• Title/Summary/Keyword: Pain severity

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Etiopathogenesis of sacroiliitis: implications for assessment and management

  • Baronio, Manuela;Sadia, Hajra;Paolacci, Stefano;Prestamburgo, Domenico;Miotti, Danilo;Guardamagna, Vittorio A.;Natalini, Giuseppe;Bertelli, Matteo
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.294-304
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    • 2020
  • The sacroiliac joints connect the base of the sacrum to the ilium. When inflamed, they are suspected to cause low back pain. Inflammation of the sacroiliac joints is called sacroiliitis. The severity of the pain varies and depends on the degree of inflammation. Sacroiliitis is a hallmark of seronegative spondyloarthropathies. The presence or absence of chronic sacroiliitis is an important clue in the diagnosis of low back pain. This article aims to provide a concise overview of the anatomy, physiology, and molecular biology of sacroiliitis to aid clinicians in the assessment and management of sacroiliitis. For this narrative review, we evaluated articles in English published before August 2019 in PubMed. Then, we selected articles related to the painful manifestations of the sacroiliac joint. From the retrieved articles, we found that chronic sacroiliitis may be caused by various forms of spondyloarthritis, such as ankylosing spondyloarthritis. Sacroiliitis can also be associated with inflammatory bowel disease, Crohn's disease, gout, tuberculosis, brucellosis, and osteoarthritis, indicating common underlying etiological factors. The pathophysiology of sacroiliitis is complex and may involve internal, environmental, immunological, and genetic factors. Finally, genetic factors may also play a central role in progression of the disease. Knowing the genetic pre-disposition for sacroiliitis can be useful for diagnosis and for formulating treatment regimens, and may lead to a substantial reduction in disease severity and duration and to improved patient performance.

The Effects of PACE Program on Self-efficacy, Pain and Joint Function in Korean Immigrant Elderly with Osteoarthritis. (PACE 프로그램이 퇴행성관절염 노인의 자기효능감과 통증 및 관절기능에 미치는 효과 - 미국이민 한국노인을 중심으로 -)

  • Sohng, Kyeong-Yae
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.278-294
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    • 1999
  • The PACE (People nth Arthritis Can Exercise) is an exercise program developed by the Arthritis Foundation to improve muscle strength and joint flexibility for patients with arthritis. The purpose of this study was to explore the effects of PACE program on self-efficacy, pain, and joint function in the Korean immigrant elderly. The PACE program was held twice a week for 6 weeks for Korean immigrant elderly who had osteoarthritis. Twenty four subjects completed the program, who were recruited in two places : 10 elderly in a senior residential apartment, and 14 elderly in a senior center supported by Congregated Meal Program for Korean Elderly. Self-efficacy(Sherer et al., 1982), pain severity(by using Visual Analogue Scale), and number of painful joints were measured before and after the PACE program. To examine the joint flexibility and strengthening, the followings were measured : the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion(ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension. Wilcoxon signed rank test was used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the PACE program. After the PACE, followings were found : 1. Self-efficacy was significantly increased. 2. Pain severity and number of painful Joints was significantly decreased. 3. The flexibility of both shoulders and arms were significantly improved, but the flexibility of knee was not changed. 4. The flexibility and strengthening of both ankle was significantly improved. In conclusion, PACE was clearly proved to be an effective exercise program to promote self-efficacy, to reduce pain, and to enhance joint function in the elderly with osteoarthritis. It is suggested that the PACE program should be recommended as one of the useful and appropriate nursing interventions for elderly with osteoarthritis.

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Aprepitant in combination with palonosetron for the prevention of postoperative nausea and vomiting in female patients using intravenous patient-controlled analgesia

  • Yoo, Jae Hwa;Kim, Soon Im;Chung, Ji Won;Jun, Mi Roung;Han, Yoo Mi;Kim, Yong Jik
    • Korean Journal of Anesthesiology
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    • v.71 no.6
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    • pp.440-446
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    • 2018
  • Background: The aim of this study was to evaluate aprepitant in combination with palonosetron as compared to palonosetron alone for the prevention of postoperative nausea and vomiting (PONV) in female patients receiving fentanyl-based intravenous patient-controlled analgesia (IV-PCA). Methods: In this randomized single-blinded study, 100 female patients scheduled for elective surgery under general anesthesia were randomized to two groups: Group AP (80 mg aprepitant plus 0.075 mg palonosetron, n = 50) and Group P (0.075 mg palonosetron, n = 50). The patients in group AP received 80 mg aprepitant per oral 1-3 h before surgery, while all patients received 0.075 mg palonosetron after induction of standardized anesthesia. All patients had postoperative access to fentanyl-based IV-PCA. The incidence of nausea and vomiting, use of rescue medication, and severity of nausea were evaluated at 6 and 24 h after surgery. Results: The incidence of nausea (54%) and vomiting (2%) in group AP did not differ significantly from that in group P (48% and 14%, respectively) during the first 24 h after surgery (P > 0.05). Patient requirements for rescue medication in group AP (29%) were similar to those in group P (32%) at 24 h after surgery (P > 0.05). There was no difference between the groups in severity of nausea during the first 24 h after surgery (P > 0.05). Conclusions: Aprepitant combined with palonosetron did not reduce the incidence of PONV as compared to palonosetron alone within 24 h of surgery in women receiving fentanyl-based IV-PCA.

A Case Report of Non-cardiac Chest Pain in a Non-erosive Reflux Disease Patient Treated with Beewha-eum (비화음으로 호전된 비미란성 역류질환(Non-erosive Reflux Disease) 환자의 비심인성 흉통(Non-cardiac chest pain) 치험 1례)

  • Jun, Hye-jin;Kim, Keum-ji;Cho, Min-ji;Ko, Seok-jae;Park, Jae-woo
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1223-1230
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    • 2020
  • Objective: The purpose of this study was to report the effectiveness of Korean medicine (Beewha-eum) on the treatment of non-cardiac chest pain (NCCP) in a patient with non-erosive reflux disease (NERD). Methods: The patient was diagnosed with a spleen-stomach weakness pattern identified by Korean medicine and was treated with herbal medicine (Beewha-eum). The severity of symptoms was assessed with a numerical rating scale (NRS) for chest pain, self-reported dyspepsia degree (%), Korean gastrointestinal symptom rating scale (KGSRS), gastrointestinal symptom score (GIS), and Functional Dyspepsia-Quality of Life(FD-QOL) score. Results: After Beewha-eum treatment, the severity of chest pain was decreased from NRS 8 to NRS 0 and the self-reported dyspepsia degree also decreased from 100% to 65%. The KGSRS score was decreased from 49 to 35, the GIS score was also decreased from 16 to 9, and the FD-QOL score was increased from 20 to 25. Conclusions: The study findings suggested that Korean medical treatment with Beewha-eum could be an effective option for treating NCCP in patients with NERD.

A case of functional abdominal pain with Gyejiyimahwangyil-tang (계지이마황일탕(桂枝二麻黃一湯) 투여 후 호전된 기능성 복통 1례)

  • Kim, Seulki
    • 대한상한금궤의학회지
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    • v.11 no.1
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    • pp.27-34
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    • 2019
  • Objective : The purpose of the present study was to report the improvement of functional abdominal pain in a patient treated with a herb medication based on a disease pattern identification diagnostic system under the provision of Shanghanlun (DPIDS). Methods : According to DPIDS, the patient was diagnosed with Taeyang-byung, no. 25 provision, and was administered with Gyejiyimahwangyil-tang herb medication for 60 days. The severity of the abdominal pain was assessed with the five-point Likert scale. Results : The abdominal pain in the patient disappeared following treatment with Gyejiyimahwangyil-tang, which is described in the 25th provision of Shanghanlun. Conclusions : The present case report suggests that '瘧', a word in the 25th provision of Shanghanlun may indicate severe abdominal pain at nighttime and not just malaria.

A Case Report of Central Post-stroke Pain Patient Treated with Scalp Acupuncture(MS6 and MS7) and Usual Treatment of Korean Medicine (두침을 활용한 뇌졸중 후 중추성 통증 환자 치험 1례)

  • Kim, Jae Hong;Park, Gwang Cheon
    • Journal of Acupuncture Research
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    • v.31 no.3
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    • pp.57-65
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    • 2014
  • Objectives : The aim of this report was to investigate the effects of scalp acupuncture on central post-stroke pain. Methods : We treated a patient with central post-stroke pain from Lt thalamo-geniculate artery territory infarction with scalp acupuncture(MS6 and MS7) and usual treatment of Korean medicine. We evaluated pain severity using numerical rating scale(NRS). The scalp acupuncture was performed once a day for 3 weeks. Results : After 15th treatment of scalp acupuncture, NRS decreased from 8 to 3. Conclusions : This result suggests that scalp acupuncture(MS6 and MS7) is effective in treating central post-stroke pain. We hope that more clinical data and studies are to be done for efficient application.

Comparison of low back pain frequency mother owing to severity of Developmental-children with disability (발달장애아동의 중증도에 따른 어머니의 요통 빈도 비교)

  • Lim, Hyoung-Won
    • Journal of Korean Physical Therapy Science
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    • v.13 no.2
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    • pp.27-36
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    • 2006
  • The purpose of this study would like to analyze statically significant difference for low back-pain frequency of mother after development-disability children. Seven nursery children with disability conducted survey from 122 mothers cared children with disability. Survey data was obtained from April 14. 2006 to May 23. 2006. The results were as follows: According to walking-existence, assistance walking, and disability-degree, low back pain incidence frequency of mothers were statically significant difference, (p<0.05). Low back pain incidence frequency of walker-ability population was 51.4%, but low back pain incidence frequency of walker-disability population was 80.0%. then low back pain incidence frequency of mothers to walking-existence was differed amount. Disabled not statically significant difference to encephalopathy and disability-type1 and disability -type2 (p>0.05). children with disability-degree and assistance walking benchmarked low back pain disability-measure. Low back pain degree not relevancy statically significant. Physical load was statically significant difference between Oswestry's low back pain score and reach effect to child-cared(p<0.05). As development-children with disability of disable degree, Mother appeared to highly low back pain frequency rate and appeared to large reach effect child-cared owing to physical load of low back pain. So hereafter, location and person request to approach with more clinical and objectively. As approach result, it will help to stress solution of children with disability owing to develop to low back pain class and family capable strengthening program and so on.

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Analysis of Nursing Records for Elderly Patients with Abdominal Pain in the Emergency Medical Center (응급의료센터에 내원한 복부통증 노인 환자에 대한 간호기록 분석)

  • Lee, Hyeo Ki;Kim, Jong Im
    • Journal of muscle and joint health
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    • v.26 no.1
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    • pp.27-34
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    • 2019
  • Purpose: This study was done to analyze nursing assessment and nursing care for pain in the electronic nursing records for the elderly patients with abdominal pain visiting the Emergency Medical Center. Methods: This study is a descriptive study based on nursing records from January to December 2015. A total of 1155 records for elderly patients with abdominal pain were gathered. Results: The mean age of elderly patients whose records were analyzed was 75.2 years. Analysis of nursing records regarding pain management showed that semi-urgent severity (93.7%), direct emergency room visits (58%), and 6.01 hours of emergency room stay (6.01 hours)were the most frequently documented characteristics of the elderly patients with pain complaints. Recording time of nursing assessment for abdominal patients was 1.01 hour; the average pain intensity was 3.97. The mostly used nursing intervention for abdominal pain was medication (65.1%). There was no record of non-pharmacological pain nursing interventions. Conclusion: The results of this study showed that improving knowledge and nursing practice for pain management is much of necessity. In particular, development of the non-pharmacological nursing interventions for pain is needed. Further research is also imperative to develop and evaluate record systems for pain management that can be used in the emergency room.

Depressive Symptoms in Diabetic Neuropathic Patients (당뇨성 신경병환자들에서 우울증상)

  • Chung, Young-Cho;Lee, Young-Ho;Han, Ki-Seok;Kwon, Oh-Young;Lim, Kyung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.52-58
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    • 1993
  • Before studying the effectiveness of amitriptyline in alleviating the pain of diabetic neuropathy, this study was designed to compare the severity and nature of depressive symtoms of diabetic patients with neuropathy with those of diabetic patients without neuropathy and patients with somatoform disorder whose complaints were mainly somatic pain, respectively. The authors administered Beck Depression Inventory(BDI) to the three groups of patients. The mean total scores of BDI were relatively low in all groups and not significantly different among the three groups. The mean scores of four subscales of BDI were also not significantly different among the three groups. These results might suggest that the pain of diabetic neuropathy did not influence on the severity and the nature of depressive symptoms of preexisting diabetes.

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FIRST Survey: Fentanyl-TTS is Rational Solution to Treat Cancer Pain and Pain Assessment as a $5^{th}$ Vital Sign in Korean Cancer Patients (암성통증: 제5의 활력징후인 통증의 강도 측정 및 펜타닐 패취(듀로제식$^{(R)}$)의 통증 조절 효과)

  • Choi, Youn-Seon;Lee, June-Young;Lim, Yeun-Keun;Kim, Chul-Soo;Song, Hong-Suk;Kim, Sam-Yong;Kim, Su-Hyun;Kim, Jun-Suk
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.238-247
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    • 2004
  • Purpose: Pain management is often needlessly suboptimal. Health care professionals are seldom trained in pain management, may not realize the importance of pain management or recognize that a patient is in pain, and may fear prescribing opioid medications. Noting that one of the problems related to health care professionals is poor assessment of pain, we studied a trend of pain severity and satisfaction with pain controls after using TTS-fentanyl in order to determine whether a regular pain assessment was effective for controlling cancer pain. Methods: We assessed the pain as a $5^{th}$ vital sign after using TTS-fentanyl in 471 hospitalized cancer patients during 4 days. The data were collected from September, 2003 to December, 2003. Pain severity was assessed by using a numeric pain intensity scale($0{\sim}10$) by ongoing pain assessment. Results: Pain assessment as a $5^{th}$ vital sign had led to reduce patient's pain scores. High degrees of satisfaction scores in both patients and doctors with TTS-fentanyl were observed. They were also negatively correlated with the pain severity. Conclusion: Regular pain assessment was effective in the management of cancer pain.

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