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Perioperative Protocol of Ankle Fracture and Distal Radius Fracture Based on Enhanced Recovery after Surgery Program: A Multicenter Prospective Clinical Controlled study 基于术后增强恢复方案的踝关节骨折和桡骨远端骨折围手术期治疗方案:一项多中心前瞻性临床对照研究
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-06-07 DOI: 10.1155/2022/3458056
Ting Li, Zhiwen Sun, Yan Zhou, Weitong Sun, P. Wang, Xinyu Cai, Junbo Liang, Jing-ming Dong, Da-Peng Zhou, Kai Yu, Ming-Xin Wu, Jiu-sheng He, Liangyuan Wen, Bao-Qing Yu, Jian Wang, Jun Yang, Fengfei Lin, Bing-Zuan Li, Zongxin Shi, Baoping Wang, Ai-Guo Wang, Gui-ling Peng, Xu Sun, Hong-Hao Xiao, Meng Mi, Xia Zhao, Chang-Run Li, Gang Liu, Shao-liang Li, Hang-yu Gu, Yuanyuan Zhou, Zhelun Tan, Xin-Bao Wu
Background The enhanced recovery after surgery (ERAS) program is aimed to shorten patients' recovery process and improve clinical outcomes. This study aimed to compare the outcomes between the ERAS program and the traditional pathway among patients with ankle fracture and distal radius fracture. Methods This is a multicenter prospective clinical controlled study consisting of 323 consecutive adults with ankle fracture from 12 centers and 323 consecutive adults with distal radial fracture from 13 centers scheduled for open reduction and internal fixation between January 2017 and December 2018. According to the perioperative protocol, patients were divided into two groups: the ERAS group and the traditional group. The primary outcome was the patients' satisfaction of the whole treatment on discharge and at 6 months postoperatively. The secondary outcomes include delapsed time between admission and surgery, length of hospital stay, postoperative complications, functional score, and the MOS item short form health survey-36. Results Data describing 772 patients with ankle fracture and 658 patients with distal radius fracture were collected, of which 323 patients with ankle fracture and 323 patients with distal radial fracture were included for analysis. The patients in the ERAS group showed higher satisfaction levels on discharge and at 6 months postoperatively than in the traditional group (P < 0.001). In the subgroup analysis, patients with distal radial fracture in the ERAS group were more satisfied with the treatment (P=0.001). Furthermore, patients with ankle fracture had less time in bed (P < 0.001) and shorter hospital stay (P < 0.001) and patients with distal radial fracture received surgery quickly after being admitted into the ward in the ERAS group than in the traditional group (P=0.001). Conclusions Perioperative protocol based on the ERAS program was associated with high satisfaction levels, less time in bed, and short hospital stay without increased complication rate and decreased functional outcomes.
手术后增强恢复(ERAS)计划旨在缩短患者的恢复过程,改善临床结果。本研究旨在比较ERAS方案和传统途径治疗踝关节骨折和桡骨远端骨折的疗效。方法:本研究是一项多中心前瞻性临床对照研究,包括来自12个中心的323例连续踝关节骨折患者和来自13个中心的323例连续桡骨远端骨折患者,计划于2017年1月至2018年12月进行切开复位内固定。根据围手术期方案,将患者分为ERAS组和传统组。主要观察出院时和术后6个月患者对整个治疗的满意度。次要结局包括入院和手术之间的延迟时间、住院时间、术后并发症、功能评分和MOS项目简短健康调查-36。结果共收集了772例踝关节骨折和658例桡骨远端骨折的资料,其中323例踝关节骨折和323例桡骨远端骨折纳入分析。ERAS组患者出院时和术后6个月满意度均高于传统组(P < 0.001)。在亚组分析中,ERAS组桡骨远端骨折患者对治疗更满意(P=0.001)。ERAS组踝关节骨折患者住院时间短(P < 0.001),住院时间短(P < 0.001),桡骨远端骨折患者入院后手术速度快于传统组(P=0.001)。结论基于ERAS方案的围手术期方案满意度高,住院时间短,并发症发生率无增加,功能预后无下降。
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引用次数: 3
Effect of Preventive Analgesia with Nalbuphine and Dexmedetomidine in Endoscopic Sinus Surgery 纳布啡与右美托咪定在鼻内镜手术中的预防性镇痛效果
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-31 DOI: 10.1155/2022/2344733
P. Yu, Jie Zhang, Yan Zou, Jun Wang
Background The study was to assess the efficacy and safety of nalbuphine combined with dexmedetomidine for preventive analgesia in endoscopic sinus surgery. Methods 110 patients with deviation of the nasal septum were randomized into the nalbuphine group (group N), dexmedetomidine combined with nalbuphine group (group DN), and saline group (group C). Fifteen minutes before the induction of anesthesia, patients in group N were injected nalbuphine 0.2 mg/kg intravenously; patients in group DN received intravenous infusion of dexmedetomidine 0.5 μg/kg and injection of nalbuphine 0.2 mg/kg; patients in group C received 0.9% saline. Mean arterial pressure (MAP), heart rate (HR), numerical rating scale (NRS) scores, quality of recovery-40 (QoR-40) scores, the need for remedial analgesia, the consumption of remifentanil and propofol, and the incidence of adverse reactions were recorded. Results MAP, HR, and NRS scores of the DN group were significantly lower and the QoR-40 scores were higher than those of groups N and C (P < 0.001). The need for remedial analgesia, the consumption of remifentanil and propofol, and the incidence of nausea in the DN group were the lowest among the three groups (P < 0.001). Conclusion Preventive analgesia with nalbuphine and dexmedetomidine in endoscopic sinus surgery can not only maintain hemodynamic stability but also reduce intraoperative anesthetic dosage, postoperative pain, and improve the quality of postoperative recovery without affecting the revival and extubation time.
本研究旨在评价纳布啡联合右美托咪定用于内镜鼻窦手术预防性镇痛的有效性和安全性。方法将110例鼻中隔偏曲患者随机分为纳布啡组(N组)、右美托咪定联合纳布啡组(DN组)和生理盐水组(C组)。N组在麻醉诱导前15 min静脉注射纳布啡0.2 mg/kg;DN组患者静脉滴注右美托咪定0.5 μg/kg,注射纳布啡0.2 mg/kg;C组给予0.9%生理盐水。记录两组患者平均动脉压(MAP)、心率(HR)、数值评定量表(NRS)评分、恢复质量-40 (QoR-40)评分、补救性镇痛需求、瑞芬太尼和异丙酚用量、不良反应发生率。结果DN组MAP、HR、NRS评分显著低于N、C组,QoR-40评分显著高于N、C组(P < 0.001)。治疗性镇痛的需要、瑞芬太尼和异丙酚的使用以及DN组恶心的发生率在三组中最低(P < 0.001)。结论纳布啡和右美托咪定在内镜鼻窦手术中预防性镇痛不仅能保持血流动力学稳定,而且在不影响苏醒和拔管时间的情况下,可减少术中麻醉用量,减少术后疼痛,提高术后恢复质量。
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引用次数: 2
Correlation Analysis between Tamoxifen and Lumbar Intervertebral Disc Degeneration: A Retrospective Case-Control Study 他莫昔芬与腰椎间盘退变的相关性分析:一项回顾性病例对照研究
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-31 DOI: 10.1155/2022/3330260
Xiangyu Li, Ruoyu Zhao, S. Rudd, W. Ding, Sidong Yang
Objectives To investigate the correlation between tamoxifen (TAM) and lumbar intervertebral disc (IVD) degeneration (IVDD). Methods The patients who visited the department of spine surgery from January 2015 to December 2020 were retrospectively reviewed. Those with a history of breast cancer surgery were identified and their data were collected. These data included patients' age, body mass index (BMI), menstrual history, postoperative history, drug treatment plan, and imaging data. The participants were divided into the TAM group and the non-TAM group. Lumbar IVDD was assessed by lumbar lordosis (LL), vertebral CT density, lumbar disc height index (DHI), Modic changes, and modified Pfirrmann grading score. SPSS 20 was used for statistical analysis. Results A total of 75 patients were included in this study, 46 patients in the TAM group and 29 patients in the non-TAM group. No significant differences were present in age, BMI, postoperative history, LL, and vertebral CT density between the two groups. The DHI of L1/2 and L2/3 in the TAM group was lower compared to the non-TAM group (P=0.038 and P=0.034, respectively), while comparisons regarding the DHI of L3/4, L4/5, and L5/S1, and the average DHI between TAM and non-TAM groups were not significant. The modified Pfirrmann grading scores of the L1/2 and L2/3 IVDs in the TAM group were higher than those in the non-TAM group (P=0.004 and P=0.025, respectively). Comparisons of L3/4, L4/5, and L5/S1 between the two groups were not significant. The comparisons regarding the occurrence of Modic changes did not show a significant difference between the TAM and non-TAM groups. Conclusions This study indicates that there might be some positive correlation between TAM use and lumbar IVDD. In particular, the degeneration of L1/2 and L2/3 has shown a correlation with TAM use.
目的探讨他莫昔芬(TAM)与腰椎间盘退变(IVDD)的相关性。方法对2015年1月至2020年12月我院脊柱外科收治的患者进行回顾性分析。研究人员确定了有乳腺癌手术史的患者,并收集了他们的数据。这些资料包括患者的年龄、体重指数(BMI)、月经史、术后史、药物治疗方案、影像学资料。参与者被分为TAM组和非TAM组。腰椎IVDD通过腰椎前凸度(LL)、椎体CT密度、腰椎间盘高度指数(DHI)、Modic变化和修正Pfirrmann分级评分进行评估。采用SPSS 20进行统计分析。结果本研究共纳入75例患者,TAM组46例,非TAM组29例。两组患者的年龄、BMI、术后病史、LL、椎体CT密度均无显著差异。TAM组L1/2和L2/3的DHI较非TAM组低(P=0.038和P=0.034),而L3/4、L4/5和L5/S1的DHI及TAM组与非TAM组的平均DHI比较无统计学意义。TAM组L1/2和L2/3 ivd的改良Pfirrmann评分高于非TAM组(P=0.004和P=0.025)。两组间L3/4、L4/5、L5/S1比较无统计学意义。关于Modic变化发生的比较在TAM组和非TAM组之间没有显着差异。结论本研究提示TAM使用与腰椎IVDD可能存在正相关。特别是,L1/2和L2/3的退化与TAM的使用有关。
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引用次数: 0
The Pain Intensity/Quality and Pain Site Association with Muscle Activity and Muscle Activity Distribution in Patients with Chronic Low Back Pain: Using a Generalized Linear Mixed Model Analysis 慢性腰痛患者疼痛强度/质量和疼痛部位与肌肉活动和肌肉活动分布的关系:使用广义线性混合模型分析
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-25 DOI: 10.1155/2022/5751204
H. Shigetoh, Y. Nishi, M. Osumi, S. Morioka
Background Pain can alter muscle activity, although it is not clear how pain intensity and site location affect muscle activity. This study aimed to reveal the complex associations among the pain site, pain intensity/quality, muscle activity, and muscle activity distribution. Methods Electromyographic signals were recorded from above a bilateral lumbar erector spinae muscle with a four-channel electrode in 23 patients with chronic low back pain while they performed a lumbar bending and returning task. We calculated the average value of muscle activity during the extension phase (agonist activity) and the centroid of muscle activity, as well as the distance between the centroid of muscle activity and pain site. We also assessed the pain site and pain intensity/quality by the interview and questionnaire method. A generalized linear mixed model analysis was performed to determine the relationships among pain intensity/quality, pain site, and muscle activity. Results The results showed that muscle activity during the extension phase was significantly negatively associated with neuropathic pain and “pain caused by light touch.” In addition, the distance between the centroid of muscle activity and pain site during the extension phase was significantly positively associated with intermittent pain, “throbbing pain,” “splitting pain,” “punishing-cruel,” and “pain caused by light touch.” Conclusions Our findings suggest the existence of a motor adaptation that suppresses muscle activity near the painful area as the pain intensity increases. Furthermore, the present study indicates that the presence or absence of this motor adaptation depended on the pain quality.
疼痛可以改变肌肉活动,尽管疼痛强度和部位如何影响肌肉活动尚不清楚。本研究旨在揭示疼痛部位、疼痛强度/质量、肌肉活动和肌肉活动分布之间的复杂关联。方法用四通道电极记录23例慢性腰痛患者在进行腰椎屈伸动作时双侧腰竖脊肌上方肌电图信号。我们计算了伸展期肌肉活动(激动剂活动)和肌肉活动质心的平均值,以及肌肉活动质心到疼痛部位的距离。我们还通过访谈和问卷调查的方法评估疼痛部位和疼痛强度/质量。采用广义线性混合模型分析确定疼痛强度/质量、疼痛部位和肌肉活动之间的关系。结果伸展期肌肉活动与神经性疼痛和轻触引起的疼痛呈显著负相关。此外,在伸展阶段,肌肉活动质心与疼痛部位之间的距离与间歇性疼痛、“悸动痛”、“劈裂痛”、“残酷的惩罚”和“轻触引起的疼痛”显著正相关。结论:我们的研究结果表明,随着疼痛强度的增加,疼痛区域附近的肌肉活动受到运动适应的抑制。此外,本研究表明,这种运动适应的存在与否取决于疼痛的质量。
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引用次数: 0
Relative Prevalence and Associated Factors of Complex Regional Pain Syndrome Type I in Patients with Radial Head Fractures Treated with Open Reduction and Internal Fixation: A Cross-Sectional Study 桡骨头骨折切开复位内固定患者I型复杂区域疼痛综合征的相对患病率及相关因素:一项横断面研究
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-19 DOI: 10.1155/2022/9214404
Siming Jia, Chuan Ren, Xiaoying Shi, Tailong Shi, Dacheng Sun, Yuqin Zhang, Kai Ding, Hao Du, Yanbin Zhu, Wei Chen
Objective This cross-sectional study aimed to examine the incidence and associated factors of complex regional pain syndrome type I (CRPS I) in patients who underwent open reduction and internal fixation (ORIF) for radial head fractures. Methods The study enrolled 601 radial head fracture patients treated with ORIF, 523 of which completed the 1-year follow-up. The incidence of CRPS I in those patients was assessed using the Budapest criteria. Patients were then divided into 2 groups: patients with CRPS I (n = 28) and patients without CRPS I (n = 495). The patients' demographic and clinical data before the operation were prospectively collected by our team. Independent t-tests and χ2 tests were used as univariate analyses to compare the demographic and clinical data between the two groups. Meanwhile, multivariate regression analysis was conducted to identify the associated risk factors for CRPS I. Results The incidence of CRPS I in patients with radial head fractures treated with ORIF was 5.5% during the first year following surgery. Significant differences were observed in age, gender, type of trauma, modified Mason Classification, and depressive personality disorders. The logistic regression analysis revealed that the female gender, modified Mason type III fractures, and depressive patients were significantly more likely to develop CRPS I (p=0.021, 0.023, and 0.025, respectively). Conclusions The incidence of CRPS I among radial head fracture patients undergoing ORIF was 5.5%. In addition, early detection of CRPS I and providing adequate intervention will likely result in greater benefits for those patients.
目的本横断面研究旨在探讨桡骨头骨折切开复位内固定(ORIF)患者并发I型复杂区域疼痛综合征(CRPS I)的发生率及相关因素。方法纳入601例经ORIF治疗的桡骨头骨折患者,其中523例完成1年随访。使用布达佩斯标准评估这些患者的CRPS I发生率。然后将患者分为2组:有CRPS I的患者(n = 28)和没有CRPS I的患者(n = 495)。本组对术前患者的人口学及临床资料进行前瞻性收集。采用独立t检验和χ2检验作为单因素分析,比较两组患者的人口学和临床资料。同时进行多因素回归分析,确定发生CRPS I的相关危险因素。结果桡骨头骨折经ORIF治疗后1年内CRPS I的发生率为5.5%。在年龄、性别、创伤类型、改良梅森分类和抑郁型人格障碍方面观察到显著差异。logistic回归分析显示,女性、改良型Mason III型骨折患者和抑郁症患者发生CRPS I的可能性显著增加(p分别为0.021、0.023和0.025)。结论桡骨头骨折行ORIF的CRPS I发生率为5.5%。此外,早期发现CRPS I并提供适当的干预可能会为这些患者带来更大的益处。
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引用次数: 1
Antinociceptive Effects and Interaction Mechanisms of Intrathecal Pentazocine and Neostigmine in Two Different Pain Models in Rats 鞘内注射戊唑嗪和新斯的明对两种不同疼痛模型大鼠的抗伤害感受作用及其相互作用机制
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-18 DOI: 10.1155/2022/4819910
Huiying Huang, Xiaohui Bai, Kun Zhang, Jin Guo, Shaoyong Wu, Handong Ouyang
Background Pentazocine produces a wide variety of actions in the treatment of perioperative analgesia. Neostigmine is a cholinesterase inhibitor used to antagonize the residual effects of muscle relaxants and also produces an analgesic effect. Objectives To investigate the analgesic effects of intrathecally injected pentazocine and neostigmine and their interaction. Methods Sprague–Dawley rats were used to test the analgesic effect of pentazocine and neostigmine using the paw formalin pain model and the incision mechanical allodynia model. Pentazocine (3, 10, 30, and 100 μg), neostigmine (0.3, 1, 3, and 10 μg) or a pentazocine-neostigmine mixture were separately injected to evaluate their antinociceptive effects alone on the treatment groups. The corresponding control group received an intrathecal injection containing the same volume of saline. The formalin pain test, or the plantar incision pain behavior test were performed 30 minutes later. Isobolographic analysis was used to evaluate the interaction between pentazocine and neostigmine. Intrathecally administered selective mu-opioid receptor antagonist CTAP, selective kappa-opioid receptor antagonist nor-Binaltorphimine (nor-BNI), nonselective opioid receptor antagonist naloxone, and muscarinic acetylcholine receptor antagonist atropine were also used to test the possible interaction mechanism. These antagonists were used 30 minutes before the pentazocine and neostigmine mixtures which were intrathecally injected. Results Intrathecally administered pentazocine (3, 10, 30, and 100 μg) and neostigmine (0.3, 1, 3, and 10 μg) alone had a marked dose-related impact on suppressing the biphasic responses in the formalin test. Pentazocine (3, 10, 30, and 100 μg) and neostigmine (0.3, 1, 3, and 10 μg) alone attenuated the mechanical allodynia in a plantar incision model in a dose-dependent manner. Isobolographic analysis revealed that the mixture of intrathecal pentazocine and neostigmine synergistically decreased both phase I and II activity in the formalin test and mechanical allodynia in the plantar incision model. Pretreatment of intrathecally administered nor-BNI, naloxone, atropine, but not CTAP, antagonized the analgesic effect of the pentazocine-neostigmine mixture. Conclusions All of these results suggest that the combined application of pentazocine and neostigmine is an effective way to relieve pain from formalin and acute incision mechanical allodynia. The synergistic effect between pentazocine and neostigmine is mostly attributed to the kappa-opioid receptor and the cholinergic receptor in the spinal cord.
背景戊唑嗪在围手术期镇痛治疗中具有多种作用。新斯的明是一种胆碱酯酶抑制剂,用于对抗肌肉松弛剂的残留作用,也产生镇痛作用。目的探讨鞘内注射戊唑嗪和新斯的明的镇痛效果及其相互作用。方法采用Sprague-Dawley大鼠建立足部福尔马林疼痛模型和切口机械异常痛模型,观察戊唑嗪和新斯的明对大鼠的镇痛作用。治疗组分别注射戊唑嗪(3、10、30、100 μg)、新斯的明(0.3、1、3、10 μg)或戊唑嗪-新斯的明合剂,观察其单独抗伤感受效果。对照组给予等量生理盐水鞘内注射。30分钟后进行福尔马林疼痛试验或足底切口疼痛行为试验。采用等密度分析法评价了戊唑嗪与新斯的明的相互作用。鞘内给药选择性阿片受体拮抗剂CTAP、选择性阿片受体拮抗剂非- binaltorphine (no - bni)、非选择性阿片受体拮抗剂纳洛酮和毒蕈碱乙酰胆碱受体拮抗剂阿托品也被用来测试可能的相互作用机制。使用这些拮抗剂30分钟后,将戊唑嗪和新斯的明混合物鞘内注射。结果鞘内单独给药戊唑嗪(3、10、30、100 μg)和新斯的明(0.3、1、3、10 μg)对抑制福尔马林试验双相反应有明显的剂量相关影响。Pentazocine(3、10、30和100 μg)和新斯的明(0.3、1、3和10 μg)分别以剂量依赖性的方式减轻足底切口模型的机械性异痛。等容积分析显示鞘内喷唑辛和新斯的明混合物协同降低福尔马林试验中的I期和II期活性和足底切口模型中的机械异位性疼痛。鞘内注射非bni、纳洛酮、阿托品预处理,而非CTAP预处理,可拮抗戊唑嗪-新斯的明混合物的镇痛作用。结论戊唑嗪联合新斯的明是缓解福尔马林所致急性切口机械疼痛的有效方法。戊唑嗪和新斯的明之间的协同作用主要归因于脊髓中的kappa-阿片受体和胆碱能受体。
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引用次数: 3
Differences and Correlations of Anxiety, Sleep Quality, and Pressure-Pain Threshold between Patients with Chronic Low Back Pain and Asymptomatic People 慢性腰痛患者与无症状人群焦虑、睡眠质量、压力-疼痛阈值的差异及相关性
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-17 DOI: 10.1155/2022/8648584
Changming Xu, Zhiwei Fu, Juan Wang, Bao Wu, Xueqiang Wang
Background Chronic low back pain (CLBP) is a clinically common and expensive disease. Patients frequently take sick leaves because of pain and dysfunction, and their unpleasant life and work experiences cause psychological depression and anxiety and affect their quality of life. Sleep disturbance is a common problem among patients with low back pain (LBP) with more than 50% complaining about poor sleep quality. This study aimed to explore the correlations between anxiety, sleep quality, and pressure-pain threshold (PPT) and their differences between patients with CLBP and asymptomatic people. Methods Forty patients with CLBP and 40 asymptomatic people were recruited. Relevant data, including State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, and PPT, were individually and independently collected by blinded physiotherapists with a practicing certificate and then statistically analyzed. An independent sample t-test was used to determine the intergroup differences between patients with CLBP and asymptomatic populations. Pearson correlation coefficient was employed for correlation analysis. Results The CLBP group had significantly higher anxiety scores (41.64 ± 9.88 vs. 36.69 ± 8.31; t = −2.496, p=0.015) than the asymptomatic group. A significant difference was found in the total score of the Pittsburgh Sleep Quality Index (6.41 ± 2.43 vs. 5.09 ± 2.18; t = −2.628, p=0.010) but not in the trait anxiety (44.00 ± 7.83 vs. 42.67 ± 9.51; t = −0.695, p=0.489) of the two groups. State−Trait Anxiety Inventory showed a low to moderate negative correlation with PPT. No remarkable correlation was observed between Pittsburgh Sleep Quality Index and PPT. Conclusions Patients with CLBP showed considerably worse state anxiety and sleep quality than asymptomatic people; however, no substantial difference in PPT was found between the two groups. The results suggest that in clinical practice, the focus should include pain and related social and psychological factors. CLBP treatment could be considered from multiple perspectives and disciplines.This trial is registered with Chinese Clinical Trial Registry (Trial registration: ChiCTR-TRC-13003701).
背景慢性腰痛(CLBP)是一种临床上常见且昂贵的疾病。患者经常因疼痛和功能障碍而请病假,不愉快的生活和工作经历导致心理抑郁和焦虑,影响生活质量。睡眠障碍是腰痛(LBP)患者的常见问题,超过50%的患者抱怨睡眠质量差。本研究旨在探讨焦虑、睡眠质量和压力-疼痛阈值(PPT)在CLBP患者和无症状患者之间的相关性及其差异。方法选取40例CLBP患者和40例无症状者。状态-特质焦虑量表、匹兹堡睡眠质量指数、PPT等相关数据由持有执业证书的盲法物理治疗师单独独立采集,并进行统计分析。使用独立样本t检验来确定CLBP患者和无症状人群之间的组间差异。采用Pearson相关系数进行相关分析。结果CLBP组焦虑评分明显高于对照组(41.64±9.88∶36.69±8.31;T =−2.496,p=0.015)高于无症状组。两组匹兹堡睡眠质量指数总分(6.41±2.43∶5.09±2.18;T =−2.628,p=0.010),但在特质焦虑方面无显著差异(44.00±7.83∶42.67±9.51;T =−0.695,p=0.489)。状态-特质焦虑量表与PPT呈低至中度负相关。匹兹堡睡眠质量指数与PPT无显著相关。结论CLBP患者的状态焦虑和睡眠质量明显差于无症状者;然而,两组之间PPT没有明显差异。结果提示,在临床实践中,应关注疼痛及其相关的社会心理因素。CLBP的治疗可以从多个角度和学科进行考虑。本试验已在中国临床试验注册中心注册(试验注册号:ChiCTR-TRC-13003701)。
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引用次数: 2
A Critical Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Female Stress Urinary Incontinence 针刺治疗女性压力性尿失禁的系统综述和荟萃分析
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-17 DOI: 10.1155/2022/5887862
Hongshuo Shi, Leizuo Zhao, Lirong Cui, Zicheng Wang, Danny Wang, Pulin Liu, Guomin Si, D. Guo, Wenbin Liu
Objectives As a urinary dysfunction disorder, stress urinary incontinence (SUI) is more common in women than in men. Acupuncture, a traditional minimally invasive technique, has potential efficacy in the treatment of SUI. The purpose of this overview is to critically assess the available evidence on acupuncture for the treatment of SUI in women. Methods Two researchers searched seven databases for systematic reviews (SRs)/meta-analyses (MAs) of randomized controlled trials (RCTs) on acupuncture for SUI. Two researchers assessed the included SRs/MAs using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results Eight published SRs/MAs were included in our overview. According to the results of the AMSTAR-2 assessment, all SRs/MAs were of very low quality. According to the ROBIS evaluation results, no SR/MA was assessed as low risk of bias. According to the results of the PRISMA checklist assessment, no SR/MA was fully reported on the checklist. According to GRADE, a total of 27 outcomes extracted from the included SRs/MAs were evaluated, and only 1 was rated as high quality. Conclusions Acupuncture may be an effective and safe complementary treatment for SUI in women. However, further standard and comprehensive SRs/MAs and RCTs are needed to provide an evidence-based medical rationale for this.
目的:应激性尿失禁(stress urinary incontinence, SUI)是一种泌尿功能障碍,女性比男性更常见。针刺作为一种传统的微创技术,在SUI的治疗中具有潜在的疗效。本综述的目的是批判性地评估针刺治疗女性SUI的现有证据。方法2名研究人员检索了7个数据库,对针刺治疗SUI的随机对照试验(RCTs)进行系统评价(SRs)/meta分析(MAs)。两位研究者使用多重系统评价评估2 (AMSTAR-2)、系统偏倚风险(ROBIS)量表、系统评价和荟萃分析首选报告项目列表(PRISMA)和推荐评估、发展和评价分级(GRADE)系统对纳入的SRs/MAs进行评估。结果8篇已发表的SRs/MAs纳入我们的综述。根据AMSTAR-2评估的结果,所有的SRs/ ma质量都很低。根据ROBIS评价结果,没有SR/MA被评价为低偏倚风险。根据PRISMA检查表评估的结果,检查表上没有完整报告SR/MA。根据GRADE,从纳入的SRs/MAs中提取的27个结局被评估,只有1个被评为高质量。结论针刺治疗女性SUI是一种安全有效的辅助治疗方法。然而,需要进一步的标准和全面的SRs/MAs和随机对照试验来提供基于证据的医学依据。
{"title":"A Critical Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Female Stress Urinary Incontinence","authors":"Hongshuo Shi, Leizuo Zhao, Lirong Cui, Zicheng Wang, Danny Wang, Pulin Liu, Guomin Si, D. Guo, Wenbin Liu","doi":"10.1155/2022/5887862","DOIUrl":"https://doi.org/10.1155/2022/5887862","url":null,"abstract":"Objectives As a urinary dysfunction disorder, stress urinary incontinence (SUI) is more common in women than in men. Acupuncture, a traditional minimally invasive technique, has potential efficacy in the treatment of SUI. The purpose of this overview is to critically assess the available evidence on acupuncture for the treatment of SUI in women. Methods Two researchers searched seven databases for systematic reviews (SRs)/meta-analyses (MAs) of randomized controlled trials (RCTs) on acupuncture for SUI. Two researchers assessed the included SRs/MAs using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results Eight published SRs/MAs were included in our overview. According to the results of the AMSTAR-2 assessment, all SRs/MAs were of very low quality. According to the ROBIS evaluation results, no SR/MA was assessed as low risk of bias. According to the results of the PRISMA checklist assessment, no SR/MA was fully reported on the checklist. According to GRADE, a total of 27 outcomes extracted from the included SRs/MAs were evaluated, and only 1 was rated as high quality. Conclusions Acupuncture may be an effective and safe complementary treatment for SUI in women. However, further standard and comprehensive SRs/MAs and RCTs are needed to provide an evidence-based medical rationale for this.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"49 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82242441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Prevalence and Risk Factors of Work-Related Upper Extremity Disorders among University Teaching Staff in Ethiopia, 2021: An Institution-Based Cross-Sectional Study 2021年埃塞俄比亚大学教职员工中与工作相关的上肢疾病的患病率和风险因素:一项基于机构的横断面研究
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-14 DOI: 10.1155/2022/7744879
Amensisa Hailu Tesfaye, T. Mekonnen, M. Alemayehu, Giziew Abere
Background Work-related upper extremity disorders (WRUEDs) are aches, pains, tension, and discomfort in the neck, shoulders, arms, wrists, hands, and fingers. The situation is escalating in educational sectors due to a lousy working environment intertwined with extracurricular deeds. However, empirical evidence focusing on academicians in higher education society is negligible. The purpose of this study is to examine the prevalence and risk factors of WRUEDs among university teaching staff in Ethiopia. Materials and Methods We conducted a cross-sectional study design from March to April 2021. A sample of 607 academicians were recruited using a stratified sampling technique, and a self-administered structured Nordic Musculoskeletal questionnaire was used to assess upper extremity disorders during the past 12 months. The collected data were entered into EpiData version 4.6 and analyzed using STATA version 14 software. The association between dependent and independent variables was computed with a binary logistic regression. The association was ascertained using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) at a p value of <0.05. Results A total of 607 participants correctly completed the questionnaire (response rate of 95.44%). Age ranges from 21 to 70 with a mean of 32.39 (SD ± 6.80)) years, and the majority (76.28%) of them were males. The prevalence of WRUED during the last 12 months was 59.14% [95% CI (55.1, 63.1)]. There is no significant difference in prevalence between males and females (45.14% versus 14%), respectively; χ2 = 0.001; p=0.974. Working more than 8 hours per day [AOR: 2.37; 95% CI (1.40, 4.00)], not performing physical exercise [AOR: 2.34; 95% CI (1.6, 3.45)], and job dissatisfaction [AOR: 2.50; 95% CI (1.69, 3.68)] were factors significantly increased the risk of experiencing WRUEDs. Conclusion This study divulged upper extremity disorder among university teaching staff is pervasive, with more than three-fifth of the academicians were suffering from the condition, and it also indicates that males experienced higher proportions of pain than females. The manifestation of upper extremity disorder was affected by working hours per day, physical activity, and job satisfaction. Optimizing working hours, having a group regular exercise, and proper management of workplace conditions related to job satisfaction are recommended to lessen the condition.
背景:与工作相关的上肢疾病(WRUEDs)是指颈部、肩部、手臂、手腕、手和手指的疼痛、紧张和不适。由于恶劣的工作环境和课外活动交织在一起,教育领域的这种情况正在加剧。然而,关注高等教育社会的学者的经验证据可以忽略不计。本研究的目的是调查埃塞俄比亚大学教学人员中wrued的患病率和危险因素。材料与方法我们于2021年3月至4月进行了横断面研究设计。使用分层抽样技术招募了607名院士,并使用自我管理的结构化北欧肌肉骨骼问卷来评估过去12个月的上肢疾病。收集的数据输入EpiData 4.6版本,使用STATA version 14软件进行分析。因变量和自变量之间的关联用二元逻辑回归计算。使用校正优势比(AOR)确定相关性,95%置信区间(CI) p值<0.05。结果共607人正确填写问卷,答复率为95.44%。年龄21 ~ 70岁,平均32.39 (SD±6.80)岁,男性居多(76.28%)。过去12个月WRUED患病率为59.14% [95% CI(55.1, 63.1)]。男性和女性的患病率无显著差异(分别为45.14%和14%);χ2 = 0.001;p = 0.974。每天工作超过8小时[AOR: 2.37;95% CI(1.40, 4.00)],不进行体育锻炼[AOR: 2.34;95% CI(1.6, 3.45)]和工作不满意度[AOR: 2.50;95% CI(1.69, 3.68)]是显著增加wrud发生风险的因素。结论上肢障碍在高校教职员工中普遍存在,超过五分之三的教职员工患有上肢障碍,且男性上肢疼痛的比例高于女性。上肢障碍的表现受每天工作时间、体力活动和工作满意度的影响。通过优化工作时间、定期进行集体锻炼、妥善管理与工作满意度相关的工作环境等措施,可以缓解这种情况。
{"title":"Prevalence and Risk Factors of Work-Related Upper Extremity Disorders among University Teaching Staff in Ethiopia, 2021: An Institution-Based Cross-Sectional Study","authors":"Amensisa Hailu Tesfaye, T. Mekonnen, M. Alemayehu, Giziew Abere","doi":"10.1155/2022/7744879","DOIUrl":"https://doi.org/10.1155/2022/7744879","url":null,"abstract":"Background Work-related upper extremity disorders (WRUEDs) are aches, pains, tension, and discomfort in the neck, shoulders, arms, wrists, hands, and fingers. The situation is escalating in educational sectors due to a lousy working environment intertwined with extracurricular deeds. However, empirical evidence focusing on academicians in higher education society is negligible. The purpose of this study is to examine the prevalence and risk factors of WRUEDs among university teaching staff in Ethiopia. Materials and Methods We conducted a cross-sectional study design from March to April 2021. A sample of 607 academicians were recruited using a stratified sampling technique, and a self-administered structured Nordic Musculoskeletal questionnaire was used to assess upper extremity disorders during the past 12 months. The collected data were entered into EpiData version 4.6 and analyzed using STATA version 14 software. The association between dependent and independent variables was computed with a binary logistic regression. The association was ascertained using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) at a p value of <0.05. Results A total of 607 participants correctly completed the questionnaire (response rate of 95.44%). Age ranges from 21 to 70 with a mean of 32.39 (SD ± 6.80)) years, and the majority (76.28%) of them were males. The prevalence of WRUED during the last 12 months was 59.14% [95% CI (55.1, 63.1)]. There is no significant difference in prevalence between males and females (45.14% versus 14%), respectively; χ2 = 0.001; p=0.974. Working more than 8 hours per day [AOR: 2.37; 95% CI (1.40, 4.00)], not performing physical exercise [AOR: 2.34; 95% CI (1.6, 3.45)], and job dissatisfaction [AOR: 2.50; 95% CI (1.69, 3.68)] were factors significantly increased the risk of experiencing WRUEDs. Conclusion This study divulged upper extremity disorder among university teaching staff is pervasive, with more than three-fifth of the academicians were suffering from the condition, and it also indicates that males experienced higher proportions of pain than females. The manifestation of upper extremity disorder was affected by working hours per day, physical activity, and job satisfaction. Optimizing working hours, having a group regular exercise, and proper management of workplace conditions related to job satisfaction are recommended to lessen the condition.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"104 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88124193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
College Students with Oral Habits Exhibit Worse Psychological Status and Temporomandibular-Related Quality of Life: A Correlational Study 有口腔习惯的大学生表现出较差的心理状态与颞下颌相关生活质量的相关研究
IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-05-11 DOI: 10.1155/2022/6079241
Wenke Yang, Xin Xiong, Yange Wu, Yufan Zhu, Jiaqi Liu, Chengxinyue Ye, Qinlanhui Zhang, Jun Wang
Purpose To evaluate the relationship between oral habits, psychological status, and temporomandibular-related quality of life among college students. Materials and Methods An online questionnaire was sent to college students who were willing to participate in this anonymous survey, which contained questions about the demographic characteristics of the participants, the Patient Health Questionnaire for Depression and Anxiety (PHQ-4), the Fonseca Anamnestic Index (FAI), and the Oral Health Impact Profile for temporomandibular disorders (OHIP-TMDs). Results A total of 505 valid questionnaires were collected from 200 males and 305 females (a mean age of 21.81 ± 2.81 years). The prevalence of oral habits in college students was 58% (294/505). Female gender (odds ratio (OR) 1.786) and having oral habits (OR 1.893) were associated with depression and anxiety. Medical students had significantly less depression and anxiety (OR 0.459) than nonmedical students. The possibility of suffering from temporomandibular disorder (TMDs) as evidenced by the OHIP-TMDs score was associated with female gender (OR 1.989) and having oral habits (OR 3.482). Students with oral habits had higher OHIP-TMDs scores. Conclusion More than half of the college students surveyed had specific oral habits, with a higher prevalence in women than in men. Having oral habits was related to a worse psychological status, higher risk of TMD, and worse temporomandibular-related quality of life.
目的探讨大学生口腔习惯、心理状态与颞下颌相关生活质量的关系。资料与方法对自愿参加匿名调查的大学生进行在线问卷调查,问卷内容包括人口统计学特征、患者抑郁与焦虑健康问卷(PHQ-4)、Fonseca记忆指数(FAI)和颞下颌疾病口腔健康影响概况(OHIP-TMDs)。结果共回收有效问卷505份,男性200份,女性305份,平均年龄21.81±2.81岁。大学生口腔习惯患病率为58%(294/505)。女性(比值比1.786)和口腔习惯(比值比1.893)与抑郁和焦虑相关。医学生的抑郁和焦虑显著低于非医学生(OR 0.459)。女性性别(OR 1.989)和口腔习惯(OR 3.482)与患颞下颌障碍(TMDs)的可能性相关。有口腔习惯的学生ohip - tmd得分较高。结论半数以上的受访大学生有特定的口腔习惯,女性的患病率高于男性。有口腔习惯与较差的心理状态、较高的TMD风险和较差的颞下颌相关生活质量有关。
{"title":"College Students with Oral Habits Exhibit Worse Psychological Status and Temporomandibular-Related Quality of Life: A Correlational Study","authors":"Wenke Yang, Xin Xiong, Yange Wu, Yufan Zhu, Jiaqi Liu, Chengxinyue Ye, Qinlanhui Zhang, Jun Wang","doi":"10.1155/2022/6079241","DOIUrl":"https://doi.org/10.1155/2022/6079241","url":null,"abstract":"Purpose To evaluate the relationship between oral habits, psychological status, and temporomandibular-related quality of life among college students. Materials and Methods An online questionnaire was sent to college students who were willing to participate in this anonymous survey, which contained questions about the demographic characteristics of the participants, the Patient Health Questionnaire for Depression and Anxiety (PHQ-4), the Fonseca Anamnestic Index (FAI), and the Oral Health Impact Profile for temporomandibular disorders (OHIP-TMDs). Results A total of 505 valid questionnaires were collected from 200 males and 305 females (a mean age of 21.81 ± 2.81 years). The prevalence of oral habits in college students was 58% (294/505). Female gender (odds ratio (OR) 1.786) and having oral habits (OR 1.893) were associated with depression and anxiety. Medical students had significantly less depression and anxiety (OR 0.459) than nonmedical students. The possibility of suffering from temporomandibular disorder (TMDs) as evidenced by the OHIP-TMDs score was associated with female gender (OR 1.989) and having oral habits (OR 3.482). Students with oral habits had higher OHIP-TMDs scores. Conclusion More than half of the college students surveyed had specific oral habits, with a higher prevalence in women than in men. Having oral habits was related to a worse psychological status, higher risk of TMD, and worse temporomandibular-related quality of life.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"15 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75385529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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Pain Research & Management
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