Abstract: Perioperative Analgesia in Major Oncology operations for the prolepsis of persistence of Chronic Neuropathic Pain might include intravenous infusion of analgesics, concomitant drugs as well as invasive techniques in all surgical stages. Achieving highly effective analgesia presupposes the interdisciplinary collaboration of the surgeon and the anesthesiologist with the patient. Purpose: To give prominence to the benefits of analgetics for the oncology patient undergoing surgery after having received appropriate perioperative treatment and starts analgesic protection from the time preceding surgical incision to the patient’s complete recovery, as far as prevention of chronic neuropathic pain is concerned. Materials & methods: Thorough review of scientific literature in scientific databases (PubMed, Scopus, hesmo.org, uicc.org, Signa Vitae) which are consistent with the way our department functions and in compliance with the protocols concerning the prolepsis of persistence of Chronic Neuropathic Pain in major oncology operation patients. Results: Major analgesic outcomes and avoidance of persistence of chronic neuropathic pain, by taking into consideration the fact that postoperative oncology patients suffer from respiratory depression after invasive analgesia techniques. Also, we are prepared to reduce the use of opioids and their adverse effects, following the procedure below: (1) Choose, when allowed, a combination of general and epidural anesthesia to achieve maximum intraoperative and postoperative analgesia. (2) Intravenous administration of non-steroidal anti-inflammatories, paracetamol, dexamethasone 8mg, NMDA receptor antagonist (Ketamine 30 mg) before incision as well as local infusion of Ropivacaine 2% solution. (3) Intravenous infusion of lidocaine, fentanyl, remifentanil, morphine, tramadol, Mg, ketamine, during surgery by adjusting doses per patient and operative time. (4) Particular caution is suggested in the immediate postoperative period so as to avoid transition from acute postoperative pain to chronic neuropathic pain. Continue drop by drop administration of ropivacaine 2% from epidural catheter. Our armamentarium includes paracetamol, tramadol, dexketoprofen, oxycodone per os, PCA morphine, pain busters (paired drainage catheters with elastomeric pumps) of ropivacaine 2%, patch lidocaine and block nerve conduction. A medical record of the postoperative analgesic course of our patients is kept and completed by our medical and nursing staff.Conclusions: Perioperative analgesia is our key concern in all oncology patients undergoing major surgeries, so as to prevent persistence of chronic neuropathic pain, taking into consideration the impaired health status of patients with acute pain conditions.
{"title":"Perioperative Analgesia in Major Oncology operations for the prolepsis of persistence of Chronic Neuropathic Pain","authors":"Dionysia Boura, Eirini Anastassopoulou, Paraskevi Koufopoulou, Koutouzis Stavros, Katsipoulakis Antonios, Papadopoulos George, V. Anastasia, Tsolou Archontia","doi":"10.22514/sv.2021.176","DOIUrl":"https://doi.org/10.22514/sv.2021.176","url":null,"abstract":"Abstract: Perioperative Analgesia in Major Oncology operations for the prolepsis of persistence of Chronic Neuropathic Pain might include intravenous infusion of analgesics, concomitant drugs as well as invasive techniques in all surgical stages. Achieving highly effective analgesia presupposes the interdisciplinary collaboration of the surgeon and the anesthesiologist with the patient. Purpose: To give prominence to the benefits of analgetics for the oncology patient undergoing surgery after having received appropriate perioperative treatment and starts analgesic protection from the time preceding surgical incision to the patient’s complete recovery, as far as prevention of chronic neuropathic pain is concerned. Materials & methods: Thorough review of scientific literature in scientific databases (PubMed, Scopus, hesmo.org, uicc.org, Signa Vitae) which are consistent with the way our department functions and in compliance with the protocols concerning the prolepsis of persistence of Chronic Neuropathic Pain in major oncology operation patients. Results: Major analgesic outcomes and avoidance of persistence of chronic neuropathic pain, by taking into consideration the fact that postoperative oncology patients suffer from respiratory depression after invasive analgesia techniques. Also, we are prepared to reduce the use of opioids and their adverse effects, following the procedure below: (1) Choose, when allowed, a combination of general and epidural anesthesia to achieve maximum intraoperative and postoperative analgesia. (2) Intravenous administration of non-steroidal anti-inflammatories, paracetamol, dexamethasone 8mg, NMDA receptor antagonist (Ketamine 30 mg) before incision as well as local infusion of Ropivacaine 2% solution. (3) Intravenous infusion of lidocaine, fentanyl, remifentanil, morphine, tramadol, Mg, ketamine, during surgery by adjusting doses per patient and operative time. (4) Particular caution is suggested in the immediate postoperative period so as to avoid transition from acute postoperative pain to chronic neuropathic pain. Continue drop by drop administration of ropivacaine 2% from epidural catheter. Our armamentarium includes paracetamol, tramadol, dexketoprofen, oxycodone per os, PCA morphine, pain busters (paired drainage catheters with elastomeric pumps) of ropivacaine 2%, patch lidocaine and block nerve conduction. A medical record of the postoperative analgesic course of our patients is kept and completed by our medical and nursing staff.Conclusions: Perioperative analgesia is our key concern in all oncology patients undergoing major surgeries, so as to prevent persistence of chronic neuropathic pain, taking into consideration the impaired health status of patients with acute pain conditions.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48373763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In 2017 the World Health Organization recognized the potential patient-related harm of polypharmacy as a matter in need of attendance in the years to come and it was set as a priority in the Medication without Harm Initiative. Polypharmacy is rather common in the elderly patients due to their multimorbidities and in patients with chronic pain. It has been related to drug adverse reactions, increased length of hospital stay, falls and increased morbidity. All these are augmented by the number of different drugs and the nature of the disease. Risk factors of polypharmacy are increasing age, female gender, low educational level and socio-economic status, multimorbidity and number of hospitalizations. The term deprescribing comes to confront this issue by means of establishing a well designed plan of discontinuing or tapering off drugs that can cause potential harm to the patient. It is based on the principles of revision of all inappropriate drugs, of gradual reduction, dicontinuation or replacement of these drugs, of designing a certain plan of action along with the patients’ education and cooperation. Guidelines already exist for certain kind of drugs (antihypertensives, statins, antipshychotics a, benzodiazepines) with positive outcomes. In the case of opioid deprescribing in chronic pain management the challenge escalates since there are further issues to be addressed. Opioid withdrawal, the fear of changing the pain management status quo and a level of uncertainty regarding the optimum tapering opioid plan are barriers in the process. Guidelines on opioid deprescribing are in need to address all these matters of concern.
{"title":"Deprescribing is essential for good prescribing","authors":"Georgia Micha","doi":"10.22514/sv.2021.193","DOIUrl":"https://doi.org/10.22514/sv.2021.193","url":null,"abstract":"In 2017 the World Health Organization recognized the potential patient-related harm of polypharmacy as a matter in need of attendance in the years to come and it was set as a priority in the Medication without Harm Initiative. Polypharmacy is rather common in the elderly patients due to their multimorbidities and in patients with chronic pain. It has been related to drug adverse reactions, increased length of hospital stay, falls and increased morbidity. All these are augmented by the number of different drugs and the nature of the disease. Risk factors of polypharmacy are increasing age, female gender, low educational level and socio-economic status, multimorbidity and number of hospitalizations. The term deprescribing comes to confront this issue by means of establishing a well designed plan of discontinuing or tapering off drugs that can cause potential harm to the patient. It is based on the principles of revision of all inappropriate drugs, of gradual reduction, dicontinuation or replacement of these drugs, of designing a certain plan of action along with the patients’ education and cooperation. Guidelines already exist for certain kind of drugs (antihypertensives, statins, antipshychotics a, benzodiazepines) with positive outcomes. In the case of opioid deprescribing in chronic pain management the challenge escalates since there are further issues to be addressed. Opioid withdrawal, the fear of changing the pain management status quo and a level of uncertainty regarding the optimum tapering opioid plan are barriers in the process. Guidelines on opioid deprescribing are in need to address all these matters of concern.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47458720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Papantonaki, Aikaterini Lappa, A. Dragatsiki, E. Gavrilaki
Aim: Migraine is the second most common form of headache after tension headache. Migraine affects 11% of the population, and is 3 times more common in women than in men. Studies have shown that migraine affects the functionality of patients at a rate of 53.7%. Aim of this study is to describe the effectiveness of SPG blockade in a female patient with chronic persistent migraine. Methods & material: We used data from our clinic. The patient came to our clinic with severe migraine (VAS pain 10) for more than two years. Her history reports migraine worsening in the last two years (>15 episodes per month). The pain is localized unilaterally is high intensity and with pulsating character. She also refers nausea, vomiting and dizziness with pain. After the remission of acute pain the patient describes cognitive dysfunction, depression and weakness. Her medication was Paracetamol 1 gr every 6 hours, Sertraline 100 mg daily, Amitriptyline 25 mg daily and Rizatriptan10mg for crisis treatment. SPG blockage was suggested to her for treatment which she accepted. Lidocaine 2% 0.6 mL to each nostril administered via nasal catheter (TX 360). Results: A total of 4 treatments were applied (1 every 30 days). At the end of the first treatment the patient reports pain relief after 15 minute VAS pain 6. The only side effect was tearing. She gradually reduced her medication. She only retain Rizatriptan. She was also start prophylactic treatment of migraine with Propranolol. At the end of the four treatment the patient reports VAS pain 0, without any episodes of acute pain and she return to her normal activity. Conclusions: SPG blockage is a simply effective and painless method to treat chronic migraine, without any serious side effects.
{"title":"Sphenopalatine Ganglion Block (SPG) for the treatment of migraine","authors":"S. Papantonaki, Aikaterini Lappa, A. Dragatsiki, E. Gavrilaki","doi":"10.22514/sv.2021.170","DOIUrl":"https://doi.org/10.22514/sv.2021.170","url":null,"abstract":"Aim: Migraine is the second most common form of headache after tension headache. Migraine affects 11% of the population, and is 3 times more common in women than in men. Studies have shown that migraine affects the functionality of patients at a rate of 53.7%. Aim of this study is to describe the effectiveness of SPG blockade in a female patient with chronic persistent migraine. Methods & material: We used data from our clinic. The patient came to our clinic with severe migraine (VAS pain 10) for more than two years. Her history reports migraine worsening in the last two years (>15 episodes per month). The pain is localized unilaterally is high intensity and with pulsating character. She also refers nausea, vomiting and dizziness with pain. After the remission of acute pain the patient describes cognitive dysfunction, depression and weakness. Her medication was Paracetamol 1 gr every 6 hours, Sertraline 100 mg daily, Amitriptyline 25 mg daily and Rizatriptan10mg for crisis treatment. SPG blockage was suggested to her for treatment which she accepted. Lidocaine 2% 0.6 mL to each nostril administered via nasal catheter (TX 360). Results: A total of 4 treatments were applied (1 every 30 days). At the end of the first treatment the patient reports pain relief after 15 minute VAS pain 6. The only side effect was tearing. She gradually reduced her medication. She only retain Rizatriptan. She was also start prophylactic treatment of migraine with Propranolol. At the end of the four treatment the patient reports VAS pain 0, without any episodes of acute pain and she return to her normal activity. Conclusions: SPG blockage is a simply effective and painless method to treat chronic migraine, without any serious side effects.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47893096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Chronakis, E. Chainaki, N. Polaki, I. Siafaka, A. Vadalouka
Introduction: Droperidol as a medicine has unique properties and it has been successfully used as analgesic, antipsychotic, antiemetic and as a sedative [1]. It is an antagonist for d2-dopamine, serotonin, histamine, and nicotinic and muscarinic cholinergic receptors. It is also a dose-dependent agonist/antagonist of GABA receptors and an agonist of a2 adrenergic receptors. Moreover, is a sodium channel blocker such as lidocaine and potentiate μ opioid receptors. Its multi-receptor action justifies its use as analgesic, antiemetic and antiphycotic medication [2]. Magnesium seems to function as an antagonist for NMDA receptors and it has been used for relief of acute and chronic pain [3, 4]. The aim of the current study is the evaluation of the efficacy of droperidol and magnesium co-administration on the patients with chronic pain. Method: All patients that attended the pain clinic for chronic pain and aged over 18 years old were included in the study. Patients with atrioventricular block any grade and patients with chronic renal failure were excluded from the study. All included patients received droperidol to the dose 2.5 mg maximum and 1 gr magnesium sulphate iv. DN4 questionnaire was used to assess the presence of neuropathic pain. VAS scale and NPS scale were used to assess the intensity of pain before and after the administration. Change in the pain scales calculated as a percentage. Results: 48 patients included in the study. 23 of them had neuropathic pain. There was a 40–50% reduction of the intensity of pain after iv administration of droperidol and magnesium. There weren’t any complications. Conclusions: The co-administration of magnesium and droperidol can relieve neuropathic and somatosensory pain. Long-term evaluation is needed.
{"title":"Efficacy of iv infusion of magnesium sulphate and dromperidol on the management of neuropathic and somatosensory chronic pain - a two pain center study","authors":"I. Chronakis, E. Chainaki, N. Polaki, I. Siafaka, A. Vadalouka","doi":"10.22514/sv.2021.159","DOIUrl":"https://doi.org/10.22514/sv.2021.159","url":null,"abstract":"Introduction: Droperidol as a medicine has unique properties and it has been successfully used as analgesic, antipsychotic, antiemetic and as a sedative [1]. It is an antagonist for d2-dopamine, serotonin, histamine, and nicotinic and muscarinic cholinergic receptors. It is also a dose-dependent agonist/antagonist of GABA receptors and an agonist of a2 adrenergic receptors. Moreover, is a sodium channel blocker such as lidocaine and potentiate μ opioid receptors. Its multi-receptor action justifies its use as analgesic, antiemetic and antiphycotic medication [2]. Magnesium seems to function as an antagonist for NMDA receptors and it has been used for relief of acute and chronic pain [3, 4]. The aim of the current study is the evaluation of the efficacy of droperidol and magnesium co-administration on the patients with chronic pain. Method: All patients that attended the pain clinic for chronic pain and aged over 18 years old were included in the study. Patients with atrioventricular block any grade and patients with chronic renal failure were excluded from the study. All included patients received droperidol to the dose 2.5 mg maximum and 1 gr magnesium sulphate iv. DN4 questionnaire was used to assess the presence of neuropathic pain. VAS scale and NPS scale were used to assess the intensity of pain before and after the administration. Change in the pain scales calculated as a percentage. Results: 48 patients included in the study. 23 of them had neuropathic pain. There was a 40–50% reduction of the intensity of pain after iv administration of droperidol and magnesium. There weren’t any complications. Conclusions: The co-administration of magnesium and droperidol can relieve neuropathic and somatosensory pain. Long-term evaluation is needed.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44392857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Tsaroucha, C. Orfanou, A. Melemeni, N. Fyrfiris, K. Theodoraki
Background: Sphenopalatine ganglion (SPG) is located within the pterygopalatine fossa, being the only ganglion outside the cranial cavity. Trigeminal neuralgia (TGN) is currently considered as an indication for SPG block, especially in medication-resistant cases. The aim of this observational study is to assess the effectiveness of the SPG block for the treatment of trigeminal neuralgia, using a noninvasive transnasal approach, by delivering local anesthetic with the alternative device Tx360 nasal applicator. Methods: This study concerns patients suffering drug-resistant TGN. In addition to their medication, these patients received SPG block, using the Tx360 nasal applicator in order to deliver 0.3 mL of xylocaine 2%, bilaterally, once a week, for 8 weeks. Eight patients presented with either classical or atypical, V2 (maxillary branch) or V3 (mandibular branch) TGN, partly or completely drug-resistant, having VAS = 8–9, under drug treatment, with no clinical improvement. Results: All patients reported significant pain relief, VAS = 5–6 (3 patients since the first application) and decrease of daily pain episodes. Specifically, after completing therapy, 6 patients were completely symptom-free, 1 reported significant clinical improvement regarding pain intensity and number of pain episodes and 1 patient reported no improvement at any disease level. Favorable outcomes have lasted for up to 3 months for each case. No significant adverse events were noted to any patient. Conclusions: Preliminary data extracted from this pilot study suggest that repetitive SPG block with the Tx360 nasal applicator may constitute an easy, rapid, safe and efficient treatment of trigeminal neuralgia. Further relative double-blind, randomized studies are required in order to draw solid conclusions.
背景:蝶腭神经节(SPG)位于翼腭窝内，是唯一位于颅腔外的神经节。三叉神经痛(TGN)目前被认为是SPG阻滞的适应症，特别是在耐药病例中。本观察性研究的目的是评估SPG阻滞治疗三叉神经痛的有效性，采用无创经鼻入路，用Tx360鼻涂药器局部麻醉。方法:本研究涉及耐药TGN患者。除了药物治疗外，这些患者还接受了SPG阻滞，使用Tx360鼻涂药器给药0.3 mL 2%的xylocaine，每周一次，持续8周。8例患者表现为典型或非典型V2(上颌支)或V3(下颌支)TGN，部分或完全耐药，VAS评分为8-9，正在接受药物治疗，临床无改善。结果:所有患者均报告明显的疼痛缓解，VAS = 5-6(3例自首次应用以来)，每日疼痛发作次数减少。具体而言，完成治疗后，6例患者症状完全消失，1例患者在疼痛强度和疼痛发作次数方面有明显的临床改善，1例患者在任何疾病水平上均无改善。每个病例的良好结果持续时间长达3个月。所有患者均未发现明显的不良事件。结论:本试验的初步数据表明，使用Tx360鼻贴器进行重复SPG阻滞可能是一种简单、快速、安全、有效的治疗三叉神经痛的方法。为了得出可靠的结论，需要进一步的相对双盲、随机研究。
{"title":"Shpenopalatine ganglion block using the Tx360 nasal applicator for the treatment of trigeminal neuralgia: A pilot study","authors":"A. Tsaroucha, C. Orfanou, A. Melemeni, N. Fyrfiris, K. Theodoraki","doi":"10.22514/sv.2021.160","DOIUrl":"https://doi.org/10.22514/sv.2021.160","url":null,"abstract":"Background: Sphenopalatine ganglion (SPG) is located within the pterygopalatine fossa, being the only ganglion outside the cranial cavity. Trigeminal neuralgia (TGN) is currently considered as an indication for SPG block, especially in medication-resistant cases. The aim of this observational study is to assess the effectiveness of the SPG block for the treatment of trigeminal neuralgia, using a noninvasive transnasal approach, by delivering local anesthetic with the alternative device Tx360 nasal applicator. Methods: This study concerns patients suffering drug-resistant TGN. In addition to their medication, these patients received SPG block, using the Tx360 nasal applicator in order to deliver 0.3 mL of xylocaine 2%, bilaterally, once a week, for 8 weeks. Eight patients presented with either classical or atypical, V2 (maxillary branch) or V3 (mandibular branch) TGN, partly or completely drug-resistant, having VAS = 8–9, under drug treatment, with no clinical improvement. Results: All patients reported significant pain relief, VAS = 5–6 (3 patients since the first application) and decrease of daily pain episodes. Specifically, after completing therapy, 6 patients were completely symptom-free, 1 reported significant clinical improvement regarding pain intensity and number of pain episodes and 1 patient reported no improvement at any disease level. Favorable outcomes have lasted for up to 3 months for each case. No significant adverse events were noted to any patient. Conclusions: Preliminary data extracted from this pilot study suggest that repetitive SPG block with the Tx360 nasal applicator may constitute an easy, rapid, safe and efficient treatment of trigeminal neuralgia. Further relative double-blind, randomized studies are required in order to draw solid conclusions.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42247231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Galeoto, M. A. Marquez, Lorenza Ottone, G. Sellitto, F. Panuccio, J. González-Bernal, M. Tofani, A. Berardi
The study aimed to translate, culturally adapt, and validate the Intermittent Catheteri-zation Adherence Scale (ICAS) in Italian for people with Spina bifida and spinal cord injury. The population consisted of adults who practice self-catheterization, recruited through online questionnaire google docs. The ICAS was translated and culturally adapted following international guidelines. The test was administered together with the Italian version of Qualiveen-30 for quality of life related to practice self-catheterization, Spinal Cord Independence Measure self-report (SCIM-SR) for independence in activities of daily living, Moorong self-efficacy scale (MSES) for self-efficacy. The ICAS was administered two times within a week, in order to assess test-retest reliability. Its psychometric properties were evaluated according to international guidelines. After the translation and cultural adaptation processes, all items were either identical or similar to the 34 study participants. For internal consistency, Cronbach’ alpha showed values of 0.845; has been obtained from the analysis of individual’s answers for each item; interclass correlation coefficient showed values of 0.995; has been obtained from analysis of the answers individuals gave each subscale after a week. Pearson’s correlation coefficient and Spearman’s Correlation Coefficient showed statistically significant correlations; has been obtained for the comparation of ICAS with Qualiveen-30 and SCIM-SR. The validation of ICAS in Italian allows professionals to work with self-catheterization for people with neurological bladder to face psychological barriers before learning about the Clean Intermittent Self Catheterization (CISC), improving patients’ adherence to it. Adherence is the basis of CISC since, if this is not carried out according to the prescription, various types of bladder problems may arise. At the same time, the ICAS can be used for the medical follow-up of people using intermittent self-catheterization techniques and finally for medical research.
{"title":"Intermittent Catheterization Adherence Scale (ICAS): Italian translation, cultural adaptation and validation","authors":"G. Galeoto, M. A. Marquez, Lorenza Ottone, G. Sellitto, F. Panuccio, J. González-Bernal, M. Tofani, A. Berardi","doi":"10.22514/sv.2021.145","DOIUrl":"https://doi.org/10.22514/sv.2021.145","url":null,"abstract":"The study aimed to translate, culturally adapt, and validate the Intermittent Catheteri-zation Adherence Scale (ICAS) in Italian for people with Spina bifida and spinal cord injury. The population consisted of adults who practice self-catheterization, recruited through online questionnaire google docs. The ICAS was translated and culturally adapted following international guidelines. The test was administered together with the Italian version of Qualiveen-30 for quality of life related to practice self-catheterization, Spinal Cord Independence Measure self-report (SCIM-SR) for independence in activities of daily living, Moorong self-efficacy scale (MSES) for self-efficacy. The ICAS was administered two times within a week, in order to assess test-retest reliability. Its psychometric properties were evaluated according to international guidelines. After the translation and cultural adaptation processes, all items were either identical or similar to the 34 study participants. For internal consistency, Cronbach’ alpha showed values of 0.845; has been obtained from the analysis of individual’s answers for each item; interclass correlation coefficient showed values of 0.995; has been obtained from analysis of the answers individuals gave each subscale after a week. Pearson’s correlation coefficient and Spearman’s Correlation Coefficient showed statistically significant correlations; has been obtained for the comparation of ICAS with Qualiveen-30 and SCIM-SR. The validation of ICAS in Italian allows professionals to work with self-catheterization for people with neurological bladder to face psychological barriers before learning about the Clean Intermittent Self Catheterization (CISC), improving patients’ adherence to it. Adherence is the basis of CISC since, if this is not carried out according to the prescription, various types of bladder problems may arise. At the same time, the ICAS can be used for the medical follow-up of people using intermittent self-catheterization techniques and finally for medical research.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46929803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ka-Eun Kim, Na-ri Shin, Soon-Hi Park, S. Nam, Y. Yoon, Soon-Kwon Park, Jeong-Sook Park, I. Cho
Thermal and massage therapies have long been used to control pain. Although spinal thermal massage (STM) has been used worldwide, its effectiveness has not been proven in a controlled clinical study. We here conducted a non-randomized controlled trial to assess the pain-relieving and immunomodulatory effects of STM in old-aged patients experiencing pain or disability. The experimental group was treated with STM five times a week for 8 weeks and rehabilitative regular care (RRC). The control group was treated with only RRC. Pain and immunological parameters were tested before treatment and after 4 and 8 weeks of treatment. The scores of three pain parameters were lowered by STM, and the differences between the groups were statistically significant at the two time points (p < 0.01). Quality of life determined using the 3-level EuroQol five-dimensional questionnaire scores was significantly higher in patients in the experimental group than those in the control group. Effect sizes (ES) were in the range of medium to large in the pain-related measures (0.54–1.22). The total leukocyte counts and the proportions of lymphocytes and subsets were not significantly different between the groups, whereas the proportions of monocytes and natural killer (NK) cells were higher in the experimental group than in the control group after 8 weeks (p < 0.05). The production of interleukin (IL)-4 and interferon γ in T cells was not significantly different between the groups, whereas the production of IL-2 was high in the control group. However, there was a significant increase in IFN-γ production by NK cells in the experimental group (at 4 weeks, p < 0.05). ES were medium in the immunological measures (0.53–0.68). No significant difference was observed in the production of proinflammatory cytokines, IL-1β, tumor necrosis factor α, or IL-6 between the groups. In conclusion, STM treatment has a positive effect on subjective pain and quality of life. It also enhanced NK cell proportion and activity, suggesting that STM may be beneficial in the prevention of viral diseases and cancer in old-aged people.
{"title":"Modulation of the human immune status by spinal thermal massage: a non-randomized controlled study","authors":"Ka-Eun Kim, Na-ri Shin, Soon-Hi Park, S. Nam, Y. Yoon, Soon-Kwon Park, Jeong-Sook Park, I. Cho","doi":"10.22514/sv.2021.144","DOIUrl":"https://doi.org/10.22514/sv.2021.144","url":null,"abstract":"Thermal and massage therapies have long been used to control pain. Although spinal thermal massage (STM) has been used worldwide, its effectiveness has not been proven in a controlled clinical study. We here conducted a non-randomized controlled trial to assess the pain-relieving and immunomodulatory effects of STM in old-aged patients experiencing pain or disability. The experimental group was treated with STM five times a week for 8 weeks and rehabilitative regular care (RRC). The control group was treated with only RRC. Pain and immunological parameters were tested before treatment and after 4 and 8 weeks of treatment. The scores of three pain parameters were lowered by STM, and the differences between the groups were statistically significant at the two time points (p < 0.01). Quality of life determined using the 3-level EuroQol five-dimensional questionnaire scores was significantly higher in patients in the experimental group than those in the control group. Effect sizes (ES) were in the range of medium to large in the pain-related measures (0.54–1.22). The total leukocyte counts and the proportions of lymphocytes and subsets were not significantly different between the groups, whereas the proportions of monocytes and natural killer (NK) cells were higher in the experimental group than in the control group after 8 weeks (p < 0.05). The production of interleukin (IL)-4 and interferon γ in T cells was not significantly different between the groups, whereas the production of IL-2 was high in the control group. However, there was a significant increase in IFN-γ production by NK cells in the experimental group (at 4 weeks, p < 0.05). ES were medium in the immunological measures (0.53–0.68). No significant difference was observed in the production of proinflammatory cytokines, IL-1β, tumor necrosis factor α, or IL-6 between the groups. In conclusion, STM treatment has a positive effect on subjective pain and quality of life. It also enhanced NK cell proportion and activity, suggesting that STM may be beneficial in the prevention of viral diseases and cancer in old-aged people.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42590000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Homma, J. Oda, Hidefumi Sano, S. Kawata, M. Itoh
Although the effectiveness of cadaver surgical training has been clarified, the decline in training effects over time has become a problem. This study examined whether repeated participation in cadaver-based educational seminar for trauma surgery (C-BEST) could suppress the decline in training effects. Basic and advanced C-BEST have pelvic package (PP) and fasciotomy of the lower extremity (FLE) as common training skills. For participants of these skills twice each, we examined the changes in a 10-point self-assessment of confidence levels (SACL) at six time points: (1) before the seminar of basic C-BEST, (2) immediately after basic C-BEST, (3) half a year after basic C-BEST, (4) before advanced C-BEST, (5) immediately after advanced C-BEST, and (6) half a year after advanced C-BEST. Data were collected from 28 basic C-BESTs and 5 advanced C-BESTs conducted from January 2013 to January 2020. Statistical analysis was performed by comparing SACL results from seminar evaluations at the six points, with significance at P < 0.05. A total of 60 participants were enrolled (postgraduate year, 16.5 ± 5.7). The interval between basic and advanced C-BEST was 27.1 ± 6.9 months. In PP, the SACL did not decrease at all six points. In FLE, SACL did not decrease at all six points, had a greater increase before versus immediately after advanced C-BEST, and did not decrease thereafter (P < 0.05). After participants retook the seminar, FLE-like procedures, which are unfamiliar to nonorthopedic surgeons, had increased and maintained self-evaluation values, whereas PP-like procedures, which are familiar to abdominal surgeons, had maintained high self-evaluation values. Therefore, repeated seminar participation could maintain the effects of cadaver training.
{"title":"Repeated participation in the cadaver-based educational seminar for trauma surgery (C-BEST) could maintain training effects: skill retention at a 2-year follow-up","authors":"H. Homma, J. Oda, Hidefumi Sano, S. Kawata, M. Itoh","doi":"10.22514/sv.2021.146","DOIUrl":"https://doi.org/10.22514/sv.2021.146","url":null,"abstract":"Although the effectiveness of cadaver surgical training has been clarified, the decline in training effects over time has become a problem. This study examined whether repeated participation in cadaver-based educational seminar for trauma surgery (C-BEST) could suppress the decline in training effects. Basic and advanced C-BEST have pelvic package (PP) and fasciotomy of the lower extremity (FLE) as common training skills. For participants of these skills twice each, we examined the changes in a 10-point self-assessment of confidence levels (SACL) at six time points: (1) before the seminar of basic C-BEST, (2) immediately after basic C-BEST, (3) half a year after basic C-BEST, (4) before advanced C-BEST, (5) immediately after advanced C-BEST, and (6) half a year after advanced C-BEST. Data were collected from 28 basic C-BESTs and 5 advanced C-BESTs conducted from January 2013 to January 2020. Statistical analysis was performed by comparing SACL results from seminar evaluations at the six points, with significance at P < 0.05. A total of 60 participants were enrolled (postgraduate year, 16.5 ± 5.7). The interval between basic and advanced C-BEST was 27.1 ± 6.9 months. In PP, the SACL did not decrease at all six points. In FLE, SACL did not decrease at all six points, had a greater increase before versus immediately after advanced C-BEST, and did not decrease thereafter (P < 0.05). After participants retook the seminar, FLE-like procedures, which are unfamiliar to nonorthopedic surgeons, had increased and maintained self-evaluation values, whereas PP-like procedures, which are familiar to abdominal surgeons, had maintained high self-evaluation values. Therefore, repeated seminar participation could maintain the effects of cadaver training.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42979732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess the effectiveness of a new scale known as “Emergency department SpO2 (peripheral capillary oxygen saturation), age, and SIRS (Systemic inflammatory response syndrome)” (ED-SAS) that can be used to predict prognosis within 24 hours following presentation compatible with acute pancreatitis in patients admitted to the emergency department. This research project was conducted as a single-center, retrospective, cohort study. The Acute Physiology and Chronic Health Evaluation II (APACHE II), SIRS, Bedside Index for Severity in Acute Pancreatitis (BISAP), ED-SAS, modified Glasgow Scale and Ranson criteria scoring of the patients were evaluated using their presentation data screened from the hospital automation system. Then, the efficiencies of these evaluation systems were compared using the receiving operating curve (ROC). The conformity of the data to the normal distribution was checked with the Kolmogorov-Smirnov test. The ROC analyses were employed to identify the cut-off values of the scoring systems in calculating death rates. The method developed by DeLong et al. was used to compare the ROC curves of the scoring systems. The study has been completed with 235 patients, 91 (38.7%) male and 144 (61.3%) female, with a mean age of 63.1 ± 17.7 years. In the ROC analysis of the ED-SAS evaluation tool to predict death rates, the area under the curve (AUC) value was found to be 0.85 (95% confidence interval: 0.79–0.89), and the Youden index was 0.62, with a p value of 0.001. Mortality prediction with ED-SAS significantly differed compared to the Ranson and SIRS scoring systems (P = 0.001 and P = 0.03, respectively). However, no statistically significant difference was found in the comparison of the ED-SAS score with the modified Glasgow and APACHE II scores (P = 0.12 and P = 0.54, respectively). It was concluded that the Baseband ED-SAS scores provided equally significant results in terms of AUC at the 95% confidence interval (P = 0.05). Statistical analyses revealed that the APACHE II, SIRS, BISAP, modified Glasgow and ED-SAS scores were found to be significantly higher among the dead in comparison to the survivors (P < 0.05). ED-SAS constitutes a simple, fast, expedient and effective evaluation system that can be utilized to predict mortality in acute pancreatitis in the emergency setting.
{"title":"How to score acute pancreatitis in the emergency setting: five systems against ED-SAS","authors":"M. Erdogan, Nihat Müjdat Hökenek","doi":"10.22514/sv.2021.147","DOIUrl":"https://doi.org/10.22514/sv.2021.147","url":null,"abstract":"To assess the effectiveness of a new scale known as “Emergency department SpO2 (peripheral capillary oxygen saturation), age, and SIRS (Systemic inflammatory response syndrome)” (ED-SAS) that can be used to predict prognosis within 24 hours following presentation compatible with acute pancreatitis in patients admitted to the emergency department. This research project was conducted as a single-center, retrospective, cohort study. The Acute Physiology and Chronic Health Evaluation II (APACHE II), SIRS, Bedside Index for Severity in Acute Pancreatitis (BISAP), ED-SAS, modified Glasgow Scale and Ranson criteria scoring of the patients were evaluated using their presentation data screened from the hospital automation system. Then, the efficiencies of these evaluation systems were compared using the receiving operating curve (ROC). The conformity of the data to the normal distribution was checked with the Kolmogorov-Smirnov test. The ROC analyses were employed to identify the cut-off values of the scoring systems in calculating death rates. The method developed by DeLong et al. was used to compare the ROC curves of the scoring systems. The study has been completed with 235 patients, 91 (38.7%) male and 144 (61.3%) female, with a mean age of 63.1 ± 17.7 years. In the ROC analysis of the ED-SAS evaluation tool to predict death rates, the area under the curve (AUC) value was found to be 0.85 (95% confidence interval: 0.79–0.89), and the Youden index was 0.62, with a p value of 0.001. Mortality prediction with ED-SAS significantly differed compared to the Ranson and SIRS scoring systems (P = 0.001 and P = 0.03, respectively). However, no statistically significant difference was found in the comparison of the ED-SAS score with the modified Glasgow and APACHE II scores (P = 0.12 and P = 0.54, respectively). It was concluded that the Baseband ED-SAS scores provided equally significant results in terms of AUC at the 95% confidence interval (P = 0.05). Statistical analyses revealed that the APACHE II, SIRS, BISAP, modified Glasgow and ED-SAS scores were found to be significantly higher among the dead in comparison to the survivors (P < 0.05). ED-SAS constitutes a simple, fast, expedient and effective evaluation system that can be utilized to predict mortality in acute pancreatitis in the emergency setting.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48121857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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