• Title/Summary/Keyword: pain assessment

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Clinical comparison of intraoral CMOS and PSP detectors in terms of time efficiency, patient comfort, and subjective image quality

  • Kamburoglu, Kivanc;Samunahmetoglu, Ercin;Eratam, Nejlan;Sonmez, Gul;Karahan, Sevilay
    • Imaging Science in Dentistry
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    • v.52 no.1
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    • pp.93-101
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    • 2022
  • Purpose: This study compared the effectiveness of complementary metal-oxide semiconductors (CMOS) and photostimulable phosphor (PSP) plates as intraoral imaging systems in terms of time efficacy, patient comfort, and subjective image quality assessment in real clinical settings. Materials and Methods: Fifty-eight patients (25 women and 33 men) were included. Patients were referred for a full-mouth radiological examination including 1 bitewing radiograph (left and right) and 8 periapical radiographs for each side (left maxilla/mandible and right maxilla/mandible). For each patient, 1 side of the dental arch was radiographed using a CMOS detector, whereas the other side was radiographed using a PSP detector, ensuring an equal number of left and right arches imaged by each detector. Clinical application time, comfort/pain, and subjective image quality were assessed for each detector. Continuous variables were summarized as mean±standard deviation. Differences between detectors were evaluated using repeated-measures analysis of variance. P<0.05 was accepted as significant. Results: The mean total time required for all imaging procedures with the CMOS detector was significantly lower than the mean total time required for imaging procedures with PSP (P<0.05). The overall mean patient comfort scores for the CMOS and PSP detectors were 4.57 and 4.48, respectively, without a statistically significant difference (P>0.05). The performance of both observers in subjectively assessing structures was significantly higher when using CMOS images than when using PSP images for all regions (P<0.05). Conclusion: The CMOS detector was found to be superior to the PSP detector in terms of clinical time efficacy and subjective image quality.

Treating COVID-19 with Qingfei Paidu Decoction with and without Ephedra Herba: A Retrospective Case Series (청폐배독탕 및 청폐배독탕거마황을 사용해 COVID-19 증상의 개선을 보인 증례 보고 : 후향적 사례군연구)

  • Kim, Kwangho;Kang, Geonhui;Lee, Young-ung;Kang, Sunny;Ji, Sangho;Song, Juhwan;Kim, Cheol-hyun;Lee, Sangkwan
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.264-273
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    • 2022
  • The purpose of this report is to describe the effects of Qingfei Paidu decoction (QPD) and QPD without Ephedra Herba on COVID-19 patients. One COVID-19 patient was treated with QPD and two others who had been sensitive to ephedra were treated with QPD without it. The fever, cough, and sore throat of all three were monitored three times a day through non-face-to-face assessment for a total of five to seven days, and cough and throat pain changes were evaluated with a numeric rating scale (NRS). After treatment, the fever and NRS scores were improved for all three patients. These results indicate that both QPD and QPD without Ephedra Herba is an effective treatment for COVID-19 symptoms.

Effects of Korean Medicine Treatment for a Meralgia Paresthetica Patient: A Case Report (대퇴신경지각이상증 환자에 대한 한의학적 치료 효과: 증례보고)

  • Ahn, Jaeseo;Kang, Dohyeon;Min, Taewoon;Lee, Hyunjun;Lee, Hansol;Kim, Hankyul;Lee, Seongmin;Cho, Sohyun;Ji, Hyungwook;Ko, Ilhwan;Kim, Jiwon;Yun, Jungmin;Jeong, Hyukjin
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.171-178
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    • 2022
  • Meralgia paresthetica is a rare femoral disease and various symptoms appear such as pain, numbness, and paresthesia in the anterolateral thigh due to entrapment of the lateral femoral cutaneous nerve. We treated the meralgia paresthetica patients with Korean medicine treatment including herbal medicine, acupuncture, Chuna manual therapy and pharmacopuncture during 12 days. Numerical rating scale (NRS), Euroqol five dimension (EQ-5D) index, and the changes of symptoms were measured for assessment. After 12 days inpatient treatment, NRS decreased from 7 to 4, EQ-5D index and the symptoms of the patient also were improved. In conclusion, this case shows Korean medicine treatment might be an effective treatment for Meralgia paresthetica.

Actigraphy-Based Assessment of Sleep Parameters in Intensive Care Unit Patients Receiving Respiratory Support Therapy (호흡지지요법을 적용 중인 중환자실 입원환자의 액티그래피 측정 수면특성)

  • Kang, Jiyeon;Kwon, Yongbin
    • Journal of Korean Critical Care Nursing
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    • v.15 no.3
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    • pp.115-127
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    • 2022
  • Purpose : This study aimed to investigate sleep parameters and to identify differences according to respiratory support therapy, sedation, and pain medication in intensive care unit (ICU) patients. Methods : In this observational study, sleep parameters were measured using actigraphy. We observed 45 sleep events in 30 ICU patients receiving respiratory support therapy. We measured the sleep parameters, time, efficiency, and wakefulness after sleep onset (WASO). The differences in sleep parameters according to the respiratory support therapy were analyzed using the Mann-Whitney U test. Results : The average daily sleep time of the participants was 776.66±276.71 minutes, of which more than 60% accounted for daytime sleep. During night sleep, the duration of WASO was 156.93±107.91 minutes, and the frequency of WASO was 26.02±25.82 times. The high flow nasal cannula (HFNC) group had a significantly shorter night sleep time (𝑥2=7.86, p =.049), a greater number of WASO (𝑥2=5.69, p =.128), and a longer WASO duration (𝑥2=8.75, p =.033) than groups of other respiratory therapies. Conclusion : ICU patients on respiratory support therapy experienced sleep disturbances such as disrupted circadian rhythm and sleep fragmentation. Among respiratory support regimens, HFNC was associated with poor sleep parameters, which appears to be associated with the insufficient use of analgesics. The results of this study warrant the development of interventions that can improve sleep in ICU patients receiving respiratory support, including HFNC.

The Utility of Picosecond Nd:YAG Laser for Tattoo Removal

  • Park, Kyong Chan;Park, Eun Soo;Nam, Seung Min;Shin, Jin Su
    • Medical Lasers
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    • v.10 no.1
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    • pp.31-36
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    • 2021
  • Background and Objectives Several predicted optimal parameters for laser treatment have been suggested, making the settings subject to variation. Thus, picosecond lasers may require more data and studies to optimize the laser parameters, increase the efficacy of each session, and minimize the total number of sessions. This study evaluated the results of picosecond laser tattoo removal in variable locations, focusing on the aesthetic outcome, number of procedures, and adverse effects. Materials and Methods Nine patients who underwent picosecond laser treatment from February 2014 to July 2020 were enrolled. Before the procedures, the required number of sessions was estimated using the Kirby-Desai scale. At the end of the treatment, the patients assessed their satisfaction. The patient and two plastic surgeons assessed the clearance of the tattoo. Results The mean of the clearance was 86.6% in both the patient and investigators assessment. The patients reported satisfaction for an average score of 5.1 ± 0.78 for the aesthetic outcome, 4.5 ± 0.78 for pain, 4.1 ± 0.92 for the number of procedures, and 4.7 ± 0.97 for adverse effects. The average number of actual procedures was 6.7 ± 1.20. The average Kirby-Desai score was 7.1 ± 1.45. Their correlation coefficient was 0.803, which is considered a strong positive correlation. Conclusion Picosecond lasers have a remarkable ability to degrade smaller tattoo pigments through a photoacoustic effect. Moreover, a picosecond laser treatment for tattoo removal can be a safe and effective method. Picosecond lasers are a promising technology with the potential to optimize the treatment of tattoos.

The Coordinative Locomotor Training Intervention Strategy Using the ICF Tool to Improve the Standing Posture in Scoliosis: A Case Report

  • Lee, Jeong-a;Kim, Jin-cheol
    • The Journal of Korean Physical Therapy
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    • v.33 no.1
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    • pp.7-15
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    • 2021
  • Purpose: This study was examined to improve the standing posture of a scoliosis client using the ICF Tool. Methods: For examination, the study subject was a 16-year-old female student diagnosed with 3curve-pelvic (3CP) type scoliosis. Information about her were collected through a client interview and based on international Classification of Functioning, Disability and Health (ICF). The ICF core set was for post-acute musculoskeletal conditions, and the ICF level 2 items suggested by National Rehabilitation Information Center (NARIC) were added to the recommendations for scoliosis. For evaluation, the ICF assessment sheet was used to identify the interaction among the problems. For the diagnosis, the client's functional problems were described in ICF terms. For the prognosis, the global goals for reaching the client's functional activity and participation level were presented as the long-and short-term goals. For the intervention, a coordinative locomotor training program composed of warm-up, main exercise, and cool-down was applied 3 times a week, 50 minutes a day, for 5 weeks. For the outcome, the differences between before and after the intervention were compared with the ICF qualifier and are shown with the ICF evaluation display. Results: Clinical advantages were observed in body function and structure (7° decrease of thoracic angle, 7 score increase of trunk muscle power, 6.47s improve of one leg standing, 4 score decrease of neck pain). The activity for maintaining the standing posture, in which the client had a primary limitation, was improved. Conclusion: Applying the coordinative locomotor training program is expected to improve scoliosis client's standing posture.

Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

  • Manjushri, Waingade;Raghavendra S, Medikeri;Shamali, Gaikwad
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.6
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    • pp.405-417
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    • 2022
  • Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.

Sodium Picosulphate with Magnesium Citrate versus Polyethylene Glycol for Bowel Preparation in Children: A Systematic Review

  • Dziechciarz, Piotr;Ruszczynski, Marek;Horvath, Andrea
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.228-239
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    • 2022
  • Purpose: To compare the effectiveness, tolerability, acceptability, and safety of sodium picosulphate with magnesium citrate (PS/Mg) and polyethylene glycol (PEG) in children (≤18 years) preparing for colonoscopy. Methods: Three electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) were searched till July 2020. Only randomized controlled trials (RCTs) were included. At least two authors independently selected studies and performed risk of bias assessment and data extraction. Results: Four RCTs (n=390), with overall good quality were included. A meta-analysis of two trials (n=224) found no statistically significant difference between the groups with respect to the proportion of patients who had excellent and good scores (≥6 points) according to the Boston Bowel Preparation Scale (relative risk: 0.99; 95% confidence interval [CI]: 0.90 to 1.08). Excellent and good scores were observed in both groups in approximately 90% of children. A meta-analysis of two other trials (n=150) showed no significant difference between the groups with respect to the mean total score for the Ottawa Bowel Preparation Scale (mean difference: 0.20; 95% CI: -0.74 to 1.14). Both regimens provided a comparable safety profile; however, PS/Mg was significantly superior to high volume PEG in terms of tolerability (abdominal pain, nausea, vomiting, bloating/flatulence/fullness) and acceptability (ease of formulation consumption, taste acceptance, need for nasogastric tube, compliance with full dose). Conclusion: PS/Mg provides a quality and safety profile similar to PEG for bowel cleansing; however, it has better acceptance and tolerance in children preparing for colonoscopy.

Physical Therapy Approach and Management for Lymphedema : Expert Opinion (림프부종의 물리치료적 접근과 관리 : 전문가 견해)

  • Lee, Hwa-Gyeong;Kim, Seong-Yeol;Choi, Kyoung-Wook
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.3
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    • pp.73-84
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    • 2022
  • Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care. Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema. Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: 1) The American Physical Therapy Association, 2) The Norton School of Lymphatic Therapy, and 3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients' presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient. Conclusion : Depending on the patients' journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients' needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

Nonoperative management of colon and mesocolon injuries caused by blunt trauma: three case reports

  • Naa, Lee;Euisung, Jeong;Hyunseok, Jang;Yunchul, Park;Younggoun, Jo;Jungchul, Kim
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.291-296
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    • 2022
  • The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.