reported. The purpose of this research was to examine, by means of a meta-analytic investigation, the prevalence rates of LBP in children and adolescents. Methods Studies were located from computerized databases (ISI Web of Knowledge, MedLine, PEDro, IME, LILACS, and CINAHL) and other sources. The search period extended to April 2011. To be included in the meta-analysis, studies had to report a prevalence rate (whether point, period or lifetime prevalence) of LBP in children and/or adolescents (? 18 years old). Two independent researchers coded the moderator variables of the studies, and extracted the prevalence rates. Separate meta-analyses were carried out for the different types of prevalence in order to avoid dependence problems. In each meta-analysis, a random-effects model was assumed to carry out the statistical analyses. Results A total of 59 articles fulfilled the selection criteria. The mean point prevalence obtained from 10 studies was 0.120 (95% CI: 0.09 and 0.159). The mean period prevalence at 12 months obtained from 13 studies was 0.336 (95% CI: 0.269 and 0.410), whereas the mean period prevalence at one week obtained from six studies was 0.177 (95% CI: 0.124 and 0.247). The mean lifetime prevalence obtained from 30 studies was 0.399 (95% CI: 0.342 and 0.459). Lifetime prevalence exhibited a positive, statistically significant relationship with the mean age of the participants in the samples and with the publication year of the studies. Conclusions The most recent studies showed higher prevalence rates than the oldest ones, and studies with a better methodology exhibited higher lifetime prevalence rates than studies that were methodologically poor. Future studies should report more information regarding the definition of LBP and there is a need to improve the methodological quality of studies.
The Prevalence of low back pain in Africa: a systematic review
Background Low back pain (LBP) is the most prevalent musculoskeletal condition and one the most common causes of disability in the developed nations. Anecdotally, there is a general assumption that LBP prevalence in Africa is comparatively lower than in developed countries. The aim of this review was to systematically appraise the published prevalence studies conducted on the African continent to establish the prevalence of LBP in Africa. Methods A comprehensive search was conducted in April 2006. The following databases PEDro, Psychinfo, Science Direct, SportsDiscus, PubMed, CINAHL, Biblioline Pro-African Wide NiPAD and SA ePublications were individually searched using specifically developed search strategies for epidemiological research conducted on LBP amongst the African population. Two reviewers independently evaluated the methodological quality of the studies reviewed. Results A total of 27 eligible epidemiological studies were included in this review. The majority of the studies (63%) were conducted in South Africa (37%) and Nigeria (26%). The most common population group involved workers (48%), while scholars comprised 15% of the population. 67% of the studies were found to be methodologically sound, and the LBP prevalence of these were analyzed. The mean LBP point prevalence among the adolescents was 12% and among adults was 32%. The average one year prevalence of LBP among adolescents was 33% and among adults was 50%. The average lifetime prevalence of LBP among the adolescents was 36% and among adults was 62%. Conclusion The findings support the global burden of disease of LBP, in addition to suggesting that LBP prevalence among Africans is rising and is of concern. Further research into the most effective strategies to prevent and manage LBP in Africa is warranted.
Louw, Quinette A; Morris, Linzette D; Grimmer-Somers, Karen
Prevalence of low back pain in adolescent athletes - an epidemiological investigation.
Low back pain (LBP) is a common symptom in the populations of western countries, and adolescent athletes seem to be prone to LBP. The main objective of this study was to analyze the point (LBP within the last 48?h), 1-year (LBP within the last 12 months) and lifetime (LBP within the entire life) prevalence rates of LBP in adolescent athletes participating in various sports. We also assessed the characteristics of LBP and its association with potential risk factors. To this end, 272 competitive adolescent athletes involved in 31 different sports (158 males, 113 females, 15.4±2.0 years, body mass index [BMI] 20.3±2.4?kg/m(2)) were enrolled in a 10-month prospective clinical trial that included a questionnaire and physical examination. We found a point prevalence of 14%, a 1-year prevalence of 57%, and a lifetime prevalence of 66% for LBP. The mean age of first appearance of LBP was 13.1±2.0 years. The lifetime prevalence was significantly higher in volleyball than in biathletes (74.3 vs. 45.7%, p=0.015). Our findings confirm that LBP is a common symptom in adolescent athletes; LBP prevalence correlates with sports participation and individual competitive level. Adolescent athletes with LBP should receive a thorough diagnostic work-up and adapt training and technique correspondingly when indicated. PMID:24424960
Schmidt, C P; Zwingenberger, S; Walther, A; Reuter, U; Kasten, P; Seifert, J; Günther, K-P; Stiehler, M
Prevalence of Baker's cyst in patients with knee pain: an ultrasonographic study.
The objectives of this study are to investigate the prevalence of Baker's cyst (BC) in patients with knee pain, and to assess the correlation between BC and severity of osteophytes and joint effusion. A retrospective study was conducted on a group of patients with knee pain referred to our outpatient clinic for ultrasonography of the knee between January 2010 and February 2011. Patients underwent an ultrasonographic exam of the knees to assess the presence of marginal femorotibial osteophytosis, joint effusion and BC. A dichotomous score was assigned to each item (1 present, 0 absent) and severity of US signs of osteoarthritis and joint effusion were also graded semiquantitatively. Collected data were processed using logistic regression analysis to evaluate the correlation between degree of osteophytosis and joint effusion and BC. Patients affected by inflammatory joint conditions or with history of joint surgery or recent trauma were excluded. A total of 399 patients with knee pain were studied (299 women), in the age range 18-89 years (mean 56.2, SD 16.3 years). 293 patients (73.4%) showed sonographic features of osteoarthritis and 251 (62.9%) joint effusion. BC was found in 102 patients (25.8%) together with a positive association with sonographic features of osteoarthritis and joint effusion. Our data show a prevalence of BC of 25.8% in a population of patients with knee pain, and suggest that BC is positively related to osteoarthritis and joint effusion. Ultrasonographic examination of knee is worthwhile in patients with painful osteoarthritis or evidence of effusion. PMID:24705029
Picerno, V; Filippou, G; Bertoldi, I; Adinolfi, A; Di Sabatino, V; Galeazzi, M; Frediani, B
Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review
BACKGROUND: Thoracic spine pain (TSP) is experienced across the lifespan by healthy individuals and is a common presentation in primary healthcare clinical practice. However, the epidemiological characteristics of TSP are not well documented compared to neck and low back pain. A rigorous evaluation of the prevalence, incidence, correlates and risk factors needs to be undertaken in order for epidemiologic data
Andrew M Briggs; Anne J Smith; Leon M Straker; Peter Bragge
Pain in hospitalized children: A prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital
BACKGROUND: Pain is under-recognised and undertreated. Although standards now exist for pain management, it is not known if this has improved care of hospitalized children. OBJECTIVES: To benchmark pain prevalence, pain intensity, pain assessment documentation and pharmacological treatment of pain. The aim was to highlight areas of good practice, identify areas for improvement and inform development of hospital standards, education, future audits and the research agenda. METHODS: The present prospective cross-sectional survey of all medical and surgical inpatient units took place on a single day at the Hospital for Sick Children (Toronto, Ontario), a Canadian tertiary and quaternary pediatric hospital. A structured, verbally administered questionnaire was used to obtain information on patient demographics, pain before admission, pain intensity during admission and pain treatment. Charts were reviewed to establish frequency of documented pain assessment, the pain assessment tool used and analgesics given. Subgroup analysis was included for age, sex, visible minority or fluency in English, medical versus surgical services and acute pain service input. RESULTS AND CONCLUSIONS: Two hundred forty-one (83%) of the 290 inpatients or their carergivers were interviewed. It was found that 27% of patients usually had pain before admission, and 77% experienced pain during admission. Of these, 23% had moderate or severe pain at interview and 64% had moderate or severe pain sometime in the previous 24 h. Analgesics were largely intermittent and single-agent, although 90% of patients found these helpful. Fifty-eight per cent of those with pain received analgesics in the preceding 24 h but only 25% received regular analgesia. Only 27% of children had any pain score documented in the preceding 24 h. It was concluded that pain was infrequently assessed, yet occurred commonly across all age groups and services and was often moderate or severe. Although effective, analgesic therapy was largely single-agent and intermittent. Widespread dissemination of results to all professional groups has resulted in the development of a continuous quality assurance program for pain at the Hospital for Sick Children. A re-audit is planned to evaluate changes resulting from the new comprehensive pain strategies.
Taylor, Elsa M; Boyer, Kristina; Campbell, Fiona A
Prevalence of joint pain is higher among women in rural Japan than urban Japanese-American women in Hawaii
OBJECTIVE—Environmental factors such as farming contribute to the frequency of joint symptoms. The purpose of this study is to explore the possible role of environment (lifestyle), by comparing the prevalence of joint pain between Japanese in a rural farming district in Japan and in urban Hawaii.?SUBJECTS AND METHODS—Current or previous pain at specific joints was surveyed among 222 women in rural Japan and 638 Japanese women in urban Hawaii aged 60-79. The age adjusted prevalence was compared using logistic regression.?RESULTS—The prevalence of pain at one or more joints was approximately 70% in Japan and 50% in Hawaii. The prevalence of knee pain in Japan ranged from 36% at ages 60-69 years to 53% at 70-79 years (mean 41%), whereas knee pain affected only 20% of women in Hawaii in both age groups. The odds ratio (and 95% CI) was 3.2 (2.1, 4.8) for knee pain, and 4.0 (2.2, 7.4) for mid-back pain in Japan, compared with Hawaii. Pain was also significantly more common in Japan at the shoulder, elbow, and ankle, but not at other joints. Women in Japan were shorter and weighed less than in Hawaii. Adjustment for body mass index increased the odds ratios to 4.4 (2.9, 6.8) for knee, and 4.5 (2.4, 8.5) for mid-back pain.?CONCLUSION—Although the potential influence of cultural factors or other sources of bias cannot be ruled out, the large differences in the prevalence of pain at specific joints suggest that environmental factors are probably responsible, because both populations are of similar genetic stock.??
Aoyagi, K.; Ross, P.; Huang, C.; Wasnich, R.; Hayashi, T.; Takemoto, T.
Effect of Axillary Lymph Node Dissection on Prevalence and Intensity of Chronic and Phantom Pain After Breast Cancer Surgery
Chronic pain after breast cancer surgery is a major problem and is expected to increase in the coming years because of an increased prevalence of breast cancer coupled with better survival. Axillary lymph node dissection (ALND) in patients with breast cancer is associated with nerve damage. The present study investigated the effect of ALND on the prevalence and intensity of
Monique A. Steegers; Bas Wolters; Andrea W. Evers; Luc Strobbe; Oliver H. Wilder-Smith
Neuropathic Pain and Psychological Morbidity in Patients with Treated Leprosy: A Cross-Sectional Prevalence Study in Mumbai
Background Neuropathic pain has been little studied in leprosy. We assessed the prevalence and clinical characteristics of neuropathic pain and the validity of the Douleur Neuropathique 4 questionnaire as a screening tool for neuropathic pain in patients with treated leprosy. The association of neuropathic pain with psychological morbidity was also evaluated. Methodology/Principal Findings Adult patients who had completed multi-drug therapy for leprosy were recruited from several Bombay Leprosy Project clinics. Clinical neurological examination, assessment of leprosy affected skin and nerves and pain evaluation were performed for all patients. Patients completed the Douleur Neuropathique 4 and the 12-item General Health Questionnaire to identify neuropathic pain and psychological morbidity. Conclusions/Significance One hundred and one patients were recruited, and 22 (21.8%) had neuropathic pain. The main sensory symptoms were numbness (86.4%), tingling (68.2%), hypoesthesia to touch (81.2%) and pinprick (72.7%). Neuropathic pain was associated with nerve enlargement and tenderness, painful skin lesions and with psychological morbidity. The Douleur Neuropathique 4 had a sensitivity of 100% and specificity of 92% in diagnosing neuropathic pain. The Douleur Neuropathique 4 is a simple tool for the screening of neuropathic pain in leprosy patients. Psychological morbidity was detected in 15% of the patients and 41% of the patients with neuropathic pain had psychological morbidity.
Lasry-Levy, Estrella; Hietaharju, Aki; Pai, Vivek; Ganapati, Ramaswamy; Rice, Andrew S. C.; Haanpaa, Maija; Lockwood, Diana N. J.
Untying chronic pain: prevalence and societal burden of chronic pain stages in the general population - a cross-sectional survey
Background Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods A cross-sectional survey with 4360 people aged???14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12 months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load, were tested by Poisson and logistic regression analyses. Results 2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and 6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]). Conclusion Chronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load.
Comparing partial and total tibial-nerve axotomy: long-term effects on prevalence and location of evoked pain behaviors.
Monophasic (one-time) nerve injuries heal without clinically significant residua in most cases, but rare individuals are left with neuropathic pain, even after seemingly minor lesions. The effects of lesion size on risk for chronic pain persistence are not well understood, particularly as concerns the complex regional pain syndrome, which is defined in part by pain "disproportionate" to the severity of the causative lesion, and extending outside the autonomous territory of a single nerve. To better clarify the expected prevalence of pain behaviors after nerve injury, we compared the effects in rats of different-sized axotomies on the prevalence and location of evoked pain behaviors. To highlight clinical relevance, we also describe a patient with iatrogenic tibial-nerve injury causing similar chronic neuralgia. Adult male Sprague-Dawley rats were anesthetized and had either 1/3, 2/3 or their entire left tibial nerves tightly ligated at two sites just below the sciatic trifurcation and the interposed nerve was cut. Unoperated rats provided controls. Sensory function in the tibial and sural-innervated territories of both plantar hindpaws was assessed for as long as 6 months postoperatively. Soon after surgery, evoked pain behavior developed in the ipsilesional sural-innervated site in a subset of axotomized rats and recovery was variable. The relationship between lesion size and prevalence and severity of hyperalgesia varied for different pain behaviors, with pinprick hyperalgesia clearly more likely after larger axotomies. In summary, partial tibial-nerve injury in rats models human disease and suggests that expectations of proportionality between lesion size and development of neuropathic pain may need revision. PMID:21199309
Unal-Cevik, Isin; Oaklander, Anne Louise
WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity
Background Health care planning for chronic pelvic pain (CPP), an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates. Methods We identified data available from Medline (1966 to 2004), Embase (1980 to 2004), PsycINFO (1887 to 2003), LILACS (1982 to 2004), Science Citation index, CINAHL (January 1980 to 2004) and hand searching of reference lists. Two reviewers extracted data independently, using a piloted form, on participants' characteristics, study quality and rates of CPP. We considered a study to be of high quality (valid) if had at least three of the following features: prospective design, validated measurement tool, adequate sampling method, sample size estimation and response rate >80%. We performed both univariate and multivariate meta-regression analysis to explore heterogeneity of results across studies. Results There were 178 studies (459975 participants) in 148 articles. Of these, 106 studies were (124259 participants) on dysmenorrhoea, 54 (35973 participants) on dyspareunia and 18 (301756 participants) on noncyclical pain. There were only 19/95 (20%) less developed and 1/45 (2.2%) least developed countries with relevant data in contrast to 22/43 (51.2%) developed countries. Meta-regression analysis showed that rates of pain varied according to study quality features. There were 40 (22.5%) high quality studies with representative samples. Amongst them, the rate of dysmenorrhoea was 16.8 to 81%, that of dyspareunia was 8 to 21.8%, and that for noncyclical pain was 2.1 to 24%. Conclusion There were few valid population based estimates of disease burden due to CPP from less developed countries. The variation in rates of CPP worldwide was due to variable study quality. Where valid data were available, a high disease burden of all types of pelvic pain was found.
Latthe, Pallavi; Latthe, Manish; Say, Lale; Gulmezoglu, Metin; Khan, Khalid S
Low back pain disability and stay at work: contradiction or necessity?
The incidence of occupational diseases in the population is high and factors such as long working hours, poor posture, psychological and physical stress can contribute to its development. Among work-related musculoskeletal disorders, back pain has a high prevalence. The aim of the present study was to quantify and characterize pain complaints and to identify individuals with low back pain, in order to assess the degree of disability. Participated 226 employees of an institution of higher education. They answered a general questionnaire about location and quantification of pain complaints visual analog scale for pain and the Quebec Disability Questionnaire. Of all the workers, 69.60% had some type of musculoskeletal complaint; of those, 15.41% had low back pain. Considering workers who had back pain, 54.9% were female, 52.94% are under 30 years old and 43.14% between 1 and 5 years of work. As for the final score for the degree of disability, 41.17% had minimal disability and 37.25% moderate disability. The present study found large number of pain complaints and high prevalence of low back pain, resulting in individual's inability and difficulties in performing work activities. PMID:22317079
Padula, Rosimeire Simprini; Carregaro, Rodrigo Luiz; Melo, Bruna; da Silva, Cláudia Regina; Oliveira, Ana Beatriz
Prevalence of sleep deprivation in patients with chronic neck and back pain: a retrospective evaluation of 1016 patients
Background Chronic low back pain (CLBP) and chronic neck pain (CNP) have become a serious medical and socioeconomic problem in recent decades. Patients suffering from chronic pain seem to have a higher prevalence of sleep disorders. Purpose To calculate the prevalence of sleep deprivation in patients with CLBP and CNP and to evaluate the factors that may contribute to sleep impairment. Methods This study was a retrospective evaluation of 1016 patients with CNP and CLBP who consulted an orthopedic department at a university hospital. Factors assessed were gender, age, diagnosis, grade of sleep deprivation, pain intensity, chronification grade, and migrational background. Pearson's chi-squared test was performed to calculate the relationship between these factors and the grade of sleep deprivation. Regression analysis was performed to explore the correlation between the grade of sleep deprivation and age, pain intensity, and chronification grade. Results A high prevalence of sleep deprivation (42.22%) was calculated in patients with CNP and CLBP, even when analgesics had been taken. About 19.88% of the patients reported serious sleep impairments (ie, <4 hours of sleep per night). The grade of sleep deprivation did not correlate with the gender or age distribution. A significant relationship was found between the grade of sleep deprivation and pain intensity, failed back surgery syndrome, and patients with a migrational background. There was a moderate relationship with intervertebral disc disease and no relationship with spinal stenosis. Conclusion Sleep disturbance should be assessed when treating patients with CNP or CLBP, especially in patients with higher pain intensity, failed back surgery syndrome, and a migrational background. Further research is needed to explore the complex relationship of sleep disturbance and chronic pain.
Artner, Juraj; Cakir, Balkan; Spiekermann, Jane-Anna; Kurz, Stephan; Leucht, Frank; Reichel, Heiko; Lattig, Friederike
Pain characteristics of adults 65 years of age and older referred to a tertiary care pain clinic
BACKGROUND: Reports indicate that characteristics of older adults with chronic pain may be different than those of younger persons. OBJECTIVE: To study the pain characteristics of older patients presenting to a tertiary pain clinic for the first time. METHODS: Age, sex and relative contributions of biomedical versus psychosocial variables contributing to chronic pain were investigated in patients 65 years of age and older, in comparison with younger patients, from a sample of 1242 consecutive new patients attending a tertiary care pain clinic. The presence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision somatoform pain disorders were defined, using an explicated method of ascertaining the biomedical and psychological variables underlying the pain complaints. RESULTS: The older patients (14.7% of the total sample) had relatively more physical problems (concordant with their complaints) but fewer psychological factors contributing to disability than the younger pain patients. Musculoskeletal and neuropathic disorders affected 40.7% and 35.2% of the older patients, respectively, while several patients had more than one painful disorder. Musculoskeletal problems were more prevalent in the women, and neuropathic problems were more prevalent in the men. CONCLUSIONS: The older pain patients are a distinct group. Factors affecting the delayed presentation of older pain patients to the pain clinic and limitations of the present study are discussed.
Mailis-Gagnon, Angela; Nicholson, Keith; Yegneswaran, Balaji; Zurowski, Mateusz
Do epidemiological results replicate? The prevalence and health-economic consequences of neck and back pain in the general population
Current estimates of the prevalence and consequences of neck and back pain vary greatly between studies. It is not known whether this variance is due to differences in methodology, or if it depends on the dynamics of the problem over time. The aim of this study was consequently an attempt to replicate and extend the findings of a previous epidemiological
Steven J. Linton; Marianne Ryberg
Prevalence of and risk factors for different measures of low back pain among female nursing aides in Taiwanese nursing homes
BACKGROUND: Although low back pain (LBP) among nursing staff, especially in nursing aides (NAs), has been a major health problem around the world, there is limited information on its prevalence in Taiwan. In addition, various measurements have been used to determine LBP; understanding the risk factors for each measurement of LBP is essential for prevention. This study aimed to assess
Chao-Kang Feng; Mei-Lien Chen; I-Fang Mao
The Prevalence of Musculoskeletal Pain in Male Cigarette Smoking Students at Shiraz University of Medical Sciences, Iran
Background The rising trend of smoking cigarettes, especially among the youth, has become a great concern in Iranian society. Not only does smoking cigarettes harm one financially, but also it will cause immense damage to the smoker as well as the society. This paper investigated the prevalence of musculoskeletal pain and the factors affecting it in young smokers. Methods The research has been conducted on 400 men smokers aged 18-30 studying at Shiraz University of Medical Sciences. Data was collected through a questionnaire containing information about age, history and amount of smoking, existence of pain and its severity according to the visual analog scale (VAS). The subjects were randomly selected while making sure the proportion of subjects from each department was appropriate. The subjects were smokers for more than two years and smoked more than five cigarettes a day. Data was analyzed by analysis of variance (ANOVA) and the least significant difference (LSD) test. Findings Among all studied subjects, 129 (32.25%) suffered from musculoskeletal pain. Most of the subjects (31.25%) had pain in their backs. The relationship between the duration of smoking and musculoskeletal pain, as well as that between the number of cigarettes smoked per day and the pain, was direct and significant. However, no significant relationship was found between age and pain. Conclusion The occurrence of musculoskeletal pain in male students was relatively high. This fact can bring irrecoverable damages to the society and would put its health at risk. It also decreases the socioeconomic improvements.
Pirouzi, Soraya; Ghanbari, Ali; Moslemi Haghighi, Farzaneh; Ghafarinejad, Farahnaz; Pouya, Fatemeh; Motiallah, Tahereh
Ethnic differences in pain and pain management
SUMMARY Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of the healthcare system, that may contribute to shaping individual differences in pain. For example, the experience of pain differentially activates stress-related physiological responses across various ethnic groups, members of different ethnic groups appear to use differing coping strategies in managing pain complaints, providers' treatment decisions vary as a function of patient ethnicity and pharmacies in predominantly minority neighborhoods are far less likely to stock potent analgesics. These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes.
Campbell, Claudia M; Edwards, Robert R
Prevalence and treatment of pain in older adults in nursing homes and other long-term care institutions: a systematic review
Background: The high prevalence of pain in older adults and its impact in this age group make it a public health issue, yet few studies of pain relief focus on older adults. Residents of long-term care facilities have more cognitive impairment than their community-living counterparts and may have difficulty reporting the presence and severity of pain. This systematic literature review
Patricia L. Fox; Parminder Raina; Alejandro R. Jadad
Prevalence and diagnostic distribution of medically unexplained painful somatic symptoms across 571 major depressed outpatients
Objective: To assess the prevalence and distribution of medically unexplained painful somatic symptoms (PSSs) versus nonpainful somatic symptoms (NPSSs) in patients diagnosed with major depressive episode (MDE). Method: A total of 571 outpatients diagnosed with MDE according to DSM-IV-TR criteria were consecutively enrolled into a cross-sectional, multicentric, observational study over a period of 7 months. Subjects were evaluated by means of the ad hoc validated 30-item Somatic Symptoms Checklist (SSCL-30) and Zung's questionnaires for depression and anxiety. The 32-item Hypomania Checklist (HCL-32) was also administered in order to explore any eventual association of PSSs or NPSSs with sub-threshold (DSM-IV-TR [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision] not recognized) bipolar disorder (BD). Results: In our sample, just 183 patients (32%) did not report painful somatic symptoms (NPSSs). Of these, 90 patients (15.76%) had no somatic symptoms at all. The remaining 388 (68%) had at least one PSS being subdivided as follows: 248 (43%) had one or two PSSs, while 140 (25%) experienced two or more. Patients with at least one PSS also reported a greater number of nonpainful somatic symptoms than NPSS. Bipolar patients (associated with higher HCL-32 scores) were less represented across PSS cases than NPSS subjects. Conversely, females were more prone to having a higher number of total somatic symptoms (and bipolar features). Conclusion: PSSs are common in patients with MDE, especially among those patients reporting fewer somatic symptoms in general as opposed to those patients who exhibit more somatic symptoms (both PSSs and NPSSs) with lower relative number of PSSs. A major therapeutic implication is that antidepressant monotherapy could be used with more confidence in unexplained PSS patients than in NPSS patients because of the latter group's lower frequency of (sub)-threshold bipolar features.
Fornaro, Michele; Maremmani, Icro; Canonico, Pier Luigi; Carbonatto, Paolo; Mencacci, Claudio; Muscettola, Giovanni; Pani, Luca; Torta, Riccardo; Vampini, Claudio; Parazzini, Fabio; Dumitriu, Arina; Perugi, Giulio
... of Orthropaedic and Sports Physical Therapy) [ PDF] Chronic Pain Management (Anesthesiology) [699KB PDF] Diagnosis and Treatment of Low- ... Journal of the American Osteopathic Association) [340KB PDF] Pain Management Task Force Final Report (Office of The Army ...
Musculoskeletal pain in Arctic indigenous and non-indigenous adolescents, prevalence and associations with psychosocial factors: a population-based study
Background Pain is common in otherwise healthy adolescents. In recent years widespread musculoskeletal pain, in contrast to single site pain, and associating factors has been emphasized. Musculoskeletal pain has not been examined in Arctic indigenous adolescents. The aim of this study was to explore the prevalence of widespread musculoskeletal pain and its association with psychosocial factors, with emphasis on gender- and ethnic differences (Sami vs. non-Sami), and the influence of pain related functional impairment. Methods This is a cross-sectional study based on The Norwegian Arctic Adolescent Health Study; a school-based survey responded by 4,881 10th grade students (RR: 83%) in North Norway, in 2003–2005. 10% were indigenous Sami. Musculoskeletal pain was based on reported pain in the head, shoulder/neck, back and/or arm/knee/leg, measured by the number of pain sites. Linear multiple regression was used for the multivariable analyses. Results The prevalence of musculoskeletal pain was high, and significantly higher in females. In total, 22.4% reported 3–4 pain sites. We found a strong association between musculoskeletal pain sites and psychosocial problems, with a higher explained variance in those reporting pain related functional impairment and in females. There were no major differences in the prevalence of musculoskeletal pain in Sami and non-Sami, however the associating factors differed somewhat between the indigenous and non-indigenous group. The final multivariable model, for the total sample, explained 21.2% of the variance of musculoskeletal pain. Anxiety/depression symptoms was the dominant factor associated with musculoskeletal pain followed by negative life events and school-related stress. Conclusions Anxiety/depression, negative life events, and school-related stress were the most important factors associated with musculoskeletal pain, especially in those reporting pain related functional impairment. The most important sociocultural aspect is the finding that the indigenous Sami are not worse off.
Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes
Background: The European Pain in Cancer survey sought to increase understanding of cancer-related pain and treatment across Europe. Patients and methods: Patients with all stages of cancer participated in a two-phase telephone survey conducted in 11 European countries and Israel in 2006-2007. The survey screened for patients experiencing pain at least weekly, then randomly selected adult patients with pain of
H. Breivik; N. Cherny; B. Collett; F. de Conno; M. Filbet; A. J. Foubert; R. Cohen; L. Dow
Prevalence and characteristics of pain in early and late stages of ALS.
The purpose of this study was to compare pain frequency in early and late stages of ALS and to describe the relationship between pain intensity and functional status. Sixty-four patients in different stages of ALS were asked to complete the Neuropathic Pain Scale and to draw the localization of their pain on a body cartoon. The Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) and Forced Vital Capacity (FVC) values were obtained from the medical record. A ?(2) correlation was used to compare the proportion of patients with pain in different stages of ALS. Correlation coefficient was used to describe the relationship between pain intensity and functional status (ALSFRS-R). Pain was reported by about half the patients. Using FVC values, patients were subdivided into early, intermediate and late stage of the disease. There was a negative correlation between pain intensity and functional status. There was no statistically significant difference in the presence of pain among patients in the different stages of ALS. In conclusion, our study showed that pain is common in ALS patients. Although pain intensity did correlate negatively with functional status, as expected, we were surprised to find that pain was also present in the early stages of the disease. PMID:23286754
Rivera, Itza; Ajroud-Driss, Senda; Casey, Pat; Heller, Scott; Allen, Jeffrey; Siddique, Teepu; Sufit, Robert
Prevalence and Psychosocial Correlates of Symptoms Suggestive of Painful Bladder Syndrome: Results from the Boston Area Community Health (BACH) Survey
Purpose The objective is to estimate the prevalence of symptoms suggestive of Painful Bladder Syndrome (PBS) defined as pain increasing as the bladder fills and/or pain relieved by urination for at least three months and its association with socio-demographics (gender, age, race/ethnicity, and socioeconomic status), lifestyle (smoking, alcohol consumption, physical activity) and psychosocial variables (sexual, physical, emotional abuse experienced as a child or as an adult, worry, trouble paying for basics, depression). Materials and Methods The data used come from the Boston Area Community Health (BACH) survey, an epidemiologic study of 5506 randomly selected adults aged 30-79 of three race/ethnic groups (Black, Hispanic, White). Results The overall prevalence of symptoms suggestive of PBS is two percent (1.3% in men and 2.6% in women) with increased prevalence in middle aged adults and those of lower socioeconomic status. Symptoms suggestive of PBS are more common in those who have experienced abuse, in those who are worried about someone close to them, and in those who are having trouble paying for basics. This pattern holds even after adjusting for depression. Conclusions PBS is associated with a number of lifestyle and psychosocial correlates. This suggests that the management of patients with PBS (physical symptoms) may benefit from a multi-faceted approach of combining medical and psychological, and cognitive treatment.
Link, Carol L.; Pulliam, Samantha J.; Hanno, Philip M.; Hall, Susan A.; Eggers, Paul W.; Kusek, John W.; McKinlay, John B.
Characteristics of visual disturbances reported by subjects with neck pain.
Visual symptoms are often reported by patients with neck pain. The aim of the study was to report on the prevalence and most troublesome visual disturbances in subjects with neck pain. Seventy subjects with neck pain and seventy healthy control subjects answered questions about the presence and magnitude (/12) - product of frequency (0-4) and intensity (0-3) of each of 16 visual symptoms noted to be associated with neck pain and other possible causes. A visual complaint index (VCI) (/168) was generated from the sum of the magnitude rating of 14 significant symptoms. The neck pain group had significantly (P > 0.05) greater prevalence and magnitude of 14/16 visual complaints and VCI (mean 27.4) compared to control subjects (mean 6.2). The most prevalent symptoms were 'need to concentrate to read' (70%) and 'sensitivity to light' (58.6%). The least prevalent were 'double vision' (28.6%) and 'dizzy reading' (38.6%). The most troublesome symptoms (greatest magnitude) were 'need to concentrate to read' (3.4/12), 'visual fatigue' (3/12), 'difficulty judging distances' (2.1/12) and 'sensitivity to light' (2.1/12) while the least troublesome complaints were 'double vision' (0.5/12), 'red eyes' (1/12) and 'spots and words moving' (1/12). The characteristics of the visual symptoms were mostly consistent for those previously associated with neck pain. Subjects with traumatic neck pain had a significantly higher VCI compared to those with idiopathic neck pain. The results could help with differential diagnosis. The visual symptoms might be related to eye movement control disturbances in neck pain, however further research is required. PMID:24521926
Treleaven, Julia; Takasaki, Hiroshi
Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages
Introduction The use of automated text messages has made it possible to identify different courses of low back pain (LBP), and it has been observed that pain often fluctuates and that absolute recovery is rather rare. The purpose of this study was to describe the prevalence of pain-free weeks and pain-free periods in subjects with non-specific LBP treated by chiropractors, and to compare subjects from two different countries in these aspects. Methods Data were obtained from two practice-based multicentre prospective outcome studies, one Danish and one Swedish, involving subjects being treated by chiropractors for non-specific LBP. Over 18 weeks, subjects answered a weekly automated text message question on the number of days in the past week that they had experienced bothersome LBP, i.e. a number between 0 and 7. The number of weeks in a row without any LBP at all ("zero weeks") as well as the maximum number of zero weeks in a row was determined for each individual. Comparisons were made between the two study samples. Estimates are presented as percentages with 95% confidence intervals. Results In the Danish and the Swedish populations respectively, 93/110 (85%) and 233/262 (89%) of the subjects were eligible for analysis. In both groups, zero weeks were rather rare and were most commonly (in 40% of the zero weeks) reported as a single isolated week. The prevalence of pain free periods, i.e. reporting a maximum of 0, 1 or 2, or 3-6 zero weeks in a row, were similar in the two populations (20-31%). Smaller percentages were reported for ? 7 zero weeks in a row. There were no significant differences between the two study groups. Conclusion It was uncommon that chiropractic subjects treated for non-specific LBP experienced an entire week without any LBP at all over 18 weeks. When this occurred, it was most commonly reported for brief periods only. Hence, recovery in the sense that patients become absolutely pain free is rare, even in a primary care population.
The prevalence of trigeminal neuritis with TMD.
Subjects with temporomandibular joint disorder (TMD) occasionally present with additional orofacial pain complaints. These can arise from dysfunction in teeth, bones, ligaments, tendons, nerves, and other structures. In this retrospective study, a group of 501 consecutive subjects with TMD complaints were evaluated for the presence of trigeminal neuritis. Very little information on the prevalence of this condition concomitant with TMDs exists in the literature. The existence of trigeminal neuritis was determined by the presence of pain when palpating trigeminal peripheral nerve branches exiting the supraorbital, infraorbital, and mental foramina in addition to the supratrochlear nerve. Each subject in this study had the involved nerves blocked with local anesthesia injections or lidocaine iontophoresis to assist in confirming the source of pain. Sixty subjects with TMD were found to have trigeminal neuritis. Early recognition of this disorder is important because treatment is usually more successful in the acute peripheral state. PMID:12889673
Dupont, John S
Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review
Background Thoracic spine pain (TSP) is experienced across the lifespan by healthy individuals and is a common presentation in primary healthcare clinical practice. However, the epidemiological characteristics of TSP are not well documented compared to neck and low back pain. A rigorous evaluation of the prevalence, incidence, correlates and risk factors needs to be undertaken in order for epidemiologic data to be meaningfully used to develop evidence-based prevention and treatment recommendations for TSP. Methods A systematic review method was followed to report the evidence describing prevalence, incidence, associated factors and risk factors for TSP among the general population. Nine electronic databases were systematically searched to identify studies that reported either prevalence, incidence, associated factors (cross-sectional study) or risk factors (prospective study) for TSP in healthy children, adolescents or adults. Studies were evaluated for level of evidence and method quality. Results Of the 1389 studies identified in the literature, 33 met the inclusion criteria for this systematic review. The mean (SD) quality score (out of 15) for the included studies was 10.5 (2.0). TSP prevalence data ranged from 4.0–72.0% (point), 0.5–51.4% (7-day), 1.4–34.8% (1-month), 4.8–7.0% (3-month), 3.5–34.8% (1-year) and 15.6–19.5% (lifetime). TSP prevalence varied according to the operational definition of TSP. Prevalence for any TSP ranged from 0.5–23.0%, 15.8–34.8%, 15.0–27.5% and 12.0–31.2% for 7-day, 1-month, 1-year and lifetime periods, respectively. TSP associated with backpack use varied from 6.0–72.0% and 22.9–51.4% for point and 7-day periods, respectively. TSP interfering with school or leisure ranged from 3.5–9.7% for 1-year prevalence. Generally, studies reported a higher prevalence for TSP in child and adolescent populations, and particularly for females. The 1 month, 6 month, 1 year and 25 year incidences were 0–0.9%, 10.3%, 3.8–35.3% and 9.8% respectively. TSP was significantly associated with: concurrent musculoskeletal pain; growth and physical; lifestyle and social; backpack; postural; psychological; and environmental factors. Risk factors identified for TSP in adolescents included age (being older) and poorer mental health. Conclusion TSP is a common condition in the general population. While there is some evidence for biopsychosocial associations it is limited and further prospectively designed research is required to inform prevention and management strategies.
Briggs, Andrew M; Smith, Anne J; Straker, Leon M; Bragge, Peter
Is undergraduate physiotherapy study a risk factor for low back pain? A prevalence study of LBP in physiotherapy students
Background Following reports of high prevalence of low back pain (LBP) in young physiotherapists [17-22], we investigated whether LBP was a problem for undergraduate physiotherapy students. Method Physiotherapy students enrolled in one Australian tertiary institution completed a validated self-administered questionnaire in April 2001, seeking information on LBP prevalence (lifetime, 12 month, one-month, one-week), and its risk factors. The survey incorporated the Nordic back questionnaire, questions on common risks for LBP, and purpose-built questions regarding educational exposures. Univariate logistic regression models were applied to test associations. Results and Discussion 72% students responded. LBP prevalence was 69% (lifetime), 63% (12-month), 44% (one-month), 28% (one-week). The risk of LBP increased significantly for students once they completed first year. Being aged 20 or 21 years (final year students) was significantly associated with all measures of LBP, compared with the youngest students. Exposure to tertiary study of greater than two years was associated with lifetime, 12 month and one-month LBP prevalence. Spending more than 20 hours in the past month 'sitting looking down' was significantly associated with one-month LBP prevalence. Similar exposure to 'treating patients' was significantly associated with one-month and one-week LBP prevalence. Conclusions Physiotherapy students should be alerted to the likelihood of LBP and is potential causes during their training, so that they enter the workforce with reduced risk of LBP. The potential for other undergraduate students to suffer LBP should also be considered.
Nyland, Leah Jane; Grimmer, Karen Anne
Spinal pain in adolescents: prevalence, incidence, and course: a school-based two-year prospective cohort study in 1,300 Danes aged 11-13
Background The severity and course of spinal pain is poorly understood in adolescents. The study aimed to determine the prevalence and two-year incidence, as well as the course, frequency, and intensity of pain in the neck, mid back, and low back (spinal pain). Methods This study was a school-based prospective cohort study. All 5th and 6th grade students (11–13 years) at 14 schools in the Region of Southern Denmark were invited to participate (N?=?1,348). Data were collected in 2010 and again two years later, using an e-survey completed during school time. Results The lifetime prevalence of spinal pain was 86% and 89% at baseline and follow-up, respectively. A group of 13.6% (95% CI: 11.8, 15.6) at baseline and 19.5% (95% CI: 17.1, 22.0) at follow-up reported that they had pain frequently. The frequency of pain was strongly associated with the intensity of pain, i.e., the majority of the participants reported their pain as relatively infrequent and of low intensity, whereas the participants with frequent pain also experienced pain of higher intensity. The two-year incidence of spinal pain varied between 40% and 60% across the physical locations. Progression of pain from one to more locations and from infrequent to more frequent was common over the two-year period. Conclusions Spinal pain is common at the age of 11–15 years, but some have more pain than others. The pain is likely to progress, i.e., to more locations, higher frequency, and higher pain intensity over a two-year period.
Erectile Dysfunction Prevalence, Time of Onset and Association with Risk Factors in 300 Consecutive Patients with Acute Chest Pain and Angiographically Documented Coronary Artery Disease
Objectives: The aim of this study was to assess erectile dysfunction prevalence, time of onset and association with risk factors in patients with acute chest pain and angiographically documented coronary artery disease.Methods: 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease were assessed using a semi-structured interview investigating their medical and sexual histories, the International Index
Francesco Montorsi; Alberto Briganti; Andrea Salonia; Patrizio Rigatti; Alberto Margonato; Andrea Macchi; Stefano Galli; Paolo M Ravagnani; Piero Montorsi
An Observational Study on the Prevalence and Pattern of Opioid Use in 25,479 Patients With Spine and Radicular Pain
Study Design. A cross-sectional analysis of data ob- tained from patients with spinal and radicular pain and their spine center treating physicians was performed. Objectives. To identify characteristics of patients treated with opioids that distinguish them from similar patients not treated with opioids in a large population of patients with spine and radicular pain, and to determine the prevalence of
Gilbert J. Fanciullo; Perry A. Ball; Gisele Girault; Robert J. Rose; Brett Hanscom; James N. Weinstein
Internet Fraud Complaint Center
NSDL National Science Digital Library
The Internet Fraud Complaint Center was created by Federal Bureau of Investigation (FBI) and the National White Collar Crime Center (NW3C) to "combat the growing problem of fraud occurring over the Internet by providing a vehicle for victims around the country to report incidents of fraud online." The IFCC allows cooperation between private citizens and law enforcement agencies in order to track and prosecute fraudulent Internet practices. Users provide details on specific cases of Internet fraud, and each complaint is carefully reviewed and referred to a law enforcement or regulatory agency for further investigation. Along with the complaint form, the site also contains basic information about the IFCC. Two valuable resources, Internet Fraud Statistics and the Flow Chart of the Complaint Data Path, will be added soon.
... or pain in at least 11 of 18 "tender points," specific spots on the neck, shoul- ders, ... other symptoms: • fatigue • trouble sleeping • morning stiffness Fibromyalgia Tender Points Treatment • • • • • Pregabalin (pre-gaB-uh-lin) and ...
Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender - a cross-sectional school study in Northern Sweden
Background Negative trends in adolescent mental and subjective health are a challenge to public health work in Sweden and worldwide. Self-reported mental and subjective health complaints such as pain, sleeping problems, anxiety, and various stress-related problems seem to have increased over time among older adolescents, especially girls. The aim of this study has therefore been to investigate perceived stress, mental and subjective health complaints among older adolescents in Northern Sweden. Methods Data were derived from a cross-sectional school-based survey with a sample consisting of 16–18?year olds (n?=?1027), boys and girls, in the first two years of upper secondary school, from different vocational and academic programmes in three public upper secondary schools in a university town in northern Sweden. Prevalence of perceived stress, subjective health complaints, general self-rated health, anxiety, and depression were measured using a questionnaire, including the Hospital Anxiety and Depression Scale (HADS). Results A large proportion of both girls and boys reported health complaints and perceived stress. There was a clear gender difference: two to three times as many girls as boys reported subjective health complaints, such as headache, tiredness and sleeping difficulties and musculoskeletal pain, as well as sadness and anxiety. High pressure and demands from school were experienced by 63.6% of girls and 38.5% of boys. Perceived stress in the form of pressure and demands correlated strongly with reported health complaints (r?=?0.71) and anxiety (r?=?0.71). Conclusions The results indicate that mental and subjective health complaints are prevalent during adolescence, especially in girls, and furthermore, that perceived stress and demands may be important explanatory factors. Future studies should pay attention to the balance between gender-related demands, perceived control and social support, particularly in the school environment, in order to prevent negative strain and stress-related ill-health. The gender gap in subjective adolescent health needs to be further explored.
Prevalence of chronic pain among Libyan adults in Derna City: a pilot study to assess the reliability, linguistic validity, and feasibility of using an Arabic version of the structured telephone interviews questionnaire on chronic pain.
There are few studies estimating the prevalence of chronic pain in countries from the Middle East. We translated the Structured Telephone Interviews Questionnaire on Chronic Pain from English into Arabic and assessed its reliability and linguistic validity before using it in a telephone survey in Libya to gather preliminary prevalence data for chronic pain. Intraclass correlations for scaled items were high, and there were no differences in answers to nominal items between the first and second completions of the questionnaire. One hundred and 4 individuals participated in a telephone survey. The prevalence of chronic pain was 25.0% (95% CI, 16.7% to 33.3%) and 50.0% (95% CI: 30.8% to 69.2) of the participants with chronic pain scored ? 12 on the Arabic S-LANSS. Mean ± SD duration of pain was 2.8 ± 1.2 years, and pain was more frequent in women (P = 0.02). 53.8% of participants had taken prescription medication for their pain, and 76.9% had used nondrug methods of treatment including traditional Libyan methods such as Kamara, a local herbal concoction. Eighty percent believed that their doctor would rather treat their illness than their pain, and 35% reported that their doctor did not think that their pain was a problem. Some participants complained that the questionnaire was too long with a mean ± SD call duration of 20 ± 5.4 minutes. We conclude that the Arabic Structured Telephone Interviews Questionnaire on Chronic Pain was reliable and linguistically valid and could be used in a large-scale telephone survey on the Libyan population. Our preliminary estimate of prevalence should be considered with caution because of the small sample size. PMID:22978448
Elzahaf, Raga A; Tashani, Osama A; Johnson, Mark I
Physical demands of work and health complaints among women working late in pregnancy
Health complaints before, during and after pregnancy were collected from 2251 women in Montreal who had been in paid employment beyond the twenty-seventh week of their first or second pregnancy. Complaints of breathlessness, fatigue, back pain, varicose veins and haemorrhoids increased during pregnancy, the proportion of women reporting these symptoms being greatest in the third trimester. Complaints at this stage
Prevalence of claims-based recurrent low back pain in a Canadian population: A secondary analysis of an administrative database
Background There is a vast literature reporting that the point prevalence of low back pain (LBP) is high and increasing. It is also known that a large proportion of acute LBP episodes are recurrent within 12 months. However, few studies report the annual trends in the prevalence of recurrent LBP or describe these trends according to age and sex categories. Methods We conducted a retrospective cohort study involving 401 264 adults selected from the administrative database of physician claims for the province of Quebec, Canada. These adults, aged 18 years and over, met the criteria of having consulted a physician three times within a 365-day period between 2000 and 2007 for a LBP condition corresponding to ICD-9 codes 721, 722, 724 or 739. All data were analyzed by sex and clustered according to specific age categories. Results We observed a decrease from 1.64% to 1.33% in the annual prevalence between 2000 and 2007 for men. This decrease in prevalence was mostly observed between 35 and 59 years of age. Older (?65 years) women were 1.35 times more at risk to consult a physician for LBP in a recurrent manner than older men. The most frequently reported diagnosis was non-specific LBP between 2000 to 2007. During the same period, sequelae of previous back surgery and spinal stenosis were the categories with the largest increases. Conclusion The annual prevalence of claims-based recurrent LBP progressively decreased between 2000 and 2007 for younger adults (<65 years) while older adults (?65 years) showed an increase. Given the aging Canadian population, recurrent low back pain could have an increasing impact on the quality of life of the elderly as well as on the healthcare system.
EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis
Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity ?30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness ?4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth ?4 mm. Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade ?3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare".
D'Agostino, M; Conaghan, P; Le Bars, M; Baron, G; Grassi, W; Martin-Mola, E; Wakefield, R; Brasseur, J; So, A; Backhaus, M; Malaise, M; Burmester, G; Schmidely, N; Ravaud, P; Dougados, M; Emery, P
The back pain of bus drivers. Prevalence in an urban area of California.
A stratified random sample of 195 subjects was selected from the membership of an urban transit union in California, two thirds consisting of motor coach operators and one third serving as a nondriving comparison group. Based on an orthopaedic medical history and physical examination, 80.5% of drivers were found to be experiencing back or neck pain at the time of examination, in contrast with 50.7 percent of nondrivers, itself a sizable percentage. For both groups, most pain was mild, (53.9 and 29.9%, respectively). The amount of severe pain was essentially the same in the two groups (10.2% and 9.0%). Both groups were most subject to low back pain. Drivers were most distinctive for movement-related pain in the cervical spine. They were also more subject in any part of the spine to postural pain. The latter finding suggests the need to introduce ergonomic and scheduling changes in the work of operating a motor coach. Drivers more than nondrivers struggled against their pain by doing exercise, seeking professional treatment, and taking medications, indicating that spinal disorders constitute a prominent health concern for workers in this occupation. PMID:1471006
Anderson, R
Prevalence of occupation-related pain among baristas and an examination of low back and shoulder demand during the preparation of espresso-based beverages.
Many baristas complain of low back pain (LBP) and upper extremity discomfort while at work. This study documented the prevalence of LBP and shoulder pain, via questionnaire, among a population of baristas to determine whether cumulative low back loads and shoulder moments are associated with pain reporting. Fifty-nine baristas completed the questionnaire; ten were also video-recorded for biomechanical analysis while making espresso beverages and cumulative and peak low back loads and shoulder moments were calculated. Seventy-three percent of those who completed the questionnaire reported having experienced LBP, and half attributed this pain to their job as a barista. Furthermore, 68% reported having experienced shoulder pain and half also attributed this pain to their job. Those who suffered from LBP had higher peak low back compression and those with shoulder pain had, in general, higher moments about their dominant shoulder. PMID:24837283
Dainty, R Scott; Alcorn, Eric; Ferguson, Chantelle A; Gregory, Diane E
Prevalence, characteristics, and management of childhood functional abdominal pain in general practice
Abstract Objective To (i) describe the proportion of children presenting with abdominal pain diagnosed by the GP as functional abdominal pain (GPFAP); (ii) evaluate the association between patient and disease characteristics and GPFAP; (iii) describe diagnostic management by the GP in children presenting with abdominal pain, and (iv) evaluate whether children with GPFAP fulfill diagnostic criteria for functional abdominal pain (FAP) as described in current literature: chronic abdominal pain (CAP) and the Rome III criteria (PRC-III) for abdominal pain-related functional gastrointestinal disorders (FGID). Design Cross-sectional study. Setting General practices in the Netherlands. Subjects 305 children aged 4–17 years consulting for abdominal pain. Main outcome measures GPFAP, CAP, FGIDs. Results 89.2% of children were diagnosed with GPFAP. Headaches and bloating were positively associated with GPFAP whereas fever and > 3 red flag symptoms were inversely associated. Additional diagnostic tests were performed in 26.8% of children. Less than 50% of all children with GPFAP fulfilled criteria for CAP and FGIDs; in 47.9% of patients the duration of symptoms at presentation was less than three months. Conclusions In almost 90% of children included in this study the GP suspected no organic cause for the abdominal pain. GPs diagnose FAP in children without alarm symptoms and order diagnostic testing in one out of four children presenting with abdominal pain. No difference was found in GPs' management between children with a diagnosis of GPFAP and other diagnoses. Only about half of the children with a GP diagnosis of FAP fulfilled time-criteria of FAP as defined in the literature.
Prevalence of Neck and Back Pain amongst Aircrew at the Extremes of Anthropometric Measurements.
National Technical Information Service (NTIS)
Back and neck pain are a significant cause of morbidity among helicopter aircrew. The majority of studies evaluating the influence of anthropometry are limited to body mass index and stature. Nine anthropometric parameters were measured and a survey was i...
A. J. Hathaway J. M. Cox K. Clayborne P. L. Walters
Shoulder pain is a frequent complaint encountered in the emergency setting. A brief review of shoulder anatomy and physical examination sets the foundation for evaluation of shoulder pain. Considerations of patient's age are helpful to predict injuries. Fractured clavicles are often seen in traumatic injuries in children and young adults, whereas fractures of the humeral head are more often seen in the elderly from traumatic injuries. Shoulder dislocations are more common in teens to fourth decade. This article reviews specific acute injuries, chronic conditions, and radiologic considerations of patients with shoulder complaints encountered in emergency settings. PMID:21543907
Ramponi, Denise R
Pain Prevalence and Management in an Internal Medicine Setting in Italy
Background. Since data on pain evaluation and management in patients admitted to internal medicine wards (IMWs) are limited, we aimed to evaluate these aspects in a cohort of internistic patients. Methods. We considered all patients consecutively admitted from June to December 2011 to our unit. Age, gender, and length-of-hospital-stay (LOS) were recorded. Comorbidities were arbitrarily defined, and pain severity was evaluated by Numeric Rating Scale (NRS) on admission and discharge. Results. The final sample consisted of 526 patients (mean age 74 ± 14 years; 308 women). Significant pain (NRS ? 3) was detected in 63% of cases, and severe (NRS ? 7) in 7.6%. Pain was successfully treated, and NRS decreased from 4.65 ± 2.05 to 0.89 ± 1.3 (P < 0.001). Compared with subjects with NRS < 3, those with significant pain were older (75.5 ± 13.9 versus 72.9 ± 14.5 years, P = 0.038), and had a higher LOS (7.9 ± 6.1 versus 7.3 ± 6.8, P = 0.048). Significant pain was independently associated with age (OR 0.984, P = 0.018), cancer (OR 3.347, P < 0.001), musculoskeletal disease (OR 3.054, P < 0.0001), biliary disease (OR 3.100, P < 0.01), and bowel disease (OR 3.100, P < 0.003). Conclusion. In an internal medicine setting, multiple diseases represent significant cause of pain. Prompt pain evaluation and management should be performed as soon as possible, in order to avoid patients' suffering and reduce the need of hospital stay.
De Giorgi, Alfredo; Pala, Marco; Mallozzi Menegatti, Alessandra; Gallerani, Massimo
Complaints against Nursing Homes: Comparing Two Sources of Complaint Information and Predictors of Complaints
ERIC Educational Resources Information Center
Purpose of the Study: Two consumer-derived measures of nursing home quality that have been underutilized by researchers are consumer complaints to the state certification agency between inspections and complaints to the Long-Term Care Ombudsman Program. This article describes these complaints, considers facility-level predictors of complaints, and…
Troyer, Jennifer L.; Sause, Wendy L.
Immigration and Health Services: Immigrant Complaint Patterns Regarding the Primary Health Care System in Israel
Complaints are a potentially important source of information regarding health care quality in societies which face constant immigration. The purpose of this study was to examine the prevalence and patterns of complaints about health services from immigrants who are clients of Health Maintenance Organizations (HMOs) in Israel, to compare them with the complaint patterns of other Israelis, and to examine
Maya Shavit; Pnina Weisberg; Iddo Gal; Israel Doron
A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks
Background The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB), acromioclavicular joint (ACJ) and glenohumeral joint (GHJ). Methods Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance arthrogram (MRA) and GHJ diagnostic block. Differences in proportions of positive and negative imaging findings in the anaesthetic response groups were assessed using Fishers test and odds ratios were calculated a for positive anaesthetic response (PAR) to diagnostic blocks. Results In the 208 subjects recruited, the rotator cuff and SAB displayed the highest prevalence of pathology on both ultrasound (50% and 31% respectively) and MRA (65% and 76% respectively). The prevalence of PAR following SAB injection was 34% and ACJ injection 14%. Of the 59% reporting a negative anaesthetic response (NAR) for both of these injections, 16% demonstrated a PAR to GHJ injection. A full thickness tear of supraspinatus on ultrasound was associated with PAR to SAB injection (OR 5.02; p < 0.05). Ultrasound evidence of a biceps tendon sheath effusion (OR 8.0; p < 0.01) and an intact rotator cuff (OR 1.3; p < 0.05) were associated with PAR to GHJ injection. No imaging findings were strongly associated with PAR to ACJ injection (p ? 0.05). Conclusions Rotator cuff and SAB pathology were the most common findings on ultrasound and MRA. Evidence of a full thickness supraspinatus tear was associated with symptoms arising from the subacromial region, and a biceps tendon sheath effusion and an intact rotator cuff were associated with an intra-articular GHJ pain source. When combined with clinical information, these results may help guide diagnostic decision making in primary care.
National Technical Information Service (NTIS)
The Army Back Complaint (ABC) Program packet provides recommended actions to develop and implement successful installation of ABC Programs. It is designed to be an educational tool to prevent injuries to the back, shoulder, or neck areas primarily as a re...
Growing pains: contemporary knowledge and recommended practice
Background Leg pain in children, described as growing pains, is a frequent clinical presentation seen by an array of health care professionals. Described since 1823, growing pains continues to puzzle practitioners, yet diagnostic criteria and evidence based treatment is available. Methods The medical literature has been searched exhaustively to access all articles (English language) pertaining to leg pains in children which are ascribed to being 'growing pains'. Results The literature, whilst plentiful in quantity and spanning two centuries, is generally replete with reiterated opinion and anecdote and lacking in scientific rigour. The author searched 45 articles for relevance, determined according to title, abstract and full text, resulting in a yield of 22 original studies and 23 review articles. From the original studies, one small (non-blinded) randomised controlled trial that focused on GP treatment with leg muscle stretching was found. Nine prevalence studies were found revealing disparate estimates. Ten cohort (some case-controlled) studies, which investigated pain attribute differences in affected versus unaffected groups, were found. One series of single case experiment designs and one animal model study were found. Conclusion Growing pains is prevalent in young children, presents frequently in the health care setting where it is poorly managed and is continuing to be researched. A common childhood complaint, growing pains needs to be acknowledged and better managed in the contemporary medical setting.
Evans, Angela M
Pain Prevalence in Hospitalized Patients in a German University Teaching Hospital
Forty-eight units were enrolled in a descriptive, cross-sectional study to identify strengths and weaknesses of pain management in a German university teaching hospital. Patients had to be ?18 years old and able to speak German; intensive care, psychiatric, obstetric and pediatric units were excluded. Structured interviews were conducted by an independent researcher not involved in patient care. Patients were asked
Barbara Strohbuecker; Herbert Mayer; George C. M. Evers; Rainer Sabatowski
nterior knee pain (AKP) is a common complaint in primary care and orthopedic clinics. In fact, in the sports medicine clinic, up to 25% of patients with knee complaints have symptoms of anterior knee pain (1). Adolescent females and other young individuals are at particular risk for AKP. In these individuals, symptoms are usually related to increased use, fre- quently
Stephen R. Christian; M. Bret Anderson; Ronald Workman; William F. Conway; Thomas L. Pope
Foot pain in rheumatoid arthritis prevalence, risk factors and management: an epidemiological study
Foot involvement is a major feature of rheumatoid arthritis (RA). Most epidemiological studies of the RA foot report radiological\\u000a changes and results of clinical examination. This study aimed to determine the prevalence of foot symptoms, frequency of foot\\u000a assessment and access to foot care from the perspective of people with RA. A questionnaire was sent to 1,040 people with RA
Simon J. Otter; Kevin Lucas; Kate Springett; Ann Moore; Kevin Davies; Liz Cheek; Adam Young; Karen Walker-Bone
Relationship of the Job Tenure of Nursing Home Top Management to the Prevalence of Pressure Ulcers, Pain, and Physical Restraint Use
The association of job tenure among nursing home administrators (NHAs) and directors of nursing (DONs) with the prevalence of pressure ulcers, pain, and physical restraint use was examined. Data sources included the 2004 National Nursing Home Survey and quality measures from the Centers for Medicare and Medicaid Services. Regression models examined NHA tenure (n = 787) and DON tenure (n
Frederic H. Decker; Nicholas G. Castle
School-Related Stress, School Support, and Somatic Complaints: A General Population Study.
ERIC Educational Resources Information Center
Examined relationship between school-related stress, social support, and somatic complaints among Norwegian adolescents. Found that students with high levels of school-related stress had a higher odds ratio for weekly headache, abdominal pain, backache, dizziness, and coexisting somatic complaints. For social support, associations were weaker, but…
Torsheim, Torbjorn; Wold, Bente
Visual Complaints From Healthy Children
It is common for healthy children with specific visual complaints to be seen for eye examinations. After a complete eye examination has ruled out pathologic conditions as the cause of these complaints, it is appropriate for the clinician to explore the possibility that normal entoptic or physiologic visual phenomena might have provoked the child's report of vision problems. Some of
John D Wright; William P Boger
Computed tomography-evaluated features of spinal degeneration: prevalence, intercorrelation, and association with self-reported low back pain
BACKGROUND CONTEXT Although the role of radiographic abnormalities in the etiology of nonspecific low back pain (LBP) is unclear, the frequent identification of these features on radiologic studies continues to influence medical decision making. PURPOSE The primary purposes of the study were to evaluate the prevalence of lumbar spine degeneration features, evaluated on computed tomography (CT), in a community-based sample and to evaluate the association between lumbar spine degeneration features. The secondary purpose was to evaluate the association between spinal degeneration features and LBP. STUDY DESIGN This is a cross-sectional community-based study that was an ancillary project to the Framingham Heart Study. SAMPLE A subset of 187 participants were chosen from the 3,529 participants enrolled in the Framingham Heart Study who underwent multidetector CT scan to assess aortic calcification. OUTCOME MEASURES Self-report measures: LBP in the preceding 12 months was evaluated using a Nordic self-report questionnaire. Physiologic measures: Dichotomous variables indicating the presence of intervertebral disc narrowing, facet joint osteoarthritis (OA), spondylolysis, spondylolisthesis, and spinal stenosis and the density (in Hounsfield units) of multifidus and erector spinae muscles were evaluated on CT. METHODS We calculated the prevalence of spinal degeneration features and mean density of multifidus and erector spinae muscles in groups of individuals with and without LBP. Using the ?2 test for dichotomous and t test for continuous variables, we estimated the differences in spinal degeneration parameters between the aforementioned groups. To evaluate the association of spinal degeneration features with age, the prevalence of degeneration features was calculated in four age groups (less than 40, 40–50, 50–60, and 60+ years). We used multiple logistic regression models to examine the association between spinal degeneration features (before and after adjustment for age, sex, and body mass index [BMI]) and LBP, and between all degeneration features and LBP. RESULTS In total, 104 men and 83 women, with a mean age (±standard deviation) of 52.6±10.8 years, participated in the study. There was a high prevalence of intervertebral disc narrowing (63.9%), facet joint OA (64.5%), and spondylolysis (11.5%) in the studied sample. When all spinal degeneration features as well as age, sex, and BMI were factored in stepwise fashion into a multiple logistic regression model, only spinal stenosis showed statistically significant association with LBP, odds ratio (OR) (95% confidence interval [CI]): 3.45 [1.12–10.68]. Significant association was found between facet joint OA and low density of multifidus (OR [95% CI]: 3.68 [1.36–9.97]) and erector spinae (OR [95% CI]: 2.80 [1.10–7.16]) muscles. CONCLUSIONS Degenerative features of the lumbar spine were extremely prevalent in this community-based sample. The only degenerative feature associated with self-reported LBP was spinal stenosis. Other degenerative features appear to be unassociated with LBP.
Kalichman, Leonid; Kim, David H.; Li, Ling; Guermazi, Ali; Hunter, David J.
Prevalence of joint-related pain in the extremities and spine in five groups of top athletes
Purpose Joint-related pain conditions from the spine and extremities are common among top athletes. The frequency of back pain has,\\u000a however, been studied in more detail, and the frequency of low-back pain in top athletes in different high-load sports has\\u000a been reported to be as high as 85%. Sport-related pain from different joints in the extremities is, however, infrequently\\u000a reported on
Pall Jonasson; Klas Halldin; Jon Karlsson; Olof Thoreson; Jonas Hvannberg; Leif Swärd; Adad Baranto
Heel pain is a common complaint among young children and adolescents. It has many causes, including trauma, overuse injuries, and tumors, and therefore a thorough clinical examination is warranted. This article outlines some common causes of pediatric heel pain. PMID:24075133
Joseph, Alison M; Labib, Irene K
High prevalence of vitamin D deficiency, secondary hyperparathyroidism and generalized bone pain in Turkish immigrants in Germany: identification of risk factors
Introduction The aim of the study was to determine the prevalence of vitamin D deficiency, secondary hyperparathyroidism (sHPT), generalized bone pain and predictors of vitamin D deficiency in a cohort of 994 healthy adult urban residents (589 males, 405 females; age range: 16–69 years) consisting of 101 Germans, 327 Turkish residents of Turkey and 566 Turkish immigrants living in Germany.Methods The mean (± standard
M. Z. Erkal; J. Wilde; Y. Bilgin; A. Akinci; E. Demir; R. H. Bödeker; M. Mann; R. G. Bretzel; H. Stracke; M. F. Holick
Prevalence and factors associated with neck, shoulder and low back pains among medical students in a Malaysian Medical College
Background The main purpose of the study was to assess the prevalence, body distributions and factors associated with musculoskeletal pain (MSP) among medical students in a private Malaysian medical college. Method This cross-sectional study was conducted among 232 medical students in a private medical college using an online questionnaire. The questionnaire was a modified Standardized Nordic Questionnaire focused on neck, shoulder and low back pain in the past week and the past year. Results Two hundred and thirty two medical students responded to the questionnaire out of 642. Mean age was 20.7?±?2.1 years. The majority were female (62.9%), Malay (80.6%) and in the preclinical years (72%). One hundred and six (45.7%) of all students had at least one site of MSP in the past week and 151 (65.1%) had at least one site of MSP in the past year. MSP in the past week was associated significantly with the academic year, (OR 2.0, 95% CI 1.15-3.67, P?=?0.015), history of trauma (OR 2.6, 95% CI 1.2-5.3, P?=?0.011), family history of MSP (OR 2.1, 95% CI 1.1-3.9, P?=?0.023) and Body Mass Index (BMI) (P?=?0.028). MSP in the past year was significantly associated with computer use (P?=?0.027), daily hours of computer use (median?±?IQR (5.0 ±3.0), history of trauma (OR 7.5, 95% CI 2.24-2.56, P?0.01) and family history of MSP (OR 2.5, 95% CI 1.31-4.90, P?=?0.006). On multivariate analysis, factors associated with MSP during the past week were a family history of MSP (p?=?0.029) and BMI (p?=?0.03). Factors associated with MSP during the past year were being in clinical years (p?=?0.002, computer use (p?=?0.038), and a history of trauma (p?=?0.030). Conclusion MSP among medical students was relatively high, thus, further clinical assessment is needed in depth study of ergonomics. The study results indicate that medical school authorities should take measures to prevent MSP due to factors related to medical school. Students should make aware of importance of weight reduction to reduce MSP.
Code of Federal Regulations, 2013 CFR
...2013-10-01 false Complaint. 386.12 Section 386.12 Transportation Other Regulations...Proceedings, Pleadings § 386.12 Complaint. (a) Complaint of...violation is one which could reasonably lead to, or has resulted in,...
Sleep complaints and restless legs syndrome in adult type 2 diabetics
Objective: To determine the prevalence and characteristics of sleep complaints and restless legs syndrome (RLS) in type 2 adult diabetics. To test the hypothesis that sleep complaints are more common among adult diabetics.Background: Restless legs syndrome is a common disorder and is a cause of insomnia and daytime somnolence. An association between RLS and diabetes mellitus has been hypothesized but
R. P Skomro; S Ludwig; E Salamon; M. H Kryger
Prevalence and Characteristics of Chronic Pain Among Chemically Dependent Patients in Methadone Maintenance and Residential Treatment Facilities
Results Chronic severe pain was experienced by 37% of MMTP patients (95% con- fidence interval (CI), 32%-41%) and 24% of inpatients (95% CI, 20%-28%; P=.03). Pain of any type or duration during the past week was reported by 80% of MMTP pa- tients and 78% of inpatients. Among those with chronic severe pain, 65% of MMTP patients and 48% of
Andrew Rosenblum; Herman Joseph; Chunki Fong; Steven Kipnis; Charles Cleland; Russell K. Portenoy
Cognitive complaints in patients after whiplash injury: the impact of malingering
OBJECTIVES—The validity of memory and concentration complaints that are often reported after a whiplash trauma is controversial. The prevalence of malingering or underperformance in post-whiplash patients, and its impact on their cognitive test results were studied.?METHODS—The Amsterdam short term memory (ASTM) test, a recently developed malingering test, was used as well as a series of conventional memory and concentration tests. The study sample was a highly selected group of patients, who were examined either as part of a litigation procedure (n=36) or in the normal routine of an outpatient clinic (n=72).?RESULTS—The prevalence of underperformance, as defined by a positive score on the malingering test, was 61% (95% CI: 45-77) in the context of litigation, and 29% (95% CI: 18-40) in the outpatient clinic (p=0.003). Furthermore, the scores on the memory and concentration test of malingering post-whiplash patients (n=43) and non-malingering post-whiplash patients (n=65) were compared with the scores of patients with closed head injury (n=20) and normal controls (n=46). The malingering post-whiplash patients scored as low as the patients with closed head injury on most tests.?CONCLUSIONS—The prevalence of malingering or cognitive underperformance in late post-whiplash patients is substantial, particularly in litigation contexts. It is not warranted to explain the mild cognitive disorders of whiplash patients in terms of brain damage, as some authors have done. The cognitive complaints of non-malingering post-whiplash patients are more likely a result of chronic pain, chronic fatigue, or depression.??
Schmand, B; Lindeboom, J; Schagen, S; Heijt, R; Koene, T; Hamburger, H
Posterior knee pain is a common patient complaint. There are broad differential diagnoses of posterior knee pain ranging from common causes such as injury to the musculotendinous structures to less common causes such as osteochondroma. A precise understanding of knee anatomy, the physical examination, and of the differential diagnosis is needed to accurately evaluate and treat posterior knee pain. This article provides a review of the anatomy and important aspects of the history and physical examination when evaluating posterior knee pain. It concludes by discussing the causes and management of posterior knee pain.
Perret, D.
37 CFR 4.3 - Submitting complaints.
Code of Federal Regulations, 2013 CFR
...COMMERCE GENERAL COMPLAINTS REGARDING INVENTION PROMOTERS § 4.3 Submitting complaints...person may submit a complaint concerning an invention promoter with the Office. A person...the complaint may be forwarded to the invention promoter and may become publicly...
Prediction of post-traumatic complaints after mild traumatic brain injury: early symptoms and biochemical markers
Objectives: To identify parameters at first presentation after mild traumatic brain injury (MTBI) that are predictive of the severity of post-traumatic complaints (PTC) after six months. Early recognition of patients with MTBI who are at risk of developing PTC would be useful because early follow up at the outpatient clinic may help to reduce the severity of these complaints in the long run. Methods: The presence of symptoms in the emergency room (ER) (headache, dizziness, nausea, vomiting, and neck pain) and biochemical markers (neurone specific enolase and S-100B) in serum were assessed as possible predictive variables for the severity of PTC. Outcome variables were the severity of 16 PTC six months after the trauma. Result: After six months, the severity of most complaints had declined to pretrauma levels but medians for headache, dizziness, and drowsiness were still increased. In a series of 79 patients, 22 (28%) reported one or more PTC after six months. After adjustment for baseline variables, an at least twofold increased severity of all PTC subgroups was reported by those patients reporting headache, dizziness, or nausea in the ER. A twofold increased severity of "cognitive" and "vegetative" PTC was also found in those with increased concentrations of biochemical serum markers at first presentation. The prevalence of full recovery after six months increased from 50% in patients with three symptoms to 78% in those with no symptoms in the ER. Inclusion of biochemical markers showed that all 10 patients with no symptoms in the ER and normal markers recovered fully. Conclusions: The presence of headache, dizziness, or nausea in the ER after MTBI is strongly associated with the severity of most PTC after six months. Identifying MTBI patients in the ER without headache, dizziness, nausea, or increased serum marker concentrations may be a promising strategy for predicting a good outcome.
de Kruijk, J R; Leffers, P; Menheere, P; Meerhoff, S; Rutten, J; Twijnstra, A
Prevalence and influencing factors of chronic back pain among staff at special schools with multiple and severely handicapped children in Germany: results of a cross-sectional study
Background In Germany, about 70,000 teachers and educational staff were teaching at more than 3,000 special schools during the school year 2010/2011. Nursing services like lifting pupils form a substantial part of the work content of the staff at special schools. Since nursing care often involves carrying and lifting pupils, there is a reason to assume an adverse effect on the musculoskeletal health of teachers and other professionals. With the present study we aimed to describe the prevalence and risk factors of chronic back pain among employees at this type of school. Methods The cross-sectional survey was carried out between August 2010 and August 2012 at 13 special schools focusing on motoric and/or holistic development of handicapped children in Rhineland-Palatinate (Germany). Teachers and educational staff were interviewed using a questionnaire. We applied multivariable logistic regression analyses to identify influencing factors of chronic back pain. Results Altogether 395 persons (response rate: 59.7%) participated in our study. Respondents were mostly female (86.8%) with a mean age of 45 years. The prevalence of chronic back pain was 38.7%. More than 40% reported frequently carrying and lifting heavy loads (>20 kg). Age [adjusted OR?=?1.03 (95%-CI 1.00-1.05) for 1-year increase in age], current smoking [adjusted OR?=?2.31 (95%-CI 1.27-4.23)], depression/depressive mood [adjusted OR?=?1.85 (95%-CI 1.12-3.06)], frequently carrying and lifting heavy loads [adjusted OR?=?2.69 (95%-CI 1.53-4.75)], and frequent exposure to environmental impacts [adjusted OR?=?2.18 (95%-CI 1.26-3.76)] were influencing factors of chronic back pain in the final multivariable regression model. Conclusions A large proportion of teachers and educational staff suffered from chronic back pain in our study, indicating a high need for treatment in this professional group. Increasing age, current smoking, a diagnosed depression/depressive mood, carrying and lifting heavy loads, and exposure to environmental impacts were associated with chronic back pain. Due to the sparse literature on the topic, further studies using a longitudinal design are necessary for a better understanding of the risk factors of chronic back pain.
Pain management in polycystic kidney disease
Pain management in polycystic kidney disease. Pain is a common complaint in patients with autosomal-dominant polycystic kidney disease, and a systematic approach is needed to differentiate the etiology of the pain and define an approach to management. A thorough history is the best clue to the multifactorial causes of the pain, superimposed upon an understanding of the complex innervation network
Zahid H. Bajwa; Sanjay Gupta; Carol A. Warfield; Theodore I. Steinman
Chronic painful conditions of the hip
Hip pain is a common complaint with many causes. Pathology in the hip can present with pain referred to sites other than the hip and pain in the hip may result from pathology elsewhere. An accurate history and examination is paramount. Chronic painful conditions of the hip summarised in this paper can be classified into three main groups: intra-articular, extra-articular
Olivia Flannery; Connor Green; Dominic Harmon; Eric Masterson
Use of Airport Noise Complaint Files to Improve Understanding of Community Response to Aircraft Noise
NASA Technical Reports Server (NTRS)
This study assessed the feasibility of using complaint information archived by modem airport monitoring systems to conduct quantitative analyses of the causes of aircraft noise complaints and their relationship to noise- induced annoyance. It was found that all computer-based airport monitoring systems provide at least rudimentary tools for performing data base searches by complainant name, address, date, time of day, and types of aircraft and complaints. Analyses of such information can provide useful information about longstanding concerns, such as the extent to which complaint rates are driven by objectively measurable aspects of aircraft operations; the degree to which changes in complaint rates can be predicted prior to implementation of noise mitigation measures; and the degree to which aircraft complaint information can be used to simplify and otherwise improve prediction of the prevalence of noise-induced annoyance in communities.
Fidell, Sanford; Howe, Richard
Vulvovaginal candida in a young sexually active population: prevalence and association with oro-genital sex and frequent pain at intercourse
Objective: To study the prevalence of vulvovaginal candida among sexually active adolescents. To determine past and present symptoms, including pain at intercourse and potential behavioural risk factors associated with vulvovaginal candidiasis. Methods: At an adolescent centre, 219 sexually active women who underwent genital examination, also completed a questionnaire on a history of genital symptoms and infections, sexual and hygiene habits, and the use of contraceptives. Symptoms and clinical signs were registered. Vaginal samples were analysed for candida species and urine for Chlamydia trachomatis. Results: Candida culture was positive in 42% of the women and only 15% were asymptomatic. A history of recurrent candidiasis was given by 22%. Frequent pain at intercourse was reported by 24% and frequent oro-genital sex by 42% of the women. Frequent pain at intercourse was significantly associated with both the growth of candida and a history of recurrent candidiasis. Oro-genital sex was an independent risk factor for the growth of candida. Conclusion: In sexually active adolescents, who underwent genital examination, candida cultures were positive in 42%. The habit of frequent oro-genital sex was associated with the growth of candida. Pain at intercourse was associated with the growth of candida and recurrent candidiasis.
Rylander, E; Berglund, A; Krassny, C; Petrini, B
The Prevalence of Groin Pain After Metal-on-Metal Total Hip Arthroplasty and Total Hip Resurfacing
Background Groin pain after total hip arthroplasty (THA) or total hip resurfacing arthroplasty can be troubling for patients and surgeons.\\u000a Potential sources of pain include infection, loosening, metal hypersensitivity, or impingement of bony structures or the iliopsoas\\u000a tendon.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes We compared the rate of groin pain after THA or hip resurfacing using metal-on-metal to those of other bearing surfaces.\\u000a \\u000a \\u000a \\u000a Methods We identified 347
Robert B. Bartelt; Brandon J. Yuan; Robert T. Trousdale; Rafael J. Sierra
The Prevalence and Overlap of Interstitial Cystitis/Bladder Pain Syndrome and Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men; Results of the RAND Interstitial Cystitis Epidemiology (RICE) Male Study
Purpose As part of the RICE study, we previously developed validated case definitions to identify interstitial cystitis/bladder pain syndrome (IC/BPS) in women and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men. Using population-based screening methods, we applied these case definitions to determine the prevalence of these conditions in men. Materials and Methods A total of 6,072 households were contacted by phone to screen for men who had symptoms of IC/BPS or CP/CPPS. An initial 296 men screened positive, of which 149 met the inclusionary criteria and completed the telephone interview. For IC/BPS, two case definitions were applied (one with high sensitivity and one with high specificity), while for CP/CPPS, a single case definition (with both high sensitivity and specificity) was used. These case definitions were used to classify subjects into groups based on diagnosis. Results The IC/BPS weighted prevalence estimate for the high sensitivity and specificity definition was 4.2% (3.1-5.3%), and 1.9% (1.1-2.7%), respectively. The CP/CPPS weighted prevalence estimate was 1.8% (0.9-2.7%). These values equate to 1,986,972 (95% CI 966,042- 2,996,924) men with CP/CPPS and to 2,107,727 (95% CI 1,240,485 – 2,974,969) men with the high specificity definition of IC/BPS in the U.S.. The overlap between men who met either the high specificity IC/BPS case definition or the CP/CPPS case definition was 17%. Conclusions Symptoms of IC/BPS and CP/CPPS are widespread among men in the US.. The prevalence of IC/BPS symptoms in men approaches that in women, suggesting that this condition may be underdiagnosed and undertreated in the male population.
Suskind, Anne M.; Berry, Sandra H.; Ewing, Brett A.; Elliott, Marc N.; Suttorp, Marika J.; Clemens, J. Quentin
Systematic Review of Prevalence, Correlates, and Treatment Outcomes for Chronic Non-Cancer Pain in Patients with Comorbid Substance Use Disorder
Summary Co-occurring substance use disorders (SUDs) are common among chronic pain patients. However, limited data are available to guide treatment for chronic pain patients with SUD. Recent data suggest that comorbid substance use disorders (SUDs) are common among chronic non-cancer pain (CNCP) patients; however, prevalence rates vary across studies and findings are limited regarding treatment options for CNCP patients with comorbid SUD. The purpose of this systematic review is to assess the prevalence, associated demographic and clinical characteristics, and treatment outcomes for CNCP patients with comorbid SUD. We conducted searches from Ovid MEDLINE, PsychINFO, and PubMED from 1950 through February 2010 and retrieved the references. Thirty-eight studies met inclusion criteria and provided data that addressed our key questions. Three to forty-eight percent of CNCP patients have a current SUD. There are no demographic or clinical factors that consistently differentiate CNCP patients with comorbid SUD from patients without SUD, though SUD patients appear to be at greater risk for aberrant medication-related behaviors. CNCP patients with SUD are more likely to be prescribed opioid medications and at higher doses than CNCP patients without a history of SUD. CNCP patients with comorbid SUD do not significantly differ in their responses to treatment compared to CNCP patients without SUD, though the quality of this evidence is low. Limited data are available to identify predictors of treatment outcome. Although clinical experience and research suggests that SUDs are common among CNCP patients, only limited data are available to guide clinicians who treat this population. Research is needed to increase understanding of the prevalence, correlates, and responses to treatment of CNCP patients with comorbid SUDs.
Morasco, Benjamin J.; Gritzner, Susan; Lewis, Lynsey; Oldham, Robert; Turk, Dennis C.; Dobscha, Steven K.
The Prevalence of Undetected Vertebral Fracture in Patients with Back Pain by Dual-Energy X-ray Absorptiometry (DXA) of the Lateral Thoracic and Lumbar Spine
Study Design This is a prospective study. Purpose This study is conducted to determine the prevalence of unrecognized vertebral fracture (VF) in patients who present with back pain. Overview of Literature VF is often unrecognized, and significantly increases the risk of further fractures. Unfortunately, the patients at a high risk for VF usually do not receive adequate therapy to reduce the fracture risk. Methods This is a prospective study of 344 patients who presented with back pain from April 2008 to May 2009. The patients underwent dual-energy X-ray absorptiometry (DXA) evaluation and vertebral fracture assessment from T4 to L4 using a hologic densitometer. Results Three hundred forty four of 386 patients who presented with back pain were included. Forty two patients were excluded because of a prior history of VF or the lack of written consent. Most of the patients were female (95.3%). The mean age of the patients was 58.21 ± 11.74 years. According to the World Health Organization definition (based on the T-score), 13.4% of the patients had normal lumbar spine bone mineral density (BMD). 27.9% of them were osteopenic and 58.7% were osteoporotic. The overall prevalence of VF, as established by lateral vertebral assessment, was 39% (n = 134). Moreover, 62.6% (n = 84) of the patients with VF had more than one fracture and 64.1% (n = 86) of them had Grade 2 or 3 fracture. Conclusions We recommend performing not only DXA scanning for BMD evaluation, but also VFA by DXA in old patients with back pain.
Akhbari, Hadi; Iraee, Morteza Bahri; Toosi, Farokh Sailanian; Khorashadizadeh, Nasrin; Rezvani, Mohammad Reza; Naseh, Ghodratollah
Repeated survey on changes in musculoskeletal complaints relative to age and work demands.
OBJECTIVES: To examine changes in musculoskeletal complaints over four years in groups of employees relative to age and work demands. METHODS: Repeated questionnaire data of male employees in heavy physical work (exposed group, n = 7324) and mental work (control group, n = 4686), stratified for age (20-9, 30-9, 40-9, 50-9), were analysed. For each employee, data on the occurrence of musculoskeletal complaints from two surveys with a mean interval of around four years were available. Changes in prevalences over the follow up interval were analysed. Proportions of new, recovered, and chronic cases as well as those free of complaints at both surveys were studied. RESULTS: For most complaints, there were significantly greater increases in prevalences in the exposed group compared with the control group over the follow up interval particularly within the group aged 40-9 for back, neck, and several sites of the upper and lower limbs. The 20-9 year age group also had significantly greater changes for several musculoskeletal complaints. Within the oldest age group (50-9) exposure to heavy physical work demands only affected changes in prevalences of neck and upper arm complaints. After four years in the cohort free of complaints at the start of the follow up the group aged 40-9 had the highest prevalence of complaints of the back, neck, and the upper and lower limbs. CONCLUSIONS: Middle aged and younger employees develop musculoskeletal complaints as a result of exposure to heavy physical work. In the oldest age group health related selection seems to mask the occupational health risks under study. To prevent the expected increase in musculoskeletal disorders and related work disability in our aging workforce, preventive measures should be taken at all stages of a working life.
de Zwart, B C; Broersen, J P; Frings-Dresen, M H; van Dijk, F J
Insomnia complaints in patients evaluated for obstructive sleep apnea
Obstructive sleep apnea (OSA) and insomnia are among the most common sleep diagnoses encountered in the sleep clinic population,\\u000a however little is known about potential interactions or associations between the two disorders. This retrospective, cross-sectional\\u000a study was designed to determine the prevalence of insomnia complaints in patients undergoing evaluation for OSA and to ascertain\\u000a which clinical and polysomnographic features are
Suzanne B. Krell; Vishesh K. Kapur
40 CFR 7.120 - Complaint investigations.
Code of Federal Regulations, 2013 CFR
...all complaints filed under this section unless...national origin, sex or religion shall be processed under the procedures for...discrimination based on age against an individual...Complaints alleging age discrimination under the Age...
Code of Federal Regulations, 2011 CFR
...INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Minor-in-Need-of-Care...Complaint. A complaint must be filed by a law enforcement officer or by the presenting officer...
Code of Federal Regulations, 2011 CFR
...INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Juvenile Offender Procedure...Complaint. A complaint must be filed by a law enforcement officer or by the presenting officer...
Prevalence and risk factors of low back pain among Thai and Myanmar migrant seafood processing factory workers in Samut Sakorn Province, Thailand.
This study assessed the prevalence of low back pain (LBP) and investigated risk factors for LBP among seafood processing factory workers in Thailand including migrant workers. The subjects were Thai and Myanmar workers in the typical seafood processing factory. A cross-sectional study was carried out with a self-administered questionnaire. Prevalence of LBP, general characteristics, life style, and working condition were investigated. The associations between LBP and risk factors were estimated by multiple logistic regression models. Of 254 workers, 165 completed the questionnaire. Half of these workers were Thai, the others were from Myanmar. The point prevalence of LBP was 28.5%. Risk factors for LBP were age over 40 yr, poor health status, history of back injury, twisting posture at work, and slipping on wet floors. The results suggest that health promotion should focus on working conditions rather than individual life style in order to prevent LBP. Furthermore, greater attention to other risk factors such as history of back injury and perception of health status after regular health check up, especially in older age groups may be needed. PMID:20562503
Tomita, Shigeru; Arphorn, Sara; Muto, Takashi; Koetkhlai, Kanatid; Naing, Saw Sandy; Chaikittiporn, Chalermchai
Cyclic pelvic pain and dysmenorrhea.
Primary dysmenorrhea, secondary dysmenorrhea, and cyclic pelvic pain syndromes represent a special subset of CPP. Although more common and no less debilitating, these conditions are better understood, more easily diagnosed, and more successfully treated than chronic pain states. It should be the expectation of both the physician and the patient that successful resolution of these complaints is possible. PMID:8115089
Smith, R P
Public Complaints and Complaint Responses in Calls to a Jordanian Radio Phone-In Program
ERIC Educational Resources Information Center
This study investigates complaints and complaint responses in interactions between local citizens and the hosts of a live two-hour radio phone-in in Jordan devoted to receiving and handling complaints of a public nature. Using Brown and Levinson's (1987) politeness model, the study examines the functions and patterns of complaints and the types of…
Migdadi, Fathi; Badarneh, Muhammad A.; Momani, Kawakib
High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury
Objective. To determine the prevalence of radio- graphic knee osteoarthritis (OA) as well as knee-related symptoms and functional limitations in female soccer players 12 years after an anterior cruciate ligament (ACL) injury. Methods. Female soccer players who sustained an ACL injury 12 years earlier were examined with stan- dardized weight-bearing knee radiography and 2 self- administered patient questionnaires, the Knee
L. S. Lohmander; M. Englund; H. Roos
Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study
Background Chronic widespread pain (CWP) is common and associated with prominent negative consequences. The aim of this study was to assess the prevalence of persistent CWP in an 11-year prospective cohort study in the general population, and to examine anxiety, depression, alcohol use, poor sleep, body mass index (BMI) and chronic disease, along with demographic, lifestyle and other health-related variables as possible predictors for the assumed CWP persistence. Methods CWP was defined as having pain at three or more predefined sites (involving the trunk and upper and lower limbs) for at least three months in the last year. We used a Norwegian general population cohort of 28,367 individuals who responded to both the second (1995–1997) and the third (2006–2008) waves of the Nord-Trřndelag Health Study (HUNT2 and HUNT3, respectively). Data were analysed with logistic regression models. Results CWP prevalence in HUNT2 was 17%. Of those reporting CWP in HUNT2, 53% still reported CWP at follow-up in HUNT3. Adjusted analyses revealed that depression and alcohol consumption were not substantially associated with the 11-year prospective CWP outcome. Poor sleep, obesity and chronic disease predicted persistent CWP, and being male and/or 60 years or older was protective. Conclusions This cohort study revealed that nearly half of the participants with baseline CWP resolved from CWP 11 years later. Among those whose CWP did not resolve, obesity, sleeping problems and chronic disease predicted CWP persistence, while aging and male sex was protective. Anxiety, mixed anxiety and depression, former smoking, and overweight were weakly associated, while depression, moderate exercise, and alcohol use were not associated with persistent CWP.
29 CFR 1984.103 - Filing of retaliation complaint.
Code of Federal Regulations, 2013 CFR
...complaints will be reduced to writing by OSHA. If the complainant is unable to file the complaint in English, OSHA will accept the complaint in any language... The complaint should be filed with the OSHA office responsible for enforcement...
29 CFR 1978.103 - Filing of retaliation complaints.
Code of Federal Regulations, 2013 CFR
...complaints will be reduced to writing by OSHA. If the complainant is unable to file a complaint in English, OSHA will accept the complaint in any other... The complaint should be filed with the OSHA office responsible for enforcement...
29 CFR 1986.103 - Filing of retaliation complaints.
Code of Federal Regulations, 2013 CFR
...complaints will be reduced to writing by OSHA. If a seaman is unable to file a complaint in English, OSHA will accept the complaint in any other language... The complaint should be filed with the OSHA office responsible for enforcement...
29 CFR 1980.103 - Filing of retaliation complaints.
Code of Federal Regulations, 2013 CFR
...complaints will be reduced to writing by OSHA. If the complainant is unable to file the complaint in English, OSHA will accept the complaint in any language... The complaint should be filed with the OSHA office responsible for enforcement...
29 CFR 1982.103 - Filing of retaliation complaints.
Code of Federal Regulations, 2013 CFR
...complaints will be reduced to writing by OSHA. If a complainant is unable to file the complaint in English, OSHA will accept the complaint in any language... The complaint should be filed with the OSHA Area Director responsible for...
29 CFR 1983.103 - Filing of retaliation complaint.
Code of Federal Regulations, 2013 CFR
...complaints will be reduced to writing by OSHA. If the complainant is unable to file the complaint in English, OSHA will accept the complaint in any language... The complaint should be filed with the OSHA office responsible for enforcement...
Review of posttraumatic stress disorder and chronic pain: the path to integrated care.
With the large number of Veterans experiencing posttraumatic stress disorder (PTSD) and chronic pain, the purpose of this article is to review the prevalence of PTSD and chronic pain, the theoretical models that explain the maintenance of both conditions, and the challenges faced by providers and families who care for these patients. The Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress with special attention to chronic pain is presented. Limited scientific evidence supports specific care and treatment of PTSD and chronic pain, and this challenges providers to investigate and research potential treatment options. Integrated care models designed for working with these patients are reviewed, including a focus on the techniques and strategies to address not only PTSD and chronic pain, but other conditions, including substance dependence and depression. A specific focus on headaches, back pain, and neuropathic pain follows, including treatment recommendations such as pharmacological, psychotherapeutic, and complementary approaches, given the high rates of these pain complaints for Veterans in PTSD clinical programs. Integrated care is presented as a viable solution and approach that challenges clinicians and researchers to develop innovative, scientifically based therapeutics and treatments to enhance the recovery and quality of life for Veterans with PTSD and chronic pain. PMID:23015584
Gibson, Carri-Ann
Use of analgesics for exercise-associated pain: prevalence and predictors of use in recreationally trained college-aged students.
The objectives of this study were to examine the use of the analgesics for the relief of exercise-associated pain (EAP) and to examine personal and/or exercise characteristics that might potentially predict such use in recreationally trained college-aged individuals. Recreationally trained college-aged students (N = 263) were invited to complete a self-administered 16-item questionnaire concerning personal exercise habits and analgesic use for EAP. The primary dependent variable was analgesic use for EAP, and additional items sought to characterize patterns and behaviors related to the use. Descriptive statistics and frequencies were calculated for all items, and logistic regression was used to evaluate the ability of 4 variables to predict analgesic use for EAP: gender, length of time performing regular exercise, weekly frequency of aerobic exercise, and weekly frequency of resistance exercise. Approximately 36% of respondents reported analgesic use for EAP, with data indicating acute use for what is generally acute pain. With predictors considered individually, gender was a significant predictor, with female respondents being more likely to use analgesics for EAP (p = 0.04). With all predictors considered concurrently, the model did not significantly contribute to the prediction of use in this sample. Potential for misuse was highlighted by a large percentage of users who described themselves as very unlikely to follow label directions and more likely to take a dose exceeding recommendations. In light of research that reports a potential detriment to muscular regeneration when analgesics are consumed with exercise, it is important to be cognizant of the use of these drugs in individuals striving to improve muscular fitness. Coaches and trainers should educate athletes about the associated risks and caution those who may unnecessarily take analgesics. PMID:23542880
Brewer, Christi B; Bentley, John P; Hallam, Jeffrey S; Woodyard, Catherine D; Waddell, Dwight E
[Osteoarticular pains as early manifestation of malignancies in children].
Based on the rewiew of the literature and own clinical observations, we presented examples of the most common pediatric onco-hematologic malignancies, that are manifested early by osteoarticular complaints. When these complaints predominate in the clinical presentation, they lead the diagnosis towards nonmalignant conditions, that are most common cause of such symptoms in children, like injuries, nonspecific reactive arthritis or inflammatory connective tissue diseases. However, in acute lymphoblastic leukaemia, the most prevalent childhood malignancy, bone and joint pains are present early in 40-60% of cases and they frequently anticipate any abnormalities in complete blood counts. Findings reported in the literature and own observations indicate that these complaints correlate with: lower white cell counts, lower percentage of blast cells in the peripheral blood and lower incidence of organomegaly - that may delay the decision of bone marrow aspiration. In our study we have also presented 4 cases of other malignancies in children, who were complaining of the osteoarticular pains, that limited they activity, long time before the beginning of treatment in Department of Oncology and Pediatric Hematology of University's Pediatric Hospital in Cracow. Long-lasting and intensive osteoarticular complains, that restraint normal activity and do not resolve during rest, spinal compression symptoms, coexisting adenopathy, hepatosplenomegaly, weight loss, change of behaviour, unexplicained fever must be recognized as specific "red flags". Oncologic vigilance must be inspired by discreet hematological abnormalites (like increased anemia, lower white cell counts with lymphocytosis, mild thrombocytopenia) -that indicate bone marrow infiltration, as well as high erythrocyte sedimentation rate, accompanied by moderately elevated C-reactive protein - characteristic for malignancy. Basic and commonly accessible radiological imaging may provide valuable information, because it can reveal tumors, osteolytic lesions or destruction of bone architecture. Laboratory tests of lactate dehydrogenase (LDH) and uric acid level, often raised in malignancies are also helpful. The aim of this study was to focus the attention of pediatricians to the necessity of including malignancy in the differential diagnosis of intensive or unexplained osteoarticular complaints. PMID:19485254
Cwikli?ska, Magdalena; Balwierz, Walentyna
[Vulvovaginal complaints, dyspareunia and oral mucosa abnormalities: erosive lichen planus].
Three women, aged 46, 48 and 73 years respectively, suffered from erosive genital lichen planus. Vulvar irritation, dyspareunia and vaginal discharge are the prominent signs of this disease. Lichen planus is an inflammatory dermatosis, which can involve skin and oral and genital mucosa. Diagnosis and treatment are difficult. Prolonged local application of a corticosteroid cream, e.g. clobetasol, is usually warranted. Narrowing of the vagina and painful mucosal lesions often prevent sexual intercourse. The combination of oral and genital complaints can help in the diagnosis of lichen planus. Strict follow-up is necessary because of the possible malignant degeneration of the disease. PMID:12043442
Mous, H V H; Helmerhorst, Th J M; den Hollander, J C; van der Meijden, W I
Comparison of Preemptive Administration of Ibuprofen Rofecoxib and Placebo in the Attenuation of Postoperative Pain Following Gynecological Surgery.
National Technical Information Service (NTIS)
One of the chief complaints of patients undergoing surgical procedures continues to be postoperative pain, which leads to increased morbidity and mortality. Preemptive analgesia is inhibition of pain pathways prior to a painful stimulus. Nonsteroidal anti...
E. K. Pulatie T. J. Bryant H. Muniz T. S. Adams J. N. Ernest
Pain following traumatic brain injury: Assessment and management
Traumatic brain injury is frequently associated with painful complaints immediately after injury and subsequently. Early assessment of possible painful conditions can be made at the time of physical examination in those who are unable to give a history. Non-verbal signs of pain, including withdrawal of a painful limb or body part, irritability or tears should draw the attention of the
Stephen Tyrer; Amy Lievesley
The application of a classification-tree model for predicting low back pain prevalence among hospital staff.
Low back pain (LBP) is a widespread musculoskeletal condition that frequently occurs in the working-age population (including hospital staff). This study proposes a classification-tree model to predict LBP risk levels in Sacré-Cśur Hospital, Lebanon (as a case study-236 chosen staffs) using various predictor individual and occupational factors. The developed tree model explained 80% of variance in LBP risk levels using standing hours/day (90% in relative importance), job status/sitting hours per day (80% each), body mass index (71%), working days/week (63%), domestic activity hours/week (36%), weight (35%), job dissatisfaction/sitting on ergonomic chairs (30% each), height (28%), gender (27%), sufficient break time (26%), using handling techniques/age (25% each), job stress (24%), marital status/wearing orthopedic insoles/extra professional activity (22% each), practicing prevention measures (20%), children care hours/week (16%), and type of sport activity/sports hours per week, car sitting, and fear of changing work due to LBP (15% each). The overall accuracy of this predictive tree once compared with actual subjects was estimated to be 77%. The proposed tree model can be used by expert physicians in their decision-making for LBP diagnosis among hospital staff. PMID:23566320
Mendelek, Fady; Caby, Isabelle; Pelayo, Patrick; Kheir, Rania Bou
Pain following spinal cord injury
Chronic pain is an important problem following spinal cord injury (SCI) and is a major impediment to effective rehabilitation. The reported prevalence of chronic SCI pain is variable but averages 65% with around one third of these people rating their pain as severe. The mechanisms responsible for the presence of pain are poorly understood. However, evidence from clinical observations and
PJ Siddall; JD Loeser
Prevalence and prognosis of non-specific chest pain among patients hospitalized for suspected acute coronary syndrome - a systematic literature search
Background The term non-specific chest pain (NSCP) is applied to hospitalized patients in order to designate that they neither have an acute coronary syndrome (ACS) nor display evidence of a coronary ischemia. The number of NSCP patients is increasing and comprehensive guidelines specifying their optimal management have not yet been introduced. The objective of this review was to explore the prevalence and prognosis of NSCP versus ACS among patients recruited in consecutive series hospitalized for chest pain suspected to be ACS. Methods This is a systematic literature search where three databases were searched from 1990 to 14 November 2011. In addition, one database was searched for Epub ahead of print per 24 March 2012. Three inclusion criteria were applied: 1. documentation of an unselected consecutive series of patients admitted for chest pain, where this review is based upon two groups of patients defined as follows: a) 'ACS/high-risk' and b) NSCP; 2. at least 100 cases with NSCP; and 3. follow-up of hospital readmissions and mortality for at least six months. Results A total of 2,204 citations were screened after removal of duplicates. Out of 80 full text articles assessed for eligibility 12 studies were included, comprising 24,829 patients (inter-study range 250 to 13,762), with 11,008 (44%) categorized as NSCP and 13,821 (56%) as 'ACS/high-risk'. The mean one-year total mortality rate among patients with NSCP in nine studies was 3.2% (inter-study range 1.4% to 8.1%), with the highest mortality among patients with pre-existing coronary heart disease (CHD). The mean one-year mortality rate among 'ACS/high-risk' patients was 18.0% (inter-study range 14.0% to 19.9%) in four studies with available data. In six studies the mean one-year readmission rate for patients with NSCP was 17.5% (inter-study range 2.5% to 40%). Conclusions Patients with NSCP represent a large, heterogeneous and important group. Due to co-existing CHD in nearly 40% of these patients, their prognosis is not necessarily benign. Although their average one-year mortality rate was almost six times lower than those with 'ACS/high-risk', the subset with concomitant CHD had a relatively poor prognosis when compared with NSCP patients without evidence of CHD.
ISO 10002 Complaints Handling System: a study
Purpose – The purpose of this paper is to provide an analysis of the ISO 10002: 2004 standard from the perspective of its context within the ISO 10001\\/2\\/3 triad of customer satisfaction complaint system and ISO 9001 quality management system standards, its complaints handling content, and the standard's applicability in a public electrical utility. Design\\/methodology\\/approach – A summary of the
Susan Hughes; Stanislav Karapetrovic
Treatment of Health Complaints Attributed to Amalgam
The aim of the present study was to compare the reduction of subjective complaints by 3 treatment strategies in 90 "amalgam patients" whose complaints could not be explained by a medical or psychological disorder. The individuals were randomly assigned either to removal of dental amalgam only (removal group), or removal in combination with a "biological detoxification" therapy with high doses
D. Melchart; S. Vogt; W. Köhler; A. Streng; W. Weidenhammer; L. Kremers; R. Hickel; N. Felgenhauer; T. Zilker; E. Wühr; S. Halbach
Complaints Soar over Student-Loan Collections
ERIC Educational Resources Information Center
Over the past five years, the number of complaints filed against agencies collecting on behalf of the U.S. Department of Education has grown by 45 percent. The Federal Trade Commission, which oversees the entire industry, received 142,743 complaints involving debt-collection companies last year, though only some involved student loans. Consumer…
Field, Kelly
Cross-cultural conceptions of pain and pain control
Pain is a ubiquitous feature of the human experience. This paper presents an anthropology of pain. Anthropology is defined as the cross-cultural and comparative study of human behavior. Pain can be acute and episodic, and pain can be constant and uninterrupted. Acute pain, lasting for minutes or hours, is reported at some time by virtually all adults and by most juveniles and is indicated by the cries and facial expressions of toddlers and infants. This universality of pain as a part of the human condition has been established by the research of many biological, physical, and social scientists. Ethnographers, physicians, and public health experts describe pain complaints for a variety of modern, industrial societies and traditional, undeveloped societies. Pain is the most frequent complaint brought to the offices of physicians in North America, and it is a focus of attention in the literate medical traditions of China, India, and Islamic cultures. Hence, the study of pain and the cultural perceptions of pain are prominent foci of anthropologists. Given that the goal of medicine is to offer medical care to all people who seek it, the practice of modern medicine may be assisted by an exploration of the possibility of cultural differences in medical beliefs and practices in the multiethnic and racially diverse patient populations today.
Failure of physician documentation of sleep complaints in hospitalized patients.
Sleep disorders are acknowledged to be common but remain underrecognized by the medical community, often attributed to the failure to question patients about their sleep quality. We examined the prevalence of sleep complaints (insomnia or excessive daytime sleepiness) in a group of general medical patients by administering a questionnaire to hospitalized patients in a Veterans Affairs tertiary care medical center. A total of 222 consecutive adults (215 men, 60 +/- 14 years; body mass index, 24.8 +/- 5.6) completed the questionnaire. Of these, 105 patients (47%) had either insomnia, excessive daytime somnolence, or both; 63 (28%) had excessive daytime somnolence, which was severe in 27 (12%). Of 75 patients (34%) who had insomnia, a third were taking hypnotic medication. Forty patients (18%) had snoring, which was associated with excessive daytime somnolence in 36, whereas 46 patients (21%) had either restless legs or a combination of leg jerks and leg kicking or twitching during sleep, associated with a sleep complaint (insomnia in 32). The medical records were subsequently reviewed to assess the admitting physicians' recognition of these symptoms. No record included mention of any patient symptom related to sleep. We conclude that symptoms related to sleep, some of which may be clinically important, are common, and that none of these complaints appear to be recognized by the physicians of record.
Meissner, H H; Riemer, A; Santiago, S M; Stein, M; Goldman, M D; Williams, A J
Pain in elderly people with severe dementia: A systematic review of behavioural pain assessment tools
BACKGROUND: Pain is a common and major problem among nursing home residents. The prevalence of pain in elderly nursing home people is 40–80%, showing that they are at great risk of experiencing pain. Since assessment of pain is an important step towards the treatment of pain, there is a need for manageable, valid and reliable tools to assess pain in
Sandra MG Zwakhalen; Jan PH Hamers; Huda Huijer Abu-Saad; Martijn PF Berger
Somatic complaints in anxious youth.
This study examined (a) demographic and clinical characteristics associated with physical symptoms in anxiety-disordered youth and (b) the impact of cognitive-behavioral therapy (Coping Cat), medication (sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7-17 years) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi-site, randomized controlled trial and received treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research are discussed (ClinicalTrials.gov number, NCT00052078). PMID:24129543
Crawley, Sarah A; Caporino, Nicole E; Birmaher, Boris; Ginsburg, Golda; Piacentini, John; Albano, Anne Marie; Sherrill, Joel; Sakolsky, Dara; Compton, Scott N; Rynn, Moira; McCracken, James; Gosch, Elizabeth; Keeton, Courtney; March, John; Walkup, John T; Kendall, Philip C
A Prospective, Non-interventional Study of Assessment and Treatment Adequacy of Pain in the Emergency Department of a Tertiary Care Cancer Hospital
Introduction: Pain is the most common reason for emergency department (ED) visits by the cancer patients. Treatment inconsistency and inadequacy are reported worldwide in the management of ED pain. We conducted a non-interventional observational study of 100 patients visiting ED with moderate to severe pain in a tertiary care cancer center. Aims: The goal of this study was to describe the characteristics of pain and its treatment by oncologists in ED. Materials and Methods: Management of 100 adult patients with complaints of moderate to severe pain was observed by the investigator in ED. Treatment was provided by the doctors of respective oncological services. Later, patients were interviewed by the investigator to collect data about the details of their pain and treatment adequacy. Results: On arrival to ED, about 65% patients reported severe pain, however no formal pain assessment was performed and no patient received strong opioids. Poor compliance for prescribed analgesic medications was noted in a large number of patients (31%), primarily due to suboptimal pain relief and lack of awareness. Protocol based analgesic treatment was non-existent in ED. Majority of patients remained in significant pain after 30 min of analgesic administration and 24% patients could never achieve more than 50% pain relief at the time of discharge. Conclusion: Due to lack of formal pain assessment and laid down protocols, suboptimal pain management is commonly prevalent in ED. Use of strong opioids continues to be scarce in management of severe pain. There is a need to formulate pain management protocols for ED pain.
Jain, P N; Parab, Swapnil Y; Thota, Raghu S
34 CFR 303.433 - Minimum State complaint procedures.
Code of Federal Regulations, 2013 CFR
...2013-07-01 false Minimum State complaint procedures. 303.433 Section 303.433 Education...Procedural Safeguards State Complaint Procedures § 303.433 Minimum State complaint procedures. (a) Time limit; minimum...
34 CFR 300.152 - Minimum State complaint procedures.
Code of Federal Regulations, 2013 CFR
...2013-07-01 false Minimum State complaint procedures. 300.152 Section 300.152 Education... State Eligibility State Complaint Procedures § 300.152 Minimum State complaint procedures. (a) Time limit; minimum...
77 FR 37558 - Disclosure of Certain Credit Card Complaint Data
Federal Register 2010, 2011, 2012, 2013
...CFPB-2011-0040] Disclosure of Certain Credit Card Complaint Data AGENCY: Bureau...discretion to publicly disclose certain credit card complaint data that do not include...information. The Bureau receives credit card complaints from consumers...
34 CFR 303.432 - Adoption of State complaint procedures.
Code of Federal Regulations, 2013 CFR
...DISABILITIES Procedural Safeguards State Complaint Procedures § 303.432 Adoption of State complaint procedures. (a) General. Each lead agency must adopt written procedures forâ (1) Resolving any complaint,...
34 CFR 300.151 - Adoption of State complaint procedures.
Code of Federal Regulations, 2013 CFR
...CHILDREN WITH DISABILITIES State Eligibility State Complaint Procedures § 300.151 Adoption of State complaint procedures. (a) General. Each SEA must adopt written procedures forâ (1) Resolving any complaint, including a...
37 CFR 4.1 - Complaints regarding invention promoters.
Code of Federal Regulations, 2013 CFR
...2013-07-01 false Complaints regarding invention promoters. 4.1 Section 4.1 ...COMMERCE GENERAL COMPLAINTS REGARDING INVENTION PROMOTERS § 4.1 Complaints regarding invention promoters. These regulations...
Complaints of insomnia in hospitalized alcoholics Quejas de insomnio en alcohólicos hospitalizados
Objective: To estimate the prevalence of insomnia complaints in a population of alcoholics hospitalized in addiction clinics in Bogotá. Method: Alcoholic patients hospitalized for detoxification in addiction clinics were recruited. Design: observational, descriptive and cross-sectional study. Data gathered by means of clinical interviews and measuring scales: Pittsburgh Sleep Quality Index and the Zung Self-rating Anxiety and Depression scales. Results: The
Franklin Escobar-Córdoba; Juan David Ávila-Cadavid; Miguel Cote-Menendez
Decision Support System for the Management of Acute Abdominal Pain (User's Manual).
National Technical Information Service (NTIS)
The Abdominal Pain Diagnostic Program is designed to aid the Independent Duty Hospital Corpsman in diagnosing and treating male patients who present with the chief complaint of acute abdominal pain. The program considers only the five most common causes o...
D. Southerland K. Fisherkeller
Introduction On 6 April 2009, at 03:32 local time, an Mw 6.3 earthquake hit the Abruzzi region of central Italy causing widespread damage in the City of L Aquila and its nearby villages. The earthquake caused 308 casualties and over 1,500 injuries, displaced more than 25,000 people and induced significant damage to more than 10,000 buildings in the L'Aquila region. Objectives This observational retrospective study evaluated the prevalence and drug treatment of pain in the five weeks following the L'Aquila earthquake (April 6, 2009). Methods 958 triage documents were analysed for patients pain severity, pain type, and treatment efficacy. Results A third of pain patients reported pain with a prevalence of 34.6%. More than half of pain patients reported severe pain (58.8%). Analgesic agents were limited to available drugs: anti-inflammatory agents, paracetamol, and weak opioids. Reduction in verbal numerical pain scores within the first 24 hours after treatment was achieved with the medications at hand. Pain prevalence and characterization exhibited a biphasic pattern with acute pain syndromes owing to trauma occurring in the first 15 days after the earthquake; traumatic pain then decreased and re-surged at around week five, owing to rebuilding efforts. In the second through fourth week, reports of pain occurred mainly owing to relapses of chronic conditions. Conclusions This study indicates that pain is prevalent during natural disasters, may exhibit a discernible pattern over the weeks following the event, and current drug treatments in this region may be adequate for emergency situations.
Frequency of Clostridium difficile among patients with gastrointestinal complaints
Aim In this study, the prevalence of C. difficile, from patients with gastrointestinal complaints and its association with other enteropathogen microbes were investigated. Background Clostridium difficile is an important pathogen associated with outbreaks of pseudomembranous colitis and other intestinal disorders, such as diarrhea. Patients and methods Enterotoxin and cytotoxin (toxin A and toxin B) of C. difficile on the patient's stool samples were detected by a double sandwich enzyme-linked Immunosorbant assay technique using a commercial kit (Premier toxins A & B; Generic Assays, Inc., Germany). The microbial isolation and examination was done, according to the standard identification methods. Results Out of 356 individuals (57.6% male and 42.4% female) the results of C. difficile were positive for 19 patients (5.3%) and negative for 337 patients (94.6%) according to the results of C. difficile antigen kit. There was no association between the existence of C. difficile toxin and microbial population or antibiotic usage. Conclusion This prevalence study clearly supports the hypothesis of a probable role of C.difficile in developing gastrointestinal complaints in patients with diarrhea. More studies are needed to evaluate the role of C. difficile in these diseases.
Nazemalhosseini-Mojarad, Ehsan; Azimirad, Masoumeh; Razaghi, Maryam; Torabi, Parisa; Moosavi, Ali; Alebouyeh, Masoud; Aslani, Mohammad Mehdi
Relationship between performance validity testing, disability status, and somatic complaints in patients with fibromyalgia.
Fibromyalgia is a chronic pain-related disorder that typically includes cognitive complaints as well as non-specific somatic complaints, such as fatigue and sleep disturbance (Wolfe et al., 2010). Fibromyalgia has also been shown to be associated with a high rate of failure on performance validity testing (PVT), which has not been examined with respect to other self-reported symptoms that are now part of the diagnostic criteria for the disorder. We evaluated 85 patients with fibromyalgia who completed objective measures of pain, sleep, and fatigue along with symptom validity measures (Word Memory Test or Test of Memory Malingering and Reliable Digit Span). Three groups were formed based on effort testing: Two PVTs Failed, One PVT Failed, and No PVTs Failed. We also formed three groups based on disability status: On Disability, Applying for Disability, and Not on Disability. A total of 37% of the patients failed one or both PVTs. PVT group analyses were significant for daily pain, weekly pain, and sleep, but not fatigue. Disability status analyses were significant for daily pain, weekly pain, and fatigue, but not sleep. The implication of this study is that PVT performance and disability status are associated with exaggeration of non-cognitive symptoms such as pain, sleep, and fatigue in persons with fibromyalgia. This study reinforces the importance of effort testing when working with medical populations. PMID:23121595
Johnson-Greene, Doug; Brooks, Lawrence; Ference, Tamar
49 CFR 605.30 - Filing a complaint.
Code of Federal Regulations, 2013 CFR
...30 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION SCHOOL BUS OPERATIONS Complaint Procedures and Remedies § 605.30 Filing a complaint....
[Greater trochanteric pain syndrome].
Greater trochanteric pain is one of the common complaints in orthopedics. Frequent diagnoses include myofascial pain, trochanteric bursitis, tendinosis and rupture of the gluteus medius and minimus tendon, and external snapping hip. Furthermore, nerve entrapment like the piriformis syndrome must be considered in the differential diagnosis. This article summarizes essential diagnostic and therapeutic steps in greater trochanteric pain syndrome. Careful clinical evaluation, complemented with specific imaging studies and diagnostic infiltrations allows determination of the underlying pathology in most cases. Thereafter, specific nonsurgical treatment is indicated, with success rates of more than 90?%. Resistant cases and tendon ruptures may require surgical intervention, which can provide significant pain relief and functional improvement in most cases. PMID:24414233
Gollwitzer, H; Opitz, G; Gerdesmeyer, L; Hauschild, M
Code of Federal Regulations, 2013 CFR
...services block grant, the Administrator, Alcohol, Drug Abuse, and Mental Health Administration; for the maternal and child health services block grant, the Administrator, Health Resources and Services Administration. Complaints with...
Hazard Complaint Procedures Handbook. MSHA Handbook Series.
National Technical Information Service (NTIS)
This handbook establishes guidelines for receiving, evaluating, responding to, and processing safety and health complaints received from miners, representatives of miners, and others. It also establishes procedures to process appeals by miners or their re...
Code of Federal Regulations, 2013 CFR
...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS NONDISCRIMINATION ON THE...others, may file a complaint with the Endowment, alleging discrimination prohibited...discrimination. However, for good cause, the Endowment may extend this time limit. The...
78 FR 52868 - Pole Attachment Complaint Procedures
Federal Register 2010, 2011, 2012, 2013
...CFR Part 1 [CS Docket No. 97-151; FCC 98-20] Pole Attachment Complaint Procedures AGENCY: Federal Communications Commission...requirements in the sections of regulations concerning pole attachments outlined in the DATES section. DATES: Effective...
Polysomnographic and quantitative electroencephalographic correlates of subjective sleep complaints in chronic tinnitus.
Chronic tinnitus, or the perception of hearing sounds without the presence of external stimulation, is estimated at about 10-15% of the population, with highest prevalence after 50 years of age. Sleep complaints are among the most prominent complaints accompanying tinnitus, but objective data are rare. In this study, we examined prospectively the subjective and objective sleep parameters of this patient population in order to determine differences in sleep disturbances associated with chronic tinnitus compared to matched controls. Forty-four subjects (22 with tinnitus and 22 controls without tinnitus), unselected with respect to sleep complaints, participated in this study. The analysis involved 1-week sleep diaries, subjective sleep questionnaires and 1 night of polysomnographic (PSG) assessment. Compared to matched controls, the tinnitus group showed lower subjective sleep quality as measured with the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries, but no significant difference in objective polysomnograph sleep parameters (i.e. sleep latency, efficiency). However, quantitative non-rapid eye movement sleep analysis revealed lower spectral power in the delta frequency band in the tinnitus group compared to controls, and this decrease was correlated with subjective sleep complaints (the lower the delta spectral power, the greater the complaints). This is the first report of an electrophysiological correlate of sleep difficulties supportive of subjective sleep complaints in the tinnitus population. PMID:20561177
Hébert, Sylvie; Fullum, Stephan; Carrier, Julie
Mindfulness-Based Stress Reduction for Chronic Pain Management
\\u000a Pain is a common complaint in primary care, with chronic pain reported in 20% of visits to general practitioners (McCaffrey\\u000a et al., 2003). Twenty percent of adults suffer from chronic pain, rising to half of those of the older age population (Cousins\\u000a et al., 2004). Chronic pain, defined as "intermittent or continuous pain persisting longer than six months or beyond
Jacqueline Gardner-Nix; Jon Kabat-Zinn
Physical inactivity is associated with chronic musculoskeletal complaints 11 years later: results from the Nord-Trřndelag Health Study
BACKGROUND: Physical inactivity is associated with several diseases, but studies evaluating the association between chronic musculoskeletal complaints (MSCs) and physical exercise have shown conflicting results. The aim of this large-scale prospective population-based study was to investigate the association between self-reported physical exercise at baseline and the prevalence of chronic musculoskeletal complaints (MSCs) 11 years later. METHODS: The results are based
Helene Sulutvedt Holth; Hanne Kine Buchardt Werpen; John-Anker Zwart; Knut Hagen
Pain management: pharmacological approaches
\\u000a More than three quarters of patients with advanced cancer experience chronic pain that is severe enough to warrant therapy\\u000a with opioid drugs [1,2]. The most prevalent pain syndromes are disease related in adults and treatment related in children\\u000a [3,4]. In adults with metastatic solid tumors, disease-related pains are usually persistent and often progressive, a pattern\\u000a that reflects the limited availability
Russell K. Portenoy; Gerri Frager
Chronic pain management in the active-duty military
NASA Astrophysics Data System (ADS)
As in the general population, chronic pain is a prevalent and burdensome affliction in active-duty military personnel. Painful conditions in military members can be categorized broadly in terms of whether they arise directly from combat injuries (gunshot, fragmentation wound, blast impact) or whether they result from non-combat injuries (sprains, herniated discs, motor vehicle accidents). Both combat-related and non-combat-related causes of pain can further be classified as either acute or chronic. Here we discuss the state of pain management as it relates to the military population in both deployed and non-deployed settings. The term non-battle injury (NBI) is commonly used to refer to those conditions not directly associated with the combat actions of war. In the history of warfare, NBI have far outstripped battle-related injuries in terms not only of morbidity, but also mortality. It was not until improvements in health care and field medicine were applied in World War I that battle-related deaths finally outnumbered those attributed to disease and pestilence. However, NBI have been the leading cause of morbidity and hospital admission in every major conflict since the Korean War. Pain remains a leading cause of presentation to military medical facilities, both in and out of theater. The absence of pain services is associated with a low return-to-duty rate among the deployed population. The most common pain complaints involve the low-back and neck, and studies have suggested that earlier treatment is associated with more significant improvement and a higher return to duty rate. It is recognized that military medicine is often at the forefront of medical innovation, and that many fields of medicine have reaped benefit from the conduct of war.
Jamison, David; Cohen, Steven P.
Predictors of Shoulder Pain and Disability Index (SPADI) and work status after 1 year in patients with subacromial shoulder pain
BACKGROUND: Shoulder pain is a common complaint in primary health care and has an unfavourable outcome in many patients. The objectives were to identify predictors for pain and disability (SPADI) and work status in patients with subacromial shoulder pain. METHODS: Secondary analyses of data from a randomized clinical controlled trial were performed. Outcome measures were the absolute values of the
Kaia Engebretsen; Margreth Grotle; Erik Bautz-Holter; Ole Marius Ekeberg; Jens Ivar Brox
Prevalence of silent gastrointestinal complications in maintenance renal transplant population.
This study aims to determine the prevalence of silent GI complications within a stable renal transplant population and to investigate whether the conversion to enteric-coated myco-phenolate sodium (EC-MPS, Myfortic) would improve symptom scores. This was a single-center, open-label, non-randomized, prospective study. Patients without any history of GI com-plaints were evaluated by means of the gastrointestinal symptom rating scale (GSRS), with subse-quent switch to EC-MPS in a group of patients. Silent complications were defined as patients who voiced no GI complaints at clinic visits despite a score of > or = 2 on GSRS scale. A total of 236 stable patients participated in the trial. The prevalence of baseline scores > or = 2 was relatively high with abdominal pain 29.66%, reflux 37.28%, indigestion 50%, constipation 58.47% and diarrhea 33.4%. Of 236 patients, 80 were converted to EC-MPS. There was statistically significant improvement on all scales in the subgroup of patients with GSRS score > or = 2 (P < 0.05). In conclusion, the GSRS scale identified a high percentage of silent gastrointestinal complications in this renal transplant population. The converted patients with higher GSRS scores reported a sustained improvement. PMID:20587864
Teplitsky, Susan; Rosaasen, Nicola; Hossain, Mohammad Akhtar; Dyck, Jennifer; Fox, Todd K; Shoker, Ahmed
Stress at Work and Psychosomatic Complaints: A Causal Interpretation
A correlation between stress at work and psychosomatic complaints is often given a direct causal interpretation. This study examines four alternative explanations: third variables that produce spurious correlations between subjective stress and psychosomatic complaints, third variables that produce spurious correlations between objective stress and psychosomatic complaints, and the reverse causation hypothesis that psychosomatic complaints lead to more stress at work.
Michael Frese
[Therapy for atypical facial pain].
Atypical facial pain is a pain in the head, neck and the face, without organic causes. It is treated at departments of physical medicine, such as dental, oral and maxillofacial surgery, otolaryngology, cerebral surgery, or head and neck surgery. In primary care, it is considered to be a medically unexplained symptom (MUS), or a somatoform disorder, such as somatization caused by a functional somatic syndrome (FSS) by psychiatrists. Usually, patients consult departments of physical medicine complaining of physical pain. Therefore physicians in these departments should examine the patients from the holistic perspective, and identify organic diseases. As atypical facial pain becomes chronic, other complications, including psychiatric complaints other than physical pain, such as depression may develop. Moreover, physical, psychological, and social factors affect the symptoms by interacting with one another. Therefore, in examining atypical facial pain, doctors specializing in dental, oral and maxillofacial medicine are required to provide psychosomatic treatment that is based on integrated knowledge. PMID:19768920
Ishida, Satoshi; Kimura, Hiroko
Low back complaints worse, but not more frequent in subjects with congenital lumbosacral malformations: a study on 5000 recruits.
The authors studied the plain radiographs and medical records of 5000 military recruits, mean age 19.1 years (range: 18 to 22), screened in a Turkish Military Hospital in the period November 2008-October 2009. They focused on the incidence of congenital lumbosacral malformations, such as spina bifida occulta and transitional vertebra, trying to find a correlation with subsequent low back complaints. Only 80 out of 748 subjects (10.7%) with low back complaints had one or more malformations, versus 744 out of 4252 subjects (17.5%) without low back complaints. This pleaded against a correlation between malformations and low back disorders. Also the literature is completely divided as to this problem, which means that there is probably no correlation at all. Interestingly, the 80 subjects with low back complaints and malformation estimated their pain level at +/- 4.6 on a Visual Analog Scale for pain, while the 668 with low back complaints but without malformation estimated their pain level at only +/- 2.2 (p = 0.007). At least two other studies led to the same conclusion. This paradox might be due to the fact that congenital malformations concentrate all external stress on the adjacent levels. PMID:23162965
Yavuz, Umut; Bayhan, A Ilhan; Beng, Kubilay; Emrem, Kurtulu?; Uzun, Macit
Pain - groin; Lower abdominal pain; Genital pain; Perineal pain ... Common causes of groin pain include: Pulled muscle, tendon, or ligaments in the leg. This problem often occurs in people who play sports such as ...
Musculoskeletal pain among women of menopausal age in Puebla, Mexico
Worldwide, complaints of musculoskeletal pain are more frequent than complaints of hot flashes amongst women of menopausal\\u000a age. The purpose of this study was to examine musculoskeletal pain among women of menopausal age in the city of Puebla, Mexico.\\u000a An opportunity sample was recruited from public parks and markets, with representation from all social classes (n=755). Mean age was 50.1~years,
Lynnette Leidy Sievert; Susan K. Goode-Null
Prevalence of self reported musculoskeletal diseases is high
Objectives: To present the prevalence of self reported musculoskeletal diseases, the coexistence of these diseases, the test-retest reliability with six months in between, and the association with musculoskeletal pain symptoms. Methods: Twelve layman descriptions of common musculoskeletal diseases were part of the questionnaires of a prospective cohort study of a random sample in the general Dutch population aged 25 years or more (baseline: n=3664, follow up after six months: n=2338). Data collection also included information about pain relating to five different anatomical areas. Results: Osteoarthritis of the knee (men 10.1%, women 13.6%) was amongst the most reported musculoskeletal diseases, whereas the figures for self reported rheumatoid arthritis (RA) were 1.6% and 4.6% for men and women, respectively. The coexistence of these diseases is high: 47 of the 66 combinations were reported more often than would be expected if they were independent of each other (p<0.05). For most diseases the test-retest reliability was good (? between 0.6 and 0.8), but for repetitive strain injury (?=0.37) and chronic arthritis other than RA (?=0.44) the agreement was fair to moderate. All complaints of pain were more often reported by those with musculoskeletal diseases than those without those diseases, and the pain pattern was disease-specific. Conclusions: Self reported musculoskeletal diseases are highly prevalent, with a fair to good reliability and a disease-specific pain pattern. Health surveys are a limited but valuable source of information for this group of health problems, which is not available from most other sources of information.
Picavet, H; Hazes, J
Recurrent limb pain in schoolchildren.
OBJECTIVES: To determine the prevalence, causes and clinical features of short lasting recurrent limb pain (recurrent limb pain) in children. DESIGN: Population-based study in two stages, with an initial screening questionnaire followed by clinical interviews and physical examination of symptomatic children. SETTING: 67 primary and secondary schools in the city of Aberdeen. SUBJECTS: 2165 children representing a random 10% sample of all schoolchildren aged between 5-15 years. MAIN OUTCOME MEASURES: (a) The causes of limb pain in children, (b) the prevalence of recurrent limb pain in schoolchildren, (c) the relationship of recurrent limb pain to childhood migraine. RESULTS: Sports and playground injuries were the most common cause of limb pain, affecting 9% of all children. The prevalence rate of recurrent limb pain was 2.6% (95% confidence interval 1.9 to 3.4). Episodes of recurrent limb pain had similar trigger factors, associated symptoms, and relieving factors to episodes of headache in children with migraine. CONCLUSIONS: Recurrent limb pain is a common cause of limb pain, with a prevalence rate of 2.6%. The close clinical and epidemiological similarities between recurrent limb pain and childhood migraine suggest a common pathogenesis.
Abu-Arafeh, I; Russell, G
Predictors of persistent acute postoperative pain: an opportunity for preventative medicine to reduce the burden of chronic pain
Chronic pain represents a major public health problem. A major precursor of a chronic pain state is persistent acute postoperative pain. Risk factors of developing persistent acute postoperative pain are identified and preventative strategies for implementation are discussed. Epidemiological studies have shown that chronic pain represents a major public health problem.1 The prevalence of chronic pain obtained ranges from 8%-80%
Edward Shipton
Posterior Hip Pain in an Athletic Population
Context: Posterior hip pain is a relatively uncommon but increasingly recognized complaint in the orthopaedic community. Patient complaints and presentations are often vague or nonspecific, making diagnosis and subsequent treatment decisions difficult. The purposes of this article are to review the anatomy and pathophysiology related to posterior hip pain in the athletic patient population. Evidence Acquisition: Data were collected through a thorough review of the literature via a MEDLINE search of all relevant articles between 1980 and 2010. Results: Many patients who complain of posterior hip pain actually have pain referred from another part of the body—notably, the lumbar spine or sacroiliac joint. Treatment options for posterior hip pain are typically nonoperative; however, surgery is warranted in some cases. Conclusions: Recent advancements in the understanding of hip anatomy, pathophysiology, and treatment options have enabled physicians to better diagnosis athletic hip injuries and select patients for appropriate treatment.
Frank, Rachel M.; Slabaugh, Mark A.; Grumet, Robert C.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.
Patterns of Pain and Interference in Patients with Painful Bone Metastases: A Brief Pain Inventory Validation Study
Bone metastases are prevalent, painful, and carry a poorer prognosis for pain control compared with other cancer pain syndromes. Standard tools to measure pain have not been validated in this patient population, and particular subgroups with more challenging symptoms have yet to be identified and studied. The objectives of this study were 1) to validate the psychometric properties of the
Jackson S. Y. Wu; Dorcas Beaton; Peter M. Smith; Neil A. Hagen
Engaging in complaint behaviour : An Indonesian perspective
This paper investigates the various factors affecting consumer complaint behaviour in Indonesia. The main objective is to determine the various demographic variables and to profile complainers and non-complainers with regard to psychographic variables, attitudes towards businesses in general, product attributes and attribution of blame. It provides a comprehensive comparison with the other studies in the literature which were mainly conducted
Ian Phau; Riana Puspita Sari
Student Complaints and Appeals: The Practitioner's View
ERIC Educational Resources Information Center
This article explores the issues facing practitioners working in the field of student complaints and appeals (including academic appeals). It is a reflective study which examines some general and historical issues, using anonymised case studies where appropriate and highlighting the diversity of practice across the sector. The author observes that…
Buckton, Liz
Code of Federal Regulations, 2013 CFR
...Hearings on Appeals Involving Questions of Fact § 4.450-4 Complaints. (a...statement in clear and concise language of the facts constituting the grounds of contest...or an interest in, the land and of the facts showing that he is qualified to do...
Prevalence of chronic musculoskeletal disorders in elderly Brazilians: a systematic review of the literature
Background Population ageing is a worldwide phenomenon that has recently challenged public healthcare systems. The knowledge of the burden of chronic musculoskeletal disorders in elders is still limited, particularly in the developing world. This systematic review aimed to investigate the prevalence of chronic musculoskeletal disorders in elderly Brazilians. Methods A comprehensive literature search was performed in five electronic databases (from inception to January 2012) and completed by additional searches in reference lists. Two review authors independently selected the eligible studies and extracted data on participants' characteristics and rates of chronic musculoskeletal disorders. One review author extracted methodological quality data. We performed a critical synthesis of the results, which were grouped into the diagnoses "chronic musculoskeletal pain" or "specific musculoskeletal diagnoses". Results Twenty five studies reporting on a total of 116,091 elderly Brazilians were included. Eight studies (32%) were of high methodological quality. There was a large variation in the measure of prevalence used by individual studies and in their definition of chronic pain. Prevalence estimates reached 86% for chronic musculoskeletal pain in any location. Studies investigating multiple pain sites found the lower limb and the spine to be the most prevalent complaints (50% each). Arthritis and rheumatism (including osteoarthritis) were the most prevalent specific musculoskeletal diagnoses (9% to 40%), followed by herniated disc (6% to 27%). Conclusions Despite the growth of the elderly population worldwide, high-quality research on the burden of chronic musculoskeletal disorders in the elderly is still scarce. Future healthcare research focusing on this age group should be a priority in developing countries since their public healthcare systems are not yet fully prepared to accommodate the needs of an aging population.
Effects of Ambulant Myofeedback Training and Ergonomic Counselling in Female Computer Workers with Work-Related Neck-Shoulder Complaints: A Randomized Controlled Trial
Objective: To investigate the effects of ambulant myofeedback training including ergonomic counselling (Mfb) and ergonomic counselling\\u000a alone (EC), on work-related neck-shoulder pain and disability. Methods: Seventy-nine female computer workers reporting neck-shoulder complaints were randomly assigned to Mfb or EC and received\\u000a four weeks of intervention. Pain intensity in neck, shoulders, and upper back, and pain disability, were measured at baseline,
Gerlienke E. Voerman; Leif Sandsjö; Miriam M. R. Vollenbroek-Hutten; Pernilla Larsman; Roland Kadefors; Hermie J. Hermens
Pain - side; Side pain ... Flank pain can be a sign of a kidney problem. However, since many organs are in this area, other causes are possible. If you have flank pain and fever , chills, blood in the urine, or ...
45 CFR 672.8 - Answer to the complaint.
Code of Federal Regulations, 2013 CFR
...Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.8 Answer...answer to the complaint with the Hearing Clerk. Any such answer to...complaint must be filed with the Hearing Clerk within twenty...
24 CFR 7.30 - Presentation of complaint.
Code of Federal Regulations, 2013 CFR
...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Complaints § 7.30 Presentation of complaint. At any...
24 CFR 7.25 - Pre-complaint processing.
Code of Federal Regulations, 2013 CFR
...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Pre-Complaint Processing § 7.25 Pre-complaint...
On the relationship between blast noise complaints and community annoyance.
Military installations typically rely on noise complaints to indicate adverse noise environments and often restrict the firing of certain weapons to reduce the number of noise complaints. Using complaints in this manner may also imply that the absence of complaints is an indicator of low community annoyance. The relationship between individual complaints and general community annoyance, however, is currently not established, and it is unknown whether implementing restrictions in reaction to individual complaints is an appropriate or necessary way to reduce community annoyance. This paper looks at whether there are significant differences in reported annoyance to complaint-referenced blast events and general military noise annoyance between those who complain and their non-complaining neighbors. Those who complained were significantly more annoyed to both complaint-referenced blast events and general military noise in comparison to their non-complaining neighbors. The implications of these findings are discussed in terms of range management. PMID:23654377
Nykaza, Edward T; Hodgdon, Kathleen K; Gaugler, Trent; Krecker, Peg; Luz, George A
45 CFR 88.2 - Complaint handling and investigating.
Code of Federal Regulations, 2013 CFR
...of the Department of Health and Human Services is designated to receive complaints based on the Federal health care provider conscience protection statutes. OCR will coordinate the handling of complaints with the Departmental funding component(s) from...
31 CFR 15.737-12 - Contents of complaint.
Code of Federal Regulations, 2013 CFR
...2013-07-01 false Contents of complaint. 15.737-12 Section 15.737-12 Money and Finance: Treasury Office of the...INTEREST Administrative Enforcement Proceedings § 15.737-12 Contents of complaint. (a)...
29 CFR 1954.20 - Complaints about State program administration.
Code of Federal Regulations, 2013 CFR
...false Complaints about State program administration. 1954.20 Section 1954.20... OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED...PLANS Complaints About State Program Administration (CASPA) § 1954.20...
29 CFR 1977.15 - Filing of complaint for discrimination.
Code of Federal Regulations, 2013 CFR
...CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS UNDER THE WILLIAMS-STEIGER OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Procedures § 1977.15 Filing of complaint for discrimination. (a) Who may file. A complaint of section...
Investigating Sexual Harassment Complaints--Part I: General Considerations.
ERIC Educational Resources Information Center
Addresses investigations of library employees' complaints of sexual harassment which could be modified for use with a patron complaint. The employer's interests in conducting an adequate and swift investigation are discussed, and the importance of maintaining confidentiality is stressed. (LRW)
Uhler, Scott F.; Allison, Rinda Y.
32 CFR 513.2 - Administrative procedures for processing complaints.
Code of Federal Regulations, 2010 CFR
...Administrative procedures for processing complaints. 513.2 Section...Administrative procedures for processing complaints. (a) Commander's...believed the creditor's debt processing privileges should be revoked...affects the Army's public image. Also, explain that...
32 CFR 513.2 - Administrative procedures for processing complaints.
Code of Federal Regulations, 2013 CFR
...Administrative procedures for processing complaints. 513.2 Section...Administrative procedures for processing complaints. (a) Commander's...believed the creditor's debt processing privileges should be revoked...affects the Army's public image. Also, explain that...
42 CFR 3.306 - Complaints to the Secretary.
Code of Federal Regulations, 2012 CFR
...DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PATIENT SAFETY ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.306 Complaints to the Secretary. (a) Right to file a complaint . A person who believes...
Is endometriosis really associated with pain?
To address the contrasting findings regarding how pain is related to endometriosis, the relationship between pain and stage of endometriosis was dissected differently by the chief complaint to eliminate selection biases. A total of 1,092 women with endometriosis were classified into two groups depending on their chief complaint, i.e., infertility (infertility group; n = 476) or pain (pain group; n = 616). The correlations between disease stage and various types of pain were analyzed differently in each group. The frequencies of chronic pelvic pain and dyspareunia increased with disease stage either in the infertility group, in the pain group or in the aggregate. On the other hand, no significant relation between the severity of dysmenorrhea and disease stage was observed in the aggregate. Interestingly, a parallel increase in the severity of dysmenorrhea with disease stage was observed in the infertility group, but not in the pain group. In view of selection biases involved in analyzing endometriosis associated with pain, these results could be seen to support the contention that chronic pelvic pain, dyspareunia and dysmenorrhea are in fact related to the extent of endometriosis. PMID:12441656
Momoeda, Mikio; Taketani, Yuji; Terakawa, Noaki; Hoshiai, Hiroshi; Tanaka, Kenichi; Tsutsumi, Osamu; Osuga, Yutaka; Maruyama, Masanori; Harada, Tasuku; Obata, Koushirou; Hayashi, Kunihiko
Evaluating persistent pain in long term care residents: what role for pain maps?
The purpose of this study was to examine the utility of the pain map as a pain assessment tool in frail nursing home residents. The study was conducted in two phases. In Phase 1, nursing home staff's knowledge of the locations of resident pain complaints was examined. We found significant deficiencies in this knowledge. In Phase 2, we examined the following test characteristics of pain extensity (number of painful body areas annotated on pain map): (1) test-retest reliability, (2) convergent validity as compared with pain intensity measured by a pain thermometer (modified vertical verbal descriptor scale) and an 11 point numerical graphic rating scale (NGRS), and (3) predictive validity with depression, functional impairment and self-rated health. Pain map scoring was performed by counting the number of involved body areas (i.e., numbered segments) using an established scoring template. Test-retest reliability by body area was excellent. Pain extensity was modestly associated with pain thermometer-scored pain intensity but not with NGRS-scored pain intensity. Pain extensity also demonstrated modest predictive validity with self-rated health, but not with depression or functional impairment. The advantage of knowing where residents hurt is that this allows staff to target their assessment and thus determine the functional implications of residents' pain. It appears that pain maps add a useful dimension to pain assessment in residents of long term care facilities. PMID:9696480
Weiner, D; Peterson, B; Keefe, F
Psychosocial Working Conditions and Cognitive Complaints among Swedish Employees
Background Cognitive complaints involving problems with concentration, memory, decision-making and thinking are relatively common in the work force. The sensitivity of both subjective and objective cognitive functioning to common psychiatric conditions, stress levels and to cognitive load makes it plausible that psychosocial working conditions play a role in cognitive complaints. Thus, this study aimed to test the associations between psychosocial work factors and cognitive complaints in nationally representative samples of the Swedish work force. Cross-sectional (n?=?9751) and prospective (n?=?3644; two time points two years apart) sequential multiple regression analyses were run, adjusting for general confounders, depressive- and sleeping problems. Additional prospective analyses were run adjusting for baseline cognitive complaints. Cross-sectional results High quantitative demands, information and communication technology (ICT) demands, underqualification and conflicts were positively associated with cognitive complaints, while social support, good resources at work and overqualification were negatively associated with cognitive complaints in all models. Skill discretion and decision authority were weakly associated with cognitive complaints. Conflicts were more strongly associated with cognitive complaints in women than in men, after adjustment for general confounders. Prospective results Quantitative job demands, ICT demands and underqualification were positively associated with future cognitive complaints in all models, including when adjusted for baseline cognitive complaints. Decision authority was weakly positively associated with future cognitive complaints, only after adjustment for depressive- and sleeping problems respectively. Social support was negatively associated with future cognitive complaints after adjustment for general confounders and baseline cognitive complaints. Skill discretion and resources were negatively associated with future cognitive complaints after adjustment for general confounders. The associations between quantitative demands and future cognitive complaints were stronger in women. Discussion/Conclusions The findings indicate that psychosocial working conditions should be taken into account when considering cognitive complaints among employees.
Stenfors, Cecilia U. D.; Magnusson Hanson, Linda; Oxenstierna, Gabriel; Theorell, Tores; Nilsson, Lars-Goran
Managing Pain in Inflammatory Bowel Disease
Pain is a common complaint in inflammatory bowel disease, and it has significant consequences for patients' quality of life. A thorough evaluation to determine the source of patients' pain should include clinical, laboratory, radiologic, and endoscopic assessments as indicated. Differentiating among active inflammation, secondary complications, and functional pain can be complicated. Even when all active disease is adequately treated, clinicians are often left with the difficulty of managing chronic pain. This paper will review the benefits and limitations of several commonly used treatments and promising future therapies. A suggested treatment algorithm will provide some guidance in this challenging area of inflammatory bowel disease management.
Jones, R. Carter W.; Wallace, Mark S.
Toward vocabulary control for chief complaint.
The chief complaint (CC) is the data element that documents the patient's reason for visiting the emergency department (ED). The need for a CC vocabulary has been acknowledged at national meetings and in multiple publications, but to our knowledge no groups have specifically focused on the requirements and development plans for a CC vocabulary. The national consensus meeting "Towards Vocabulary Control for Chief Complaint" was convened to identify the potential uses for ED CC and to develop the framework for CC vocabulary control. The 10-point consensus recommendations for action were 1) begin to develop a controlled vocabulary for CC, 2) obtain funding, 3) establish an infrastructure, 4) work with standards organizations, 5) address CC vocabulary characteristics for all user communities, 6) create a collection of CC for research, 7) identify the best candidate vocabulary for ED CCs, 8) conduct vocabulary validation studies, 9) establish beta test sites, and 10) plan publicity and marketing for the vocabulary. PMID:18439204
Haas, Stephanie W; Travers, Debbie; Tintinalli, Judith E; Pollock, Daniel; Waller, Anna; Barthell, Edward; Burt, Catharine; Chapman, Wendy; Coonan, Kevin; Kamens, Donald; McClay, James
[Treatment of low back pain (pain of locomotive organs)].
Several diseases, including the functional somatic syndromes (FSS), are characterized by pain involving locomotive structures. These disorders include low back pain, neck-shoulder-arm syndrome and fibromyalgia. FSS patients are convinced that their illness is not a psychosomatic disorder, being instead a bodily disease. Therefore, physicians such as orthopedic surgeons play an important role in supporting patients suffering from FSS with locomotive pain, because these patients expect their physicians to treat them for a physical, rather than a psychological disorder. The author investigated the patient-doctor relationship in the examination room of a hospital, and designated pain combined with a depressive state characterized by agitation and helplessness, a common complaint made by FSS and psychosomatic disorder patients, 'painful depression'. Pain and depression influence each other and trigger a vicious downward spiral termed the 'pain-depression deflation spiral'. Generally, orthopedic surgeons can achieve good relationships with FSS patients with locomotive structure pain, despite suspicion of psycho-social factors. It is concluded that physical examinations and treatments by orthopedic surgeons, conducting physical examinations only, can serve as a very good psychosomatic approach to painful depression/FSS patients. PMID:19768917
Tanikawa, Hirotaka
Duloxetine in the management of chronic musculoskeletal pain
Chronic musculoskeletal pain is among the most frequent painful complaints that healthcare providers address. The bulk of these complaints are chronic low back pain and chronic osteoarthritis. Osteoarthritis is the most common form of arthritis in the United States. It is a chronic degenerative disorder characterized by a loss of cartilage, and occurs most often in older persons. The management of osteoarthritis and chronic low back pain may involve both nonpharmacologic (eg, weight loss, resistive and aerobic exercise, patient education, cognitive behavioral therapy) and pharmacologic approaches. Older adults with severe osteoarthritis pain are more likely to take analgesics than those with less severe pain. The pharmacologic approaches to painful osteoarthritis remain controversial, but may include topical as well as oral nonsteroidal antiinflammatory drugs, acetaminophen, duloxetine, and opioids. The role of duloxetine for musculoskeletal conditions is still evolving.
Smith, Howard S; Smith, Eric J; Smith, Benjamin R
Duloxetine in the management of chronic musculoskeletal pain.
Chronic musculoskeletal pain is among the most frequent painful complaints that healthcare providers address. The bulk of these complaints are chronic low back pain and chronic osteoarthritis. Osteoarthritis is the most common form of arthritis in the United States. It is a chronic degenerative disorder characterized by a loss of cartilage, and occurs most often in older persons. The management of osteoarthritis and chronic low back pain may involve both nonpharmacologic (eg, weight loss, resistive and aerobic exercise, patient education, cognitive behavioral therapy) and pharmacologic approaches. Older adults with severe osteoarthritis pain are more likely to take analgesics than those with less severe pain. The pharmacologic approaches to painful osteoarthritis remain controversial, but may include topical as well as oral nonsteroidal antiinflammatory drugs, acetaminophen, duloxetine, and opioids. The role of duloxetine for musculoskeletal conditions is still evolving. PMID:22767991
Smith, Howard S; Smith, Eric J; Smith, Benjamin R
The Prevalence of Sacroiliitis and Spondyloarthritis in Patients with Sarcoidosis
Introduction. Sarcoidosis is a chronic granulomatous disease, which can involve different organs and systems. Coexistence of sarcoidosis and spondyloarthritis has been reported in numerous case reports. Purpose. To determine the prevalence of sacroiliitis and spondyloarthritis in patients previously diagnosed with sarcoidosis and to investigate any possible relation with clinical findings. Materials and Methods. Forty-two patients with sarcoidosis were enrolled in the study. Any signs and symptoms in regard to spondyloarthritis (i.e., existence of inflammatory back pain, gluteal pain, uveitis, enthesitis, dactylitis, inflammatory bowel disease, and psoriasis) were questioned in detail and biochemical tests were evaluated. Sacroiliac joint imaging and lateral heel imaging were performed in all patients. Results. Sacroiliitis was found in 6 of the 42 (14.3%) sarcoidosis patients and all of these patients were female. Common features of the disease in these six patients were inflammatory back pain as the major clinical complaint, stage 2 sacroiliitis as revealed by radiological staging, and the negativity of HLA B-27 test. These six patients with sacroiliitis were diagnosed with spondyloarthritis according to the criteria of ASAS and of ESSG. Conclusion. We found spondyloarthritis in patients with sarcoidosis at a higher percentage rate than in the general population (1–1.9%). Controlled trials involving large series of patients are required for the confirmation of the data.
Kobak, Senol; Sever, Fidan; Ince, Ozlem; Orman, Mehmet
The prevalence of sacroiliitis and spondyloarthritis in patients with sarcoidosis.
Introduction. Sarcoidosis is a chronic granulomatous disease, which can involve different organs and systems. Coexistence of sarcoidosis and spondyloarthritis has been reported in numerous case reports. Purpose. To determine the prevalence of sacroiliitis and spondyloarthritis in patients previously diagnosed with sarcoidosis and to investigate any possible relation with clinical findings. Materials and Methods. Forty-two patients with sarcoidosis were enrolled in the study. Any signs and symptoms in regard to spondyloarthritis (i.e., existence of inflammatory back pain, gluteal pain, uveitis, enthesitis, dactylitis, inflammatory bowel disease, and psoriasis) were questioned in detail and biochemical tests were evaluated. Sacroiliac joint imaging and lateral heel imaging were performed in all patients. Results. Sacroiliitis was found in 6 of the 42 (14.3%) sarcoidosis patients and all of these patients were female. Common features of the disease in these six patients were inflammatory back pain as the major clinical complaint, stage 2 sacroiliitis as revealed by radiological staging, and the negativity of HLA B-27 test. These six patients with sacroiliitis were diagnosed with spondyloarthritis according to the criteria of ASAS and of ESSG. Conclusion. We found spondyloarthritis in patients with sarcoidosis at a higher percentage rate than in the general population (1-1.9%). Controlled trials involving large series of patients are required for the confirmation of the data. PMID:24899899
Kobak, Senol; Sever, Fidan; Ince, Ozlem; Orman, Mehmet
Psychometric properties of the MMPI-2-RF Somatic Complaints (RC1) scale.
The MMPI-2 Restructured Form (MMPI-2-RF; Tellegen & Ben-Porath, 2008) was designed to be psychometrically superior to its MMPI-2 counterpart. However, the test has yet to be extensively evaluated in diverse clinical settings. The purpose of this study was to examine the psychometric properties of the MMPI-2-RF Somatic Complaints (RC1) scale in a clinically relevant population. Participants were 399 patients diagnosed with either epilepsy or psychogenic nonepileptic seizures on the basis of video-electroencephalograph monitoring. The internal structure of the MMPI-2-RF was evaluated using taxometric, confirmatory factor analysis, and item response theory procedures. Data from 4 content-specific scales directly related to RC1 (Malaise, Gastrointestinal Complaints, Head Pain Complaints, and Neurological Complaints) indicated that the latent construct of somatization is a dimensional variable with a bifactor structure. However, consistent with the scale's construction, a unidimensional model also provided adequate fit. A 2-parameter logistic item response theory model better accounted for observed item responses than did 1- or 3-parameter models. Results suggest that the RC1 scale is most precise for T score estimates between 55 and 90. Overall, the scale appears to be well suited for the assessment of somatization. PMID:20822262
Thomas, Michael L; Locke, Dona E C
Workup of Female Patients With Sleep Complaints
In the primary care setting, fatigue and other sleep complaints are often elicited during the course of history taking for\\u000a another presenting problem or are mentioned as the practitioner is about to exit the exam room. Women may experience symptoms\\u000a differently than men do; for example, women with sleep apnea are more likely than men to complain of insomnia, and
Diana Monaghan
Orbitofrontal Gray Matter Relates to Early Morning Awakening: A Neural Correlate of Insomnia Complaints?
Sleep complaints increase profoundly with age; prevalence estimates of insomnia in the elderly reach up to 37%. The three major types of nocturnal complaints are difficulties initiating (DIS) and maintaining (DMS) sleep and early morning awakening (EMA), of which the latter appears most characteristic for aging. The neural correlates associated with these complaints have hardly been investigated, hampering the development of rational treatment and prevention. A recent study on structural brain correlates of insomnia showed that overall severity, but not duration, of insomnia complaints is associated with lower gray matter (GM) density in part of the left orbitofrontal cortex (OFC). Following up on this, we investigated, in an independent sample of people not diagnosed with insomnia, whether individual differences in GM density are associated with differences in DIS, DMS, and EMA. Sixty five healthy participants (mean age?=?41?years, range 18–56) filled out questionnaires and underwent structural magnetic resonance imaging. Three compound Z-scores were computed for questionnaire items relating to DIS, DMS, and EMA. Whole-brain voxel-based morphometry was used to investigate their association with GM density. Results show that participants with lower GM density in a region where the left inferior OFC borders the insula report more EMA, but not DIS or DMS. This is the first study to investigate structural brain correlates of specific sleep characteristics that can translate into complaints in insomniacs. The selective association of EMA with orbitofrontal GM density makes our findings particularly relevant to elderly people, where EMA represents the most characteristic complaint. It is hypothesized that low GM density in aforementioned orbitofrontal area affects its role in sensing comfort. An intact ability to evaluate comfort may be crucial to maintain sleep, especially at the end of the night when sleep is vulnerable because homeostatic sleep propensity has dissipated.
Stoffers, Diederick; Moens, Sarah; Benjamins, Jeroen; van Tol, Marie-Jose; Penninx, Brenda W. J. H.; Veltman, Dick J.; Van der Wee, Nic J. A.; Van Someren, Eus J. W.
Adults with ADHD and Sleep Complaints: A Pilot Study Identifying Sleep-Disordered Breathing Using Polysomnography and Sleep Quality Assessment
ERIC Educational Resources Information Center
Objective: ADHD and sleep-disordered breathing are both prevalent in adulthood. Because both conditions may be responsible for similar symptoms of cognitive impairment, the authors investigate whether their presentation may overlap in adults diagnosed with ADHD. Method: Data are collected from six adults with sleep complaints who were diagnosed…
Surman, Craig B. H.; Thomas, Robert J.; Aleardi, Megan; Pagano, Christine; Biederman, Joseph
Diagnosis and Treatment of Multiseptate Gallbladder with Recurrent Abdominal Pain
Laparoscopic cholecystectomy is usually performed for gallstones or polyp of the gallbladder. Multiseptate gallbladder is a rare congenital malformation. Although several asymptomatic cases have been described, patient usually present with right upper abdominal pain. We present a 29-year-old female patient with multiseptate gallbladder, cholecystectomy was performed, and her abdominal pain and gastrointestinal complaints have resolved.
Karaca, Turgut; Yoldas, Omer; Bilgin, Bulent Caglar; Bilgin, Selma; Evcik, Ender; Ozen, Saadet
Chronic pain is a healthcare problem that significantly affects the mental health, and the professional and private life of patients. It can complicate many disorders and represents a common symptom of rheumatologic diseases, but the data on its prevalence is still limited. Pain is a ubiquitous problem in systemic sclerosis (SSc). SSc-related pain has been studied on the basis of biomedical models and is considered a symptom caused by the disease activity or previous tissue damage. Effective pain management is a primary goal of the treatment strategy, although this symptom in SSc has not yet been investigated in detail. However, these patients do not all respond adequately to pharmacological pain therapies, therefore in these cases a multimodal approach needs to be adopted. PMID:24938196
Stisi, S; Sarzi-Puttini, P; Benucci, M; Biasi, G; Bellissimo, S; Talotta, R; Atzeni, F
Chronic pain, compensation and clinical knowledge
The nosological status of the putative clinical entity of compensation neurosis and the relationship of chronic pain complaints to compensation are explored. It is concluded that, using the traditional criteria of diagnostic validity, there is no support for the view that a specific type of psychiatric disorder related to compensation or litigation can be demonstrated. Although it has been generally
George Mendelson
Physical Therapy for Patients with Back Pain
The aim of this study was to describe the physical therapy diagnosis and treatment in patients with back pain. More specifically, the relationship between the duration of the complaint and the diagnosis and treatment was analysed. Data were used from a representative survey of physical therapeutic practice in the Netherlands. The patients were divided into three groups on the basis
Roelof WA van der Valk; Joost Dekker; Margriet E van Baar
FTC's Top 10 Consumer Fraud Complaints of 2001
NSDL National Science Digital Library
The Top 10 Consumer Fraud Complaints of 2001 report has recently been released by the Federal Trade Commission (FTC). According to the FTC, identity theft headed the top 10 consumer fraud complaints, accounting for forty-two percent of the 204,000 complaints entered into the FTC's Consumer Sentinel database last year. Howard Beales, Director of the FTC's Bureau of Consumer Protection, stated that "consumers who report their complaints to the FTC are helping law enforcement find and stop rip-off artists." Therefore, if you have been a victim of an egregious consumer violation or misdeed, do no hesitate to call the FTC and report your complaint(s); the complaints in the Consumer Sentinel database are a valuable tool for state and federal consumer protection agencies that investigate and prosecute fraud.
Identifying symptom groups from Emergency Department presenting complaint free text using SNOMED CT.
Patients presenting to Emergency Departments may be categorised into different symptom groups for the purpose of research and quality improvement. The grouping is challenging due to the variability in the way presenting complaints are recorded by clinical staff. This work proposes analysis of the presenting complaint free-text using the semantics encoded in the SNOMED CT ontology. This work demonstrates a validated prototype system that can classify unstructured free-text narratives into patient's symptom group. A rule-based mechanism was developed using variety of keywords to identify the patient's symptom group. The system was validated against the manual identification of the symptom groups by two expert clinical research nurses on 794 patient presentations from six participating hospitals. The comparison of system results with one clinical research nurse showed 99.3% sensitivity; 80.0% specificity and 0.9 F-score for identifying "chest pain" symptom group. PMID:22195208
Wagholikar, Amol S; Lawley, Michael J; Hansen, David P; Chu, Kevin
Ataques de nervios and somatic complaints among island and mainland Puerto Rican children.
Previous research has documented the association between the Latino cultural idiom of distress, ataques de nervios (i.e., "attacks of nerves"), and unexplained neurological symptoms among adults. However, the associations between ataques and somatic complaints in children have not been sufficiently explored. Aims: In this study, we assessed the relation between this anxiety-related experience, henceforth ataques, and somatic complaints in a probability sample of Puerto Rican youth, ages 5-13 years, living in San Juan, Puerto Rico (N = 1353) and in the South Bronx, New York (N = 1138). When both sites were combined, children with ataques were significantly more likely to have either a lifetime prevalence of asthma or headaches, and tended to have more stomach aches and a history of epilepsy or seizure than children without ataques. Further within site analyses showed a similar patterning of complaints for the South Bronx sample as for the combined sample. However, children in San Juan with ataques were only slightly more likely to experience headaches, and at risk for injury, than those without ataques. In addition, comparisons between ataque sufferers across sites indicated that children in San Juan with ataques were at elevated risk for serious illness or injury in comparison to those in the South Bronx with ataques. Ataques are significantly associated with a wide range of physical complaints in Puerto Rican youth. However, their pattern of associations differs by context. PMID:20370802
Lopez, Irene; Ramirez, Rafael; Guarnaccia, Peter; Canino, Glorisa; Bird, Hector
Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Tests for Evaluating Musculoskeletal Complaints in Children. Executive Summary. Effective Health Care Program. Comparative Effectiveness Review Number 50.
National Technical Information Service (NTIS)
Musculoskeletal (MSK) pain is common in children and adolescents, with an estimated prevalence ranging from 2 to 50 percent. MSK pain can affect physical, psychological, and social function and often prompts consultation with a physician. However, MSK pai...
C. Ha D. M. Dryden J. Homik J. E. Ellsworth K. Bond K. O. Wong M. Kirkland
This book contains 13 chapters. Some of the chapter titles are: Importance of the Problem; Neurophysiology and Biochemistry of Pain; Assessment of Pain in Patients with Cancer; Drug Therapy; Chemotherapy and Radiotherapy for Cancer Pain; Sympton Control as it Relates to Pain Control; and Palliative Surgery in Cancer Pain Treatment.
M. Swerdlow; V. Ventafridda
Potential underuse of analgesics for recognized pain in nursing home residents with dementia: a cross-sectional study.
The expression of pain is altered in people with dementia (PWD), increasing the risk of undertreatment in that population. The objective of this study was to determine whether dementia and the absence of pain assessment in the patients' medical chart reduced the probability of analgesic use in a large sample of nursing home (NH) residents. This is a cross-sectional study using data from 6275 residents (mean age 86 ± 8.2 years; 73.7% women) from 175 NHs located in France. Information on residents' health status (including dementia and pain assessment) and NHs' structure and organisation were recorded by the NH staff. The NH staff sent to the research team drug prescriptions participants were taking. They were screened for the use of analgesics (dependent variable) and other medications potentially used for pain management. The prevalence of analgesic use was 46.8% (42.3% for PWD and 52% for people with no dementia). A binary logistic regression showed that PWD (odds ratio 0.75; 95% confidence interval 0.66-0.85) and those who had no pain assessment records (odds ratio 0.64; 95% confidence interval 0.53-0.79) had significant lower probabilities of taking analgesics; these results were independent of pain complaints. Results remained fairly unchanged after performing several sensitivity analyses. Our results suggest that improvements are needed in pain management in NHs, particularly for PWD. Implementing systematic evaluations of pain in NHs' routine would contribute to a better management of pain, which can lead to important benefits for residents. PMID:23872102
de Souto Barreto, Philipe; Lapeyre-Mestre, Maryse; Vellas, Bruno; Rolland, Yves
Experiences of employees with arm, neck or shoulder complaints: a focus group study
Background Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. Methods A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. Results Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). Conclusions Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an existing self-management program to the characteristics of employees suffering from CANS.
Myofascial Pain Syndrome in Chronic Back Pain Patients
Background Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. Methods This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. Results The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS (?2 = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P < 0.001) in Visual Analogue Score (VAS) and Modified Oswestry Disability Score (MODS) with standard management during three consecutive visits at six-month intervals. Conclusions MPS prevalence among chronic back pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome.
Nizar, Abd Jalil
Low back pain associated with internal snapping hip syndrome in a competitive cyclist
Low back pain is a common complaint among cyclists. Here we present the case of a competitive master cyclist with low back pain and whose symptoms ultimately resolved when he was treated for internal snapping hip syndrome. Internal snapping hip syndrome is a painful lesion of the iliopsoas caused by snapping of the tendon over the iliopectineal eminence or anterior
T L Little; J Mansoor
Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... awkwardly on the heel Conditions related to heel pain include: Achilles tendinitis, inflammation of the large tendon ...
... is one of the most common reasons for abdominal pain. If you haven't had a bowel movement ( ... disease , or inflammatory bowel disease also can cause abdominal pain. Food. Some kids get abdominal pain because they ...
Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There ... also have a slightly different response to a pain reliever. Over-the-counter (OTC) medicines are good for ...
... by: Anterior knee pain Arthritis -- including rheumatoid arthritis, osteoarthritis, and gout Baker's cyst -- a fluid-filled swelling ... This may reduce swelling and provide support. Take acetaminophen for pain or ibuprofen for pain and swelling. ...
Functional Abdominal Pain Syndrome in Morbidly Obese Patients Following Laparoscopic Gastric Bypass Surgery
Background: Roux-en-Y gastric bypass surgery (RYGBP) is one of the most common bariatric surgeries, which is being performed using various techniques like gastrojejunostomy by hand swen, linear or circular stapler. Abdominal pain is a common complaint following laparoscopic gastric bypass procedure (LGBP), which has different aetiologies, such as overeating, adhesion, internal herniation, bile reflux and many more. In this study LGBP was performed in an ante-colic ante-gastric pattern in a double loop manner and the prevalence and distribution of pain in morbidly obese patients undergoing LGBP was assessed. Objectives: The aim of this study was to analyze the distribution and frequency of post LGBP pain in morbidly obese patients. Patients and Methods: This study was performed on 190 morbidly obese patients referred to Hazrat Rasoul Hospital in Tehran. After LGBP, pain was measured in the following intervals: 24 hours, one week and one month after the operation. Before the operation onset, 2 mg Keflin and 5000 IU subcutaneous heparin were administered as prophylaxis. LGBP was performed using five ports including: one 11 mm port was placed 15-20 cm far from the xiphoid, one 12-mm port in mid-clavicular line at the level of camera port, one 5-mm port in subcostal area in ante-axillary region in the left, another 5-mm port in the right mid-clavicular area and a 5-mm port in sub-xyphoid. All operations were done by the same team. Staple was used for all anastomoses and hand sewn technique to close the staple insertion site. The mesenteric defect was left open and no effort was made to repair it. Results: The results of this study showed that 99.94 % of the patients had complains of pain in the first 24 hours of post operation, about 60% after one week and 29.5 % still had pain after one month. In addition, left upper quadrant (LUQ) was found to be the most prevalent site for the pain in 53.7% of the patients in the first 24 hours, 59.6% after one week and 16.8% after one month (except for obscure pain) with a significance of < 0.05. Conclusions: In this study, the authors analyzed the location and disturbance level of pain after LGBP, which could serve as a cornerstone for further researches. The authors suggest that long-term follow-up (for more than a year after operation) should be considered in future studies and also the relationship between the drainage site and pain should be investigated.
Eidy, Mohammad; Pazouki, Abdolreza; Raygan, Fahimeh; Ariyazand, Yazdan; Pishgahroudsari, Mohadeseh; Jesmi, Fatemeh
Changes in prevalence of subjective fatigue during 14-day 6° head-down bed rest
NASA Astrophysics Data System (ADS)
The present study examines the prevalence of subjective fatigue in young healthy males during 14 days of 6° head-down bed rest (HDBR) by using a multidimensional questionnaire. Forty-one subjects completed the Subjective Fatigue Scale questionnaire to assess the fatigue-related complaints and symptoms. The questionnaire is composed of three sections, with 10 items each. The sections measured drowsiness and dullness (Section 1), difficulty in concentration (Section 2), and the projection of physical disintegration (Section 3). The subjects answered simple questions between 1400 and 1700 on 6 measurement days before and during the HDBR period. The prevalence rate of low back pain was markedly high (80.5%) on the second day and more than 50% in the first half of the HDBR period, and any complaints related to either a lack of sleep or a deterioration in the quality of sleep continued until the end of the HDBR period. Our findings may be useful in developing preventive strategies against physical and mental fatigue associated with prolonged HDBR, horizontal bed rest, and microgravity environments.
Hirayanagi, Kaname; Natsuno, Toyoki; Shiozawa, Tomoki; Yamaguchi, Nobuhisa; Watanabe, Yoriko; Suzuki, Satomi; Iwase, Satoshi; Mano, Tadaaki; Yajima, Kazuyoshi
Managing osteoarthritic knee pain.
Osteoarthritis is one of the most common forms of arthritis seen in primary care practice. Pain associated with this condition is the chief complaint of most patients, prompting them to seek medical attention. Pain can originate from the synovial membrane, joint capsule, periarticular muscles and ligaments, and periosteum and subchondral bone, among other sources. Although osteoarthritis is traditionally thought of as a noninflammatory type of arthritis, inflammatory mechanisms can be present. Therefore, management of osteoarthritic pain involves both nonpharmacologic and pharmacologic modes of therapy. Nonpharmacologic approaches include osteopathic manipulative treatment, physical therapy, exercise, use of assistive devices, and weight reduction. Pharmacologic options may be topical, intra-articular, or oral in route of administration and include acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids. Patients often benefit from combinations of therapeutic modalities. Although pain relief is a chief motivator for patients with osteoarthritis to seek medical attention, a secondary benefit of successful treatment is slowing the decrease in patients' quality of life. PMID:17986674
Barron, Melanie C; Rubin, Bernard R
Clinical diagnosis for discogenic low back pain
Discogenic lower back pain (DLBP) is the most common type of chronic lower back pain (LBP), accounting for 39% of cases, compared to 30% of cases due to disc herniation, and even lower prevalence rates for other causes, such as zygapophysial joint pain. Only a small proportion (approximately 20%) of LBP cases can be attributed with reasonable certainty to a
Yin-gang Zhang; Tuan-mao Guo; Xiong Guo; Shi-xun Wu
Beyond pain in fibromyalgia: insights into the symptom of fatigue
Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue.
Pain perception during menstrual cycle.
Sexual hormones influence complex brain function and pain perception. Many psychophysical studies attempted to establish pain perception changes across menstrual cycle in animal models and healthy women or those with chronic pain. General results are quite uncertain in regard to consistent menstrual-related fluctuations of pain perception. The few studies applying neurophysiological procedures to test pain-related changes during menstrual cycle suggested a fluctuation of central modulation of pain across phases, with a prevalence of excitatory versus inhibitory control in the premenstrual period, which may explain the cyclic worsening of many syndromes, such as migraine. Whatever is the relevance of menstrual cycle on individual painful symptoms, it should be accepted as one of the numerous factors influencing mechanisms of neuromodulation. PMID:21556710
de Tommaso, Marina
Substantial Daily Pain Among Nursing Home Residents
Results: The analysis is based on 27,628 nursing home residents 65 and older with mean age of 82.8 years; 20% African American; 25% male. Seventeen percent had substantial daily pain. By nursing home, reported substantial daily pain prevalence ranged from 0% to 54.7%. The prevalence of pain was less in smaller nurs- ing homes (P.001). Bivariate correlations were signif- icant
Patricia Sawyer; J. Porter Lillis; Eric V. Bodner; Richard M. Allman
Pathogenesis of cognitive complaints in patients on hemodialysis
Memory-concentration complaints are a common symptom among end-stage renal disease patients receiving hemodialysis. However, assuming an organic basis for these complants might lead to unnecessary and expensive testing. To further explore the etiology of cognitive complaints, this study examined the contribution of demographic, neuropsychological, medical, affective, and personality variables to memory-concentration complaints in 426 hemodialysis patients. Following stepwise multiple regression
Andrew L. Brickman; Susan E. Yount; Nancy T. Blaney; Sharon Rothberg; Atara Kaplan De-Nour
48 CFR 1503.905 - Procedures for investigating complaints.
Code of Federal Regulations, 2010 CFR
...System ENVIRONMENTAL PROTECTION AGENCY GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Whistle Blower Protections for Contractor Employees 1503.905 Procedures for investigating complaints. The...
48 CFR 1503.905 - Procedures for investigating complaints.
Code of Federal Regulations, 2010 CFR
...System ENVIRONMENTAL PROTECTION AGENCY GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Whistle Blower Protections for Contractor Employees 1503.905 Procedures for investigating complaints. The...
... are not usually advisable for acute back pain. Chronic Back Pain Treatment for chronic back pain falls into two basic categories: the ... some of the more commonly used treatments for chronic back pain. Nonsurgical Treatments Hot or cold: Hot or cold packs—or ...
Somatic Complaints in Pediatric Patients: A Prospective Study of the Role of Negative Life Events, Child Social and Academic Competence, and Parental Somatic Symptoms
This prospective study of 197 pediatric patients with chronic abdominal pain examined the role of negative family life events and several potential moderator variables (child social and academic competence, parental somatic symptoms, and child sex) in child somatic complaints 1 year after a clinic visit. Results indicated that (a) among children low in social competence at the time of the
Lynn S. Walker; Judy Garber; John W. Greene
Gabapentin dosing for neuropathic pain: Evidence from randomized, placebo-controlled clinical trials
Background: Pain is one of the most common reasons for seeking medical attention, and neuropathic pain is among the most common types of pain. Despite its prevalence, neuropathic pain is often underrecognized and inadequately treated. Many cases are refractory to the medications traditionally used for pain, such as nonsteroidal anti-inflammatory drugs. Tricyclic antidepressants are considered first-line agents for neuropathic pain,
Miroslav Backonja; Robert L Glanzman
Clinical complaints and their handling: a time for change?
OBJECTIVES--To assess the performance of the hospital complaints procedure for complaints proceeding to peer review and the quality of responses to complainants. DESIGN--Retrospective study of data on clinical complaints proceeding to peer review during 1986-91 from clinical records, correspondence, reports of the complaints investigations, and expert review of written responses to complainants. SETTING--Northern Regional Health Authority, covering three million people. SUBJECTS--All 71 clinical complaints investigated to the third stage of the hospital complaints procedure and a sample of 65 written responses to complainants. MAIN MEASURES--Characteristics, duration, and outcome of complaints; findings of peer review; and quality of written responses at various stages in the procedure as evaluated by an expert panel against eight agreed criteria. RESULTS--The median duration of a complaint investigated through all stages of the procedure was 381 days. The longest median stages were those involving attempted resolution locally (131 days) and in which peer review was being arranged (113 days). More complaints alleging failure of communication were upheld by peer review (46/59, 78%) than those alleging misapplication of clinical skills (20/98, 20%) or failure to initiate appropriate investigations or treatment (8/32, 25%). Written responses commonly fell below the standards agreed by the expert panel. CONCLUSIONS--The hospital complaints procedure takes too long and its final peer review stage may not demonstrate sufficient impartiality. The written responses suggest that criticism is not welcomed as a way of improving service. IMPLICATION--The clinical complaints procedure needs to be reformed to ensure true accountability to patients.
Donaldson, L J; Cavanagh, J
Itch and burning pain in women with partial vaginismus with or without vulvar vestibulitis.
Fifty-three women with partial vaginismus with or without vulvar vestibulitis and 27 asymptomatic women estimated sensations of burning pain and itch at 20 standardized moments during a standardized penetration situation, including vaginal muscle contractions. Forty-three women with partial vaginismus (81.1%) reported burning pain, 23 (43.4%) itch, and 22 (41.5%) both complaints, compared to 0% of the asymptomatic women. In 17 of 22 cases, burning pain preceded the appearance of itch and in four cases the two complaints coincided. The median time from the moment when burning pain started until itch appeared was 150 seconds. PMID:17365516
Engman, Maria; Wijma, Klaas; Wijma, Barbro
Cognitive and emotional control of pain and its disruption in chronic pain.
Chronic pain is one of the most prevalent health problems in our modern world, with millions of people debilitated by conditions such as back pain, headache and arthritis. To address this growing problem, many people are turning to mind-body therapies, including meditation, yoga and cognitive behavioural therapy. This article will review the neural mechanisms underlying the modulation of pain by cognitive and emotional states - important components of mind-body therapies. It will also examine the accumulating evidence that chronic pain itself alters brain circuitry, including that involved in endogenous pain control, suggesting that controlling pain becomes increasingly difficult as pain becomes chronic. PMID:23719569
Bushnell, M Catherine; Ceko, Marta; Low, Lucie A
The use of semantic network analysis to manage customer complaints
Effective handling of customer complaints is obviously in the consumers' interest, but analysis of the letters can also provide valuable information to the organization. Organizations can use customer complaints as a way of recording organizational information and tracking effectiveness of their consumer relationship management. In this paper, we argue that organizations should adopt the use of semantic network analysis as
Glynis A. Fitzgerald; Marya L. Doerfel
Patients' complaints as a management tool for continuous quality improvement
Continuous quality improvement focuses on the customer and, therefore, requires attention to customers' feedback as a vital input. Customers' feedback in general hospitals includes utilization statistics of various services, patient satisfaction surveys and patients' complaints. The role of complaint data as a management tool, and particularly as applied to quality improvement, has received little attention in the literature. As a
Rachel Javetz; Zvi Stern
Applying social network analysis on customer complaint handling
Purpose – The paper aims to examine existing information flows formally and informally within a customer complaint handling process, and to identify possible improvement areas to strengthen the effectiveness of this process in the workplace. These objectives are derived from the fact more than 80 percent of complaints have taken longer than the targeted timeframe during the past two years
Agnieszka Sitko-Lutek; Supakij Chuancharoen; Arkhom Sukpitikul; Kongkiti Phusavat
29 CFR 24.103 - Filing of retaliation complaint.
Code of Federal Regulations, 2013 CFR
...complaints will be reduced to writing by OSHA. If a complainant is not able to file... The complaint should be filed with the OSHA Area Director responsible for enforcement...was employed, but may be filed with any OSHA officer or employee. Addresses and...
29 CFR 33.12 - Complaint handling procedures.
Code of Federal Regulations, 2013 CFR
...Complaint handling procedures. 33.12 Section 33.12 Labor Office of the Secretary of...BY THE DEPARTMENT OF LABOR § 33.12 Complaint handling procedures...pursuant to a request from the ASAM. (k) The ASAM shall notify all...
Pain usually occurs as a result of tissue damage and has a role in healing and protection. However, in certain conditions it has no functional purpose and can become chronic and debilitating. A demand for more effective treatments to deal with this highly prevalent problem requires a better understanding of the underlying mechanisms. TRP channels are associated with numerous sensory functions across a wide range of species. Investigation into the expression patterns, electrophysiological properties and the effects of channel deletion in transgenic animal models have produced a great deal of evidence linking these channels to transduction of noxious stimuli as well as signalling within the pain system. PMID:24961972
Sexton, Jane E; Vernon, Jeffrey; Wood, John N
Sexual pain is an underrecognized and poorly treated constellation of disorders that significantly impact affected women and their partners. Recognized as a form of chronic pain, sexual pain disorders are heterogeneous and include dyspareunia (superficial and deep), vaginismus, vulvodynia, vestibulitis, and noncoital sexual pain disorder. Women too often tolerate pain in the belief that this will meet their partners' needs. This article provides a review of the terminology and definition of the condition, theories on the pathophysiology, diagnostic considerations, and recommendations on the management of female sexual pain. PMID:20393420
Boardman, Lori A; Stockdale, Colleen K
A factor analytical study of tinnitus complaint behaviour.
Two separate factor analyses were conducted on various self-rated complaints about tinnitus and related neuro-otological symptoms, together with audiometric measurements of tinnitus 'intensity' (masking level and loudness matching levels). Two general tinnitus complaint factors were identified, i.e. 'intrusiveness of tinnitus' and 'distress due to tinnitus'. 3 specific tinnitus complaint factors were also found, i.e. 'sleep disturbance', 'medication use' and 'interference with passive auditory entertainments'. Other neuro-otological symptoms and the audiometric measures did not load on these factors. An exception was provided by loudness matches at 1 kHz, which had a small loading on the 'intrusiveness of tinnitus' factor. Self-rated loudness had a high loading on this factor. Otherwise, the loudness (either self-rated or determined by loudness matching) was unrelated to complaint dimensions. The clinical implications of the multifactorial nature of tinnitus complaint behaviour are considered. PMID:4004646
Jakes, S C; Hallam, R S; Chambers, C; Hinchcliffe, R
Imaging the painful osteoarthritic knee joint: what have we learned?
Pain in the peripheral joints is an increasingly common problem, resulting in significant patient disability and health-care expenditure. Osteoarthritis (OA), a syndrome of joint pain with associated structural changes, is the most prevalent joint disease, yet the etiology of pain in OA is not entirely clear. Traditional assessment of the structure–pain relationship in knee OA has relied on conventional radiography,
Claire YJ Wenham; Philip G Conaghan
Pathogenesis of Painful Diabetic Neuropathy
The prevalence of diabetes is rising globally and, as a result, its associated complications are also rising. Painful diabetic neuropathy (PDN) is a well-known complication of diabetes and the most common cause of all neuropathic pain. About one-third of all diabetes patients suffer from PDN. It has a huge effect on a person's daily life, both physically and mentally. Despite huge advances in diabetes and neurology, the exact mechanism of pain causation in PDN is still not clear. The origin of pain could be in the peripheral nerves of the central nervous system. In this review, we discuss various possible mechanisms of the pathogenesis of pain in PDN. We discuss the role of hyperglycaemia in altering the physiology of peripheral nerves. We also describe central mechanisms of pain.
Rajbhandari, Satyan
Pain in U.S. Nursing Homes: Validating a Pain Scale for the Minimum Data Set
Purpose: The aim of this study was to validate a pain scale for the Minimum Data Set (MDS) assessment instru- ment and examine prevalence of pain in major nursing home subpopulations, including type of admission and cognitive status. Design and Methods: This study con- sidered validation of the MDS pain items and derivation of scale performed against the Visual Analogue
Brant E. Fries; Samuel E. Simon; John N. Morris; Caroli Flodstrom; Fred L. Bookstein
A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis\\/chronic pelvic pain
BACKGROUND: The etiology and treatment of chronic prostatitis\\/chronic pelvic pain syndrome (CP\\/CPPS) remain poorly understood. Pain, lower urinary tract voiding symptoms and negative impact on quality of life (QOL) are the most common complaints. Acupuncture, which has been widely used to treat painful and chronic conditions, may be a potential treatment to alleviate the constellation of symptoms experienced by men
Jillian L Capodice; Zhezhen Jin; Debra L Bemis; David Samadi; Brian A Stone; Steven Kapan; Aaron E Katz
The epidemiology of neck pain.
Neck pain is becoming increasingly common throughout the world. It has a considerable impact on individuals and their families, communities, health-care systems, and businesses. There is substantial heterogeneity between neck pain epidemiological studies, which makes it difficult to compare or pool data from different studies. The estimated 1 year incidence of neck pain from available studies ranges between 10.4% and 21.3% with a higher incidence noted in office and computer workers. While some studies report that between 33% and 65% of people have recovered from an episode of neck pain at 1 year, most cases run an episodic course over a person's lifetime and, thus, relapses are common. The overall prevalence of neck pain in the general population ranges between 0.4% and 86.8% (mean: 23.1%); point prevalence ranges from 0.4% to 41.5% (mean: 14.4%); and 1 year prevalence ranges from 4.8% to 79.5% (mean: 25.8%). Prevalence is generally higher in women, higher in high-income countries compared with low- and middle-income countries and higher in urban areas compared with rural areas. Many environmental and personal factors influence the onset and course of neck pain. Most studies indicate a higher incidence of neck pain among women and an increased risk of developing neck pain until the 35-49-year age group, after which the risk begins to decline. The Global Burden of Disease 2005 Study is currently making estimates of the global burden of neck pain in relation to impairment and activity limitation, and results will be available in 2011. PMID:21665126
Hoy, D G; Protani, M; De, R; Buchbinder, R
Experiences of Living with Pain after a Spinal Cord Injury.
National Technical Information Service (NTIS)
Persistent chronic pain is prevalent after a spinal cord injury (SCI), with about two-thirds of persons with SCI reporting persistent pain despite available treatments. There is a risk for a significant psychosocial impact and a substantially reduced qual...
E. G. Widerstrom-Noga
Pain and life quality within 2 years of spinal cord injury
The prevalence and classification of pain were investigated in 46 patients admitted consecutively with traumatic spinal cord injury to a rehabilitation hospital. All were studied within 2 years of trauma. Forty-six percent experienced pain of moderate-to-severe intensity. The patients with pain were classified into five categories: diffuse pain, segmental pain, root pain, visceral pain and non-neurogenic pain. Most patients experienced
A G Wagner Anke; A E Stenehjem; J Kvalvik Stanghelle; AGW Anke
... taking, including over-the-counter medications, supplements and herbal remedies. Sometimes there can be serious interactions. Your ... or call our Information Specialists for a copy. Side Effects of Pain Medication Some pain medications have ...
\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Patients suffering with chronic diffuse pain who lack objective clinical and laboratory findings (e.g., fibromyalgia) frequently\\u000a are dismissed as not having real pain, which only perpetuates their illness.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a There are four principal categories of pain: nociceptive pain, neuropathic pain, chronic pain of complex etiology, and psychogenic\\u000a pain.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Pain assessment should include attention to possible psychological and sociocultural
John B. Winfield
... ulcers Something stuck in the throat (for example, fish or chicken bones) Tooth infection or abscess ... with the painful swallowing, including: Abdominal pain Chills Cough Fever Heartburn Nausea or vomiting Sour taste in ...
The prevalence of gastroesophageal reflux disease among hospital employees.
Quantitative estimate of the actual prevalence of the gastroesophageal reflux disease (GERD) is difficult to obtain because most of the patients with heartburn have intermittent symptoms. The aim of this study was to assess the frequency of typical and atypical symptoms suggesting GERD to investigate the association of habits and social conditions reported to lead to reflux in the employees of hospital. A total of 2037 collected forms were assessed. The prevalence of GERD was found to be 21.7% (442). The prevalence of symptoms other than heartburn in employees with and without GERD symptoms were 6.6% versus 3.4% (P?0.05) for asthma, 27.6% versus 8.3% (P?0.001) for night cough, 50% versus 19.5% (P?0.001) for noncardiac chest pain. Dyspeptic complaints were found to be significantly higher among GERD patients (P?0.001). By multiple logistic regression analysis, female gender (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.03-1.60, P?=?0.027), non-steroidal anti-inflammatory drug medication (OR 1.29, 95% CI 1.03-1.60, P?=?0.021) and body mass index over 30 (OR 2.26, 95% CI 1.60-3.18, P?0.001) were independent risk factors associated with GERD symptoms. GERD is a common health problem in Turkey, and its prevalence is similar to that of Western populations with different symptom profiles. Female gender, non-steroidal anti-inflammatory drug, and body mass index >30?kg/m(2) were independent risk factors associated with GERD symptoms. Age, alcohol, coffee, tea, and tobacco smoking do not seem to be risk factors for reflux. PMID:23020266
Ercelep, O B; Caglar, E; Dobrucali, A
... ACOG practice bulletin no. 51. Chronic pelvic pain. Obstetrics & Gynecology, 103 ,589–605. [top] UCSF Medical Center. ( ... profile of women with chronic pelvic pain. Clinical Obstetrics and Gynecology, 33 ,130–136 [top] What are ...
... over-the counter medicine, such as acetaminophen or ibuprofen, to relieve pain, and apply heat to the ... an injury. Use anti-inflammatory medicines, such as ibuprofen and aspirin, to relieve pain and discomfort, and ...
[Spontaneous pain attacks: neuralgic pain].
Paroxysmal orofacial pains can cause diagnostic problems, especially when different clinical pictures occur simultaneously. Pain due to pulpitis, for example, may show the same characteristics as pain due to trigeminal neuralgia would. Moreover, the trigger point of trigeminal neuralgia can either be located in a healthy tooth or in the temporomandibular joint. Neuralgic pain is distinguished into trigeminal neuralgia, glossopharyngeal neuralgia, Horton's neuralgia, cluster headache and paroxysmal hemicrania. In 2 cases trigeminal neuralgia is successfully managed with a neurosurgical microvascular decompression procedure according to Jannetta. Characteristic pain attacks resembling neuralgic pain result from well understood pathophysiological mechanisms. Consequently, adequate therapy, such as a Janetta procedure and specific pharmacological therapy, is available. PMID:17147031
de Bont, L G M
20 CFR 1002.304 - If an individual files a complaint with VETS and VETS' efforts do not resolve the complaint, can...
Code of Federal Regulations, 2013 CFR
...2013-04-01 false If an individual files a complaint with VETS and VETS' efforts do not resolve the complaint, can the individual...1002.304 If an individual files a complaint with VETS and VETS' efforts do not resolve the complaint,...
Only Half of the Chronic Pain After Thoracic Surgery Shows a Neuropathic Component
Chronic pain is a common complication after thoracic surgery. The cause of chronic post-thoracotomy pain is often suggested to be intercostal nerve damage. Thus chronic pain after thoracic surgery should have an important neuropathic component. The present study investigated the prevalence of the neuropathic component in chronic pain after thoracic surgery. Furthermore, we looked for predictive factors for prevalence and
Monique A. H. Steegers; Daphne M. Snik; A. F. T. M. Verhagen; Miep A. van der Drift; Oliver H. G. Wilder-Smith
Effects of Ambulant Myofeedback Training and Ergonomic Counselling in Female Computer Workers with Work-Related Neck-Shoulder Complaints: A Randomized Controlled Trial
Objective: To investigate the effects of ambulant myofeedback training including ergonomic counselling (Mfb) and ergonomic counselling alone (EC), on work-related neck-shoulder pain and disability. Methods: Seventy-nine female computer workers reporting neck-shoulder complaints were randomly assigned to Mfb or EC and received four weeks of intervention. Pain intensity in neck, shoulders, and upper back, and pain disability, were measured at baseline, immediately after intervention, and at three and six months follow-up. Results: Pain intensity and disability had significantly decreased immediately after four weeks Mfb or EC, and the effects remained at follow up. No differences were observed between the Mfb and EC group for outcome and subjects in both intervention groups showed comparable chances for improvement in pain intensity and disability. Conclusions: Pain intensity and disability significantly reduced after both interventions and this effect remained at follow-up. No differences were observed between the two intervention groups.
Sandsjo, Leif; Vollenbroek-Hutten, Miriam M. R.; Larsman, Pernilla; Kadefors, Roland; Hermens, Hermie J.
Joint pain may result from traumas or repeated microtraumas, as in sports injuries. Pain in osteoarthritis starts before any\\u000a objective finding. It has been demonstrated that in the first stages of this disease, pain is due to intraosseous venous engorgement\\u000a for the earlier thickening of the cortical bone under the articular cartilage. The mechanisms of inflammatory pain are more\\u000a complex
Massimo Zoppi; Elisabetta Beneforti
Pain - neck; Neck stiffness ... this as having a stiff neck. If neck pain involves nerves, you may feel numbness, tingling, or ... A common cause of neck pain is muscle strain or tension. Usually, ... Such activities include: Bending over a desk for hours Poor ...
Correlates of persistent sleep complaints after traumatic brain injury.
The objective of the study was to examine factors associated with persistent sleep complaint (SC) after traumatic brain injury. The study design consisted of a retrospective chart review case series, with longitudinal follow-up data. Subjects were identified from Georgia Model Brain Injury System with sleep data post-injury. Twenty three (47.9%) had no sleep complaint at either 6 or 12 months post-injury or resolved sleep complaint at 12 months (Without Persistent SC group); 25 (52.1%) maintained a sleep complaint from 6 to 12 months or reported a sleep complaint at 12 months post-injury (With Persistent SC group). Demographic, premorbid and peri-injury characteristics and The Neurobehavioral Functioning Inventory (NFI) scores did not differentiate the two groups. The Without Persistent SC group had a slight improvement from 6 to 12 months post-injury in post-traumatic stress (PTS) symptoms and depression. Significant psychological patterns were identified in those with persistent SC at both 6 and 12 months post-injury, i.e., worse depression and worse PTS symptoms. This trend was apparent at 6 months and became significant at 12 months post-injury. However, subjects with newly emerging sleep complaints at 12 months had similar characteristics as the Without Persistent SC group. The observed psychological patterns associated with persistent sleep complaint in a specific time course after brain injury have important research and clinical implications that merit further study. PMID:23721355
Huang, Wei; Bliwise, Donald L; Johnson, Theodore M; Long, Qi; Kutner, Nancy; Stringer, Anthony Y
Cognitive status in persons with amalgam-related complaints.
Self-reported cognitive symptoms are frequent in persons with amalgam-related complaints, but few studies have focused on their cognitive function. The aim was to examine a symptom profile and whether participants with amalgam-related complaints have cognitive deficits in comparison with control individuals. We drew 342 participants with amalgam-related complaints and 342 one-to-one matched control individuals from a longitudinal population-based study. For 81 of the participants with amalgam-related complaints and controls, data were available approximately five years before the onset of complaints, making a longitudinal analysis possible. All participants were assessed by a self-reported health questionnaire and a comprehensive cognitive test battery. The participants with amalgam-related complaints reported more symptoms, mainly musculoskeletal and neuropsychological, compared with control individuals (p < 0.001). The results revealed no significant difference between the amalgam and control group, either cross-sectionally or longitudinally, for any of the cognitive tests. These results suggest that cognitive decline is not associated with amalgam-related complaints. PMID:20739704
Sundström, A; Bergdahl, J; Nyberg, L; Bergdahl, M; Nilsson, L-G
Acupuncture for Cancer Pain and Related Symptoms
Cancer pain is one of most prevalent symptoms in patients with cancer. Acupuncture and related techniques have been suggested for the management of cancer pain. The National Comprehensive Cancer Network (NCCN®) guidelines for adult cancer pain recommends acupuncture, as one of integrative interventions, in conjunction with pharmacologic intervention as needed. This review presents the latest available evidence regarding the use of acupuncture for cancer pain. It also provides "actionable" acupuncture protocols for specific cancer pain conditions and related symptoms in order to provide more clinically relevant solutions for clinicians and cancer patients with pain. These conditions include postoperative cancer pain, postoperative nausea and vomiting, postsurgical gastroparesis syndrome, opioid-induced constipation, opioid-induced pruritus, chemotherapy-induced neuropathy, aromatase inhibitor-associated joint pain, and neck dissection-related pain and dysfunction.
Lu, Weidong; Rosenthal, David S
Postoperative pain management and Acute Pain Service activity in Canada
A survey of postoperative pain management practices was mailed to the 56 Canadian university-affiliated teaching hospitals\\u000a in December 1991. The aims of the survey were (1) to determine the prevalence, structure, and function of Acute Pain Services\\u000a and (2) to determine the use and management of patient-controlled analgesia (PCA) and epidural opiate analgesia (EOA) in teaching\\u000a hospitals. Responses were received
D. L. Zimmermann; J. Stewart
Disturbances of Pain Perception in Temporomandibular Pain Syndrome
\\u000a Musculoskeletal pain affecting the orofacial region is quite prevalent and has frequently been reported throughout the developed\\u000a world (Dworkin and Ohrbach 2001). Common TMD symptoms include spontaneous pain in the area of the ear, the temporomandibular joint, or the muscles of mastication,\\u000a physical limitations or irregularities in jaw movement, and clicking and popping noises in the temporomandibular joint during\\u000a jaw
Gary B. Rollman; Joanne M. Gillespie
Rapid 13C Urea Breath Test to Identify Helicobacter pylori Infection in Emergency Department Patients with Upper Abdominal Pain
Introduction: In emergency department (ED) patients with upper abdominal pain, management includes ruling out serious diseases and providing symptomatic relief. One of the major causes of upper abdominal pain is an ulcer caused by Helicobacter pylori (H. pylori), which can be treated and cured with antibiotics. We sought to estimate the prevalence of H. pylori infection in symptomatic patients using a convenience sample at a single urban academic ED and demonstrate the feasibility of ED-based testing. Methods: We prospectively enrolled patients with a chief complaint of pain or discomfort in the upper abdomen for 1 year from February 2011 until February 2012 at a single academic urban ED. Enrolled subjects were tested for H. pylori using a rapid point of care 13C Urea Breath Test (UBT) [Exalenz Bioscience]. We compared patient characteristics between those who tested positive versus negative for the disease. Results: A total of 205 patients with upper abdominal pain were tested over 12 months, and 24% (95% confidence interval: 19% to 30%) tested positive for H. pylori. Black subjects were more likely to test positive than white subjects (28% v. 6%, P < 0.001). Other factors, such as age and sex, were not different between the 2 groups. Conclusion: In our ED, H. pylori infection was present in 1 in 4 patients with epigastric pain, and testing with a UBT was feasible. Further study is needed to determine the risk factors associated with infection, the prevalence of H. pylori in other EDs, the effect of the test on ED length of stay and the costeffectiveness of an ED-based test-and-treat strategy.
Meltzer, Andrew C.; Pierce, Rebecca; Cummings, Derek A.T.; Pines, Jesse M.; May, Larissa; Smith, Meaghan A.; Marcotte, Joseph; McCarthy, Melissa L.
Rapid (13)C Urea Breath Test to Identify Helicobacter pylori Infection in Emergency Department Patients with Upper Abdominal Pain.
Introduction: In emergency department (ED) patients with upper abdominal pain, management includes ruling out serious diseases and providing symptomatic relief. One of the major causes of upper abdominal pain is an ulcer caused by Helicobacter pylori (H. pylori), which can be treated and cured with antibiotics. We sought to estimate the prevalence of H. pylori infection in symptomatic patients using a convenience sample at a single urban academic ED and demonstrate the feasibility of ED-based testing. Methods: We prospectively enrolled patients with a chief complaint of pain or discomfort in the upper abdomen for 1 year from February 2011 until February 2012 at a single academic urban ED. Enrolled subjects were tested for H. pylori using a rapid point of care (13)C Urea Breath Test (UBT) [Exalenz Bioscience]. We compared patient characteristics between those who tested positive versus negative for the disease. Results: A total of 205 patients with upper abdominal pain were tested over 12 months, and 24% (95% confidence interval: 19% to 30%) tested positive for H. pylori. Black subjects were more likely to test positive than white subjects (28% v. 6%, P < 0.001). Other factors, such as age and sex, were not different between the 2 groups. Conclusion: In our ED, H. pylori infection was present in 1 in 4 patients with epigastric pain, and testing with a UBT was feasible. Further study is needed to determine the risk factors associated with infection, the prevalence of H. pylori in other EDs, the effect of the test on ED length of stay and the costeffectiveness of an ED-based test-and-treat strategy. PMID:23687549
Meltzer, Andrew C; Pierce, Rebecca; Cummings, Derek A T; Pines, Jesse M; May, Larissa; Smith, Meaghan A; Marcotte, Joseph; McCarthy, Melissa L
Bladder pain can have a number of different etiologies. This brief summary provides an overview of bladder pain syndrome, including current evidence-based recommendations for diagnosis and management.
Payne, Christopher
Pain and Inflammatory Bowel Disease
Abdominal pain is a common symptom of inflammatory bowel disease (IBD: Crohn's disease, ulcerative colitis). Pain may arise from different mechanisms, which can include partial blockage and gut distention as well as severe intestinal inflammation. A majority of patients suffering from acute flares of IBD will experience pain, which will typically improve as disease activity decreases. However, a significant percentage of IBD patients continue experiencing symptoms of pain despite resolving inflammation and achieving what appears to be clinical remission. Current evidence suggests that sensory pathways sensitize during inflammation, leading to persistent changes in afferent neurons and central nervous system pain processing. Such persistent pain is not only a simple result of sensory input. Pain processing and even the activation of sensory pathways is modulated by arousal, emotion, and cognitive factors. Considering the high prevalence of iatrogenic as well as essential neuropsychiatric comorbidities including anxiety and depression in IBD patients, these central modulating factors may significantly contribute to the clinical manifestation of chronic pain. The improved understanding of peripheral and central pain mechanisms is leading to new treatment strategies that view pain as a biopsychosocial problem. Thus, improving the underlying inflammation, decreasing the excitability of sensitized afferent pathways, and altering emotional and/or cognitive functions may be required to more effectively address the difficult and disabling disease manifestations.
Bielefeldt, Klaus; Davis, Brian; Binion, David G.
76 FR 56506 - Agency Information Collection (Complaint of Employment Discrimination) Activity Under OMB Review
Federal Register 2010, 2011, 2012, 2013
...Collection (Complaint of Employment Discrimination) Activity Under OMB Review AGENCY...Title: Complaint of Employment Discrimination, VA Form 4939. OMB Control Number...VA Form 4939 to file complaint of discrimination. An agency may not conduct or...
76 FR 38743 - Proposed Information Collection (Complaint of Employment Discrimination) Activity: Comment Request
Federal Register 2010, 2011, 2012, 2013
...Collection (Complaint of Employment Discrimination) Activity: Comment Request AGENCY...process a complaint of employment discrimination. DATES: Written comments and recommendations...Title: Complaint of Employment Discrimination, VA Form 4939. OMB Control...
29 CFR 1691.5 - Agency processing of complaints of employment discrimination.
Code of Federal Regulations, 2010 CFR
...processing of complaints of employment discrimination. 1691.5 Section 1691.5 ...PROCEDURES FOR COMPLAINTS OF EMPLOYMENT DISCRIMINATION FILED AGAINST RECIPIENTS OF FEDERAL...processing of complaints of employment discrimination. (a) Within ten days of...
29 CFR 1691.5 - Agency processing of complaints of employment discrimination.
Code of Federal Regulations, 2010 CFR
...processing of complaints of employment discrimination. 1691.5 Section 1691.5 ...PROCEDURES FOR COMPLAINTS OF EMPLOYMENT DISCRIMINATION FILED AGAINST RECIPIENTS OF FEDERAL...processing of complaints of employment discrimination. (a) Within ten days of...
28 CFR 42.605 - Agency processing of complaints of employment discrimination.
Code of Federal Regulations, 2010 CFR
...processing of complaints of employment discrimination. 42.605 Section 42.605 ...Procedures for Complaints of Employment Discrimination Filed Against Recipients of Federal...processing of complaints of employment discrimination. (a) Within ten days of...
76 FR 35949 - Agency Information Collection (Civil Rights Discrimination Complaint) Activity Under OMB Review
Federal Register 2010, 2011, 2012, 2013
...Information Collection (Civil Rights Discrimination Complaint) Activity Under OMB Review...INFORMATION: Title: Civil Rights Discrimination Complaint, VA Form 10-0381. OMB...a formal complaint of the alleged discrimination. An agency may not conduct or...
High-risk chief complaints III: abdomen and extremities.
Abdominal and extremity complaints are a frequent reason for presentation to the emergency department. Although these are common complaints, several abdominal and extremity disease entities may be missed or may be subject to delayed diagnosis. This article provides an overview of the diagnosis and management of several high-risk abdominal and extremity complaints, including appendicitis, abdominal aortic aneurysm, mesenteric ischemia, bowel obstruction, retained foreign body, hand and finger lacerations, fractures, and compartment syndrome. Each section focuses primarily on the pitfalls in diagnosis by highlighting the limitations of history, physical examination findings, and diagnostic testing and provides specific risk management strategies. PMID:19932403
Tekwani, Karis; Sikka, Rishi
Germany's waste policy draws more complaints
The U.K. government, backed by France, Spain, and a number of other European Community (EC) members, has submitted a complaint to the European Commission regarding shipments of packaging wastes from Germany. Well-funded German wastes collectors are able to pay recycling firms up to $350/m.t. to take wastes or offer refuse at zero cost, depending on quality. According to the U.K.'s Department of Trade and Industry (DTI; London) plastics wastes imports to the U.K. increased 450% between 1991 and 1992-most of the hike was in Germany shipments. Such increases, the DTI says, prevent the development of domestic waste recycling efforts in the U.K. Other countries supporting the U.K. position include Denmark, the Netherlands, Italy, Ireland, and Luxembourg. The German waste export issue stems from its packaging recycling regulation, which has resulted in mountains of waste being collected along with strong reserves of funds. However, the country has insufficient recycling capacity. In 1992, when it is estimated 200,000 m.t. of plastics packaging was collected, Germany's recycling capabilities amounted to 60,000 m.t. Long term, Germany aims to recycle plastics through refineries or crackers. Shorter term, it is building storage capacity. A DTI spokesman says approaches have recently been made by the U.K. to Germany to set up bilateral talks to remedy the situation. In addition, the issue will likely be on the agenda of a meeting between Germany and U.K. industry and environmental ministers in Bonn next week. The commission is in the process of drawing up a pan-European packaging directive, which in its draft form sets an obligation on each EC country to treat wastes internally.
Chynoweth, E.
Imperforate hymen presenting as chronic low back pain.
Imperforate hymen in an adolescent usually presents with cyclic abdominal pain or with pelvic mass associated with primary amenorrhea. We present a 13-year-old girl with chronic lower back pain of 6 months' duration as the only complaint. On physical examination, multiple trigger points were detected in the quadratus lumborum and gluteus medius muscles bilaterally. Abdominal ultrasound revealed hematometrocolpos secondary to an imperforate hymen. Hymenectomy was performed, with complete resolution of the back pain. Myofascial pain syndrome with a viscerosomatic reflex is a possible explanation for the clinical presentation of our patient. PMID:23958769
Domany, Erel; Gilad, Oded; Shwarz, Michael; Vulfsons, Simon; Garty, Ben Zion
Chronic and Recurrent Pelvic Pain
\\u000a Chronic and recurrent pelvic pain (CPP) in children and adolescents has been recognized for decades. However, data on the\\u000a etiology, natural history, treatment, and long-term consequences of painful pelvic conditions in these patients are lacking.\\u000a The problem's prevalence remains uncertain, and the majority of therapies are extrapolated from research on adults. The normal\\u000a developmental changes and coping strategies of children
Lynda Wells
Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey.
Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor quality of life. An international group of investigators assembled by a task force of the International Association for the Study of Pain (IASP) evaluated the prevalence and characteristics of BKP as part of a prospective, cross-sectional survey of cancer pain. Fifty-eight clinicians in 24 countries evaluated a total of 1095 patients with cancer pain using patient-rated items from the Brief Pain Inventory (BPI) and observer-rated measures. The observer-rated information included demographic and tumor-related data, the occurrence of BKP, and responses on checklists of pain syndromes and pathophysiologies. The clinicians reported BKP in 64.8% of patients. Physicians from English-speaking countries were significantly more likely to report BKP than other physicians. BKP was associated with higher pain scores and functional interference on the BPI. Multivariate analysis showed an independent association of BKP with the presence of more than one pain, a vertebral pain syndrome, pain due to plexopathy, and English-speaking country. These data confirm the high prevalence of BKP, its association with more severe pain and functional impairment, and its relationship to specific cancer pain syndromes. Further studies are needed to characterize subtypes of BKP. The uneven distribution of BKP reporting across pain specialists from different countries suggests that more standardized methods for diagnosing BKP are needed. PMID:15198130
Caraceni, Augusto; Martini, Cinzia; Zecca, Ernesto; Portenoy, Russell K; Ashby, M A; Hawson, G; Jackson, K A; Lickiss, N; Muirden, N; Pisasale, M; Moulin, D; Schulz, V N; Rico Pazo, M A; Serrano, J A; Andersen, H; Henriksen, H T; Mejholm, I; Sjogren, P; Heiskanen, T; Kalso, E; Pere, P; Poyhia, R; Vuorinen, E; Tigerstedt, I; Ruismaki, P; Bertolino, M; Larue, F; Ranchere, J Y; Hege-Scheuing, G; Bowdler, I; Helbing, F; Kostner, E; Radbruch, L; Kastrinaki, K; Shah, S; Vijayaram, S; Sharma, K S; Devi, P Sarashawathi; Jain, P N; Ramamani, P V; Beny, A; Brunelli, C; Maltoni, M; Mercadante, S; Plancarte, R; Schug, S; Engstrand, P; Ovalle, A F; Wang, X; Alves, M Ferraz; Abrunhosa, M R; Sun, W Z; Zhang, L; Gazizov, A; Vaisman, M; Rudoy, S; Gomez Sancho, M; Vila, P; Trelis, J; Chaudakshetrin, P; Koh, M L J; Van Dongen, R T M; Vielvoye-Kerkmeer, A; Boswell, M V; Elliott, T; Hargus, E; Lutz, L
Consumer Complaint Behaviour In Sport Consumption: A Theoretical Model
In this study, traditional consumer complaint behaviours (CCBs) are re-examined in an experiential context; specifically, the consumption of live sport. It is proposed that these behaviours are not motivated by the \\
Michael Volkov; Jane Summers; Melissa Johnson Morgan
32 CFR 1907.04 - Suggestions and complaints.
Code of Federal Regulations, 2013 CFR
...complaints. 1907.04 Section 1907.04 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CHALLENGES TO CLASSIFICATION OF DOCUMENTS BY AUTHORIZED HOLDERS PURSUANT TO SEC. 1.8 OF EXECUTIVE ORDER...
32 CFR 1909.04 - Suggestions and complaints.
Code of Federal Regulations, 2013 CFR
...complaints. 1909.04 Section 1909.04 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY ACCESS BY HISTORICAL RESEARCHERS AND CERTAIN FORMER GOVERNMENT PERSONNEL PURSUANT TO SEC. 4.4 OF EXECUTIVE...
32 CFR 1900.04 - Suggestions and complaints.
Code of Federal Regulations, 2013 CFR
...complaints. 1900.04 Section 1900.04 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY PUBLIC ACCESS TO CIA RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) General § 1900.04...
29 CFR 1614.105 - Pre-complaint processing.
Code of Federal Regulations, 2013 CFR
...of race, color, religion, sex, national origin, age, disability, or genetic...1614.201(a) and a lawsuit under the ADEA instead of an administrative complaint of age discrimination under this part, the duty...
45 CFR 1201.3 - Service of summonses and complaints.
Code of Federal Regulations, 2013 CFR
...2013-10-01 2013-10-01 false Service of summonses and complaints...CORPORATION FOR NATIONAL AND COMMUNITY SERVICE PRODUCTION OR DISCLOSURE...Corporation for National and Community Service, 1201 New York Avenue,...
47 CFR 1.721 - Format and content of complaints.
Code of Federal Regulations, 2013 CFR
...paragraph (a)(6) of this section. Nevertheless, complaints on the Accelerated Docket shall fully set out the facts and legal theories on which the complainant premises its claims. (iii) In light of the requirement for staff-supervised settlement...
32 CFR 513.2 - Administrative procedures for processing complaints.
Code of Federal Regulations, 2010 CFR
...action. (2) If the soldier is a patient attached to a medical holding detachment (MHD), the complaint will be sent there for action. The commander of the MHD will take action per this regulation. (3) The command receiving the...
29 CFR 1977.17 - Withdrawal of complaint.
Code of Federal Regulations, 2013 CFR
...CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS UNDER THE WILLIAMS-STEIGER OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Procedures § 1977.17 Withdrawal of complaint. Enforcement of the provisions of section 11(c) is not only a...
Physical complaints in girls with major depression - A controlled study.
Major depression is a frequent affective disorder in young adolescents. Patients do not only suffer from severe psychological but also from physical impairments. Aim of the present study is a description of physical complaints in girls with major depression. Seventy-three patients fulfilling DSM-IV criteria for major depression were compared to 72 controls. Physical complaints were assessed by a standardised and validated German questionnaire (Giessen Scale of Physical Complaints in Children and Adolescents). Patients reported significantly more complaints, in particular exhaustion and circulation problems. Physical problems are more likely to be a consequence rather than a cause of depression. Treatment of adolescents? depression should consider coping with body dysfunction during depressive episodes. PMID:24755039
Schmidt, Ulrike; Laessle, Reinhold
76 FR 5161 - Determination Regarding National Appraisal Complaint Hotline
Federal Register 2010, 2011, 2012, 2013
...Hotline AGENCY: Appraisal Subcommittee (ASC) of the Federal Financial Institutions...Council. ACTION: Determination by the ASC regarding a national appraisal complaint...2010 (Act), the Appraisal Subcommittee (ASC) has determined that no one national...
40 CFR 135.4 - Service of complaint.
Code of Federal Regulations, 2013 CFR
...PROTECTION AGENCY (CONTINUED) WATER PROGRAMS PRIOR NOTICE OF CITIZEN SUITS Prior Notice Under the Clean Water Act § 135.4 Service of complaint...under section 505(a)(1) of the Act to the Administrator of the...
25 CFR 141.59 - Customer complaint procedures.
Code of Federal Regulations, 2011 CFR
...AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES BUSINESS PRACTICES ON THE NAVAJO, HOPI AND ZUNI RESERVATIONS Enforcement Powers, Procedures and Remedies § 141.59 Customer complaint procedures. (a) Any customer of a licensee...
Are prescribed medications effective in the treatment of insomnia complaints?
Although frequently investigated in the general population, the epidemiology of insomnia complaints and their treatment have received little attention in general practice. This study recruited patients ?15 years of age, consecutively, from 127 general practitioners in France. The physicians collected data from 11,810 of their patients, of whom 55.5% were women. Insomnia complaints were reported by 26.2% (25.4% to 27%)
Maurice M Ohayon; M Caulet; L Arbus; M Billard; A Coquerel; J.-D Guieu; B Kullmann; F Laffont; P Lemoine; J Paty; J. C Pechadre; M.-F Vecchierini; H Vespignani
Pain in Parkinson's Disease Associated with COMT Gene Polymorphisms
Background. PD patients present high incidence of pain with unknown pathogenesis. Objective. We investigated the relation of COMT polymorphisms rs4633 and rs6267 with PD pain. Subjects and Methods. One hundred PD patients and 105 controls were evaluated with simplified Mc GILL pain scale and VAS scale. PD patients were assessed with H&Y grade, UPDRS score, and HAMD scale. Polymorphisms rs4633 and rs6267 were detected by PCR and direct sequencing. Results. Fifty-seven percent of PD patients experienced pain, consisting of PD-related pain (64.91%) (the majority was dystonia pain) and non-PD-related pain (35.09%) (psychogenic pain was most frequent). The frequency of rs6267 genotype "GT/TT" and allele "T" was higher in PD pain. No difference was observed in frequencies of rs4633 between PD pain and without pain. UPDRS and depression score were higher in PD pain. The onset age was earlier in PD-related pain (57.43 ± 19.71) than non-PD-related pain (63.36 ± 6.88). Conclusion. PD patients possess a high prevalence of pain. Dystonia pain was the most frequent type of PD-related pain. COMT gene rs6267 allele "T" associated with PD pain. PD pain was influenced by disease severity and depression. PD onsets earlier in patients with PD-related pain than non-PD-related pain.
Li, Wanjun; Chen, Yongqian; Yin, Bowen; Zhang, Limei
Anterior knee pain is the most common knee complaint. It may be due to a variety of soft tissue or osseous abnormalities. Knowledge of the radiologic appearance of the abnormalities allows more accurate diagnosis of the cause of the pain including chondral abnormalities, patellar instability and dislocation, femoral trochlear dysplasia, abnormal patellar location, bipartite patella, various tendinopathies, bursal inflammation, traction apophysitis in pediatric and adolescent patients, and miscellaneous diseases including mediopatellar plica syndrome and Hoffa's disease. Radiographs are often obtained to exclude acute osseous abnormalities, such as fractures. Magnetic resonance (MR) imaging offers superior soft tissue contrast resolution and allows for more accurate evaluation of the underlying etiology and therefore may improve treatment and possible surgical planning. PMID:24473994
Samim, Mohammad; Smitaman, Edward; Lawrence, David; Moukaddam, Hicham
Parents' Experiences of Pain and Discomfort in People with Learning Disabilities
ERIC Educational Resources Information Center
There are few measures of pain for people with limited ability to communicate. Eight parents of adults with a known learning disability and associated physical health complaint were interviewed to explore their experience of identifying and managing the pain felt by their children. The parents did not often perceive their son or daughter to be in…
Clarke, Zara Jane; Thompson, Andrew R.; Buchan, Linda; Combes, Helen
Latent Variable Analysis of Coping, Anxiety\\/Depression, and Somatic Symptoms in Adolescents With Chronic Pain
Reports of adolescents' coping with recurrent pain, symptoms of anxiety\\/depression, and somatic complaints were obtained from a sample of 164 adolescents with recurrent abdominal pain and their parents. Confirmatory factor analysis revealed that coping consisted of 3 nonorthogonal factors: Primary Control Engagement Coping (problem solving, emotional expression, and emotional regulation), Secondary Control Engagement Coping (positive thinking, cognitive restructuring, acceptance, and
Bruce E. Compas; Margaret C. Boyer; Catherine Stanger; Richard B. Colletti; Alexandra H. Thomsen; Lynette M. Dufton; David A. Cole
Muscle fatigue in relation to forearm pain and tenderness among professional computer users
BACKGROUND: To examine the hypothesis that forearm pain with palpation tenderness in computer users is associated with increased extensor muscle fatigue. METHODS: Eighteen persons with pain and moderate to severe palpation tenderness in the extensor muscle group of the right forearm and twenty gender and age matched referents without such complaints were enrolled from the Danish NUDATA study of neck
Gert F Thomsen; Pete W Johnson; Susanne W Svendsen; Ann I Kryger; Jens Peter E Bonde
Adult Outcomes of Pediatric Recurrent Abdominal Pain: Do They Just Grow Out of It?
Objective. To determine whether medi- cally unexplained recurrent abdominal pain (RAP) in childhood predicts abdominal pain, irritable bowel syn- drome (IBS), other somatic complaints, and psychiatric symptoms and disorders in young adulthood. Methods. A sample of 28 young adults evaluated for RAP between the ages of 6 and 17 years were compared with 28 individually matched former childhood partici- pants
John V. Campo; Carlo Di Lorenzo; Laurel Chiappetta; D. Kathleen Colborn; J. Carlton Gartner; Paul Gaffney; Samuel Kocoshis; David Brent
Latent Variable Analysis of Coping, Anxiety/Depression, and Somatic Symptoms in Adolescents with Chronic Pain
ERIC Educational Resources Information Center
Reports of adolescents' coping with recurrent pain, symptoms of anxiety/depression, and somatic complaints were obtained from a sample of 164 adolescents with recurrent abdominal pain and their parents. Confirmatory factor analysis revealed that coping consisted of 3 nonorthogonal factors: Primary Control Engagement Coping (problem solving,…
Compas, Bruce E.; Boyer, Margaret C.; Stanger, Catherine; Colletti, Richard B.; Thomsen, Alexandra H.; Dufton, Lynette M.; Cole, David A.
Lean Body Mass and Body Fat Distribution in Participants With Chronic Low Back Pain
Background: Loss of muscle mass and central obesity progress with aging, but the effect of muscle loss on chronic low back pain has not been precisely evaluated. Methods: Three hundred thirty Japanese persons aged 45 to 69 years, with a complaint of low back pain for longer than 3 months (n =2 03) and age- and sex- matched healthy control
Yoshitaka Toda; Neil Segal; Tamami Toda; Tadanobu Morimoto; Ryokei Ogawa
Changes in health complaints after removal of amalgam fillings.
The aim of the present study was to investigate whether removal of all amalgam fillings was associated with long-term changes in health complaints in a group of patients who attributed subjective health complaints to amalgam fillings. Patients previously examined at the Norwegian Dental Biomaterials Adverse Reaction Unit were included in the study and assigned to a treatment group (n = 20) and a reference group (n = 20). Participants in the treatment group had all amalgam fillings replaced with other restorative materials. Follow-ups took place 3 months, 1 and 3 years after removal of all amalgam fillings. There was no intervention in the reference group. Subjective health complaints were measured by numeric rating scales in both groups. Analysis of covariance was used to compare changes in health complaints over time in the two groups. In the treatment group, there were significant reductions in intra-oral and general health complaints from inclusion into study to the 3-year follow-up. In the reference group, changes in the same period were not significant. Comparisons between the groups showed that reductions in intra-oral and general health complaints in the treatment group were significantly different from the changes in the reference group. The mechanisms behind this remain to be identified. Reduced exposure to dental amalgam, patient-centred treatment and follow-ups, and elimination of worry are factors that may have influenced the results. PMID:21517933
Sjursen, T T; Lygre, G B; Dalen, K; Helland, V; Laegreid, T; Svahn, J; Lundekvam, B F; Björkman, L
Focal epilepsy with ictal abdominal pain: a case report.
Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed us to make a diagnosis of focal epilepsy with ictal abdominal pain. This is a rare epileptic phenomenon that should be suspected in patients with unexplained paroxysmal abdominal pain and migraine-like symptoms. We suggest that, after the exclusion of more common etiologies, focal epilepsy with ictal abdominal pain should be considered in patients with paroxysmal abdominal pain and ictal EEG abnormalities. PMID:24321431
Cerminara, Caterina; El Malhany, Nadia; Roberto, Denis; Curatolo, Paolo
Neuropathic pain is triggered by lesions to the somatosensory nervous system that alter its structure and function so that pain occurs spontaneously and responses to noxious and innocuous stimuli are pathologically amplified. The pain is an expression of maladaptive plasticity within the nociceptive system, a series of changes that constitute a neural disease state. Multiple alterations distributed widely across the nervous system contribute to complex pain phenotypes. These alterations include ectopic generation of action potentials, facilitation and disinhibition of synaptic transmission, loss of synaptic connectivity and formation of new synaptic circuits, and neuroimmune interactions. Although neural lesions are necessary, they are not sufficient to generate neuropathic pain; genetic polymorphisms, gender, and age all influence the risk of developing persistent pain. Treatment needs to move from merely suppressing symptoms to a disease-modifying strategy aimed at both preventing maladaptive plasticity and reducing intrinsic risk.
Costigan, Michael; Scholz, Joachim; Woolf, Clifford J.
Pain with mammography: fact or fiction?
This article presents an overview of current knowledge about mammography-related pain and discomfort. Possible causes of pain and discomfort are discussed along with the results of two pilot studies that investigated the prevalence and severity of pain and discomfort associated with film-screen mammograms in a mobile screening program. Based on these studies, the authors conclude that pain is a problem for a significant number of women from diverse ethnic and socioeconomic backgrounds. A nursing care plan is provided to assist nurses in reducing mammography-related pain and discomfort. PMID:8321705
Nielsen, B; Miaskowski, C; Dibble, S L
Challenges of the pregnant athlete and low back pain.
Low back pain during pregnancy is a common problem with a high prevalence among pregnant athletes. The etiology of pregnancy-related low back pain remains unclear, although more evidence is supporting a biomechanical/musculoskeletal origin. This article will review the causes of low back pain in athletes and pregnant women, differentiate low back from pelvic girdle pain, and discuss the treatment and prevention of pregnancy-related low back and pelvic girdle pain. PMID:22236825
Noon, Megan L; Hoch, Anne Z
Spinal Cord Mechanisms of Chronic Pain and Clinical Implications
Chronic pain is a prevalent and challenging problem for most medical practitioners. Because of the complex pathologic mechanisms\\u000a involved in chronic pain, optimal treatment is still under development. The spinal cord is an important gateway for peripheral\\u000a pain signals transmitted to the brain. In chronic pain states, painful stimuli trigger afferent fibers in the dorsal horn\\u000a to release neuropeptides and
Hsinlin Thomas Cheng
Non-invasive brain stimulation techniques for chronic pain in adults
Description of the condition: Chronic pain is a common problem. When defined as pain of greater than three months duration, prevalence studies indicate that up to half the adult population suffer from chronic pain, and 10 to 20% experience clinically significant chronic pain (Smith 2008). In Europe 19% of adults experience chronic pain of moderate to severe intensity with serious
Neil E OConnell; Benedict M Wand; Louise Marston; Sally Spencer; Lorraine H De Souza
Cross-sectional assessment of pain and physical function in skeletal dysplasia patients.
Short stature skeletal dysplasia (SD) patients have orthopedic and neurologic complications causing significant pain and physical disability. We conducted a large cross-sectional online survey in 361 people with short stature SD (>10?years) to describe pain prevalence, characteristics, and the relationship between pain and function. Chronic pain prevalence per Brief Pain Inventory (BPI) was 70.3%. Women reported more pain than men (73% vs 63% p?=?0.04). Pain Severity Score (average of current, worst, least and average pain) averaged 3.3?±?2, while the Pain Interference Score (with daily activities) averaged 3.4?±?2.7 on a 10-point scale. Per Bleck scale, 20.5% had little or no functional capacity. Increasing age and decreased ambulation independently predicted chronic pain. Chronic pain is prevalent in short stature SD patients and associated with poor physical function. Further study is required to clarify the temporal relationship among pain, function and treatments. PMID:23106480
Alade, Y; Tunkel, D; Schulze, K; McGready, J; Jallo, G; Ain, M; Yost, T; Hoover-Fong, J
[Greater trochanteric pain syndrome of the hip].
Lateral pain of the hip with point tenderness at the Greater Trochanter is a common musculoskeletal complaint. It is frequently diagnosed as trochanteric bursitis; however, this term is inaccurate because of evident non-inflammatory pathologies, particularly of the abductor tendons of the hip. It is important to differentiate this extra-articular source from an intra-articular or a lower back source of pain. Imaging is useful in cases of trauma, prolonged pain or uncertain diagnosis. Non-operative treatment that involves modifying activities, physiotherapy, analgesics, steroid injections and shock wave therapy is usually helpful. Nevertheless, despite the above treatments, about one third of the patients suffer from chronic pain and disability. These patients may be candidates for operative intervention. Currently, there are endoscopic surgical techniques for local decompression, bursectomy and suture of torn tendons similar to surgery used in the shoulder. PMID:24716427
Haviv, Barak; Bronak, Shlomo; Thein, Rafael
The end of antibiotic treatment in adults with acute sinusitis-like complaints in general practice? A placebo-controlled double-blind randomized doxycycline trial.
BACKGROUND: Acute sinusitis-like complaints are very common and are usually treated with antibiotics in spite of the lack of evidence for the effectiveness of antibiotic therapy and the increasing number of resistant strains. AIM: To assess the effectiveness of doxycycline in adults with acute sinusitis-like complaints in general practice. METHOD: The effects of doxycycline in a placebo-controlled, double-blind, randomized trial were assessed in adults consulting their general practitioner (GP) with complaints after a common cold or influenza, pain in the head when bending forward, purulent nasal discharge, predominantly unilateral maxillary pain, toothache, or pain when chewing. Primary outcome events were the resolution of facial pain and the resumption of daily activities. Treatment differences were assessed by means of Kaplan-Meier curves and hazard ratios. The follow-up period was 42 days. RESULTS: No significant difference was found in time to recover between the doxycycline-treated group and the placebo-treated group. However, the adjusted hazard ratio for the group receiving doxycycline was 1.17 (95% CI = 0.87-1.57) for the resolution of pain and 1.31 (95% CI = 0.96-1.78) for the resumption of daily activities. After 10 days, 85% of all patients reported improvement and 60% were completely cured. Side effects were reported by 17% of the doxycycline-treated group, with two patients withdrawing because of side effects. CONCLUSIONS: Data from this study indicate that doxycycline does not add to the effectiveness of decongestive nose drops and steam inhalation in treating acute sinusitis-like complaints in general practice adults.
Stalman, W; van Essen, G A; van der Graaf, Y; de Melker, R A
Common Gastrointestinal Complaints in Older Adults
\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Medication effects and specific dietary factors, such as acid and foods lowering esophageal sphincter pressure, require special\\u000a attention in older adults with esophageal and gastric disorders.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a The high prevalence of atrophic gastritis in older adults increases the risk for vitamin B12 malabsorption and deficiency.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Evaluation of both diarrhea and constipation requires a thorough history (paying attention to
Stephen A. McClave
Overweight and obesity are associated with musculoskeletal complaints as early as childhood: a systematic review.
In order to examine (i) the association between weight status and musculoskeletal complaints (MSC) in children, and (ii) whether overweight and obese children have a higher risk of developing MSC than normal-weight children Medline, Embase, Web of Science and Cochrane were searched (all years up to 2 January 2013) for observational studies studying direct associations between body mass index (or weight status) and MSC in children. Forty studies, together studying over one million children, were included. There was moderate quality of evidence that being overweight in childhood is positively associated with musculoskeletal pain (risk ratio [RR] 1.26; 95% confidence interval [CI]: 1.09-1.45). In addition, low quality of evidence was found for a positive association between overweight and low back pain (RR 1.42; 95% CI: 1.03-1.97) and between overweight and injuries and fractures (RR 1.08; 95% CI: 1.03-1.14). Although the risk of developing an injury was significantly higher for overweight than for normal-weight adolescents (RR: 2.41, 95% CI: 1.42 to 4.10), this evidence was of very low quality. Overweight and obesity are associated with musculoskeletal pain, injuries and fractures as early as childhood. More high-quality prospective cohort studies are needed to study the nature of this relationship. PMID:23941399
Paulis, W D; Silva, S; Koes, B W; van Middelkoop, M
Characteristics of complaints resulting in disciplinary actions against Danish GPs
Abstract Objective The risk of being disciplined in connection with a complaint case causes distress to most general practitioners. The present study examined the characteristics of complaint cases resulting in disciplinary action. Material and methods The Danish Patients' Complaints Board's decisions concerning general practice in 2007 were examined. Information on the motives for complaining, as well as patient and general practitioner characteristics, was extracted and the association with case outcome (disciplinary or no disciplinary action) was analysed. Variables included complaint motives, patient gender and age, urgency of illness, cancer diagnosis, healthcare settings (daytime or out-of-hours services), and general practitioner gender and professional seniority. Results Cases where the complaint motives involved a wish for placement of responsibility (OR = 2.35, p = 0.01) or a wish for a review of the general practitioner's competence (OR = 1.95, p = 0.02) were associated with increased odds of the general practitioner being disciplined. The odds of discipline decreased when the complaint was motivated by a feeling of being devalued (OR = 0.39, p = 0.02) or a request for an explanation (OR = 0.46, p = 0.01). With regard to patient and general practitioner characteristics, higher general practitioner professional seniority was associated with increased odds of discipline (OR = 1.97 per 20 additional years of professional seniority, p = 0.01). None of the other characteristics was statistically significantly associated with discipline in the multiple logistic regression model. Conclusion Complaint motives and professional seniority were associated with decision outcomes. Further research is needed on the impact of professional seniority on performance.
Pain in cognitively impaired nursing home patients
Pain is an understudied problem in frail elderly patients, especially those with cognitive impairment, delirium, or dementia. The focus of this study was to describe the pain experienced by patients in skilled nursing homes, which have a high prevalence of cognitive impairment. A random sample of 325 subjects was selected from ten community skilled nursing homes. Subjects underwent a cross-sectional
Bruce A. Ferrell; Betty R. Ferrell; Lynne Rivera
Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 208 patients with orofacial pain
Introduction The purpose of this study was to assess the structural characteristics of styloid process (SP) by cone-beam computed tomography (CBCT) examination in a patient population suffering from orofacial pain. The second aim was to assess the prevalence of elongated SP and its relation to gender, site and subjective symptoms in the study population. Methods Clinical and radiographic records of 208 patients were evaluated retrospectively. Radiological examinations including measurements of the structure, length, and medial angulations of SP were performed on CBCT images. Results Out of 208 patients, 96 (46%) had not-elongated SP, 28 (13%) had left side, 16 (8%) had right side, and 68 (33%) had bilateral elongation of SP. The patients with elongated SP had significantly decreased angle values. There were no statistically significant differences in length values of SP between males and females in both groups. Significantly increased prevalence of symptoms except headache was observed in patients with elongated SP. Conclusions This study presents the CBCT as an alternative method to CT or panoramic radiographs for the measurement and the assessment of the styloid process. Patients suffering from orofacial pain, who also had elongated SP, had increased rate of corresponding neurological complaints compared with non-elongated ones.
Medications for neuropathic pain: current trends
Neuropathic pain is by definition a chronic pain condition that occurs and persists in a heterogeneous group of aetiologically\\u000a different diseases characterised by a primary lesion or dysfunction of the peripheral or central nervous system. Neuropathic\\u000a pain has an important prevalence in the general population, and a severe impact on quality of life and mood of affected patients.\\u000a Therapy is
B. Colombo; P. O. L. Annovazzi; G. Comi
Pain, which afflicts up to 20% of the population at any time, provides both a massive therapeutic challenge and a route to understanding mechanisms in the nervous system. Specialised sensory neurons (nociceptors) signal the existence of tissue damage to the central nervous system (CNS), where pain is represented in a complex matrix involving many CNS structures. Genetic approaches to investigating
Tom Foulkes; John N. Wood
Low Back Pain in Young Athletes
Context Low back pain in young athletes is a common complaint and should be taken seriously. It frequently results from a structural injury that requires a high degree of suspicion to diagnose and treat appropriately. Evidence Acquisition A Medline search was conducted from 1996 to May 2008 using the search terms "low back pain in children" and "low back pain in athletes." Known texts on injuries in young athletes were also reviewed. References in retrieved articles were additionally searched for relevant articles. Sources were included if they contained information regarding diagnosis and treatment of causes of low back pain in children. Results Low back pain is associated with sports involving repetitive extension, flexion, and rotation, such as gymnastics, dance, and soccer. Both acute and overuse injuries occur, although overuse injuries are more common. Young athletes who present with low back pain have a high incidence of structural injuries such as spondylolysis and other injuries to the posterior elements of the spine. Disc-related pathology is much less common. Simple muscle strains are much less likely in this population and should be a diagnosis of exclusion only. Conclusion Young athletes who present with low back pain are more likely to have structural injuries and therefore should be investigated fully. Muscle strain should be a diagnosis of exclusion. Treatment should address flexibility and muscle imbalances. Injuries can be prevented by recognizing and addressing risk factors. Return to sport should be a gradual process once the pain has resolved and the athlete has regained full strength.
Purcell, Laura; Micheli, Lyle
Postoperative sleep disruptions: a potential catalyst of acute pain?
Despite the substantial advances in the understanding of pain mechanisms and management, postoperative pain relief remains an important health care issue. Surgical patients also frequently report postoperative sleep complaints. Major sleep alterations in the postoperative period include sleep fragmentation, reduced total sleep time, and loss of time spent in slow wave and rapid eye movement sleep. Clinical and experimental studies show that sleep disturbances may exacerbate pain, whereas pain and opioid treatments disturb sleep. Surgical stress appears to be a major contributor to both sleep disruptions and altered pain perception. However, pain and the use of opioid analgesics could worsen sleep alterations, whereas sleep disruptions may contribute to intensify pain. Nevertheless, little is known about the relationship between postoperative sleep and pain. Although the sleep-pain interaction has been addressed from both ends, this review focuses on the impact of sleep disruptions on pain perception. A better understanding of the effect of postoperative sleep disruptions on pain perception would help in selecting patients at risk for more severe pain and may facilitate the development of more effective and safer pain management programs. PMID:24074687
Chouchou, Florian; Khoury, Samar; Chauny, Jean-Marc; Denis, Ronald; Lavigne, Gilles J
Sexual dysfunction in type III chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) observed in Turkish patients
Aim Chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) is a common disabling condition that is primarily associated\\u000a with pain in the urogenital region and disturbances in urinary and sexual function. Chronic pelvic pain symptoms are the most\\u000a common presentation, especially perineal, lower abdominal, testicular, penile as well as ejaculatory pain. Other genitourinary\\u000a tract complaints include voiding disorders and sexual
N. C. SonmezM; M. C. Kiremit; S. Güney; S. Arisan; O. Akça; A. Dalk?l?ç
Marital Complaints, Demographic Characteristics, and Symptoms of Mental Distress in Divorce.
ERIC Educational Resources Information Center
Explored patterns of marital complaints in a sample of 209 divorcing men and women. Used two codes of complaints. Results indicated that marital complaints varied over time and by sex, education, social class, length of marriage, and income. Some complaints were correlated with symptoms of mental health disturbance. (Author/RC)
Kitson, Gay C.; Sussman, Marvin B.
Systems Genetics of Chronic Pain.
National Technical Information Service (NTIS)
Chronic pain is among the most prevalent health problems in the United States today, affecting 10% of the population and costing the U.S. billions of dollars each year in health care expenses, lost income, and lost productivity. Genetic differences among ...
C. J. Bult
Referred speech-language and hearing complaints in the western region of S?o Paulo, Brazil
OBJECTIVE: The aim of this study was to characterize the epidemiological profile of the population attending primary health care units in the western region of the city of Săo Paulo, Brazil, highlighting referred speech-language and hearing complaints. METHOD: This investigation was a cross-sectional observational study conducted in primary health care units. Household surveys were conducted and information was obtained from approximately 2602 individuals, including (but not limited to) data related to education, family income, health issues, access to public services and access to health services. The speech-language and hearing complaints were identified from specific questions. RESULTS: Our results revealed that the populations participating in the survey were heterogeneous in terms of their demographic and economic characteristics. The prevalence of referred speech-language and hearing complaints in this population was 10%, and only half the users of the public health system in the studied region who had complaints were monitored or received specific treatment. CONCLUSIONS: The results demonstrate the importance of using population surveys to identify speech-language and hearing complaints at the level of primary health care. Moreover, these findings highlight the need to reorganize the speech-language pathology and audiology service in the western region of Săo Paulo, as well as the need to improve the Family Health Strategy in areas that do not have a complete coverage, in order to expand and improve the territorial diagnostics and the speech-language pathology and audiology actions related to the prevention, identification, and rehabilitation of human communication disorders.
Samelli, Alessandra Giannella; Rondon, Silmara; Oliver, Fatima Correa; Junqueira, Simone Renno; Molini-Avejonas, Daniela Regina
Assessment of pain in the neonate.
Accurate pain assessment in preterm and term neonates in the neonatal intensive care unit (NICU) is of vital importance because of the high prevalence of painful experiences in this population, including both daily procedural pain and postoperative pain. Over 40 tools have been developed to assess pain in neonates, and each NICU should choose a limited number of pain assessment tools for different populations and contexts. Only two pain assessment tools have a metric adjustment to account for differences of pain assessment in prematurity. Preterm neonates do not display behavior and physiologic indicators of pain as reliably and specifically as full term infants, and preterm infants are vulnerable to long term sequelae of painful experiences. "Brain-oriented" approaches for more objective measurement of pain in neonates may become available in the future. In the meantime, neonatal pain assessment tools need to be taught, implemented, and their ongoing use optimized to form a consistent, reproducible basis for the safe and effective treatment of neonatal pain. PMID:23972751
Maxwell, Lynne G; Malavolta, Carrie P; Fraga, Maria V
Interprovider variation of celiac disease testing in childhood chronic abdominal pain
Background To determine within one tertiary care center: 1) the variation between providers in testing for celiac disease in children with chronic abdominal pain; 2) the characteristics of those children who were more likely to be tested, and 3) the prevalence of celiac disease in those evaluated. Methods Retrospective review of children with a primary complaint of chronic abdominal pain referred to a tertiary care children's hospital for pediatric gastroenterology evaluation over a 2-year period was conducted. Children with at least two visits and without an identified organic etiology for the pain were included. Results 160 children were evaluated by 16 pediatric gastroenterologists and one nurse practitioner. Celiac serologic testing was completed in 63 (39.4%) children. There was no significant variance in the frequency of celiac serologic testing between providers. Child age, gender, body mass index, and baseline gastrointestinal symptoms did not predict whether celiac serologic testing occurred, though Caucasians (P?0.01) were more likely to be tested. Eighty-two (51.3%) children underwent either serologic testing and/or esophagogastroduodenoscopy. Four (4.9%, 95% CI: 1.6-11.3%) of the 82 tested were diagnosed with celiac disease. Conclusions Though interprovider variation for celiac disease testing in children with chronic abdominal pain did not occur, a large number of these children were not evaluated for celiac disease. Children's race/ethnicity but not their associated gastrointestinal symptoms predicted whether celiac testing was undertaken. In those tested, celiac disease was identified in a higher percentage than that expected in the general population.
The profile of patients' complaints in a regional hospital
Background: A hospital should be an institution of understanding and respecting patients' rights, their families, physicians and other caregivers. Hospitals and all other healthcare centers must be cautious toward respecting ethical aspects of care and treatment. On the other hand, patients' satisfaction reflects capabilities of physicians and medical staff as well as the extent patients' rights and treatment quality are observed. Nowadays, complaints handling is considered as an essential component of healthcare system in line with promoting health standards. In the present study, researchers attempt to identify the resources, individuals, complained issues, and measures which are considered to handle these issues in a regional hospital. Methods: We employed a descriptive, cross-sectional study to conduct this research. The research population included cases registered at the complaints unit of one of the hospitals in Isfahan in selected months of 2012 to 2013. The data were collected through observation of available documents. Excel software program was used for data analysis. Results: Findings indicate that despite a decrease in the total number of complaints, there was an increase in the number of complaints about medical staff. Nursing staff were considered as the second highly complained unit during the study period. Conclusion: Results obtained from the present study can be taken as experiences to modify and amend the hospital's future performance. In general, the existence of complaints in a system is an indication of gaps when providing healthcare services. Creating an organized system to collect complaints and reviewing them helps hospitals to be cognizant of their defects and plan to prevent their reoccurrence.
Jabbari, Alireza; Khorasani, Elahe; Jafarian Jazi, Marzie; Mofid, Maryam; Mardani, Raja
The profile of patients' complaints in a regional hospital.
Background: A hospital should be an institution of understanding and respecting patients' rights, their families, physicians and other caregivers. Hospitals and all other healthcare centers must be cautious toward respecting ethical aspects of care and treatment. On the other hand, patients' satisfaction reflects capabilities of physicians and medical staff as well as the extent patients' rights and treatment quality are observed. Nowadays, complaints handling is considered as an essential component of healthcare system in line with promoting health standards. In the present study, researchers attempt to identify the resources, individuals, complained issues, and measures which are considered to handle these issues in a regional hospital. Methods: We employed a descriptive, cross-sectional study to conduct this research. The research population included cases registered at the complaints unit of one of the hospitals in Isfahan in selected months of 2012 to 2013. The data were collected through observation of available documents. Excel software program was used for data analysis. Results: Findings indicate that despite a decrease in the total number of complaints, there was an increase in the number of complaints about medical staff. Nursing staff were considered as the second highly complained unit during the study period. Conclusion: Results obtained from the present study can be taken as experiences to modify and amend the hospital's future performance. In general, the existence of complaints in a system is an indication of gaps when providing healthcare services. Creating an organized system to collect complaints and reviewing them helps hospitals to be cognizant of their defects and plan to prevent their reoccurrence. PMID:24757690
Jabbari, Alireza; Khorasani, Elahe; Jafarian Jazi, Marzie; Mofid, Maryam; Mardani, Raja
The prevalence of soft tissue rheumatism
The prevalence of various forms of soft tissue rheumatism, including painful low back syndrome (PLBS), painful restricted shoulder syndrome (PRSS), and epicondylitis without an underlying specific rheumatic disease, and the resultant loss of time from work were determined in a total population of 4,683 rural and 1,103 urban subjects aged 15 years and over in Central Java, Indonesia. In the
J. Darmawan; H. A. Valkenburg; K. D. Muirden; R. D. Wigley
Relation of chronotype to sleep complaints in the general Finnish population.
Individuals show variation in their preference for the daily timing of activities. In this study the authors analyzed whether chronotypes associate with sleep duration and sleep-related complaints. The authors used the National FINRISK Study 2007 Survey data on 3696 women and 3162 men, representative of the Finnish population aged 25 yrs and older, for the assessment of chronotype and self-reported sleep. Evening types experienced insomnia symptoms, had nightmares, and had used recently hypnotics significantly more often than other chronotypes among both men and women. In a multinominal logistic regression model predicting insufficient sleep, the association of eveningness with insufficient sleep was not abolished after adjustment for sex, age, and sleep duration. The prevalence of short sleepers was significantly higher in evening types among men than among women, whereas that of long sleepers was significantly higher in evening types among both men and women, as compared with the other chronotypes. These results indicate that eveningness predisposes individuals to a range of sleep complaints. PMID:22390244
Merikanto, Ilona; Kronholm, Erkki; Peltonen, Markku; Laatikainen, Tiina; Lahti, Tuuli; Partonen, Timo
... or damaged. This condition is called rotator cuff tendinitis . Shoulder pain may also be caused by: Arthritis ... recommend such exercises. If you are recovering from tendinitis, continue to do range-of-motion exercises to ...
... simple and inexpensive, and works for some kids. Peppermint oil enteric-coated capsules often decrease pain in ... effective than adding fiber alone [6] . Enteric-coated peppermint oil While this study found that fiber and ...
... damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact ... this short relaxation experience, you may want to send for the longer audio version, available in our ...
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MedlinePLUS Videos and Cool Tools
... protective mechanism, alerting it to potential or actual damage to the body's tissues. In the example of ... the pain receptors in the skin detect tissue damage from the bee sting. Then, the peripheral nerves ...
Lung carcinoma presenting as mechanical back pain: a case report
The case describes a female patient with squamous cell carcinoma of the lung who initially presented with mechanical upper-back and neck pain. She had been successfully treated with spinal manipulation for a similar complaint one year earlier, a factor that decreased the suspicion of pathological process on her second presentation. Serious disease as the cause of back pain must be considered in cases with certain historical factors, or when the patient fails to respond to treatment for mechanical back pain. ImagesFigure 1Figure 3
Bougie, Jacqueline D; Burns, Stephen H
Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association - www.theacpa.org National Fibromyalgia and Chronic Pain Association - www.fmcpaware.org ...
Education On Prehospital Pain Management: A Follow-Up Study
Introduction: The most common reason patients seek medical attention is pain. However, there may be significant delays in initiating prehospital pain therapy. In a 2001 quality improvement (QI) study, we demonstrated improvement in paramedic knowledge, perceptions, and management of pain. This follow-up study examines the impact of this QI program, repeated educational intervention (EI), and effectiveness of a new pain management standard operating procedure. Methods: 176 paramedics from 10 urban and suburban fire departments and two private ambulance services participated in a 3-hour EI. A survey was performed prior to the EI and repeated one month after the EI. We reviewed emergency medical services (EMS) runs with pain complaints prior to the EI and one month after the EI. Follow-up results were compared to our prior study. We performed data analysis using descriptive statistics and chi-square tests. Results: The authors reviewed 352 surveys and 438 EMS runs with pain complaints. Using the same survey questions, even before the EI, 2007 paramedics demonstrated significant improvement in the knowledge (18.2%; 95% CI 8.9%, 27.9%), perceptions (9.2%; 95% CI 6.5%, 11.9%), and management of pain (13.8%; 95% CI 11.3%, 16.2%) compared to 2001. Following EI in 2007, there were no significant improvements in the baseline knowledge (0%; 95% CI 5.3%, 5.3%) but significant improvements in the perceptions of pain principles (6.4%; 95% CI 3.9%, 9.0%) and the management of pain (14.7%; 95% CI 11.4%, 18.0%). Conclusion: In this follow up study, paramedics' baseline knowledge, perceptions, and management of pain have all improved from 6 years ago. Following a repeat educational intervention, paramedics further improved their field management of pain suggesting paramedics will still benefit from both initial and also ongoing continuing education on the topic of pain management.
French, Scott C.; Chan, Shu B.; Ramaker, Jill
The relationship between symptoms of post-traumatic stress disorder and pain, affective disturbance and disability among patients with accident and non-accident related pain
Recent studies have reported a high prevalence of symptoms of post-traumatic stress disorder (PTSD) among individuals with chronic pain. Studies suggest that persons with pain and PTSD also display higher levels of affective disturbance. In the present study we examined self-reports of pain, affective disturbance, and disability among pain patients with and without symptoms of PTSD. Patients without PTSD symptoms
Michael E. Geisser; Randy S. Roth; Jan E. Bachman; Thomas A. Eckert
Risk indicators in low back pain.
Injuries leading to low back pain can occur by direct trauma, overexertion or repetitive trauma. Overexertion is claimed by 60% of low back pain patients as the cause of injury. Of these patients with overexertion injuries, 66% implicated lifting and 20% pushing or pulling. It is, however, difficult to relate the workplace to the complaint of low back pain in a specific worker, and low back pain is found quite often in those with sedentary occupations. The incidence, severity and potential disability are all related to the demands on the individual in the workplace. Among the factors implicated are the requirements for lifting (particularly when compared to the worker's lifting capacity), pushing and pulling, posture, and cyclic loading. Drivers of heavy vehicles have two to four times the average incidence of serious low back pain. This is probably due to the cyclic loading environment. The general psychosocial environment (including that at work) is an important risk factor. The first attack of low back pain occurs in the teens or twenties. Low back pain is as frequent in females as males, although women in manual materials handling jobs are at greater risk. Posture, anthropometry and mobility measures have limited prognostic value. Muscle strength and physical fitness probably have some value. Radiographic findings have little pragmatic value. PMID:2532529
Pope, M H
Pain-QuILT: Clinical Feasibility of a Web-Based Visual Pain Assessment Tool in Adults With Chronic Pain
Background Chronic pain is a prevalent and debilitating problem. Accurate and timely pain assessment is critical to pain management. In particular, pain needs to be consistently tracked over time in order to gauge the effectiveness of different treatments. In current clinical practice, paper-based questionnaires are the norm for pain assessment. However, these methods are not conducive to capturing or tracking the complex sensations of chronic pain. Pain-QuILT (previously called the Iconic Pain Assessment Tool) is a Web-based tool for the visual self-report and tracking of pain (quality, intensity, location, tracker) in the form of time-stamped records. It has been iteratively developed and evaluated in adolescents and adults with chronic pain, including usability testing and content validation. Clinical feasibility is an important stepping-stone toward widespread implementation of a new tool. Our group has demonstrated Pain-QuILT clinical feasibility in the context of a pediatric chronic pain clinic. We sought to extend these findings by evaluating Pain-QuILT clinical feasibility from the perspective of adults with chronic pain, in comparison with standard paper-based methods (McGill Pain Questionnaire [MPQ] and Brief Pain Inventory [BPI]). Objective The goal of our study was to assess Pain-QuILT for (1) ease of use, (2) time for completion, (3) patient preferences, and (4) to explore the patterns of self-reported pain across the Pain-QuILT, MPQ, and BPI. Methods Participants were recruited during a scheduled follow-up visit at a hospital-affiliated pain management and physical rehabilitation clinic in southwestern Ontario. Participants self-reported their current pain using the Pain-QuILT, MPQ, and BPI (randomized order). A semistructured interview format was used to capture participant preferences for pain self-report. Results The sample consisted of 50 adults (54% female, 27/50) with a mean age of 50 years. Pain-QuILT was rated as significantly easier to use than both the MPQ and BPI (P<.01) and was also associated with the fewest difficulties in completion. On average, the time to complete each tool was less than 5 minutes. A majority of participants (58%, 29/50) preferred Pain-QuILT for reporting their pain over alternate methods (16%, 8/50 for MPQ; 14%, 7/50 for BPI; 12%, 6/50 for "other"). The most commonly chosen pain descriptors on MPQ were matched with Pain-QuILT across 91% of categories. There was a moderate-to-high correlation between Pain-QuILT and BPI scores for pain intensity (r=.70, P<.01). Conclusions The results of this clinical feasibility study in adults with chronic pain are consistent with our previously published pediatric findings. Specifically, data indicate that Pain-QuILT is (1) easy to use, (2) quick to complete, (3) preferred by a majority of patients, and (4) correlated as expected with validated pain measures. As a digital, patient-friendly method of assessing and tracking pain, we conclude that Pain-QuILT has potential to add significant value as one standard component of chronic pain management.
Kumbhare, Dinesh; Stinson, Jennifer N; Henry, James L
Pain in thalassaemia: the effects of age on pain frequency and severity.
Pain is not a symptom generally associated with thalassaemia. However, providers have noted increasing patient reports of pain, creating an impetus for this prospective, observational assessment of pain in thalassaemia patients. The primary study goals were to assess pain prevalence, severity, location, and potential risk factors. This was a multicentre, prospective study of thalassaemia patients receiving care at 12 Thalassaemia Clinical Research Network sites. Pain was assessed using the Brief Pain Inventory. Two hundred and fifty-two thalassaemia patients ranging in age from 12 to 71 years (mean 28.8) were enrolled. Sixty-four per cent reported experiencing pain during the last 4 weeks, 22% of whom reported pain on a daily basis. Ordinal regression analysis of pain ratings demonstrated significant (P < 0.001) correlation of increased age with increased pain, irrespective of diagnosis, transfusion status, gender, bone density, chelator type or iron overload. Eighty-one per cent reported having pain for 1 year or longer and 31% reported pain for five or more years. Pain is a major cause of morbidity and an unrecognized problem for patients with thalassaemia. Age is the strongest predictor of frequency and severity. Little else is known about the aetiology and predictors of this pain syndrome. PMID:23278768
Haines, Dru; Martin, Marie; Carson, Susan; Oliveros, Olivia; Green, Sage; Coates, Thomas; Eile, Jennifer; Schilling, Leann; Dinu, Bogan; Mendoza, Tito; Gerstenberger, Eric; Trachtenberg, Felicia; Vichinsky, Elliott
Pain in Thalassemia: The Effects of Age on Pain Frequency and Severity
Pain is not a symptom generally associated with thalassaemia. However, providers have noted increasing patient reports of pain, creating an impetus for this prospective, observational assessment of pain in thalassaemia patients. The primary study goals were to assess pain prevalence, severity, location, and potential risk factors. This was a multicentre, prospective study of thalassaemia patients receiving care at 12 Thalassaemia Clinical Research Network (TCRN) sites. Pain was assessed using the Brief Pain Inventory (BPI). 252 thalassaemia patients ranging in age from 12 to 71 years (mean 28.8) were enrolled. Sixty-four percent reported experiencing pain during the last four weeks, 22% of whom reported pain on a daily basis. Ordinal regression analysis of pain ratings demonstrated significant (P < 0.001) correlation of increased age with increased pain, irrespective of diagnosis, transfusion status, gender, bone density, chelator type or iron overload. Eighty-one percent reported having pain for one year or longer and 31% reported pain for five or more years. Pain is a major cause of morbidity and an unrecognized problem for patients with thalassaemia. Age is the strongest predictor of frequency and severity. Little else is known about the aetiology and predictors of this pain syndrome.
Haines, Dru; Martin, Marie; Carson, Susan; Oliveros, Olivia; Green, Sage; Coates, Thomas; Eile, Jennifer; Schilling, Leann; Dinu, Bogan; Mendoza, Tito; Gerstenberger, Eric; Trachtenberg, Felicia; Vichinsky, Elliott
Chest pain in primary care: is the localization of pain diagnostically helpful in the critical evaluation of patients? - A cross sectional study
Background Chest pain is a common complaint and reason for consultation in primary care. Traditional textbooks still assign pain localization a certain discriminative role in the differential diagnosis of chest pain. The aim of our study was to synthesize pain drawings from a large sample of chest pain patients and to examine whether pain localizations differ for different underlying etiologies. Methods We conducted a cross-sectional study including 1212 consecutive patients with chest pain recruited in 74 primary care offices in Germany. Primary care providers (PCPs) marked pain localization and radiation of each patient on a pictogram. After 6 months, an independent interdisciplinary reference panel reviewed clinical data of every patient, deciding on the etiology of chest pain at the time of patient recruitment. PCP drawings were entered in a specially designed computer program to produce merged pain charts for different etiologies. Dissimilarities between individual pain localizations and differences on the level of diagnostic groups were analyzed using the Hausdorff distance and the C-index. Results Pain location in patients with coronary heart disease (CHD) did not differ from the combined group of all other patients, including patients with chest wall syndrome (CWS), gastro-esophageal reflux disease (GERD) or psychogenic chest pain. There was also no difference in chest pain location between male and female CHD patients. Conclusions Pain localization is not helpful in discriminating CHD from other common chest pain etiologies.
Functional somatic symptoms in 5-7 year old children: assessment, prevalence and co-occurrence.
Medically unexplained or functional somatic symptoms (FSS) in children constitute a major clinical problem. However, research data on FSS in young children are few, and epidemiological studies are hampered by lack of good standardised measures. The present thesis consists of two studies: In study one, we developed two measures to assess FSS in young children. The first measure is a parent interview, the Soma Assessment Interview (SAI), to assess the 1-year prevalence and associated impairment caused by FSS. The interview can be performed by lay interviewers and subsequently rated clinically by physicians. A preliminary validation showed a good agreement on FSS recognition between two clinical raters (kappa = 0.86), a good concurrent validity with independent measures of physical complaints and a good discrimination on the prevalence of FSS between a community sample and clinical samples. The second measure is a systematic medical record review of FSS in paediatric patients: the Medical Record Review for Functional Somatic Symptoms in Children (MRFC). Our findings suggest that the MRFC allows identification of subgroups of paediatric patients with multisymptomatic FSS and long-term and/or impairing FSS and it may prove useful for case finding in clinical and epidemiological research. In study two, we investigated the parent-reported FSS and their impairment in a population-based sample of Danish 5-7-year-old children. We used the SAI as the main measure. Data from 1,327 children from The Copenhagen Child Cohort 2000 were analysed. Impairing symptoms were defined as FSS causing substantial discomfort, impairment of everyday life, absence from daycare or school and/or health care seeking. We found that FSS are common in this age group with a 1-year prevalence of 23.2%. Different pain complaints, i.e. limb pain, abdominal pain and headache, were the most prevalent types of FSS. A subgroup of children with impairing FSS (4.4%) was identified. These children were more likely to present multisymptomatic FSS than children with non-impairing FSS. Health anxiety symptoms (HAS) and their associations with different physical health variables, including FSS, were investigated in the same population of 5-7-year-old children. In total, 2.4% presented prominent HAS, and the level of HAS was correlated with general poor health, chronic physical disease and physical complaints including FSS. In children with FSS, we found significant associations between the level of HAS and the impact of the childrens´ FSS in terms of number of doctor's visits and missed school and/or daycare due to FSS as well as the degree of parental worries about the childrens´ FSS. Furthermore, HAS were significantly associated with emotional symptoms. The findings suggest an early onset of somatisation and point to the need for clinical and preventive intervention in a substantial proportion of children. The findings also suggest a close link between HAS, FSS and emotional symptoms. Medically unexplained or functional somatic symptoms (FSS) in children constitute a major clinical problem. However, research data on FSS in young children are few, and epidemiological studies are hampered by lack of good standardised measures. PMID:23171751
Rask, Charlotte Ulrikka
Cerebrospinal fluid levels of opioid peptides in fibromyalgia and chronic low back pain
Background The mechanism(s) of nociceptive dysfunction and potential roles of opioid neurotransmitters are unresolved in the chronic pain syndromes of fibromyalgia and chronic low back pain. Methods History and physical examinations, tender point examinations, and questionnaires were used to identify 14 fibromyalgia, 10 chronic low back pain and 6 normal control subjects. Lumbar punctures were performed. Met-enkephalin-Arg6-Phe7 (MEAP) and nociceptin immunoreactive materials were measured in the cerebrospinal fluid by radioimmunoassays. Results Fibromyalgia (117.6 pg/ml; 85.9 to 149.4; mean, 95% C.I.; p = 0.009) and low back pain (92.3 pg/ml; 56.9 to 127.7; p = 0.049) groups had significantly higher MEAP than the normal control group (35.7 pg/ml; 15.0 to 56.5). MEAP was inversely correlated to systemic pain thresholds. Nociceptin was not different between groups. Systemic Complaints questionnaire responses were significantly ranked as fibromyalgia > back pain > normal. SF-36 domains demonstrated severe disability for the low back pain group, intermediate results in fibromyalgia, and high function in the normal group. Conclusions Fibromyalgia was distinguished by higher cerebrospinal fluid MEAP, systemic complaints, and manual tender points; intermediate SF-36 scores; and lower pain thresholds compared to the low back pain and normal groups. MEAP and systemic pain thresholds were inversely correlated in low back pain subjects. Central nervous system opioid dysfunction may contribute to pain in fibromyalgia.
Baraniuk, James N; Whalen, Gail; Cunningham, Jill; Clauw, Daniel J
An international survey of pain in adolescents
Background A common belief is that pain is uncommon and short lived in adolescents. However, the burden of pain in adolescents is unclear because of limitations in previous research. The aim of this study is to estimate the prevalence of headache, stomach-ache and backache in adolescents and to explore the extent to which these three forms of pain coexist based upon a representative sample of adolescents from 28 countries. Methods Data were analysed from three consecutive waves (1997/98, 2001/02 and 2005/06) of the Health Behavior in School-aged Children: WHO Collaborative Cross-National survey (HBSC). Prevalence estimates are based upon adolescents who reported experiencing headache, stomach-ache or backache at least monthly for the last 6 months. Results There were a total of 404,206 participants with a mean (±SD) age of 13.6 (±1.7) years (range 9.8 to 17.3 years). The prevalence of headache was 54.1%, stomach-ache 49.8%, backache 37%, and at least one of the three pains 74.4%. Girls had a higher prevalence of the three pains than boys and the prevalence of pain increased with age. Headache, stomach-ache and backache frequently coexist, for example, of those with headache: 21.2% had headache alone, 31% suffered from both headache and stomach-ache, 12.1% suffered from backache and headache, and 35.7% had all three pains. Conclusions Somatic pain is very common in adolescents, more often coexisting than occurring in isolation. Our data supports the need for further research to improve the understanding of these pains in adolescents.
Effect of education, occupation and some lifestyle factors on common rheumatic complaints in a Swedish group aged 50-70 years.
The relation between common rheumatic diseases such as osteoarthrosis, arthralgia without definite signs of osteoarthrosis, subacromial shoulder pain, different forms of tendinitis, low back pain and neck pain, and the level of formal education, occupational workload and some lifestyle factors were examined in 502 of 900 randomly selected subjects aged 50-70 years. The group with rheumatic complaints had a higher proportion of subjects with a lower level of formal education (less than or equal to eight years) by bivariate analysis. In multivariate analysis, the major risk factors were: a self rated heavy workload (odds ratio (OR) 6.4), sleep disturbance (OR 3.6), and advanced age (OR 2.0 per five year increase) for osteoarthrosis; a self rated heavy workload for subacromial shoulder pain (OR 5.4) and low back pain (OR 4.8); and a self rated heavy workload (OR 8.0) and female sex (OR 4.8) for neck pain. A self rated heavy workload was strongly correlated with a low level of formal education. A heavy workload (i.e. previous or present principal occupation) could only be confirmed in the groups with neck pain and low back pain on the basis of available occupational classification data. Neck pain was thus associated with occupations entailing repetitive tasks and awkward posture with respect to the neck, shoulders, and back. Low back pain was associated with occupations entailing awkward posture with respect to the neck, shoulders, and back, and occupations entailing exposure to vibration and heavy manual work. It is concluded that, in a cross sectional sample of an elderly population, a low level of formal education and self rated heavy physical work are associated with the occurrence of adult rheumatic complaints, though the self rated heavy workload could only be verified in the groups with neck pain and low back pain. There correlations between heavy work and low back pain, and especially neck pain, suggest that successful prevention would mean a substantial economic gain to the community. Whether the level of education is a marker of risk factors other than a heavy occupational workload needs further evaluation.
Jacobsson, L; Lindgarde, F; Manthorpe, R; Ohlsson, K
Chronic pain and pain-related disability across psychiatric disorders in a clinical adolescent sample
Background People who suffer from psychiatric disorders are burdened with a high prevalence of chronic illnesses and pain, but evidence on pain prevalence among adolescents with psychiatric disorders is scarce. The aim of this study was to investigate the frequency and location of self-reported chronic pain and pain-related disability in adolescent psychiatric patients. Methods This study was part of the larger Health Survey administered at the Department of Child and Adolescent Psychiatry (CAP) at St. Olav's University Hospital, in Trondheim, Norway. All patients aged 13–18 years who visited the CAP clinic at least once between February 15, 2009 and February 15, 2011 were invited to participate. A total of 717 (43.5% of eligible/invited patients) participated; of these, 566 were diagnosed with one or more psychiatric disorders. The adolescents completed a questionnaire, which included questions about pain and pain-related disability. Clinical diagnoses were classified by a clinician according to International Statistical Classification of Diseases and Related Health Problems, 10th revision criteria. Results In adolescents with psychiatric disorders, 70.4% reported chronic pain, and 37.3% experienced chronic pain in three or more locations (multisite pain). Chronic musculoskeletal pain was the most prevalent type of pain (57.7%). Pain-related disability was found in 22.2% of the sample. The frequency of chronic pain and multisite pain increased with age, and girls reported a higher frequency of chronic pain, multisite pain and pain-related disability than boys did. There was an increased risk of chronic pain among adolescents with mood or anxiety disorders versus those with hyperkinetic disorders, yet this was not present after adjusting for sex. Comorbidity between hyperkinetic and mood or anxiety disorders involved an increased risk of pain-related disability. Conclusions In this study, seven out of 10 adolescents with psychiatric disorders reported chronic pain. These findings indicate the importance of early detection of chronic pain in adolescents with psychiatric disorders, to provide targeted treatment and reduce poor long-term outcomes.
The Nature of Subjective Cognitive Complaints of Older Adults
ERIC Educational Resources Information Center
The current study investigated the nature of subjective cognitive complaints of older adults in relation to a broad array of individual cognitive functions known to decline with age. A 60-item questionnaire was developed to examine: (1) whether older adults experience problems with these cognitive functions (problems with cognition); (2) the…
Newson, Rachel S.; Kemps, Eva B.
45 CFR 672.7 - Issuance of complaint.
Code of Federal Regulations, 2013 CFR
...has violated any provision of the Antarctic Conservation Act, other Act or attendant regulations, or a permit issued under the ACA, he may institute a proceeding for the assessment of a civil penalty or other sanctions by issuing a complaint under the...
Symptom Complaint Patterns in College Students with Learning Disabilities.
ERIC Educational Resources Information Center
This study analyzed symptom complaint patterns and perceived academic impairment in a sample of 189 university students diagnosed with various learning disorders (LD). Each participant underwent an extensive standardized assessment battery and was diagnosed according to the fourth edition of the Diagnostic and Statistical Manual of Mental…
Kane, Steven T.; Joy, Crystal
Throwing the dice for the diagnosis of vaginal complaints?
BACKROUND: Vaginitis is among the most common conditions women are seeking medical care for. Although these infections can easily be treated, the relapse rate is high. This may be due to inadequate use of the diagnostic potential. METHODS: We evaluated the misjudgement rate of the aetiology of vaginal complaints. A total of 220 vaginal samples from women with a vaginal
Andreas Schwiertz; David Taras; Kerstin Rusch; Volker Rusch
Latent variable analysis of coping, anxiety/depression, and somatic symptoms in adolescents with chronic pain.
Reports of adolescents' coping with recurrent pain, symptoms of anxiety/depression, and somatic complaints were obtained from a sample of 164 adolescents with recurrent abdominal pain and their parents. Confirmatory factor analysis revealed that coping consisted of 3 nonorthogonal factors: Primary Control Engagement Coping (problem solving, emotional expression, and emotional regulation), Secondary Control Engagement Coping (positive thinking, cognitive restructuring, acceptance, and distraction), and Disengagement Coping (denial, avoidance, and wishful thinking). Structural equation modeling using latent variables revealed that secondary control engagement coping predicted lower levels of anxiety/depression symptoms and somatic complaints, and disengagement coping was related to higher levels of anxiety/depression and somatic complaints. Implications for understanding child and adolescent coping with pain are highlighted. PMID:17154742
Compas, Bruce E; Boyer, Margaret C; Stanger, Catherine; Colletti, Richard B; Thomsen, Alexandra H; Dufton, Lynette M; Cole, David A
Idiopathic Hand and Arm Pain: Delivering Cognitive Behavioral Therapy as Part of a Multidisciplinary Team in a Surgical Practice
ERIC Educational Resources Information Center
Cognitive behavioral therapists may have a unique and growing role in orthopedics departments. In helping patients cope with pain, particularly where there is no specific biomedical treatment or cure, cognitive behavioral practitioners can help prevent, early on, the transition from an acute pain complaint to a costly, disabling, and interfering…
Vranceanu, Ana-Maria.; Ring, David; Kulich, Ronald; Zhao, Meijuan; Cowan, James; Safren, Steven
Cerebellopontine angle (CPA) tumor mimicking dental pain following facial trauma.
Facial injuries are common during workplace accidents. These incidents are also associated with an increase in both mortality and morbidity rates. The following case describes a 40-year-old white Hispanic patient with paroxysmal facial pain on the right side, one year in duration. The patient reported facial trauma as a result of a direct fall thought to be related to his pain complaints five months prior to arriving at the New Jersey Dental School emergency unit. The facial pain was progressively worsening ever since the accident. Upon arrival at the emergency unit, a comprehensive intraoral and extraoral examination was performed. Application of a local anesthetic at the site of the pain produced equivocal results. After obtaining a complete history and clinical examination, an MRI was ordered to rule out the possibility of a space-occupying lesion in the brain considered as a possible source of the pain. This case focuses on different aspects relative to dental care: the importance of a complete history and patient evaluation in order to make an accurate diagnosis; the complexity of orofacial pain; and the training required for dental health care providers who treat unusual oral and facial pain complaints. PMID:20806740
Khan, Junad; Heir, Gary M; Quek, Samuel Y P
[Damages to health in schools. Complaints caused by the use of formaldehyde-emitting materials in school buildings].
Low formaldehyd-concentrations were measured in three Cologne schools (mean 1 = 0,4425; mean 2 = 0,5725; mean 3 = 0,1292 ppm). As the main sources of emission were identified formaldehyd-urea-bound chip-plates in acoustic-ceilings and wainscots. To study the connection between the complaints of pupils and CH20-emissions 1594 pupils of these schools were questioned using a specially elaborated questionnaire. The questions concerned multiple complaints and disturbances of health as well as their anamnesis in chronological relationship with school attendance. Compared to controls consisting of 497 pupils of a school, where no CH2O-emitting chip-plates were used, the inquiry showed a significant increase (p less than 0,00005) of so-called functional disturbances (headache, disorder of concentrating ability, dizziness, nausea), affections of the respiratory tract (irritation of the mucosa of the nose and the pharynx, dry cough) and irritation of the conjunctiva. In regard to the anamneses, the difference between the investigation-group and the control-group was even more significant and additional complaints such as somnipathy, abdominal pain, skin disease were observed frequently. Comparing the normal distribution of so-called functional disturbances in pupils found in literature, the examined group of this study showed an even higher rate of the relative accumulation. The repeated investigation in one school (n = 328) 8 months after removal of the emission-sources demonstrated a very clear reduction of complaints by an average of 71,2 per cent. PMID:7372230
Burdach, S; Wechselberg, K