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  1. High mountain soils and periglacial features at the Torres del Paine, National Park Torres del Paine, Chile.

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    Senra, Eduardo; Schaefer, Carlos; Simas, Felipe; Gjorup, Davi

    2015-04-01

    The Torres del Paine National Park (TPNP) is located on the southern limit of the Andean Southern Ice Field, part of the Magallanes and Antartica Chilena region, in the province of Ultima Esperanza. The TPNP has a very heterogeneous climate due to orographic influence and wet air masses from the Pacific. The geology is basically Cretaceous metasedimentary rocks and Miocene granitic plutons and batholiths. We studied the main soils and geoenvironments of Mt Ferrier mountain and its surroundings, based on soils , landforms and vegetation aspects. The geoenvironmental stratification was based on the combined variation and integration of pedo-litho-geomorphological features with the vegetation. WE used detailed geological maps, a DEM and slope maps and WorlView II satellite images. Fifteen soils profiles were sampled and classified according to Soil Taxonomy (2010) at all genovironments, ranging from 50 m a.s.l to the at high plateau just below the permanent snowline, under periglacial conditions (~1004m asl). Three soil temperature and moisture monitoring sites were set, allowing for 24 consecutive months (2011 to 2013). Seven geoenvironments were identified with distinct soil and landform characteristics, all with a similar geological substrate. The landform and vegetation have a strong connection with the landscape dynamic, controlling erosional and depositional processes, resulting from glacier advances and retreats in the Late Quaternary. Wind blown materials is widespread, in the form of loess material, accumulating in the higher parts of the landscape. On the other hand, accumulation of organic matter in the water-saturated depressions is common in all altitudes. Generally the soils are acidic and dystrophic, with little exceptions. The following geoenvironments were identified: Periglacial Tundra, Loess slopes, Talus and scarpmentd, Fluvio-glacial terraces, Fluvio-lacustrine plains, Moraines and Paleodunes. The regional pedology show the occurrence of five soil

  2. Trail impacts and trail impact management related to ecotourism visitation at Torres del Paine National Park, Chile

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    Farrell, T.A.; Marion, J.L.

    2002-01-01

    Ecotourism and protected area visitation in Central and South America are largely dependent upon a relatively undisturbed quality of natural resources. However, visitation may impact vegetation, soil, water and wildlife resources, and degrade visitor facilities such as recreation sites and trails. Findings are reported from trail impact research conducted at Torres del Paine National Park in Patagonia, Chile. The frequency and magnitude of selected trail impacts and the relative effect of the amount of use, vegetation type, trail position and trail grade are investigated. Findings differed from previous studies in that amount of use was significantly related to both trail width increases and trail erosion. Management actions to minimize trail impacts are offered.

  3. Evolution of the Great Tehuelche Paleolake in the Torres del Paine National Park of Chilean Patagonia during the Last Glacial Maximum and Holocene Evolución del Gran Paleolago Tehuelche en el Parque Nacional Torres del Paine de la Patagonia chilena durante el Último Máximo Glacial y Holoceno

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    Marcelo A Solari

    2012-01-01

    Full Text Available A number of glacial moraines are distributed from the eastern margin of the Torres del Paine drainage basin to near the present margin of the Patagonian Ice Fields, together with a set of regionally continuous lacustrine terraces related to glacial fluctuations. The geomorphology, supported by lake sediment evidence, indicates the existence of a single proglacial paleolake in this area, here referred to as the Great Tehuelche Paleolake. This concept helps to clarify the chronology of glacial events and leads to a better understanding of the evolution of the hydrologic system in the Torres del Paine area. Glacial advances previously referred to as A, B and C occurred during the Last Glacial Maximum and fed the Great Tehuelche Paleolake with meltwater, allowing it to reach its maximum extension. The discovery of thrombolites at Laguna Amarga suggests that the drainage of the paleolake towards the Última Esperanza Fjord took place at 7,113 Cal. yr BP, after the melting of an ice barrier that existed during the earlier glacial advance. This gave rise to the development of a complex fluvio-lacustrine hydrologic system that persists to the present day.Un grupo de morrenas glaciales están distribuidas desde el margen este de la cuenca de drenaje de Torres del Paine hacia el margen actual de los Campos de Hielo Patagónicos. Las morrenas se observan en conjunto con un grupo de terrazas lacustres regionales, las cuales están vinculadas a las fluctuaciones glaciales. La geomorfología y evidencias de sedimentos lacustres indican la existencia de un único lago proglacial, referido en este estudio como Gran Paleolago Tehuelche. Este concepto ayuda a clarificar la cronología de los eventos glaciales y permite una mejor comprensión de la evolución del sistema hidrológico del sector de Torres del Paine. Los eventos glaciales, previamente referidos como Avance A, B y C, ocurrieron durante el Último Máximo Glacial y alimentaron con aguas de fusión al

  4. Adherence of pain assessment to the German national standard for pain management in 12 nursing homes

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    Osterbrink, Jürgen; Bauer, Zsuzsa; Mitterlehner, Barbara; Gnass, Irmela; Kutschar, Patrick

    2014-01-01

    BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommen...

  5. Adherence of Pain Assessment to the German National Standard for Pain Management in 12 Nursing Homes

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    Jürgen Osterbrink

    2014-01-01

    Full Text Available BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice.

  6. Pain palliative Radiopharmaceuticals; Radiofarmacos paliativos del dolor

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, B M [Instituto Nacional de Pediatria (Mexico)

    1994-12-31

    A pain relieving agents based on {beta} emitters mainly and in some cases a complex preparation are being given for bone metastasis in relation with breast,prostate and lung carcinoma with good performance in clinical practice.Several radionuclides and radiopharmaceuticals are mentioned giving strength to those newly proposed, 153Sm and 186Re.Bibliography.

  7. Future Directions for Pain Management: Lessons from the Institute of Medicine Pain Report and the National Pain Strategy.

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    Mackey, Sean

    2016-02-01

    According to the Institute of Medicine Relieving Pain in America Report and the soon to be released National Pain Strategy, pain affects over 100 million Americans and costs our country in over $500 billion per year. We have a greater appreciation for the complex nature of pain and that it can develop into a disease in itself. As such, we need more efforts on prevention of chronic pain and for interdisciplinary approaches. For precision pain medicine to be successful, we need to link learning health systems with pain biomarkers (eg, genomics, proteomics, patient reported outcomes, brain markers) and its treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Temporomandibular joint and muscle disorder-type pain and comorbid pains in a national US sample.

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    Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

    2011-01-01

    To compare prevalences of self-reported comorbid headache, neck, back, and joint pains in respondents with temporomandibular joint and muscle disorder (TMJMD)-type pain in the 2000-2005 US National Health Interview Survey (NHIS), and to analyze these self-reported pains by gender and age for Non-Hispanic (NH) Whites (Caucasians), Hispanics, and NH Blacks (African Americans). Data from the 2000-2005 NHIS included information on gender, age, race, ethnicity, education, different common types of pain (specifically TMJMD-type, severe headache/migraine, neck, and low back pains), changes in health status, and health care utilization. Estimates and test statistics (ie, Pearson correlations, regressions, and logistic models) were conducted using SAS survey analysis and SUDAAN software that take into account the complex sample design. A total of 189,977 people (52% female and 48% males, 73% NH Whites, 12% Hispanic, 11% NH Blacks, and 4% "Other") were included. A total of 4.6% reported TMJMD-type pain, and only 0.77% overall reported it without any comorbid headache/migraine, neck, or low back pains; also 59% of the TMJMD-type pain (n = 8,964) reported ⋝ two comorbid pains. Females reported more comorbid pain than males (odds ratio [OR] = 1.41, P neck pain, 64% low back pain, and 62% joint pain. Differences in gender and race by age patterns were detected. For females, headache/migraine pain with TMJMD-type pain peaked around age 40 and decreased thereafter regardless of race/ethnicity. Neck pain continued to increase up to about age 60, with a higher prevalence for Hispanic women at younger ages, and more pronounced in males, being the highest in the non-Whites. Low back pain was higher in Black and Hispanic females across the age span, and higher among non-White males after age 60. Joint pain demonstrated similar patterns by race/ethnicity, with higher rates for Black females, and increased with age regardless of gender. TMJMD-type pain was most often associated with

  9. High precision ages from the Torres del Paine Intrusion, Chile

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    Michel, J.; Baumgartner, L.; Cosca, M.; Ovtcharova, M.; Putlitz, B.; Schaltegger, U.

    2006-12-01

    The upper crustal bimodal Torres del Paine Intrusion, southern Chile, consists of the lower Paine-Mafic- Complex and the upper Paine-Granite. Geochronologically this bimodal complex is not well studied except for a few existing data from Halpern (1973) and Sanchez (2006). The aim of this study is to supplement the existing data and to constrain the age relations between the major magmatic pulses by applying high precision U-Pb dating on accessory zircons and 40Ar/39Ar-laser-step-heating-ages on biotites from the Torres del Paine Intrusion. The magmatic rocks from mafic complex are fine to medium-grained and vary in composition from quartz- monzonites to granodiorites and gabbros. Coarse-grained olivine gabbros have intruded these rocks in the west. The granitic body is represented by a peraluminous, biotite-orthoclase-granite and a more evolved leucocratic granite in the outer parts towards the host-rock. Field observations suggest a feeder-zone for the granite in the west and that the granite postdates the mafic complex. Two granite samples of the outermost margins in the Northeast and South were analyzed. The zircons were dated by precise isotope-dilution U-Pb techniques of chemically abraded single grains. The data are concordant within the analytical error and define weighted mean 206/238U ages of 12.59 ± 0.03 Ma and 12.58 ± 0.01 Ma for the two samples respectively. A 40Ar/39Ar-age for the second sample yield a date of 12.37 ± 0.11 Ma. Three 40Ar/39Ar -ages of biotites were obtained for rocks belonging to the mafic complex. A hbl-bio- granodiorite from the central part, approximately 150 m below the subhorizontal contact with the granite, gives an age of 12.81 ± 0.11 Ma. A hbl-bio-granodiorite and an olivine-gabbro west of the feeder-zone date at 12.42 ± 0.14 Ma and 12.49 ± 0.11 Ma, respectively. The obtained older age of 12.81 Ma for the granodiorite in the central part is consistent with structural relationships of brittle fracturing of the mafic

  10. National survey of pain clinics in Croatia: Organization and services

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    Mahir Fidahić

    2015-05-01

    Full Text Available Objective. To analyze organization and therapeutic procedures administered in tertiary outpatient pain clinics in Croatia. Methods. Data about organization of pain clinics, its personnel, equipment, continuing medical education, therapeutic procedures, research activities and relations with pharmaceutical industry were collected using questionnaires. Results. Twenty-two Croatian pain clinics were included in the study. Most of the pain clinics employ exclusively anesthesiologists and nurses. The most frequently prescribed therapeutic procedures in pain clinics were pharmacotherapy, transcutaneous electrical nerve stimulation, acupuncture and trigger point injections. Almost all pain clinics provide educational material for patients. Most of the pain clinics have regular interactions with pharmaceutical companies. Prescribing decisions were based mostly on information from scientific meetings, research articles and consultations with colleagues. Information sources which are considered to be the gold standard – the systematic reviews of The Cochrane Collaboration – were used less frequently (n=12; 57% than advertising materials from pharmaceutical companies (n=16; 76%. Few physicians and other pain clinics staff had scientific degrees or academic titles or were involved in a research project. Conclusion. The national study about pain clinics in Croatia pointed out that there is room for improvement of their organization and services. Pain clinics should employ health-care professionals with diverse backgrounds. They should offer treatments backed by the highest-level of scientific evidence. Since pain is a major public health issue, pain clinic staff should engage more in research to contribute to the growing field of pain research, to enhance capacities for pain research in Croatia, to incorporate scientific evidence into their daily decision-making and to enable evidence-based practice.

  11. National survey of pain clinics in Croatia: Organization and services.

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    Fidahić, Mahir; Dogan, Katarina; Sapunar, Damir; Puljak, Livia

    2015-01-01

    To analyze organization and therapeutic procedures administered in tertiary outpatient pain clinics in Croatia. Data about organization of pain clinics, its personnel, equipment, continuing medical education, therapeutic procedures, research activities and relations with pharmaceutical industry were collected using questionnaires. Twenty-two Croatian pain clinics were included in the study. Most of the pain clinics employ exclusively anesthesiologists and nurses. The most frequently prescribed therapeutic procedures in pain clinics were pharmacotherapy, transcutaneous electrical nerve stimulation, acupuncture and trigger point injections. Almost all pain clinics provide educational material for patients. Most of the pain clinics have regular interactions with pharmaceutical companies. Prescribing decisions were based mostly on information from scientific meetings, research articles and consultations with colleagues. Information sources which are considered to be the gold standard--the systematic reviews of The Cochrane Collaboration--were used less frequently (n=12; 57%) than advertising materials from pharmaceutical companies (n=16; 76%). Few physicians and other pain clinics staff had scientific degrees or academic titles or were involved in a research project. The national study about pain clinics in Croatia pointed out that there is room for improvement of their organization and services. Pain clinics should employ health-care professionals with diverse backgrounds. They should offer treatments backed by the highest-level of scientific evidence. Since pain is a major public health issue, pain clinic staff should engage more in research to contribute to the growing field of pain research, to enhance capacities for pain research in Croatia, to incorporate scientific evidence into their daily decision-making and to enable evidence-based practice. Copyright © 2015 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  12. Adherence of pain assessment to the German national standard for pain management in 12 nursing homes.

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    Osterbrink, Jürgen; Bauer, Zsuzsa; Mitterlehner, Barbara; Gnass, Irmela; Kutschar, Patrick

    2014-01-01

    Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, 'Action Alliance Pain-Free City Muenster', the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic⁄acute pain-affected persons and highly recommended for practice. To evaluate the state of pain assessment and to identify need for improvement in 12 nursing homes in a German city. In the present study, the authors used an ex-post-facto design (survey methodology). Available written policies for routine pain assessment in residents ≥65 years of age were reviewed and a standardized online survey completed by 151 of 349 nurses in 12 nursing home facilities was conducted between September 2010 and April 2011. Most of the included nursing homes provided written policies for pain assessment, and the majority of nurses reported that they assess and regularly reassess pain. However, observational tools for residents with severe cognitive impairment and written reassessment schedules were lacking in many facilities or were inconsistent. Essentially, pain assessment appeared to be feasible in the majority of the German nursing homes studied. However, the absence or inconsistency of reassessment schedules indicate that pain management guidelines should include a detailed and explicit reassessment schedule for the heterogenic needs of nursing home residents. For residents with severe cognitive impairment, assessment tools are needed that are simple to use and clearly indicate the presence or absence of pain.

  13. The Torres del Paine intrusion as a model for a shallow magma chamber

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    Baumgartner, Lukas; Bodner, Robert; Leuthold, Julien; Muntener, Othmar; Putlitz, Benita; Vennemann, Torsten

    2014-05-01

    The shallow magmatic Torres del Paine Intrusive Complex (TPIC) belongs to a series of sub-volcanic and plutonic igneous bodies in Southern Chile and Argentina. This trench-parallel belt is located in a transitional position between the Patagonia Batholith in the West, and the alkaline Cenozoic plateau lavas in the East. While volumetrically small amounts of magmatism started around 28 my ago in the Torres del Paine area, and a second period occurred between 17-16 Ma, it peaked with the TPIC 12.59-12.43 Ma ago. The spectacular cliffs of the Torres del Paine National park provide a unique opportunity to study the evolution of a very shallow magma chamber and the interaction with its host rocks. Intrusion depth can be estimated based on contact metamorphic assemblages and granite solidus thermobarometry to 750±250 bars, corresponding to an intrusion depth of ca. 3km, ca. 500m above the base of the intrusion. Hornblende thermobarometry in mafic rocks agrees well with these estimates (Leuthold et al., 2014). The TPIC is composed of a granitic laccolith emplaced over 90ka (Michel et al., 2008) in 3 major, several 100m thick sheets, forming an overall thickness of nearly 2 km. Contacts are sharp between sheets, with the oldest sheet on the top and the youngest on the bottom (Michel et al., 2008). The granitic laccolith is under-plated by a ca. 400m thick mafic laccolith, built up over ca. 50ka (Leuthold et al. 2012), constructed from the bottom up. Granitic and mafic sheets are themselves composed of multiple metric to decametric pulses, mostly with ductile contacts between them, resulting in outcrop patterns resembling braided stream sediments. The contact of the TPIC with the Cretaceous flysch sediments document intrusion mechanism. Pre-existing sub-horizontal fold axes are rotated in the roof of the TPIC, clearly demonstrating ballooning of the roof; no ballooning was observed in the footwall of the intrusion. Extension during ballooning of the roof is indicated by

  14. The First National Pain Medicine Summit--final summary report.

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    Lippe, Philipp M; Brock, Charles; David, Jose; Crossno, Ronald; Gitlow, Stuart

    2010-10-01

    Pain is ubiquitous. At some point in time it affects everyone. For many millions pain becomes chronic, a scourge that impacts every facet of life-work, hobbies, family relations, social fabric, finances, happiness, mood, and even the very essence of identity. According to the National Institutes of Health (NIH), pain is one of our most important national public health problems, a silent epidemic. In 1998, NIH reported that the annual amount spent on health care, compensation, and litigation related to pain had reached one hundred billion dollars ($100,000,000,000). Considering that health care costs have doubled since then, it is not unreasonable to assume that the costs related to pain care have doubled as well. Millions of patients suffer needlessly with acute pain, with cancer pain, and with chronic pain. The ineffective management of pain results in an escalating cascade of health care issues. Acute pain that is not treated adequately and promptly results in persistent pain that eventually causes irreversible changes in the nervous system. This translates into progressive bio-psycho-social epiphenomena resulting in further pain and disability. It creates a vicious cycle transforming a functional human being into an invalid who becomes a burden to family, to society, and to oneself. In the face of adequate medical science, adequate technical skills, and adequate resources the reality of delayed and inadequate pain care is paradoxical. This dilemma deserves close scrutiny and effective remediation. The American Medical Association (AMA), long dedicated to the need to improve pain care in this country, has been faced with this reality. It was from this vision that the idea of holding a Pain Medicine Summit was conceived. Resolution 321 (A-08) set in motion a process that would bring together a diverse group of stakeholders for the purpose of discussing the present and future status of pain care; a process that culminated in a broad-based coalition of physicians

  15. Society of Behavioral Medicine (SBM) position statement: improving access to psychosocial care for individuals with persistent pain: supporting the National Pain Strategy's call for interdisciplinary pain care.

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    Janke, E Amy; Cheatle, Martin; Keefe, Francis J; Dhingra, Lara

    2018-03-01

    Policy makers have articulated a need for clear, evidence-based guidance to help inform pain policy. Persistent pain is common, expensive, and debilitating, and requires comprehensive assessment and treatment planning. Recently released opioid prescribing guidelines by the CDC (2016) emphasize the importance of using nonopioid therapies before considering opioid treatment for those without a malignant illness. The National Pain Strategy (2016) underscores the importance of comprehensive, interdisciplinary pain care. Unfortunately, despite persuasive evidence supporting the efficacy of psychosocial approaches, these interventions are inaccessible to the majority of Americans. Psychosocial approaches to pain management should be available for all individuals with persistent pain and in all health care settings and contexts as part of the comprehensive, interdisciplinary approach to pain care as outlined in the National Pain Strategy. To achieve this, we must prioritize reimbursement of evidence-based psychosocial approaches for pain assessment and management and improve provider training and competencies to implement these approaches.

  16. 11. El avance del Front National en Francia

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    Ferrer Sánchez, Albert

    2016-01-01

    Este artículo tiene por objeto analizar las causas del ascenso electoral de la formación ultraderechista francesa Front National (FN). En primer lugar, estudia la evolución política de dicho partido a fin de mostrar los cambios y las continuidades de su estrategia, su programa y sus discursos. Una vez analizados el contenido, la oferta política del nuevo Front National y el contexto político y social de Francia, muestra las razones por las cuales la formación ultraderechista se ha convertido ...

  17. Pregnant women's expectations about pain intensity during childbirth and their attitudes towards pain management: Findings from an Icelandic national study.

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    Karlsdottir, Sigfridur Inga; Sveinsdottir, Herdis; Olafsdottir, Olof Asta; Kristjansdottir, Hildur

    2015-12-01

    Pregnant women expect childbirth to be painful. However, little is known about their expectations of the intensity of pain in childbirth (EIPC) and their attitudes to pain management. The design was a cross-sectional survey, with self-reported questionnaires used to collect data from low-risk pregnant women (N = 1111) early in pregnancy at 26 of the largest primary health care centres in Iceland. This consecutive national sample was stratified by residency. The mean score for the EIPC was 5.58 (SD = 1.38) measured on a 7 point scale. The strongest predictors of a high EIPC score were: negative attitude to the impending childbirth (OR = 2.39), low manifestation of a sense of security (OR = 1.80), and a positive attitude to pain management with medication (OR = 1.63). Women living outside the capital area were less likely to have a high EIPC (OR = 0.68). Most women (77%) had a positive attitude towards pain management without medication and 35% had a positive attitude to pain management with medication. The study detected multiple predictors of women's EIPC and attitude to pain management. Early and throughout pregnancy, midwives and health care professionals need to address these predictors in order to assist women to prepare themselves for the pain of labour. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Current perspectives of acute pain treatment Perspectivas actuales de tratamiento del paciente con dolor agudo

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    Tiberio Alvarez Echeverri

    1993-03-01

    Full Text Available

    In the last years opioids have become of great importance in the relief of postoperative and other forms of acute pain. Reasons for this trend have been the availability of agonist opioids like phentanyl. sulphentanyl and alphentanyl and the results of research on the physlology. The pharmacology and the chemistry of drug receptors and neurotransmitters. The studies on chemicals other than opioids that contribute to pain relief when administered through different ways. specially the spinal. Have also influenced such a trend.

    En los últimos años los opiáceos han adquirido gran importancia en el alivio del dolor agudo especialmente del tipo postoperatorio. Una de las razones ha sido la disponibilidad de morfínicos agonistas como el fentanil, el sufentanil y el alfentanil; otra es la investigación de la fisiología, la farmacología y la química de los receptores y los neurotransmisores como de sustancias diferentes a los opláceos, aplicadas por diferentes vías en especial la espinal, que coadyuvan al alivio del dolor.

  19. Challenge of improving postoperative pain management: case studies of three acute pain services in the UK National Health Service.

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    Powell, A E; Davies, H T O; Bannister, J; Macrae, W A

    2009-06-01

    Previous national survey research has shown significant deficits in routine postoperative pain management in the UK. This study used an organizational change perspective to explore in detail the organizational challenges faced by three acute pain services in improving postoperative pain management. Case studies were conducted comprising documentary review and semi-structured interviews (71) with anaesthetists, surgeons, nurses, other health professionals, and managers working in and around three broadly typical acute pain services. Although the precise details differed to some degree, the three acute pain services all faced the same broad range of inter-related challenges identified in the organizational change literature (i.e. structural, political, cultural, educational, emotional, and physical/technological challenges). The services were largely isolated from wider organizational objectives and activities and struggled to engage other health professionals in improving postoperative pain management against a background of limited resources, turbulent organizational change, and inter- and intra-professional politics. Despite considerable efforts they struggled to address these challenges effectively. The literature on organizational change and quality improvement in health care suggests that it is only by addressing the multiple challenges in a comprehensive way across all levels of the organization and health-care system that sustained improvements in patient care can be secured. This helps to explain why the hard work and commitment of acute pain services over the years have not always resulted in significant improvements in routine postoperative pain management for all surgical patients. Using this literature and adopting a whole-organization quality improvement approach tailored to local circumstances may produce a step-change in the quality of routine postoperative pain management.

  20. Frequency, Impact, and Predictors of Persistent Pain Following Root Canal Treatment: A National Dental PBRN Study

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    Nixdorf, Donald R.; Law, Alan S.; Lindquist, Kimberly; Reams, Gregory J.; Cole, Emery; Kanter, Keith; Nguyen, Ruby H.N.; Harris, D. Robert

    2015-01-01

    Root canal treatment (RCT) is commonly performed surgery and persistent pain is known to occur, but little is known about how these patients are affected by this pain. While biopsychosocial mechanisms are thought to be associated with the development of such pain, similar to persistent pain following surgery in other body sites, little is known about the baseline predictors for persistent pain. We assessed the frequency of persistent pain 6 months following RCT, measured the impact this pain had on patients, and determined predictive factors for persistent tooth pain in a multi-center prospective cohort study conducted within the National Dental Practice-Based Research Network. Of 708 patients enrolled, 651 (91.9%) provided follow-up data, with 65 (10.0%) meeting criteria for pain 6 months following RCT. On average, these patients reported their pain as mild to moderate in intensity, present for about 10 days in the preceding month, and minimally interfered with daily activities. After adjusting for type of dental practitioner and patient age, gender and household income, pain duration over the week prior to RCT significantly increased the risk of developing persistent pain (odds ratio [OR]=1.19 per 1 day increase in pain duration, 95% confidence interval [CI]: 1.07–1.33), whereas optimism about the procedure reduced the risk (OR=0.39, 95% CI: 0.22–0.67). Our data suggest that persistent pain following RCT is fairly common, but generally does not have a large impact on those experiencing it. Furthermore, patient age and gender did not predict persistent pain, while pre-operative pain duration and the patient’s expectation did. PMID:26335907

  1. Pain Psychology: A Global Needs Assessment and National Call to Action

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    Scheman, Judith; Davin, Sara; Burns, John W.; Murphy, Jennifer L.; Wilson, Anna C.; Kerns, Robert D.; Mackey, Sean C.

    2016-01-01

    Objective. The Institute of Medicine and the draft National Pain Strategy recently called for better training for health care clinicians. This was the first high-level needs assessment for pain psychology services and resources in the United States. Design. Prospective, observational, cross-sectional. Methods. Brief surveys were administered online to six stakeholder groups (psychologists/therapists, individuals with chronic pain, pain physicians, primary care physicians/physician assistants, nurse practitioners, and the directors of graduate and postgraduate psychology training programs). Results. 1,991 responses were received. Results revealed low confidence and low perceived competency to address physical pain among psychologists/therapists, and high levels of interest and need for pain education. We found broad support for pain psychology across stakeholder groups, and global support for a national initiative to increase pain training and competency in U.S. therapists. Among directors of graduate and postgraduate psychology training programs, we found unanimous interest for a no-cost pain psychology curriculum that could be integrated into existing programs. Primary barriers to pain psychology include lack of a system to identify qualified therapists, paucity of therapists with pain training, limited awareness of the psychological treatment modality, and poor insurance coverage. Conclusions. This report calls for transformation within psychology predoctoral and postdoctoral education and training and psychology continuing education to include and emphasize pain and pain management. A system for certification is needed to facilitate quality control and appropriate reimbursement. There is a need for systems to facilitate identification and access to practicing psychologists and therapists skilled in the treatment of pain. PMID:26803844

  2. Back pain in ophthalmology: National survey of Indian ophthalmologists

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    Ramesh Venkatesh

    2017-01-01

    Full Text Available Purpose: The aim is to assess the prevalence, severity, and associations of back pain among Indian ophthalmologists. Methods: A self-reporting questionnaire was sent to ophthalmologists with valid e-mail addresses registered with the All India Ophthalmological Society. The survey was open for responses for 2 months. Results: A total of 651 (5.96% responses were obtained; 394 (61% males and 257 (39% females. Half (50% of responses were obtained from doctors belonging to 31–40 years' age group. Two hundred and thirty (35% of the ophthalmologists had height ranging from 161 to 170 cm and 443 (68% had weight ranging from 51 to 75 kg. Four hundred and eighty-one (73.8% of the respondents had <15 years of ophthalmic experience. Cataract (346; 53.1% and general ophthalmology (342; 52.5% were commonly practised by the ophthalmologists. Time spent in the outpatient department (OPD was 39.37 ± 16.32 h/week and in the operating theater 13.64 ± 9.89 h/week, respectively. Self-reported prevalence of back pain was 70.5%. Fully 49% of respondents had low back pain, followed by neck pain (33% and upper extremity symptoms (16%. Age <50 years (odds ratio [OR] = 2.4485, female gender (OR = 2.0265, long working hours in OPD (OR = 1.6524, and performing retinal lasers and indirect ophthalmoscopy (OR = 3.3251 showed positive association with back pain. The intolerable back pain was noted in <7% of the respondents. Around 398 (61% respondents felt that their back pain was exacerbated while doing work and 86.6% felt that up to 5 h/week was lost due to persistent backache. Yoga and some form of exercise (74.3% was practised to alleviate back pain. Conclusion: Back pain symptoms appear to be common among ophthalmologists. Awkward posture and prolonged working hours are responsible for developing back pain among ophthalmologists. Performing yoga and regular exercises, modifications in instrumentation and creating a larger workforce of eye care practitioners are needed

  3. [Inpatient acute pain management in German hospitals: results from the national survey "Akutschmerzzensus 2012"].

    Science.gov (United States)

    Erlenwein, J; Stamer, U; Koschwitz, R; Koppert, W; Quintel, M; Meißner, W; Petzke, F

    2014-04-01

    In 2007, the German national guidelines on "Treatment of acute perioperative and post-traumatic pain" were published. The aim of this study was to describe current structure and process data for acute pain management in German hospitals and to compare how the guidelines and other initiatives such as benchmarking or certification changed the healthcare landscape in the last decade. All directors of German departments of anesthesiology according to the DGAI ("Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin", German Society for Anesthesiology and Intensive Care) were mailed a standardized questionnaire on structures and processes of acute pain management in their hospitals. A total of 403 completed questionnaires (46 %) could be evaluated. Of hospitals, 81 % had an acute pain service (ASD), whereby only 45 % met defined quality criteria. Written standards for acute pain management were available in 97 % of the hospitals on surgical wards and 51 % on nonsurgical wards. In 96 %, perioperative pain was regularly recorded (generally pain at rest and/or movement, pain-related functional impairment in 16 % only). Beside these routine measurements, only 38 % of hospitals monitored pain for effectiveness after acute medications. Often interdisciplinary working groups and/or pain managers are established for hospital-wide control. As specific therapy, the patient-controlled analgesia and epidural analgesia are largely prevalent (> 90 % of all hospitals). In the last decade, intravenous and oral opioid administration of opioids (including slow release preparations) has become established in acute pain management. The survey was representative by evaluating 20 % of all German hospitals. The organizational requirements for appropriate pain management recommended by the German guidelines for acute pain recommended have been established in the hospital sector in recent years. However, the organizational enforcement for acute pain management in

  4. Nurse prescribing for inpatient pain in the United Kingdom: a national questionnaire survey.

    Science.gov (United States)

    Stenner, Karen L; Courtenay, Molly; Cannons, Karin

    2011-07-01

    Nurses make a valuable contribution to pain services and have the potential to improve the safety and effectiveness of pain management. A recent addition to the role of the specialist pain nurse in the United Kingdom has been the introduction of prescribing rights, however there is a lack of literature about their role in prescribing pain medication. The aim of this study was to develop a profile of the experience, role and prescribing practice of these nurses. A descriptive questionnaire survey. 192 National Health Service public hospital inpatient pain services across the United Kingdom. 161 qualified nurse prescribers were invited to participate, representing 98% of known nurse prescribers contributing to inpatient pain services. The survey was completed in November 2009 by 137 nurses; a response rate of 85%. Compared with nurse prescribers in the United Kingdom in general, participants were highly qualified and experienced pain specialists. Fifty-six percent had qualified as a prescriber in the past 3 years and 22% reported that plans were underway for more nurses to undertake a nurse prescribing qualification. Although all participants worked in inpatient pain services, 35% also covered chronic pain (outpatient) services and 90% treated more than one pain type. A range of pain medications were prescribed, averaging 19.5 items per week. The role contained a strong educational component and contributed to informing organisational policy on pain management. Prescribing was said to improve nurses' ability to promote evidence-based practice but benefits were limited by legislation on prescribing controlled drugs. Findings demonstrate that pain nurses are increasingly adopting prescribing as part of their advanced nurse role. This has implications for the development needs of pain nurses in the United Kingdom and the future role development of nurses in other countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Root Canal Therapy Reduces Multiple Dimensions of Pain: A National Dental PBRN Study

    Science.gov (United States)

    Law, Alan S.; Nixdorf, Donald R.; Rabinowitz, Ira; Reams, Gregory J.; Smith, James A.; Torres, Anibal V.; Harris, D. Robert

    2014-01-01

    Background Initial orthograde root canal therapy (RCT) is used to treat dentoalveolar pathosis. The affect RCT has on pain intensity has been frequently reported, but the affect on other dimensions of pain has not. Also, the lack of large prospective studies involving diverse groups of patients and practitioners that are not involved in data collection suggest that there are multiple opportunities for bias to be introduced when this data is systematically aggregated. Method This prospective observational study assessed pain intensity, duration, and its interference with daily activities among RCT patients. Sixty-two practitioners (46 general dentists, 16 endodontists) in the National Dental Practice-Based Research Network enrolled patients requiring RCT. Patient reported data were collected before, immediately following, and one week after treatment using the Graded Chronic Pain Scale. Results Enrollment of 708 patients was completed over 6 months with 655 patients (93%) providing one-week follow-up data. Prior to treatment, patients reported a mean (±standard deviation) worst pain intensity of 5.3±3.8 (0-10 scale), 50% had “severe” pain (≥7), and mean days in pain and days pain interfered with activities were 3.6±2.7 and 0.5±1.2, respectively. Following treatment, patients reported a mean worst pain intensity of 3.0±3.2, 19% had “severe” pain, and mean days in pain and days with pain interference were 2.1±2.4 and 0.4±1.1, respectively. All changes were statistically significant (ppain, significantly reducing pain intensity, duration, and related interference. Further research is needed to reduce the proportion of patients reporting “severe” post-operative pain. PMID:25190605

  6. A study of National Health Service management of chronic osteoarthritis and low back pain.

    Science.gov (United States)

    Hart, Oliver R; Uden, Ruth M; McMullan, James E; Ritchie, Mark S; Williams, Timothy D; Smith, Blair H

    2015-04-01

    To describe treatment and referral patterns and National Health Service resource use in patients with chronic pain associated with low back pain or osteoarthritis, from a Primary Care perspective. Osteoarthritis and low back pain are the two commonest debilitating causes of chronic pain, with high health and social costs, and particularly important in primary care. Understanding current practice and resource use in their management will inform health service and educational requirements and the design and optimisation of future care. Multi-centre, retrospective, descriptive study of adults (⩾18 years) with chronic pain arising from low back pain or osteoarthritis, identified through primary care records. Five general practices in Scotland, England (two), Northern Ireland and Wales. All patients with a diagnosis of low back pain or osteoarthritis made on or before 01/09/2006 who had received three or more prescriptions for pain medication were identified and a sub-sample randomly selected then consented to an in-depth review of their medical records (n=264). Data on management of chronic pain were collected retrospectively from patients' records for three years from diagnosis ('newly diagnosed' patients) or for the most recent three years ('established' patients). Patients received a wide variety of pain medications with no overall common prescribing pattern. GP visits represented the majority of the resource use and 'newly diagnosed' patients were significantly more likely to visit their GP for pain management than 'established' patients. Although 'newly diagnosed' patients had more referrals outside the GP practice, the number of visits to secondary care for pain management was similar for both groups. This retrospective study confirmed the complexity of managing these causes of chronic pain and the associated high resource use. It provides an in-depth picture of prescribing and referral patterns and of resource use.

  7. Self- Reported Comorbid Pains in Severe Headaches or Migraines in a US National Sample

    Science.gov (United States)

    Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

    2012-01-01

    Aims To compare prevalence of self-reported comorbid temporomandibular joint muscle disorder (TMJMD)-type, neck, back and joint pains in people with severe headache or migraine; analyze these self-reported pains in the 2000–2005 US National Health Interview Survey (NHIS) by gender and age for Non-Hispanic Whites, Hispanics and Non-Hispanic Blacks (African Americans). Methods NHIS data included information on gender, age, race, ethnicity, health status, and common pain types: severe headache or migraine, TMJMD-type, neck, and low back in the last 3 months, as well as prior month joint pains. Analyses included survey prevalence estimation and survey logistic regression to obtain odds ratios and 95% confidence intervals. Results 189,967 adults, 48% males, 52% females; 73% White, 12% Hispanic, and 11% Black were included. 29,712 (15%) of the entire sample reported severe headache or migraine, 19,228 (64%) had severe headache or migraine with at least one comorbid pain. 10,200 (33%) reported 2 or more comorbid pains, with no gender difference, and with Hispanics (n=1,847 or 32%) and Blacks (n=1,301 or 30%) less likely to report 2 or more comorbid pains than Whites (n=6,747 or 34%) (OR=0.91, p=0.032; OR=0.82, pheadache or migraine is often associated with other common pains, seldom existing alone. Two or more comorbid pains are common, similarly affecting gender and racial/ethnic groups. PMID:22553936

  8. Intelligence in childhood and chronic widespread pain in middle age: the National Child Development Survey.

    Science.gov (United States)

    Gale, Catharine R; Deary, Ian J; Cooper, Cyrus; Batty, G David

    2012-12-01

    Psychological factors are thought to play a part in the aetiology of chronic widespread pain. We investigated the relationship between intelligence in childhood and risk of chronic widespread pain in adulthood in 6902 men and women from the National Child Development Survey (1958 British Birth Cohort). Participants took a test of general cognitive ability at age 11 years; and chronic widespread pain, defined according to the American College of Rheumatology criteria, was assessed at age 45 years. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using log-binomial regression, adjusting for sex and potential confounding or mediating factors. Risk of chronic widespread pain, defined according to the American College of Rheumatology criteria, rose in a stepwise fashion as intelligence fell (P for linear trend intelligence quotient, the RR of chronic widespread pain was 1.26 (95% CI 1.17-1.35). In multivariate backwards stepwise regression, lower childhood intelligence remained as an independent predictor of chronic widespread pain (RR 1.10; 95% CI 1.01-1.19), along with social class, educational attainment, body mass index, smoking status, and psychological distress. Part of the effect of lower childhood intelligence on risk of chronic widespread pain in midlife was significantly mediated through greater body mass index and more disadvantaged socioeconomic position. Men and women with higher intelligence in childhood are less likely as adults to report chronic widespread pain. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  9. Pain profiles in a community dwelling population following spinal cord injury: a national survey.

    Science.gov (United States)

    Burke, Dearbhla; Fullen, Brona M; Lennon, Olive

    2017-07-24

    While as many as 60% of patients with spinal cord injury (SCI) develop chronic pain, limited data currently exists on the prevalence and profile of pain post-SCI in community dwelling populations. A cross-sectional population survey. Primary care. Community dwelling adults with SCI. Following ethical approval members registered to a national SCI database (n=1,574) were surveyed. The survey included demographic and SCI characteristics items, the International Spinal Cord Injury Pain Basic Data Set (version 1) the Douleur Neuropathique 4 questionnaire (interview) and questions relating to health care utilisation. Data were entered into the Statistical Package for the Social Sciences (version 20) Significance was set P < 0.05 for between group comparisons. In total 643 (41%) surveys were returned with 458 (71%) respondents experiencing pain in the previous week. Neuropathic pain (NP) was indicated in 236 (37%) of responses and nociceptive pain in 206 (32%) Common treatments for pain included medications n=347 (76%) massage n=133 (29%) and heat n=115 (25%). Respondents with NP reported higher pain intensities and increased healthcare service utilisation (P= < 0.001) when compared to those with nociceptive pain presentations. A higher proportion of females than males reported pain (P = 0.003) and NP (P = 0.001) and those unemployed presented with greater NP profiles compared with those in education or employment (P = 0.006). Pain, in particular NP post SCI interferes with daily life, increases health service utilisation and remains refractory to current management strategies. Increased availability of multi-disciplinary pain management and further research into management strategies is warranted.

  10. Low Back Pain Prevalence and Associated Factors in Iranian Population: Findings from the National Health Survey

    Directory of Open Access Journals (Sweden)

    Akbar Biglarian

    2012-01-01

    Full Text Available Background. There are very few studies that had a sample size sufficient to explore the association between factors related to low back pain in a representative sample of the Iranian population. Objective. To examine the relationship between sociodemographic factors, smoking, obesity, and low back pain in Iranian people. Methods. We used Iranian adults respondents (n=25307 from the National Health Survey. Adjusted odds ratios and 95% confidence intervals were estimated by using logistic regression. Results. The prevalence of low back pain was found in 29.3% of the studied sample. High age, female sex, being married, obesity, low-economic index, being smoker, in a rural residence, and low educational attainment, all increased the odds of low back pain. Conclusions. Our findings add to the evidence on the importance of obesity in relation to low back pain. These results can be used as a basis to reinforce health programs to prevent obesity.

  11. Vertebroplasty in the treatment of back pain; La vertebroplastica nel trattamento delle sindromi algiche del rachide

    Energy Technology Data Exchange (ETDEWEB)

    Muto, Mario; Muto, Emanuale; Izzo, Roberto; Diano, Alvaro Antonio; Lavagna, Arcangelo; Di Furia, Ugo [Istituto di Neuroradiologia AORN Cardarelli, Napoli (Italy)

    2005-03-01

    adjacent to the treated vertebrae. Discussion and conclusions: Since the first case of vertebroplasty was used in vertebral haemangioma, the possibility of using this technique in other pathological conditions such a metastatic lesions and osteoporotic compression fractures has been clear. MR has a key role in the selection of patients while bone scan and CT can be useful in selected cases. Absolute contraindication is local or systemic infection while relative contraindications are epidural extension of the neoplastic lesion, vertebra plana, clinical signs of myelopathy of radiculopathy and coagulation disorders. The results of our study were better in patients treated for osteoporosis or haemangioma than in cancer patients. We consider percutaneous vertebroplasty a valid technique for the treatment of the pain due to osteoporotic compression fractures, vertebral haemangiomas or metastatic lesions. [Italian] Scopo: Obiettivo di questo lavoro e' di dimostrare la utilita' della vertebroplastica nel trattamento di alcune sindromi algiche vertebrali in casi selezionati. Materiale e metodi: Riportiamo la nostra esperienza in 85 pazienti trattati con vertebroplastica percutanea la maggior parte dei quali per lombagia o dorsalgia da crolli vertebrali o sindromi dolorose su base porotica acuta, per angiomi vertebrali o per lesioni secondarie di tipo osteolitico. La selezione dei pazienti da trattare viene effettuata sulla base della valutazione clinica, della RM o in alternativa della scintografia ossea. La TC viene effettuata prima del trattamento solo in casi selezionati, quandosi voglia valutare l'integrita' del muro posteriore del corpo vertebrale. Abbiamo trattato 55 pazienti affetti da crolli o sindromi algiche vertebrali acute, 10 pazienti affetti da angiomi vertebrali dolenti o aggressivi, e 20 pazienti affetti da lesioni secondarie. Il paziente e' sempre posizionato prono e la procedura e' stata effettuata sotto controllo scopico in 80 casi

  12. PREVALENCE OF MUSCULOSKELETAL PAIN AMONG SWIMMERS IN AN ELITE NATIONAL TOURNAMENT.

    Science.gov (United States)

    de Almeida, Matheus Oliveira; Hespanhol, Luiz Carlos; Lopes, Alexandre Dias

    2015-12-01

    Professional swimmers are often affected by a high number of injuries due to their large amount of training. The occurrence of musculoskeletal pain during an important tournament has not been investigated. The objective of the study was to assess the prevalence of musculoskeletal pain and its characteristics in professional swimmers. Secondary objectives included evaluating the swimmers' injury history over the previous 12 months, and examining the association of the presence of pain with personal and training characteristics of the swimmers. Observational, cross-sectional study. Two-hundred and fifty-seven swimmers who participated in the Brazilian Swimming Championship were included in the study and answered a questionnaire about personal and training characteristics, presence of pain, and injuries in the previous 12 months. The relative risk of presence of pain was calculated for the following variables: gender, BMI, stroke specialty, swimmer's position, strength training, practice of another physical activity, and previous injuries. The prevalence of musculoskeletal pain was about 20%, with 60% of swimmers reporting at least one injury in the previous 12 months. The shoulder was the most commonly affected region and tendinopathy was the most common type of previous injury. No significant relationships were found between the presence of pain and personal or training characteristics. The results demonstrated that the prevalence of musculoskeletal pain in professional swimmers participating in the most important Brazilian national tournament was approximately 20%, while the majority of participants reported previous injuries in many areas. 2c.

  13. Tratamento da dor em queimados Tratamiento del dolor en quemados Pain management in burn patients

    Directory of Open Access Journals (Sweden)

    Rodrigo José Alencar de Castro

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Apesar dos avanços, ainda é observado manejo analgésico inadequado dos pacientes com queimaduras. O objetivo desta revisão foi coletar dados sobre tratamento da dor em queimados. CONTEÚDO: Foi feita revisão sobre os mecanismos de dor, avaliação do paciente com queimadura e o tratamento farmacológico e não farmacológico. CONCLUSÕES: O manejo da dor em pacientes vítimas de queimaduras ainda é um desafio por parte da equipe multiprofissional. A avaliação frequente e contínua da resposta apresentada pelo paciente é muito importante, tendo em vista os vários momentos por que passa o paciente internado em decorrência de uma queimadura, além de uma terapêutica combinada com medicações analgésicas e medidas não farmacológicas. Entender a complexidade de alterações fisiopatológicas, psicológicas e bioquímicas apresentadas por um paciente em tratamento de queimadura é o primeiro passo para alcançar o sucesso no seu manejo analgésico.JUSTIFICATIVA Y OBJETIVOS: Pese a los progresos alcanzados, todavía se observa un manejo analgésico inadecuado de los pacientes con quemaduras. El objetivo de esta revisión, fue la recolección de datos sobre el tratamiento del dolor en pacientes quemados. CONTENIDO: Se efectuó una revisión sobre los mecanismos de dolor, evaluación del paciente con quemadura, y el tratamiento farmacológico y no farmacológico. CONCLUSIONES: El manejo del dolor en los pacientes víctimas de quemaduras todavía es un reto por parte del equipo multiprofesional. La evaluación frecuente y continua de la respuesta presentada por el paciente es muy importante, teniendo en cuenta los diversos momentos por los que pasa el paciente ingresado en razón de una quemadura, además de una terapéutica combinada con medicaciones analgésicas y con medidas no farmacológicas. Entender la complejidad de las alteraciones fisiopatológicas, psicológicas y bioquímicas presentadas por un

  14. Leg ulcers in older people: a national study addressing variation in diagnosis, pain and sleep disturbance.

    Science.gov (United States)

    Hellström, Amanda; Nilsson, Camilla; Nilsson, Annina; Fagerström, Cecilia

    2016-01-21

    . National guidelines in managing leg ulcers, which also consider consequences such as sleep disturbances, pain and discomfort, are needed.

  15. Management of postoperative pain: experience of the Niamey National Hospital, Niger

    Directory of Open Access Journals (Sweden)

    Chaibou MS

    2012-12-01

    Full Text Available Maman Sani Chaibou,1 Samuila Sanoussi,2 Rachid Sani,2 Nouhou A Toudou,1 Hadjara Daddy,1 Moussa Madougou,1 Idrissa Abdou,1 Habibou Abarchi,2 Martin Chobli31Department of Anesthesiology and Intensive Care, 2Department of Surgery, The Niamey National Hospital, Niamey, Republic of Niger; 3Department of Anesthesiology, Hubert K Maga University Teaching Hospital, Cotonou, BeninObjective: The aim of this study was to evaluate the management of postoperative pain at the Niamey National Hospital.Methods: A prospective study was conducted in the Department of Anesthesiology and Intensive Care at the Niamey National Hospital from March to June, 2009. Data collected included age, sex, literacy, American Society of Anesthesiologists (ASA physical status classification, type of anesthesia, type of surgery, postoperative analgesics used, and the cost of analgesics. Three types of pain assessment scale were used depending on the patient's ability to describe his or her pain: the verbal rating scale (VRS, the numerical rating scale (NRS, or the visual analog scale (VAS. Patients were evaluated during the first 48 hours following surgery.Results: The sample included 553 patients. The VRS was used for the evaluation of 72% of patients, the NRS for 14.4%, and the VAS for 13.6%. Of the VRS group, 33.9%, 8.3%, and 2.1% rated their pain as 3 or 4 out of 4 at 12, 24, and 48 hours postoperatively, respectively. For the NRS group, 33.8%, 8.8%, and 2.5% rated their pain as greater than 7 out of 10 at 12, 24, and 48 hours postoperatively, respectively. For the VAS group, 29.3%, 5.4%, and 0% rated their pain as greater than 7 out of 10 at 12, 24, and 48 hours postoperatively, respectively. Conclusion: Postoperative pain assessment and management in developing countries has not been well described. Poverty, illiteracy, and inadequate training of physicians and other health personnel contribute to the underutilization of postoperative analgesia. Analysis of the results

  16. Prescription Pain Reliever Abuse and Dependence among Adolescents: A Nationally Representative Study

    Science.gov (United States)

    Wu, Li-Tzy; Ringwalt, Christopher L.; Mannelli, Paolo; Patkar, Ashwin A.

    2008-01-01

    The study investigates the prevalence, patterns, and correlates of adolescents' abuse, sub-threshold dependence, and dependence on prescription pain relievers (PPRs) in a nationally representative sample. Results show dependence on PPRs can take place without abuse and that sub-threshold dependence could have implications for major diagnostic…

  17. A Nationally Scaled Telebehavioral Health Program for Chronic Pain: Characteristics, Goals, and Psychological Outcomes.

    Science.gov (United States)

    Mochari-Greenberger, Heidi; Peters, Aimee; Vue, Lee; Pande, Reena L

    2017-08-01

    Millions of U.S. adults suffer from chronic pain with a high prevalence of comorbid mental health issues. Telehealth-delivered behavioral therapy for chronic pain has been evaluated in the research setting. The purpose of this study was 1) to describe a nationally scaled, standardized, telebehavioral therapy program for patients with chronic pain and behavioral comorbidities, and 2) evaluate characteristics, goals, and psychosocial outcomes among program participants. This was mixed-methods retrospective cohort analysis among consecutive program graduates (mean age 53y; 24% male). The 8-week program was delivered by a licensed therapist and a behavior coach through telephone/secure video and tailored to each participant's behavioral health needs and goals. Participant chief complaints, behavioral goals, and mood triggers were abstracted by deidentified clinical record review using structured qualitative research methods. Depression, anxiety, and stress symptom data were collected at baseline and program graduation using the validated Depression Anxiety Stress Scales 21. Back pain (42%) and hip/leg/knee pain (28%) comprised the most common chief complaints. Pain management (44%) and weight loss (43%) were the most frequently cited goals. At baseline, approximately half of participants had elevated depression (59%), anxiety (54%), and/or stress (48%) scores. Triggers for depressed, anxious, or stressed mood included severe pain (47%), health concerns (46%), and interpersonal relationship challenges (45%). At graduation, significant improvement in median depression (-54%), anxiety (-50%), and stress (-33%) symptom scores was observed among those with non-normal baseline values (p health program for chronic pain experienced significant improvement in depression, anxiety, and stress symptoms and shared several complaints, goals, and mood triggers.

  18. Fluid and heat transport at the Torres del Paine laccolith (Patagonia/Chile)

    International Nuclear Information System (INIS)

    Putliz, B; Baumgartner, L.P; Oberhansli, R; Diamond, L; Altenberger, U

    2001-01-01

    The 12 Ma old Torres del Paine laccolith (TPL) is part of a chain of isolated Miocene plutons and subvolcanic rocks which intruded the foothills of the southern Andes of Chile and Argentina (Halpern, 1973; Michael, 1984). The 12x12 km big laccolith, an I-type granite, intruded mudstones, sandstones, carbonates and conglomerates of the Cretaceous Cerro Torre and Punta Barrosa formation (Wilson, 1991) creating a well defined, but small contact aureole of 200-400m width. The TPL contains abundant textural evidence of fluid exsolution and eutectic crystallisation. It hence represents a good example for the transport of large quantities of magmatic aqueous fluids to the uppermost level of the crust. The pluton is well exposed and its rugged topography allows the investigation of the roof, the lateral rims and the base of the intrusion. Field and textural observations, phase petrological constraints, oxygen isotope and fluid inclusion data are used to unravel mechanism and patterns of fluid and heat transport in the intrusion and the contact aureole. The Torres del Paine Intrusives form a calcalkaline suite, ranging from gabbros through diorites to leucogranites. The intrusive body has the general shape of a laccolith (Skarmeta and Castelli, 1997). Gabbroic and dioritic rocks are only exposed at the lower levels. Granites are clearly predominant - the main body of the laccolith is composed of a fine to medium grained biotite-orthoclase granite. The TPL is remarkable for its abundance of miarolitic cavities. Locally, at the margins of the pluton, a microgranitic phase is found with up to 15% of cavities. While some miaroles are isolated, others are interconnected, forming tube-like structures. Open miaroles contain euhedral crystals of quartz and feldspar. Other important phases are biotite, tourmaline, fayalite and late chlorite and carbonate. Individual crystals are typically between < 1cm up to a few cm in length. Some miaroles are completely filled with coarse quartz

  19. Psychosocial and physical work environment, and risk of pelvic pain in pregnancy. A study within the Danish national birth cohort

    DEFF Research Database (Denmark)

    Juhl, Mette; Andersen, Per Kragh; Olsen, Jørn

    2005-01-01

    OBJECTIVE: The sparse knowledge of the aetiology of pelvic pain in pregnancy makes evidence based prevention a limited option. The aim of this study was to examine the relation between pelvic pain in pregnancy and physical and psychosocial working conditions. METHODS: This study used self reported...... data on working conditions for 1219 cases and 1539 controls, sampled as a nested case-control study within the Danish national birth cohort. Cases and controls were selected on the basis of self reported pelvic pain intensity, pain localisation, and pain impact on daily living activities. Exposure data...... were collected prospectively; early in pregnancy and before the onset of pelvic pain. Main outcome measures were odds ratios for pelvic pain in pregnancy as a function of physical and psychosocial working conditions. RESULTS: Pregnant women with fixed evening work and with rotating shifts (without...

  20. Pain

    OpenAIRE

    H.W. Snyman

    1980-01-01

    The medical profession has always been under pressure to supply public explanations of the diseases with which it deals. On the other hand, it is an old characteristic of the profession to devise comprehensive and unifying theories on all sorts of medical problems. Both these statements apply to pain - one of the most important and clinically striking phenomena and expressions of man since his origin in the mists of time.

  1. Pain

    Directory of Open Access Journals (Sweden)

    H.W. Snyman

    1980-09-01

    Full Text Available The medical profession has always been under pressure to supply public explanations of the diseases with which it deals. On the other hand, it is an old characteristic of the profession to devise comprehensive and unifying theories on all sorts of medical problems. Both these statements apply to pain - one of the most important and clinically striking phenomena and expressions of man since his origin in the mists of time.

  2. Pain in European long-term care facilities: Cross-national study in Finland, Italy and the Netherlands

    NARCIS (Netherlands)

    Achterberg, W.P.; Gambassi, G.; Finne-Soveri, H.; Liperoti, R.; Noro, A.; Frijters, D.H.M.; Cherubini, A.; Dell'Aquila, G.; Ribbe, M.W.

    2010-01-01

    There have been very few and limited cross-national comparisons concerning pain among residents of long-term care facilities in Europe. The aim of the present cross-sectional study has been to document the prevalence of pain, its frequency and severity as well as its correlates in three European

  3. Prescription pain reliever misuse and levels of pain impairment: 3-year course in a nationally representative outpatient sample of US adults

    Directory of Open Access Journals (Sweden)

    Novak SP

    2016-06-01

    Full Text Available Scott P Novak,1 Cristie Glasheen,1 Carl L Roland,2 1Behavioral Health Epidemiology, RTI International, 2Clinical Sciences and Outcomes Evidence, Pfizer Inc., Durham, NC, USA Background: The primary aim of this work was to present the prevalence data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, a representative 3-year longitudinal survey (ages 18+ years that captured information on patterns of self-reported pain interference and prescription pain reliever misuse. A second aim was to assess the degree to which the risk of various types of opioid misuse (onset, desistance, and incidence of dependence was related to the longitudinal course of self-reported pain interference over the 3-year period. Methods: We used a two-wave, nationally representative sample of adults (aged 18+ years in which the baseline data were collected during 2001–2002 and a single follow-up was obtained ~3 years later (2004–2005 with 34,332 respondents with complete data on study variables for both waves. Results: Our findings indicated that ~10% reported high pain interference in the past month at each wave. There was tremendous stability in levels of pain, with ~5% reporting consistent levels of high impairment over the 3-year study, a proxy for chronic pain. Levels of pain were more strongly associated with prescription pain reliever misuse concurrently rather than prospectively, and the association was largely linear, with the likelihood of misuse increasing with levels of pain. Finally, health service factors were also prominent predictors of onset, but not the outcomes, of desistance or transitions to problem use. Conclusion: This study is the first to use a nationally representative sample with measures of pain and drug use history collected over an extended period. These results may help provide clinicians with an understanding that the risk of misuse is greatest when pain is active and may help guide the selection of

  4. Are joint and soft tissue injections painful? Results of a national French cross-sectional study of procedural pain in rheumatological practice

    Directory of Open Access Journals (Sweden)

    Poncet Coralie

    2010-01-01

    Full Text Available Abstract Background Joint, spinal and soft tissue injections are commonly performed by rheumatologists in their daily practice. Contrary to other procedures, e.g. performed in pediatric care, little is known about the frequency, the intensity and the management of procedural pain observed in osteo-articular injections in daily practice. Methods This observational, prospective, national study was carried out among a French national representative database of primary rheumatologists to evaluate the prevalence and intensity of pain caused by intra-and peri-articular injections, synovial fluid aspirations, soft tissue injections, and spinal injections. For each physician, data were collected over 1 month, for up to 40 consecutive patients (>18-years-old for whom a synovial fluid aspiration, an intra or peri-articular injection or a spinal injection were carried out during consultations. Statistical analysis was carried out in order to compare patients who had suffered from pain whilst undergoing the procedure to those who had not. Explanatory analyses were conducted by stepwise logistic regression with the characteristics of the patients to explain the existence of pain. Results Data were analysed for 8446 patients (64% female, mean age 62 ± 14 years recruited by 240 physicians. The predominant sites injected were the knee (45.5% and spine (19.1%. Over 80% of patients experienced procedural pain which was most common in the small joints (42% and spine (32% Pain was severe in 5.3% of patients, moderate in 26.6%, mild in 49.8%, and absent in 18.3%. Pain was significantly more intense in patients with severe pain linked to their underlying pathology and for procedures performed in small joints. Preventative or post-procedure analgesia was rarely given, only to 5.7% and 36.3% of patients, respectively. Preventative analgesia was more frequently prescribed in patients with more severe procedural pain. Conclusion Most patients undergoing intra-or peri

  5. Bodily pain intensity in nursing home residents with pressure ulcers: analysis of national minimum data set 3.0.

    Science.gov (United States)

    Ahn, Hyochol; Stechmiller, Joyce; Fillingim, Roger; Lyon, Debra; Garvan, Cynthia

    2015-06-01

    Clinical reports suggest that superficial pressure ulcers produce pain, but that pain decreases as the wound advances in stage. This study of the relationship between pressure ulcer stage and bodily pain intensity in nursing home residents was a secondary analysis of the national Minimum Data Set 3.0 assessment data in long-term care facilities, collected from nursing home residents at least 65 years of age. Data were examined from residents with pressure ulcers who completed a bodily pain intensity interview between January and March 2012 (N = 41,680) as part of the MDS comprehensive assessment. After adjusting for other variables (e.g., cognition, functional impairment, presence of comorbidities, use of scheduled pain medication, and sociodemographic variables), bodily pain intensity for those with more severe pressure ulcers in comparison to those with Stage I ulcers was higher by 11% (Stage II), 14% (Stage III), 24% (Stage IV), and 22% (suspected deep tissue injury). Because multivariate analysis showed that greater bodily pain intensity was associated with an advanced stage of pressure ulcer, health care providers should assess bodily pain intensity and order appropriate pain management for nursing home residents with pressure ulcers, particularly for those with advanced pressure ulcers who are vulnerable to greater bodily pain intensity. © 2015 Wiley Periodicals, Inc.

  6. Deepwater fish assemblages at Isla del Coco National Park and Las Gemelas Seamount, Costa Rica

    Directory of Open Access Journals (Sweden)

    Richard M. Starr

    2012-11-01

    Full Text Available The deepwater faunas of oceanic islands and seamounts of the Eastern Tropical Pacific are poorly known. From 11-22 September 2009 we conducted an exploration of the deepwater areas of the Isla del Coco Marine Conservation Area, Costa Rica and a nearby seamount using a manned submersible. The goal of the exploration was to characterize the habitats and biota, and conduct quantitative surveys of the deepwater portions of Isla del Coco National Park and Las Gemelas Seamount, located about 50km southwest of Isla del Coco. We completed a total of 22 submersible dives, spanning more than 80hr underwater, and collected a total of 36hr of video. We surveyed habitats from 50-402m and observed more than 45 species of fishes, some of which have not yet been described and are likely new to science. The diversity of fish species in deep water at Isla del Coco National Park was lower than the diversity of fishes in shallow water, and eight species groups accounted for more than 95% of the total fish biomass. The combined density of all fish species was higher at Las Gemelas Seamount (253 fishes/100m² than at Isla del Coco National Park (138 fishes/100m². The combined density of fishes in habitats comprised primarily of bedrock or large boulders outcrops was more than three times as high at Las Gemelas Seamount as it was at Isla del Coco National Park. This discrepancy was caused by the extremely high concentration of Anthiinae fishes in rocky habitats at Las Gemelas Seamount. Densities of fishes in the other habitats were similar between the two sites. Similarly, when estimates of fish density were plotted by slope categories the density was much greater on steep slopes, which were usually comprised of rock habitats. Also, the density of fishes was greatest on high rugosity habitats. Results of these submersible surveys indicate that seamounts in the tropical eastern Pacific Ocean may be an important source of biodiversity and that more quantitative surveys

  7. Vesuvium national park; Il Parco Nazionale del Vesuvio

    Energy Technology Data Exchange (ETDEWEB)

    Iozzolino, I. [Naples Univ. (Italy)

    1995-03-01

    The presented paper deal with the future of Vesuvium National Park. A brief history of the park institution is stated together with geo-physical, floristical, and faunistical aspects. Some considerations are reported about human activities and economic aspects in park area. Furthermore, future problems in park management are pointed out.

  8. The Impact of a National Guideline on the Management of Cancer Pain on the Practice of Pain Assessment and Registration

    NARCIS (Netherlands)

    Besse, K.; Vernooij-Dassen, M.J.F.J.; Vissers, K.; Engels, Y.

    2016-01-01

    The Dutch clinical practice guideline on the diagnosis and management of pain in patients with cancer was published in 2008 and intensively promoted to healthcare professionals who see patients with cancer. One of the most important recommendations is the systematic registering of the pain and its

  9. Hombro doloroso y lesiones del manguito rotador Painful shoulder and rotator cuff disorders

    OpenAIRE

    Karla Mora-Vargas

    2008-01-01

    Se presenta el caso de una mujer de 52 años conocida sana, sin antecedentes positivos, quien inicia con dolor y disfunción del miembro superior izquierdo, la cual fue tratada con antiinflamatorios no esteroideos inicialmente, sin embargo, al persistir los síntomas y apoyado con estudios radiológicos recibe tratamiento inyectado a nivel del hombro. Cuadro que evoluciona posteriormente a ruptura del manguito rotador, con su subsiguiente reparación quirúrgica y fisioterapia, logrando la recupera...

  10. Prevalence and treatment of pain in non-institutionalized very old population: transversal study at national level.

    Science.gov (United States)

    Gálvez-Barrón, César; Narvaiza, Leire; Dapena, María D; Macho, Oscar; Rodríguez-Molinero, Alejandro

    2016-04-01

    In Europe, there is no conclusive data at national level about pain prevalence in non-institutionalized very old population. In USA, it has recently been reported a high prevalence (56 %); however, this data can not be extrapolated to other regions because the known influence of geographical and ethnic differences. Furthermore there are few data on use of treatments for pain in this population. To explore prevalence and considered pharmacological treatments for pain in this population. Transversal study on 551 participants aged 80 or more living in Spain (non-institutionalized). Probabilistic multistage sampling was carried out, stratified by sex and place of residence. All Spanish regions were considered for recruitment process. Pain (last 4 weeks), intensity (Face Pain Scale), localization and pharmacological treatments were evaluated by in-person interviews. Pain's prevalence was 52.5 % (CI 95 % 48.28-56.80) and 38.5 % experienced pain of at least moderate intensity. The most frequently involved body regions were lower limbs (26.6 %) and dorso-lumbar region (21.9 %). Only 40 % of participants with pain and 43.2 % with moderate or severe pain used analgesics, and paracetamol was less frequently used than non-steroidal anti-inflammatory drugs at any pain intensity. Age was not associated with higher prevalence [odds ratios 0.97 (CI 95 % 0.93-1.02) in females and 0.99 (CI 95 % 0.92-1.06) in males]. The prevalence of pain in non-institutionalized very old people is high. Pain is probably being undertreated, even moderate or severe pain. Guideline's recommendations are probably not being considered to select the analgesic therapy.

  11. Pain associated with health and economic burden in France: results from recent National Health and Wellness Survey data

    Directory of Open Access Journals (Sweden)

    Hadjiat Y

    2018-01-01

    Full Text Available Yacine Hadjiat,1 Alain Serrie,2 Richard Treves,3 Berangere Chomier,1 Laurent Geranton,4 Stephane Billon5 1Medical Department, Mundipharma SAS, Paris, 2Pain and Palliative Care Department, CHU Lariboisiere, Paris, 3Rheumatology Department, CHU Limoges, Limoges, 4Public Affairs Department, Mundipharma, 5Department of Health Economics, University Paris Dauphine, Paris, France Purpose: This study aimed to estimate the prevalence of pain among French adults and assess the impact of pain on health-related quality of life (HRQoL, activity impairment, and health care resource use (HRU.Patients and methods: Respondents from the 2015 France National Health and Wellness Survey (N=19,173 were categorized by self-reported pain (experienced pain in the past 12 months vs no pain and compared on HRQoL (36-Item Short Form Health Survey version 2: Mental Component Summary, Physical Component Summary, and Short Form-6 Dimensions health utilities, activity impairment (Work Productivity and Activity Impairment questionnaire, employment status, and HRU (health care provider visits, emergency room visits, and hospitalizations. Bivariate analyses examined differences between pain groups stratified by age, sex, income, and Charlson comorbidity index (CCI scores.Results: Pain prevalence was 20.2% (n=4007. Mean Physical Component Summary decrements with pain ranged from 3.4 to 8.1 points among those aged <35 years to those aged 45–54 years, respectively. Results for Mental Component Summary and Short Form-6 Dimensions scores followed similar patterns. Regardless of income, sex, or CCI group, pain was associated with significant decrements on all HRQoL measures (for all, p<0.05. The impact of pain on activity impairment was lowest among those <35 years; this impact was higher in middle age and then tapered off among those aged ≥75 years. Pain was associated with greater activity impairment and more health care provider visits across income, sex, and CCI groups (for all

  12. Radiopharmaceuticals for palliative therapy pain; Radiofarmacos para terapia paliativa del dolor

    Energy Technology Data Exchange (ETDEWEB)

    Gaudiano, Javier [Universidad de la Republica, Montevideo (Uruguay). Centro de Medicina Nuclear

    1994-12-31

    Dissemination to bone of various neoplasms is cause of pain with poor response by major analgesics.Indications. Radiopharmaceuticals,description of main characteristics of various {beta} emitter radionuclides.Choose of patients for worm indication of pain palliative therapy with {beta} emitter radiopharmaceuticals is adequate must be careful . Contraindications are recognized.Pre and post treatment controls as clinical examination and complete serology are described.It is essential to subscribe protocols,keep patient well informed,included the physician in charge of the patient as part of the team.Bibliography.

  13. Las áreas silvestres protegidas del estado como zonas de conservación de la naturaleza: El Parque Nacional Torres del Paine, Región de Magallanes y de la Antártica Chilena

    Directory of Open Access Journals (Sweden)

    M. González

    2013-12-01

    Full Text Available El presente trabajo es una breve descripción del Parque Nacional Torres del Paine, un área protegida localizada en el sur de Chile, que se caracteriza por la presencia de paisajes montañosos de origen glaciar, con una serie de lagos, lagunas, y ríos, los cuales albergan especies endémicas de flora y fauna. Estas características convierten a este parque en uno de los más visitados a nivel nacional. Se discuten aspectos sobre conservación y manejo del parque.

  14. Association between dental pain and depression in Korean adults using the Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Yang, S E; Park, Y G; Han, K; Min, J A; Kim, S Y

    2016-01-01

    The purpose of this study was to evaluate the relationships between the prevalence of depression and dental pain using a well characterised, nationally representative, population-based study. This study analysed data from the 2012 Korea National Health and Nutrition Examination Survey (n = 4886). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Depression was defined as the participant having been diagnosed as depression during the previous year. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI), controlling for a range of covariates. Results demonstrated that participants included in 'root canal treatment is necessary' showed higher prevalence of self-reported dental pain; in particular, participants with depression presented more dental pain than those without depression. After adjusting for sociodemographic factors, self-reported dental pain increased in participants with depression. The AOR (95% CI) for having self-reported dental pain was 1·58 (1·08-2·33) in dentists' diagnosis of no dental pain/depression group, 1·62 (1·32-1·98) in dentists' diagnosis of dental pain/no depression group and 2·84 (1·10-7·37) in dentists' diagnosis of dental pain/depression group. It was concluded that depression was associated with dental pain after adjustment for potential confounders in Korean adults. Thus, dentists should consider the possible presence of psychopathology when treating patients with dental pain. © 2015 John Wiley & Sons Ltd.

  15. Characterization of deepwater invertebrates at Isla del Coco National Park and Las Gemelas Seamount, Costa Rica

    Directory of Open Access Journals (Sweden)

    Richard M. Starr

    2012-11-01

    Full Text Available The deepwater faunas of oceanic islands and seamounts of the Eastern Tropical Pacific are poorly known. From 11-22 September 2009, we conducted an exploration of the deepwater areas around Isla del Coco National Park and Las Gemelas Seamount, located about 50km southwest of Isla del Coco, Costa Rica using a manned submersible to survey the seafloor habitats. The goal of the exploration was to characterize the habitats and biota, and conduct quantitative surveys of the deepwater portions of Isla del Coco National Park and Las Gemelas. We completed a total of 22 successful submersible dives, spanning more than 80hr underwater, and collected a total of 36hr of video. With respect to invertebrates, our objectives were to gather quantitative information on species composition, density, distribution and habitat associations as well as to compare the invertebrate communities between the two sites. A total of 7 172 invertebrates were counted from analysis of the video collected on this project. Larger organisms were counted and placed into 27 taxonomic groups to characterize the deepwater invertebrate fauna of Las Gemelas Seamount and Isla del Coco National Park. The Shannon-Weiner Index for biodiversity (H’ was calculated to be 0.14 ± 0.02 for Isla del Coco and 0.07 ± 0.03 for Las Gemelas surveys. Although richness was fairly equal between the two sites, evenness was greater at Isla del Coco (J = 0.04 ± 0.006 when compared to Las Gemelas (J = 0.02 ± 0.01. This lower level of evenness in the community at Las Gemelas was a result of high densities of a few dominant species groups, specifically sea urchins and black corals. We also evaluated invertebrate percent cover at both Isla del Coco and Las Gemelas Seamount with respect to habitat type, slope and rugosity. Results indicated that highly rugose habitats contained the highest frequencies of all invertebrates at both sites, with the exception of glass sponges and polychaetes at Isla del Coco

  16. Out-of-Pocket Expenditures on Complementary Health Approaches Associated with Painful Health Conditions in a Nationally Representative Adult Sample

    Science.gov (United States)

    Nahin, Richard L.; Stussman, Barbara J.; Herman, Patricia M.

    2015-01-01

    National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, use of complementary health approaches, reasons for this use, and associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for co-morbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (S.E. $0.9 billion) OOP on these approaches to manage these painful conditions. Total OOP expenditures seen in those using complementary approaches for their back pain ($8.7 billion, S.E. $0.8 billion) far outstripped that of any other condition, with the majority of these costs ($4.7 billion, S.E. $0.4 billion) resulting from visits to complementary providers. Annual condition-specific per-person OOP costs varied from a low of $568 (SE $144) for regular headaches, to a high of $895 (SE $163) for fibromyalgia. PMID:26320946

  17. Magnetoterapia para alivio del dolor por artrosis cervical Magnetotherapy for the pain relief due to cervical arthrosis

    Directory of Open Access Journals (Sweden)

    Martha María Niubó Elías

    Full Text Available Se realizó un estudio de casos y controles de 40 pacientes con artrosis cervical atendidos en el Servicio de Rehabilitación Integral del Hospital Provincial Docente "Dr. Joaquín Castillo Duany" de Santiago de Cuba, desde agosto hasta diciembre del 2008, a fin de evaluar la efectividad de la magnetoterapia para aliviar el dolor.Los integrantes de la casuística fueron asignados a uno de 2 grupos: los tratados con campo magnético de baja frecuencia e intensidad, combinado con el tratamiento convencional (grupo de estudio y los que recibieron tratamiento convencional (grupo control. Los resultados obtenidos evidenciaron que la terapia combinada fue más efectiva, lo cual se logró con 10 sesiones de tratamiento.A case-control study was conducted in 40 patients with cervical arthrosis attended at the Service of Comprehensive Rehabilitation from "Dr. Joaquín Castillo Duany" Provincial Teaching Hospital of Santiago de Cuba, from August to December, 2008, with the purpose of evaluating the effectiveness of the magnetotherapy to alleviate the pain. Patients of the case material were divided into 2 groups: those treated with low frequency and intensity magnetic field combined with conventional treatment (study group and those that received conventional treatment (control group. The obtained results showed that the combined therapy was more effective, which was achieved with 10 sessions of treatment.

  18. Predictors of compliance with short-term treatment among patients with back pain Factores predictivos del cumplimiento del tratamiento a corto plazo en pacientes con lumbalgia

    Directory of Open Access Journals (Sweden)

    Neusa Maria Costa Alexandre

    2002-08-01

    with the expectation of barriers in following the proposed treatment, with comorbidity, and with longer duration of treatment in this program. Conclusions. The findings of our study indicate that patient compliance with back pain treatment is a serious and complex problem. Nevertheless, while this study was only an exploratory one, we believe that the results of this study can be used by care providers to identify patients likely to become noncompliant and also by researchers to plan specific studies on the effectiveness of treatment programs for patients with low back pain.Objetivos. Aunque se han hecho grandes esfuerzos por encontrar tratamientos eficaces para las lumbalgias, la eficacia de las diferentes modalidades terapéuticas puede depender de su cumplimiento por parte del paciente. El objetivo de este estudio prospectivo consistió en investigar si las características demográficas del paciente, los factores clínicos, los obstáculos externos al cumplimiento del tratamiento y la percepción subjetiva de la discapacidad y la calidad de vida, la depresión y el control sobre la salud permiten predecir el cumplimiento de un programa fisioterapéutico para pacientes con lumbalgia. Métodos. El estudio, de cohorte, prospectivo y exploratorio, se realizó en la ciudad de Nueva York en 1999. Todos los participantes contestaron un cuestionario durante el examen clínico inicial, realizado por un fisioterapeuta, y fueron seguidos durante el tratamiento. Se investigó el cumplimiento de los tres regímenes terapéuticos prescritos a cada uno de los pacientes, que consistieron en asistir a sesiones programadas de fisioterapia, realizar un programa de ejercicios en su casa y visionar cintas de vídeo educativas sobre la espalda. Dependiendo de cada caso, el programa terapéutico planeado podía durar entre 2 y 6 semanas. Para caracterizar a los pacientes se empleó un conjunto de instrumentos que medían la limitación funcional subjetiva, la calidad de vida, la depresi

  19. PREVALENCE OF SELF-REPORTED SPINAL PAIN IN BRAZIL: RESULTS OF THE NATIONAL HEALTH RESEARCH

    Directory of Open Access Journals (Sweden)

    LUIZA GOMES SANTOS

    Full Text Available ABSTRACT Objective: To identify the prevalence and distribution of cases of self-reported spinal disorders by persons who are 18 years or older living in Brazil according to sociodemographic variables. Methods: We used the Pesquisa Nacional de Saúde (PNS, national health research, developed by the Brazilian Institute of Geography and Statistics (IBGE in partnership with the Ministry of Health. The data obtained from the website of IBGE System of Automatic Recovery - SIDRA were analyzed using the SPSS Statistics software version 20.0, IBM. Results: In Brazil 19% of the adult population report chronic spinal pain, 15.26% (± 4.56 men and 20.08% (+/- 4.11 women. After the age of 60, the prevalence is higher. Regarding skin color 18.26% (± 3.53 are white, 17.27% (± 6.65 are black and 17.93% (± 4.05 are brown, with no statistical difference. As for education, 23.55% (±5.70 had low or absent schooling (p < 0.001. The southern region of Brazil has the highest percentage (23.3% of adults with chronic problems in the spine, and the state with the highest percentage is Paraná, with 26%. Conclusions: The results showed that there is a relationship between spinal pain and sociodemographic characteristics, pointing to the southern region as the most affected by spinal disorders when compared to other regions of the country.

  20. Intrusion of basaltic magma into a crystallizing granitic magma chamber: The Cordillera del Paine pluton in southern Chile

    Science.gov (United States)

    Michael, Peter J.

    1991-10-01

    The Cordillera del Paine pluton in the southernmost Andes of Chile represents a deeply dissected magma chamber where mafic magma intruded into crystallizing granitic magma. Throughout much of the 10x15 km pluton, there is a sharp and continuous boundary at a remarkably constant elevation of 1,100 m that separates granitic rocks (Cordillera del Paine or CP granite: 69 77% SiO2) which make up the upper levels of the pluton from mafic and comingled rocks (Paine Mafic Complex or PMC: 45 60% SiO2) which dominate the lower exposures of the pluton. Chilled, crenulate, disrupted contacts of mafic rock against granite demonstrate that partly crystallized granite was intruded by mafic magma which solidified prior to complete crystallization of the granitic magma. The boundary at 1,100 m was a large and stable density contrast between the denser, hotter mafic magma and cooler granitic magma. The granitic magma was more solidified near the margins of the chamber when mafic intrusion occurred, and the PMC is less disrupted by granites there. Near the pluton margins, the PMC grades upward irregularly from cumulate gabbros to monzodiorites. Mafic magma differentiated largely by fractional crystallization as indicated by the presence of cumulate rocks and by the low levels of compatible elements in most PMC rocks. The compositional gap between the PMC and CP granite indicates that mixing (blending) of granitic magma into the mafic magma was less important, although it is apparent from mineral assemblages in mafic rocks. Granitic magma may have incorporated small amounts of mafic liquid that had evolved to >60% SiO2 by crystallization. Mixing was inhibited by the extent of crystallization of the granite, and by the thermal contrast and the stable density contrast between the magmas. PMC gabbros display disequilibrium mineral assemblages including early formed zoned olivine (with orthopyroxene coronas), clinopyroxene, calcic plagioclase and paragasite and later-formed amphibole

  1. Deepwater fish assemblages at Isla del Coco National Park and Las Gemelas Seamount, Costa Rica

    Directory of Open Access Journals (Sweden)

    Richard M. Starr

    2012-11-01

    Full Text Available The deepwater faunas of oceanic islands and seamounts of the Eastern Tropical Pacific are poorly known. From 11-22 September 2009 we conducted an exploration of the deepwater areas of the Isla del Coco Marine Conservation Area, Costa Rica and a nearby seamount using a manned submersible. The goal of the exploration was to characterize the habitats and biota, and conduct quantitative surveys of the deepwater portions of Isla del Coco National Park and Las Gemelas Seamount, located about 50km southwest of Isla del Coco. We completed a total of 22 submersible dives, spanning more than 80hr underwater, and collected a total of 36hr of video. We surveyed habitats from 50-402m and observed more than 45 species of fishes, some of which have not yet been described and are likely new to science. The diversity of fish species in deep water at Isla del Coco National Park was lower than the diversity of fishes in shallow water, and eight species groups accounted for more than 95% of the total fish biomass. The combined density of all fish species was higher at Las Gemelas Seamount (253 fishes/100m² than at Isla del Coco National Park (138 fishes/100m². The combined density of fishes in habitats comprised primarily of bedrock or large boulders outcrops was more than three times as high at Las Gemelas Seamount as it was at Isla del Coco National Park. This discrepancy was caused by the extremely high concentration of Anthiinae fishes in rocky habitats at Las Gemelas Seamount. Densities of fishes in the other habitats were similar between the two sites. Similarly, when estimates of fish density were plotted by slope categories the density was much greater on steep slopes, which were usually comprised of rock habitats. Also, the density of fishes was greatest on high rugosity habitats. Results of these submersible surveys indicate that seamounts in the tropical eastern Pacific Ocean may be an important source of biodiversity and that more quantitative surveys

  2. Differential Diagnoses for Persistent Pain Following Root Canal Treatment: A Study in the National Dental PBRN

    Science.gov (United States)

    Nixdorf, Donald R.; Law, Alan S.; John, Mike T.; Sobieh, Radwa M.; Kohli, Richie; Nguyen, Ruby H.N.

    2015-01-01

    Introduction Pain present 6 months following root canal treatment (RCT) may be either of odontogenic or nonodontogenic origin. This is importance because treatments and prognoses are different; therefore the aim of this study was to provide specific diagnoses of patients reporting pain 6 months after receiving initial orthograde RCT. Methods We enrolled patients from the Midwest region of an existing prospective observational study of pain after RCT. Pain at 6 months was defined as ≥1 day of pain and average pain intensity of at least 1/10 over the preceding month. An Endodontist and an Orofacial Pain practitioner independently performed clinical evaluations, which included periapical and cone-beam CT radiographs, to determine diagnoses. Results Thirty-eight out of the 354 eligible patients in the geographic area (11%) met the pain criteria, with 19 (50%) consenting to be clinically evaluated. As the sole reason for pain, 7 patients (37%) were given odontogenic diagnoses (4 involving the RCT tooth, 3 involving an adjacent tooth). Eight patients (42%) were given nonodontogenic pain diagnoses (7 from referred temporomandibular disorder (TMD) pain, 1 from persistent dentoalveolar pain disorder (PDAP)). Two patients (11%) had both odontogenic and nonodontogenic diagnoses, while 2 (11%) no longer fit the pain criteria at the time of the clinical evaluation. Conclusion Patients reporting “tooth” pain 6 months following RCT had a nonodontogenic pain diagnosis accounting for some of this pain, with TMD being the most frequent nonodonotgenic diagnosis. Dentists should have the necessary knowledge to differentiate between these diagnoses to adequately manage their patients. PMID:25732400

  3. Drug-induced chest pain and myocardial infarction. Reports to a national centre and review of the literature

    NARCIS (Netherlands)

    J.P. Ottervanger (Jan Paul); J.H.P. Wilson (Paul); B.H.Ch. Stricker (Bruno)

    1997-01-01

    textabstractObjectives: To analyse reports of drug-induced myocardial infarction and chest pain sent to a national reporting centre. To review which drugs were suspected of exhibiting these adverse events and what mechanisms were involved. Methods: During the 20-year period 1975 through 1994, a

  4. Procedural Pain in Palliative Care: Is It Breakthrough Pain? A Multicenter National Prospective Study to Assess Prevalence, Intensity, and Treatment of Procedure-related Pain in Patients With Advanced Disease.

    Science.gov (United States)

    Magnani, Caterina; Giannarelli, Diana; Casale, Giuseppe

    2017-08-01

    To assess the prevalence of breakthrough pain (BTP) provoked by 6 common procedures in patients with advanced disease. A prospective, cross-sectional, multicenter, national study was performed in 23 palliative care units in Italy. Patients were recruited if they were undergoing one of the following procedures as part of normal care: turning, personal hygiene care, transfer from bed to chair, bladder catheterization, pressure ulcer care, and subcutaneous drug administration. The Numerical Rating Scale was used to measure pain intensity before, during, and after the procedure. One thousand seventy-nine eligible patients were enrolled: 49.7% were male and their mean age was 78.0±11.2 years. Of all patients, 20.9% had experienced a BTP episode within the 24 hours before recruitment. The overall prevalence of procedure-induced BTP was 11.8%, and the mean intensity score (Numeric Rating Scale) was 4.72±1.81. Notably, patients experienced a significant increase in pain intensity during all procedures (Ppatients (12.7%) received analgesics before undergoing any of the procedures, and almost none (1.7%) received analgesics during the procedures to alleviate acute pain. Our findings highlight that simple daily care procedures can lead to BTP among patients with advanced disease. Because such procedures are performed very often during palliative care, more individualized attention to procedural pain control is necessary. Additional research on procedural pain in patients with advanced disease should be encouraged to provide further evidence-based guidance on the use of the available medication for predictable pain flares.

  5. Prescribing for pain--how do nurses contribute? A national questionnaire survey.

    Science.gov (United States)

    Stenner, Karen; Carey, Nicola; Courtenay, Molly

    2012-12-01

    To provide information on the profile and practice of nurses in the UK who prescribe medication for pain. Pain is widely under-reported and under-treated and can have negative consequences for health and psychosocial well-being. Indications are that nurses can improve treatment and access to pain medications when they prescribe. Whilst nurses working in many practice areas treat patients with pain, little is known about the profile, prescribing practice or training needs of these nurses. A descriptive questionnaire survey. An online questionnaire was used to survey 214 nurses who prescribed for pain in the UK between May and July 2010. Data were analysed using descriptive statistics and non-parametric tests. Half the participants (50%) worked in primary care, 32% in secondary care and 14% worked across care settings. A range of services were provided, including general practice, palliative care, pain management, emergency care, walk-in-centres and out-of-hours. The majority (86%) independently prescribed 1-20 items per week. Non-opioid and weak opioids analgesics were prescribed by most (95%) nurses, whereas fewer (35%) prescribed strong opioids. Training in pain had been undertaken by 97% and 82% felt adequately trained, although 28% had problems accessing training. Those with specialist training prescribed a wider range of pain medications, were more likely to prescribe strong opioids and were more often in pain management roles. Nurses prescribe for pain in a range of settings with an emphasis on the treatment of minor ailments and acute pain. A range of medications are prescribed, and most nurses have access to training. The nursing contribution to pain treatment must be acknowledged within initiatives to improve pain management. Access to ongoing training is required to support nurse development in this area of practice to maximise benefits. © 2012 Blackwell Publishing Ltd.

  6. Non-pharmacologic measures for relief of pain Medidas no farmacológicas para el alivio del dolor

    Directory of Open Access Journals (Sweden)

    Tiberio Alvarez Echeverri

    1998-01-01

    Full Text Available In this review the author discusses some aspects of non-pharmacologic therapies for relief of pain and suffering; both physical and psychological approaches are included; the former include heat and cold applicatio", exercises, neurostimulation and acupuncture; the latter are education, biofeedback, relaxation, musictherapy, hypnosis, thought sustitution, images and group and family therapy. Aiso discussed are spiritual assistance and humanized touch. The goal of these approaches is to obtain proximity with the suffering human being. El objetivo de esta revisión es discutir algunos aspectos de las terapias no farmacológicas para aliviar el dolor y el sufrimiento las cuales no han recibido la atención que merecen por parte del personal de la salud. Se incluyen elementos de la terapia física como el calor, el frío, el ejercicio, la neuroestimulación y la acupuntura; la terapia cognoscitiva y conductual con métodos como la educación, la retroalimentación, la relajación, la musicoterapia, la hipnosis, la distracción, la sustitución de pensamientos e imágenes y la terapia grupal y familiar. Se discuten aspectos de la asistencia espiritual y el tacto humanizado. Todo esto con el fin de lograr un acercamiento humanizado al hombre que sufre.

  7. Posttraumatic stress disorder and chronic pain are associated with opioid use disorder: Results from a 2012-2013 American nationally representative survey.

    Science.gov (United States)

    Bilevicius, Elena; Sommer, Jordana L; Asmundson, Gordon J G; El-Gabalawy, Renée

    2018-07-01

    Chronic pain conditions and posttraumatic stress disorder (PTSD) commonly co-occur and are associated with opioid use disorder (OUD). The aims of this paper were to identify prevalence estimates of OUD among individuals with and without PTSD and assess independent and combined contributions of PTSD and chronic pain conditions on OUD in a nationally representative sample. Data were extracted from 36,309 individuals from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Past-year PTSD and OUD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 edition. Respondents reported physician-confirmed, past-year chronic pain conditions, categorized into musculoskeletal pain (e.g., arthritis), digestive pain (e.g., pancreatitis), and nerve pain (e.g., reflex sympathetic dystrophy). We examined the weighted prevalence of OUD among those with and without PTSD. Multiple logistic regressions examined the association between PTSD and chronic pain conditions on OUD. The prevalence of OUD was higher among those with PTSD than those without. Comorbid PTSD/musculoskeletal pain and PTSD/nerve pain conditions were associated with increased odds of OUD, compared to those with neither PTSD nor chronic pain conditions. Digestive pain conditions were not associated with OUD. Comorbid PTSD/musculoskeletal pain conditions demonstrated an additive relationship on OUD compared to musculoskeletal pain conditions and PTSD alone. Results reveal that musculoskeletal pain and nerve pain conditions are associated with increased odds of OUD, but only musculoskeletal pain conditions display an additive relationship on OUD when combined with PTSD. These findings have implications for opioid management and screening among those with comorbid conditions. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Caracterización de la situación posincendio en el área afectada por el incendio de 2005 en el Parque Nacional de Torres del Paine (Chile a partir de imágenes multiespectrales Characteristics of areas affected by fire in 2005 at Parque Nacional de Torres del Paine (Chile as assessed from multispectral images

    Directory of Open Access Journals (Sweden)

    RAFAEL M NAVARRO CERRILLO

    2008-03-01

    Full Text Available El uso de sensores remotos para la evaluación de la severidad es una de los aspectos más importantes en el estudio de grandes incendios, así como la aplicación de los resultados para el proceso de restauración. En este trabajo se ha estudiado la aplicación de imágenes de los sensores Landsat ETM+ y ASTER para evaluar la vegetación previa, la superficie recorrida por el fuego y los daños producidos por el incendio ocurrido en el año 2005 en el Parque Nacional de Torres del Paine (Chile. Los resultados obtenidos indican que el índice delta NBR es bastante versátil para evaluar la superficie afectada, estimada en este caso en 17.138 ha, así como la severidad de los daños (Fiabilidad = 81,5 %; k = 0,73. Por otro lado, se ha confirmado la adecuación del uso de imágenes Landsat ETM+ para mejorar la calidad de los mapas de vegetación previa a la ocurrencia del fuego (Fiabilidad = 79,5 %; k = 0,75. La combinación de esta información se ha podido aplicar para apoyar la restauración del área afectada por el incendio. Sin embargo, los resultados también han mostrado algunas limitaciones de los sensores, en particular en la definición de ecosistemas con representaciones superficiales pequeñas y/o fragmentadas, lo cual sugiere que el uso de sensores de mayor resolución espacial puede mejorar los productos cartográficos finales y, por tanto, la calidad de los trabajos de restauraciónThe use of remote sensors is one of the most important aspects in the study of large fires for an assessment of their severity, as well as the application of the results to the restoration process. This work has studied the application of images from the Landsat ETM + ASTER sensors in order to evaluate the prior vegetation, the surface burned and the damage caused by a fire occurring in 2005 in the National Park of Torres del Paine (Chile. The results obtained indicate that the delta NBR index is reasonably versatile for evaluating the affected surface

  9. 77 FR 68146 - Notice of Intent To Prepare an Environmental Impact Statement for the Paseo del Morro National...

    Science.gov (United States)

    2012-11-15

    ... Intent To Prepare an Environmental Impact Statement for the Paseo del Morro National Recreational Trail.... 4332) (2) (C), the National Park Service (NPS) will prepare an Environmental Impact Statement for the... San Juan, protect the historic walls of El Morro, encourage educational tourism within the area. The...

  10. A national survey of pain clinics within the United Kingdom and Ireland focusing on the multidisciplinary team and the incorporation of the extended nursing role.

    Science.gov (United States)

    Kailainathan, Pungavi; Humble, Stephen; Dawson, Helen; Cameron, Fiona; Gokani, Shyam; Lidder, Gursimren

    2018-02-01

    Inconsistencies in the availability and quality of pain service provision have been noted nationally, as have lengthy waiting times for appointments and lack of awareness of the Pain Clinic role. The 2013 NHS England report stated that specialist pain services must offer multispecialty and multidisciplinary pain clinics. This national survey of multidisciplinary pain service provision in the United Kingdom and Ireland provides a snapshot of pain service provision in order to review and highlight what variations exist in multidisciplinary team (MDT) provision and working patterns. A common perception among clinicians is that financial pressures have led to alternate ways of staff utilisation with variable degrees of success. The survey included 143 pain clinics, focusing principally on MDT working patterns, MDT composition and adoption of the extended role. The results identified that the majority of Pain Clinics utilise the MDT approach. However, provision of critical components such as regular MDT meetings is highly variable as is the composition of the MDT itself and also working patterns of the individual clinicians. The survey reports the successful use of the extended roles for specialist nurses in follow up clinics. In contrast, the survey highlights that a large proportion of clinicians surveyed have reservations about both the effectiveness and the safety of utilising specialist nurses in the extended role to see new referrals of complex pain patients to pain clinics. This survey underlines the essential requirement for incorporation of greater MDT working locally and nationally and allocation of appropriate resources to facilitate this.

  11. Reflections on the relationship between chronic pain and family structure Reflexiones sobre la relación del color crónico con la estructura familiar

    Directory of Open Access Journals (Sweden)

    Tiberio Alvarez Echeverri

    1990-02-01

    Full Text Available

    This review deals with the influence of chronic pain upon the patient's family; based mainly on the work of the Center for Pain Evaluation and Treatment (University of Pittsburgh, emphasis is made on the following aspects: 1. The multidimensional model of pain that includes biological, motivational, conductual, affective, cognitive and evaluative variables. 2. The family as etiologic and perpetuating agent of pain. 3. The negative impact of chronic pain upon the physical, sexual, psychologic, sociocultural and economic aspects of family life. 4. The importance of family evaluation as to the degree of cohesion and integration; the ability for conflict solving and the interaction pat1erns. 5. Treatment should include opportune and adequate information; the search of a meaning for the problem; the relief from pain and suffering; the offer of constant help and support and the selection of specific therapy for each situation.

    En el presente artículo se discuten algunos aspectos de la influencia que tiene en su familia el paciente con dolor crónico. Se hace una revisión de la literatura científica sobre el tema con especial mención de los trabajos del Centro para Evaluación y Tratamiento del Dolor de la Universidad de Pittsburgh. Se destacan los siguientes aspectos: 1. El modelo multidimensional del dolor que incluye las variables biológica, motivacional, conductual, afectiva, cognitiva y evaluativa. 2. La familia como agente causal del dolor: desde el punto de vista psicodinámico se habla de familias que tienen mayor propensión al dolor, caracterizadas por relaciones interpersonales difíciles, agresivas, hostiles y en las que son frecuentes los sentimientos de pérdida, culpabilidad, derrota y sufrimiento. 3. La familia como agente perpetuador del dolor: en ciertas familias el dolor cr

  12. National Institute for Health and Care Excellence updates the stable chest pain guideline with radical changes to the diagnostic paradigm.

    Science.gov (United States)

    Timmis, Adam; Roobottom, Carl A

    2017-07-01

    In the 2016 update of the stable chest pain guideline, the National Institute for Health and Care Excellence (NICE) has made radical changes to the diagnostic paradigm that it-like other international guidelines-had previously placed at the centre of its recommendations. No longer are quantitative assessments of the disease probability considered necessary to determine the need for diagnostic testing and the choice of test. Instead, the recommendation is for no diagnostic testing if chest pain is judged to be 'non-anginal' and CT coronary angiography (CTCA) in patients with 'typical' or 'atypical' chest pain with additional perfusion imaging only if there is uncertainty about the functional significance of coronary lesions. The new emphasis on anatomical-as opposed to functional-testing is driven in large part by cost-effectiveness analysis and despite inevitable resource implications NICE calculates that annual savings for the population of England will be significant. In making CTCA the default diagnostic testing strategy in its updated chest pain guideline, NICE has responded emphatically to calls from trialists for CTCA to have a greater role in the diagnostic pathway of patients with suspected angina. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Association of chronic widespread pain with objectively measured physical activity in adults: findings from the National Health and Nutrition Examination survey.

    Science.gov (United States)

    Dansie, Elizabeth J; Turk, Dennis C; Martin, Kathryn R; Van Domelen, Dane R; Patel, Kushang V

    2014-05-01

    Chronic widespread pain (CWP) is a common and potentially debilitating disorder. Patterns of physical activity (PA) in adults with CWP have primarily been investigated using subjective, self-report measures. The current study sought to characterize PA among community-dwelling individuals with CWP, chronic regional pain, or no chronic pain using objective measurements obtained via accelerometry in the 2003 to 2004 National Health and Nutrition Examination Survey. Data from 3,952 participants ages 20 and older were analyzed to assess relationships between pain status and objective measurements of PA. Prevalence of CWP was 3.3% and 5.4% in men and women, respectively. In men and women, the average activity counts per minute and time spent in moderate-to-vigorous PA were significantly lower for the CWP group than for the no chronic pain group. Interestingly, time spent in sedentary, light, and lifestyle activities was not associated with pain status. Statistical interaction tests indicated that the effects of chronic pain on counts per minute were stronger in men than in women. Despite recommendations for increased moderate-to-vigorous PA as a pain management strategy for CWP, results from this nationally representative study indicate that adults with CWP participate in less moderate-to-vigorous PA than individuals without chronic pain. Using objective measurement of PA in a nationally representative sample, this study demonstrates that adults with CWP participate in reduced daily and moderate-to-vigorous PA in comparison to people with no chronic pain. Findings indicate that clinicians should emphasize the importance of increasing PA in patients with CWP. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

  14. 78 FR 76296 - National Institute of Neurological Disorders and Stroke, Interagency Pain Research Coordinating...

    Science.gov (United States)

    2013-12-17

    ... critical gaps in basic and clinical research on the symptoms and causes of pain; (c) make recommendations... Committee. Appointment to this Committee shall be made without discrimination on the basis of age, race, ethnicity, gender, sexual orientation, disability, and cultural, religious, or socioeconomic status. The...

  15. Avaliação da dor em neonatologia Evaluación del dolor en neonatología Pain evaluation in neonatology

    Directory of Open Access Journals (Sweden)

    Yerkes Pereira e Silva

    2007-10-01

    ém-nascidos.JUSTIFICATIVA Y OBJETIVOS: El estudio del dolor ha avanzado mucho en las últimas décadas haciendo con que la evaluación y la intervención sean una preocupación creciente entre los profesionales de la salud. El objetivo de la evaluación del dolor debe ser el de proporcionar datos precisos para determinar cuáles acciones deben ser toma de las para aliviarlo o eliminarlo y la mismo tiempo, evaluar la eficacia de esas acciones. La finalidad de esta revisión fue discutir los métodos utilizados en la evaluación del dolor en neonatología, cuando las estrategias de tratamiento utiliza de las sin una evaluación sistemática del dolor no son eficaces o adecua de las. CONTENIDO: No existe ninguna técnica ampliamente aceptada y fácilmente ejecutable y uniforme para la evaluación del dolor en niños, especialmente en los recién nacidos y lactantes que pueda ser utilizada en todas las situaciones. Antes de confiar en la exactitud de los datos de Evaluación, se hace necesario que los profesionales de la salud se sientan seguros con los instrumentos usados en la recolección del esos datos. Varios indicadores pueden ser usados en la evaluación, cuantificación y calificación del estímulo doloroso, y cuando se analizan en conjunto, permiten el desglose entre el dolor y los estímulos no dolorosos. Aunque sea deseable la estandarización objetiva para la medición de la intensidad del dolor, tal medida no existe todavía. La medición ene sea franja etaria es hecha por medio de parámetros fisiológicos (frecuencia cardíaca, frecuencia respiratoria, presión arterial, etc y comportamentales (expresión facial, postura y vocalización o verbalización, utilizando escalas de evaluación, cada una con sus ventajas y limitaciones. CONCLUSIONES: La actual atención para mejores métodos de medida y evaluación del dolor aportó para aumentar la sensibilidad de los profesionales de salud con relación a la naturaleza de las experiencias dolorosas. El dolor debe ser entendido como la

  16. Apendicularias (Urochordata y quetognatos (Chaetognatha del Parque Nacional Isla del Coco, Costa Rica Appendicularians (Urochordata and chaetognaths (Chaetognatha of Isla del Coco National Park, Costa Rica

    Directory of Open Access Journals (Sweden)

    Iván Castellanos-Osorio

    2012-11-01

    Full Text Available Las apendicularias y quetognatos son miembros importantes del zooplancton pero poco estudiados en Costa Rica y no del todo en el Parque Nacional Isla del Coco, Pacífico tropical este. Se recolectaron muestras epipelágicas de zooplancton de la zona oceánica (0-50m de la Isla del Coco, en noviembre de 2001 y sobre parches arrecifales en 2009. Se analizó la composición de especies de apendicularias y quetognatos presentes en 31 muestras. Nueve especies de apendicularias, y ocho especies de quetognatos fueron identificadas. Oikopleura longicauda fue la más abundante en el área estudiada (217organismos, representando el 65.56% del número total de apendicularias, seguida por Oikopleura rufescens, con 35 (10.57%. Todas las especies de apendicularias encontradas en este estudio son comunes en las aguas cálidas de los océanos, seis especies se registran aquí por primera vez en aguas de la Isla del Coco y dos son nuevos registros para Costa Rica. Entre los quetognatos, Flaccisagitta enflata fue la especie más común (85 ejemplares, representando el 50.6% del número total registrada en este estudio, seguida por Serratosagitta pacifica con 38 organismos (20.62%. Zonosagitta bedoti estuvó representada por un solo espécimen. Estas especies también se han registrado en las aguas tropicales del Pacífico oriental, pero seis especies son nuevos registros para Isla del Coco. Los datos sobre la distribución y morfología de las especies registradas se presentan junto con las claves para la identificación de los taxones en el área estudiada.Appendicularians and chaetognaths are important members of the zooplancton but little studied in Costa Rica and not at all at Isla del Coco Nacional Park, eastern tropical Pacific. Epipelagic (0-50m zooplankton samples from the oceanic area off Isla del Coco, were collected in November 2001, and over patch reefs in 2009. We analized the species composition of appendicularians and chaetognaths present in 31

  17. Chronic pain and pattern of health care utilization among Malaysian elderly population: National Health and Morbidity Survey III (NHMS III, 2006).

    Science.gov (United States)

    Mohamed Zaki, Lily R; Hairi, Noran N

    2014-12-01

    The aims of this study were to report prevalence of chronic pain and to examine whether chronic pain influence healthcare usage among elderly Malaysian population. This was a sub-population analysis of the elderly sample in the Malaysia's Third National Health and Morbidity Survey (NHMS III) 2006, a nation-wide population based survey. A subset of 4954 elderly aged 60 years and above was used in the analysis. Chronic pain, pain's interference and outcome variables of healthcare utilization (hospital admission and ambulatory care service) were all measured and determined by self-report. Prevalence of chronic pain among elderly Malaysian was 15.2% (95% CI: 14.5, 16.8). Prevalence of chronic pain increased with advancing age, and the highest prevalence was seen among the old-old group category (21.5%). Across young-old and old-old groups, chronic pain was more prevalent among females, Indian ethnicity, widows/widowers, rural residency and those with no educational background. Our study showed that chronic pain alone increased hospitalization but not visits to ambulatory facilities. Presence of chronic pain was significantly associated with the frequency of hospitalization (aIRR 1.11; 95% CI 1.02, 1.38) but not ambulatory care service. Chronic pain is a prevalent health problem among the elderly in Malaysia and is associated with higher hospitalization rate among the elderly population. This study provides insight into the distribution of chronic pain among the elderly and its relationship with the patterns of healthcare utilization. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Radiographic findings of femoroacetabular impingement in National Football League Combine athletes undergoing radiographs for previous hip or groin pain.

    Science.gov (United States)

    Nepple, Jeffrey J; Brophy, Robert H; Matava, Matthew J; Wright, Rick W; Clohisy, John C

    2012-10-01

    The purpose of this study was to investigate the prevalence of radiographic findings of femoroacetabular impingement (FAI) in elite football players with a history of hip pain or groin injury who underwent radiographs. We performed a retrospective review of athletes undergoing hip radiography at the National Football League Combine from 2007 to 2009. Radiographs were obtained in athletes with a history of hip pain or injury. Anteroposterior pelvis and frog-lateral radiographs were obtained in 123 hips (107 players) that met our inclusion criteria. Radiographic indicators of cam-type FAI (alpha angle, head-neck offset ratio) and pincer-type FAI (acetabular retroversion, center-edge angle, acetabular inclination) were recorded. Findings were correlated with clinical factors (previous groin/hip pain, position, race, and body mass index). The most common previous injuries included groin strain (n = 57) and sports hernia/abdominal strain (n = 21). Markers of cam- and/or pincer-type FAI were present in 94.3% of hips (116 of 123). Radiographic evidence of combined cam- and pincer-type FAI was the most common (61.8%, 76 hips), whereas isolated cam-type FAI (9.8%, 12 hips) and pincer-type FAI (22.8%, 28 hips) were less common. The most common deformities included acetabular retroversion (71.5%) and an abnormal alpha angle (61.8%). A body mass index greater than 35 was associated with the presence of global overcoverage (46.2% v 17.3%, P = .025). Radiographic indicators of FAI are very common among athletes evaluated at the National Football League Scouting Combine subjected to radiographic examination for the clinical suspicion of hip disease. Elite football athletes with significant or recurrent pain about the hip should be evaluated clinically and radiographically for FAI, because pain from FAI may be falsely attributed to or may be present in addition to other disorders. Level IV, therapeutic case series. Copyright © 2012 Arthroscopy Association of North America

  19. "Floating signifiers": Negotiating the meaning of national in Montenegro, at the Internet chat room Café del Montenegro

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    Čarna Brković

    2016-03-01

    Full Text Available The paper represents the analysis of the narratives that deal with the sentiment of national belonging in Montenegro within the chat room Café del Montenegro. The practice of the Internet chat room users is perceived as cultural engagement – „practicing" the State and the emotion of national identification of its own kind. By writing, arguing, negotiating the meaning of the state and nation an abundance of different and broken knowledge’s are created- many histories, geographies, ethics and politics are offered. On the one hand, these directly undermines, jeopardizes and questions the power of the State narrative, hitherto negotiating the nation, the State, authentic devotion, simultaneously manufacturing the state-nation as a reality. The result of mutual correspondence in the chat room is persistent negotiation of the meaning of national categories in Montenegro over the years.

  20. Chronic discrimination and bodily pain in a multiethnic cohort of midlife women in the Study of Women's Health Across the Nation.

    Science.gov (United States)

    Dugan, Sheila A; Lewis, Tené T; Everson-Rose, Susan A; Jacobs, Elizabeth A; Harlow, Siobán D; Janssen, Imke

    2017-09-01

    A growing literature links discrimination to key markers of biobehavioral health. While racial or ethnic differences in pain are seen in experimental and clinical studies, the authors were interested in how chronic discrimination contributes to pain within multiple racial or ethnic groups over time. Participants were 3056 African American, Caucasian, Chinese, Hispanic, and Japanese women from the Study of Women's Health Across the Nation. The Everyday Discrimination Scale was assessed from baseline through 13 follow-up examinations. The bodily pain subscale of the MOS 36-Item Short-Form Health Survey (SF-36) was assessed annually. There were large racial or ethnic differences in reports of discrimination and pain. Discrimination attributions also varied by race or ethnicity. In linear mixed model analyses, initially adjusted for age, education, and pain medications, chronic everyday discrimination was associated with more bodily pain in all ethnic groups (beta = -5.84; P discrimination remained a significant predictor of pain for African American (beta = -4.50; P discrimination were strongly linked to reports of bodily pain for the majority of women. Further research is needed to determine if addressing psychosocial stressors, such as discrimination, with patients can enhance clinical management of pain symptoms.

  1. Current management of pregnancy-related low back pain: a national cross-sectional survey of U.K. physiotherapists.

    Science.gov (United States)

    Bishop, A; Holden, M A; Ogollah, R O; Foster, N E

    2016-03-01

    Pregnancy-related low back pain (LBP) is very common. Evidence from a systematic review supports the use of exercise and acupuncture, although little is known about the care received by women with pregnancy-related back pain in the U.K. To describe current acupuncture and standard care management of pregnancy-related LBP by U.K. physiotherapists. Cross-sectional survey of physiotherapists with experience of treating women with pregnancy-related LBP from three professional networks of the Chartered Society of Physiotherapy. In total, 1093 physiotherapists were mailed a questionnaire. The questionnaire captured respondents' demographic and practice setting information, and experience of managing women with pregnancy-related back pain, and investigated the reported management of pregnancy-related LBP using a patient case vignette of a specific, 'typical' case. The overall response rate was 58% (629/1093). Four hundred and ninety-nine physiotherapists had experience of treating women with pregnancy-related LBP and were included in the analysis. Most respondents worked wholly or partly in the U.K. National Health Service (78%). Most respondents reported that they treat patients with pregnancy-related LBP in three to four one-to-one treatment sessions over 3 to 6 weeks. The results show that a range of management strategies are employed for pregnancy-related LBP, and multimodal management is common. The most common reported treatment was home exercises (94%), and 24% of physiotherapists reported that they would use acupuncture with the patient described in the vignette. This study provides the first robust data on the management of pregnancy-related LBP by U.K. physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Observations of Litter Deposited in the Deep Waters of Isla del Coco National Park, Eastern Tropical Pacific

    Directory of Open Access Journals (Sweden)

    Beatriz Naranjo-Elizondo

    2018-03-01

    Full Text Available Marine debris is recognized as a major threat to biodiversity and can be found ubiquitously even in remote regions, including deep-sea environments. Isla del Coco National Park is known as one of the best protected areas around the world, a preferred diving destination, and is also renowned for large aggregations of pelagic species that attract illegal commercial fisheries. Despite its pristine reputation, this study demonstrates that anthropogenic debris can affect this remote and well protected area. Images of marine debris were taken using the DeepSee submersible, mainly plastic litter from fishing gear were found between 200 and 350 m depth. A total of 40 items of debris were found in 5.48% of 365 dives, 60% of the items were plastics, and local boat and fishing activities provided most of litter. Our aim with this research is to raise awareness about the potential problem of solid wastes and fishing gear deposited in the deep environments of Isla del Coco National Park and to explore the potential implications for the ecological integrity of this protected area, including ghost fishing and the possible ingestion of pollutants. These results provide useful management information for the area, especially if one considers the constant pressure of illegal fishing and tourism at Isla del Coco National Park.

  3. The Use of Analgesic and Other Pain-Relief Drugs to Manage Chronic Low Back Pain: Results from a National Survey.

    Science.gov (United States)

    Gouveia, Nélia; Rodrigues, Ana; Ramiro, Sofia; Eusébio, Mónica; Machado, Pedro M; Canhão, Helena; Branco, Jaime C

    2017-03-01

    To analyze and characterize the intake profile of pain-relief drugs in a population-based study of adults with chronic low back pain (CLBP). EpiReumaPt was a cross-sectional Portuguese population-based study (10,661 subjects). Self-reported active CLBP was considered to be low back pain on the day of enrollment and for ≥ 90 days. Prevalence and profile of analgesic intake was characterized among those self-reporting active CLBP, taking into account the intensity of pain and the World Health Organization (WHO) analgesic ladder. We further investigated whether the presence of active CLBP was a factor independently associated with the intake of analgesics (adjusted for potential confounders). Among 1,487 subjects with active CLBP, only 18.7% were using analgesic/pain-relief drugs. Estimated prevalence was anxiolytics, 14.1%; nonsteroidal anti-inflammatory drugs (NSAIDs), 12.3%; antidepressants, 10.1%; analgesic, antipyretics, 6.6%; anticonvulsants, 3.4%; central muscle relaxants, 2.6%; and analgesic opioids, 1.6%. Most subjects with severe pain were in the first step of the WHO analgesic ladder: NSAIDs plus anxiolytics (4.6%), NSAIDs plus antidepressants (3.2%), or NSAIDs plus muscle relaxants (2.5%). The presence of active CLBP was significantly associated with the intake of all therapeutic groups: antidepressants (odds ratio [OR] = 12.56; P pain-relief drug intake in patients with active CLBP was very low, even for those with severe pain. The WHO analgesic ladder was carefully followed, with an extremely conservative use of analgesic opioids even for those with severe pain. © 2016 World Institute of Pain.

  4. Psychosocial and Demographic Correlates of Employment versus Disability Status in a National Community Sample of Adults with Chronic Pain: Toward a Psychology of Pain Presenteeism

    Science.gov (United States)

    Karoly, Paul; Ruehlman, Linda S.; Okun, Morris A.

    2013-01-01

    Background Although chronic pain is a source of work-related disability, relatively little research has addressed the psychological factors that differentiate individuals in chronic pain who leave the workforce from those who remain on the job despite their pain. Objective The present study examined a small set of attitudinal and coping-related factors as potential correlates of pain-related disability versus continued part- or full time employment over and above the role of well-known risk factors. Methods A large sample of adult men and women with chronic pain drawn from across the United States (N= 1293) by means of random digit dialing was subdivided into two groups: working (N = 859) and on disability (N = 434). Both groups were interviewed (by telephone) to complete a set of instruments (called the Profile of Chronic Pain: Extended Assessment [PCP: EA] Battery) measuring pain attitudes and coping methods. Results Logistic regression analysis revealed, as expected, that continued employment status was inversely related to pain severity and work status was positively related to higher education and being Hispanic. After controlling for severity and demographic factors, belief in a medical cure and catastrophizing tendencies were significant inverse predictors and task persistence was a positive predictor of continued employment. Conclusions Results revealed both demographic and attitudinal predictors of continued employment, and highlight the value of harnessing insights from the psychology of work engagement to better understand the processes underlying pain presenteeism. Interventions designed to keep persons with pain in the active work force should build upon and extend the present findings. PMID:24010682

  5. 78 FR 15024 - National Institute of Neurological Disorders and Stroke, Interagency Pain Research Coordinating...

    Science.gov (United States)

    2013-03-08

    ... made without discrimination on the basis of age, race, ethnicity, gender, sexual orientation... America: A Blueprint for Transforming Prevention, Care, Education, and Research.'' DATES: Nominations are..., Care, Education, and Research.'' The National Institutes of Health and the IPRCC are seeking...

  6. The opioid epidemic and national guidelines for opioid therapy for chronic noncancer pain: a perspective from different continents.

    Science.gov (United States)

    Häuser, Winfried; Schug, Stephan; Furlan, Andrea D

    2017-05-01

    A marked rise in opioid prescriptions for patients with chronic noncancer pain (CNCP) with a parallel increase in opioid abuse/misuse, and resulting deaths was noted in the Unites states in the past decade (opioid epidemic). In response, the US Center of Diseases Control (CDC) developed a guideline for prescribing of opioids for patients with CNCP. To assess (1) if there is an opioid epidemic in Australia, Canada, and Germany (2) to compare Australian, Canadian, German, and Center of Diseases Control guidelines recommendations for long-term opioid therapy for CNCP. National evidence-based guidelines and PubMed were searched for recommendations for opioid prescriptions for CNCP. There are signs of an opioid epidemic in Australia and Canada, but not in Germany. Guidelines in all 4 countries provide similar recommendations: opioids are not the first-line therapy for patients with CNCP; regular clinical assessments of benefits and harms are necessary; excessive doses should be avoided (recommended morphine equivalent daily doses range from 50 to 200 mg/d); stopping rules should be followed. All guidelines do not recommend the use of opioids in chronic pain conditions without an established nociceptive or neuropathic cause such as fibromyalgia and primary headache. Implementation of opioid prescribing guidelines should ensure that physicians prescribe opioids only for appropriate indications in limited doses for selected patients and advice patients on their safe use. These measures could contribute to reduce prescription opioid misuse/abuse and deaths.

  7. Comparison of logistic regression and artificial neural network in low back pain prediction: second national health survey.

    Science.gov (United States)

    Parsaeian, M; Mohammad, K; Mahmoudi, M; Zeraati, H

    2012-01-01

    The purpose of this investigation was to compare empirically predictive ability of an artificial neural network with a logistic regression in prediction of low back pain. Data from the second national health survey were considered in this investigation. This data includes the information of low back pain and its associated risk factors among Iranian people aged 15 years and older. Artificial neural network and logistic regression models were developed using a set of 17294 data and they were validated in a test set of 17295 data. Hosmer and Lemeshow recommendation for model selection was used in fitting the logistic regression. A three-layer perceptron with 9 inputs, 3 hidden and 1 output neurons was employed. The efficiency of two models was compared by receiver operating characteristic analysis, root mean square and -2 Loglikelihood criteria. The area under the ROC curve (SE), root mean square and -2Loglikelihood of the logistic regression was 0.752 (0.004), 0.3832 and 14769.2, respectively. The area under the ROC curve (SE), root mean square and -2Loglikelihood of the artificial neural network was 0.754 (0.004), 0.3770 and 14757.6, respectively. Based on these three criteria, artificial neural network would give better performance than logistic regression. Although, the difference is statistically significant, it does not seem to be clinically significant.

  8. Magnetic resonance arthrography in chronic wrist pain. Artografia con Risonanza Magnetica (arto-RM) nelle malattie dolorose croniche del polso

    Energy Technology Data Exchange (ETDEWEB)

    Valeri, G.; Ferrara, C. (Ancona Univ. (Italy). Cattedra di Radiologia); Carloni, S. (Ancona Univ. (Italy). Cattedra di Ortopedia) (and others)

    The purpose of this paper is to investigate the clinical role of Magnetic Resonance Arthrography (MRA) of the wrist in subjects with chronic pain. Thirty-five patients complaining of wrist pain for more than 6 months were submitted to MRI an MRA. All patients received and intra-articular injection of 2-10 mL of a 10 mmol saline solution of Gd-DPTA. The overall diagnostic accuracy rates of MRI and MRA were 40% and 81% respectively, with sensitivity and specificity of 63% and 39% (MRI) and of 82% and 79% (MRA). The conclusion is that compared with MRI, MRA can be considered a useful tool for the visualization of interosseus carpal ligaments and of the triangular fibrocartilage complex. MRA also helps detect injuries in these structures.

  9. Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey.

    Science.gov (United States)

    Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean

    2016-09-01

    The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors, and to identify worker groups with an increased vulnerability for low back pain in the United States. The data used for this cross-sectional study came from the 2010 National Health Interview Survey, which was designed to collect data on health conditions and related risk factors from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% confidence interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment, and job insecurity. Work hours, occupation, and other work organizational factors (nonstandard work arrangements and alternative shifts) were also examined. The prevalence of self-reported low back pain in the previous 3 months among workers in the United States was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15-1.41), exposure to hostile work (OR 1.39, CI 1.25-1.55), and job insecurity (OR 1.44, CI 1.24-1.67), while controlling for demographic characteristics and other health-related factors. Older workers who had nonstandard work arrangements were more likely to report low back pain. Women who worked 41 to 45 hours per week and younger workers who worked >60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including male health care practitioners, female and younger health care support workers, and female farming, fishing, and forestry workers, had an increased risk of

  10. Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey

    Science.gov (United States)

    Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean

    2017-01-01

    Objectives The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors and to identify worker groups with an increased vulnerability for low back pain in the US. Methods The data used for this study came from the 2010 National Health Interview Survey (NHIS), which was designed to collect data on health conditions and related risk factors obtained from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% Confidence Interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment and job insecurity. Work hours, occupation and other work organizational factors (non-standard work arrangements and alternative shifts) were also examined. Results The prevalence rate of self-reported low back pain in previous three months among workers in the U.S. was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15–1.41), exposure to hostile work (OR 1.39, CI 1.25–1.55), and job insecurity (OR 1.44, CI 1.24–1.67), while controlling for demographic characteristics and other health related factors. Older workers who had non-standard work arrangements were more likely to report low back pain. Females who worked 41–45 hours per week and younger workers who worked over 60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including, male healthcare practitioners, female and younger healthcare support workers, and female farming, fishing and forestry workers had

  11. Descriptions and records of Cladiopsocidae and Dolabellopsocidae (Insecta: Psocodea: 'Psocoptera') from Valle del Cauca and National Natural Park Gorgona, Colombia.

    Science.gov (United States)

    Calderón-Martínez, Nadia R; González-Obando, Ranulfo; Aldrete, Alfonso N García

    2014-11-28

    The results of a survey on the species diversity of the families Cladiopsocidae and Dolabellopsocidae (Psocodea: 'Psocoptera': Psocomorpha: Epipsocetae) in Valle del Cauca and in the National Natural Park (NNP) Gorgona, Colombia, are presented. The specimens studied were collected in the context of two scientific projects, in which 12 species in the two families were identified, five in Cladiopsocidae and seven in Dolabellopsocidae. In the first family, Cladiopsocus presented a new record in the country and four new species; in the latter, two genera were identified, Dolabellopsocus, with three new species and two new records, and Isthmopsocus, with two new species. This study presents the description of the nine new species from Valle del Cauca and NNP Gorgona, the new records for Colombia and identification keys to the neotropical species of both families.

  12. Spinal pain and co-occurrence with stress and general well-being among young adolescents: a study within the Danish National Birth Cohort.

    Science.gov (United States)

    Stallknecht, Sandra Elkjær; Strandberg-Larsen, Katrine; Hestbæk, Lise; Andersen, Anne-Marie Nybo

    2017-06-01

    This study aims to describe the patterns in low back, mid back, and neck pain complaints in young adolescents from the Danish National Birth Cohort (DNBC) and to investigate the co-occurrence of spinal pain and stress and general well-being, respectively. Cross-sectional data from the 11-year follow-up of DNBC were used. As part of a web-based survey, a total of 45,371 young adolescents between 10 and 14 years old completed the Young Spine Questionnaire, the Stress in Children Questionnaire, and a one-item question on general well-being. Associations between spinal pain and, respectively, stress and general well-being were estimated by means of multiple logistic regression models. Almost one fifth of boys and one quarter of girls reported spinal pain. Compared with adolescents who reported no stress, adolescents reporting medium and high values of stress had odds ratios (OR) of 2.19 (95% CI 2.08-2.30) and 4.73 (95% CI 4.28-5.23), respectively, of reporting spinal pain (adjusted for age, gender, and maternal education). Adolescents who reported poor general well-being had an OR of 2.50 (95% CI 2.31-2.72) for reporting spinal pain compared to adolescents with good general well-being. Spinal pain is a common complaint among young adolescents and co-occurs with stress and poor general well-being. The mutual dependency between the factors remained to be explained. What is Known: • The prevalence of spinal pain increases rapidly during childhood and adolescence, but different measurement instruments result in great variation in the estimates of spinal pain in children and adolescents. • Some studies have shown that different psychosocial measures are associated with spinal pain in children and adolescents. What is New: • Spinal pain, as measured by the newly developed and validated Young Spine Questionnaire, is a common complaint in young adolescents aged 10-14 years. • Spinal pain in young adolescents co-occurs with stress and poor general well-being.

  13. The Canadian minimum dataset for chronic low back pain research: a cross-cultural adaptation of the National Institutes of Health Task Force Research Standards.

    Science.gov (United States)

    Lacasse, Anaïs; Roy, Jean-Sébastien; Parent, Alexandre J; Noushi, Nioushah; Odenigbo, Chúk; Pagé, Gabrielle; Beaudet, Nicolas; Choinière, Manon; Stone, Laura S; Ware, Mark A

    2017-01-01

    To better standardize clinical and epidemiological studies about the prevalence, risk factors, prognosis, impact and treatment of chronic low back pain, a minimum data set was developed by the National Institutes of Health (NIH) Task Force on Research Standards for Chronic Low Back Pain. The aim of the present study was to develop a culturally adapted questionnaire that could be used for chronic low back pain research among French-speaking populations in Canada. The adaptation of the French Canadian version of the minimum data set was achieved according to guidelines for the cross-cultural adaptation of self-reported measures (double forward-backward translation, expert committee, pretest among 35 patients with pain in the low back region). Minor cultural adaptations were also incorporated into the English version by the expert committee (e.g., items about race/ethnicity, education level). This cross-cultural adaptation provides an equivalent French-Canadian version of the minimal data set questionnaire and a culturally adapted English-Canadian version. Modifications made to the original NIH minimum data set were minimized to facilitate comparison between the Canadian and American versions. The present study is a first step toward the use of a culturally adapted instrument for phenotyping French- and English-speaking low back pain patients in Canada. Clinicians and researchers will recognize the importance of this standardized tool and are encouraged to incorporate it into future research studies on chronic low back pain.

  14. Elasmobranchs observed in deepwaters (45-330m at Isla del Coco National Park, Costa Rica (Eastern Tropical Pacific

    Directory of Open Access Journals (Sweden)

    Jorge Cortés

    2012-11-01

    Full Text Available Isla del Coco is an oceanic island 500km off the Pacific coast of Costa Rica. It is a National Park and its marine fauna has been relatively well protected. The island is famous for its elasmobranch (sharks, rays and skates sightings in shallow waters. Here we present a catalogue of the deepwater elasmobranchs observed with the DeepSee submersible. Five species of sharks, six species of skates and one ray have been observed between 45 and 330m depth. Triaenodon obesus, the white tip reef shark, was commonly observed between 80 and 301m, but only in the afternoons. Sphyrna lewini, the scalloped hammerhead shark, was observed as deep a 303m, but commonly between 45 and 90m, and close to the island. Odontaspis ferox, the smalltooth sand tiger shark, was observed between 82 and 316m. Echinorhinus cookei, the prickly shark, was observed between 91 and 320m. Rhincodon typus, the whale shark, was observed only close to the island, between 77 and 80m. Taeniura meyeni, the marbled ray, was observed only close to the island, between 45 and 90m. A Dasyatis sp., similar to the the diamond stingray, was observed only once close to the island at 60m; this is the first report of this genus at Isla del Coco National Park. Manta birostris, the giant manta, was only observed close to the island at 90m. Mobula tarapacana, the sicklefin devil ray, was observed between 60 and 326m, extending its maximum depth almost 10 times what has been reported. Aetobatus narinari, the spotted eagle ray, was observed only close to the island between 60 and 82m. Torpedo peruana, the Peruvian torpedo ray, was observed only once at 313m, and is the first record of this species from Isla del Coco National Park.

  15. Trends in funding for research on pain: a report on the National Institutes Of Health grant awards over the years 2003 to 2007.

    Science.gov (United States)

    Bradshaw, David H; Empy, Court; Davis, Phillip; Lipschitz, David; Dalton, Peter; Nakamura, Yoshio; Chapman, C Richard

    2008-12-01

    In recent years, the National Institutes of Health (NIH) has experienced unprecedented reductions in its customary annual budget increases. Consequently, researchers, health care policy planners and others have a pressing need for accurate information on NIH funding patterns. We created a unique and objective system for compiling, classifying, and analyzing data on NIH grant awards and funding for research on pain, nausea, and dyspnea using naïve observers, cross-validation by multiple raters, and face validation by experts. We present results of our method and analyses for the period from 2003 to 2007. Following a 12% increase from 2003 to 2004, funding for pain research fell by 9.4% per year on average over the next 3 years. The percent of the total NIH budget going to support pain research increased to 0.78% in 2004 but fell to 0.61% in 2007. A piecewise regression model confirmed the declining trend represented a significant fit to the data (R(2)=0.98, p=0.024). Separate breakdowns by Institutes showed similar patterns. Analyses of nausea and dyspnea research support revealed small but steady increases over the same period. Declining support for pain research disproportionate to decreases in the NIH budget signals a need for measures to promote funding for meritorious applications. Results of 5 year trends in numbers of grants and funding for research in pain, nausea, and dyspnea by the NIH show overall declines for pain but slight increases for nausea and dyspnea. Declining support for pain research that exceeds the reductions in the total NIH budget signals a need for measures to increase pain research funding.

  16. Radiological protection in the interventional techniques: experience in the Pain Clinic of the CIMEQ; Proteccion radiologica en las tecnicas intervencionistas: experiencia en la Clinica del Dolor del CIMEQ

    Energy Technology Data Exchange (ETDEWEB)

    Guerrero C, M. C.; Benitez N, P. P.; Gonzalez G, Y. [Centro de Investigaciones Medico Quirurgicas, Av. 216 Esq. 11B, Playa Siboney, 6096 La Habana (Cuba); Martinez G, A.; Gonzalez R, N. [Centro de Proteccion e Higiene de las Radiaciones, Carretera de la Cantera, Victoria II, Km. 21.5 Guanabacoa, La Habana (Cuba); Sanchez Z, L. R., E-mail: mayka@infomed.sld.cu [Hospital C. Q. Hermanos Ameijeiras, San Lazaro 701, Centro Habana, La Habana (Cuba)

    2014-08-15

    The Pain Clinic of the CIMEQ offers treatment to patients with different pathologies, using interventional techniques as the radiology like visual guide to reach the target structure and to apply the election technique. The personnel that carry out these procedures are inserted in the program of radiological surveillance of the institution, reason for which a radiological event could be detected where the main physician responsible of the service was implied. In this work the results of an investigation are presented realized with the objective of to know the causes of the event and to determine the necessary measures to avoid that this repeats again. The investigation was oriented to three fundamental aspects: medical exam of the affected worker; evaluation of the operational procedures from the radiological protection view point; and dosimetric measurements simulating the real conditions of work for which were used ionization chamber, radiometer and PMMA mannequin. As a result of the medical exam was detected that the main physician of the service did not use during the execution of all the procedures the extremities dosimetry and that he presented a radio induced erythema in the right hand, reason for which he was separated of the activity with ionizing radiations, until the conclusion of the investigation. With relationship to the evaluation of the operational procedures from the radiological protection view point, was verified that the medical physician not carried out any collimation of the beam and he was located in the positions where the dose rate reached the maximum values, frequently introducing the hands in the direct beam; that which implied an overexposure of the superior extremities and a not optimized exposure for whole body. This result was proven with the realized experimental measurements, which gave dose estimated values in extremities of the order of the deterministic effects. The investigation facilitated to introduce modifications in the

  17. Toxina botulínica no tratamento da dor Toxina botulínica en el tratamiento del dolor Botulinum toxin in pain treatment

    Directory of Open Access Journals (Sweden)

    Orlando Carlos Gomes Colhado

    2009-06-01

    indicaciones, todavía están en fase de comprobación con relación a su eficacia. El objetivo de este estudio fue revisar el historial, las propiedades farmacológicas y las aplicaciones clinicas de la TxB, cuando se usa en el tratamiento de dolores de diferentes etiologías. CONTENIDO: La TxB es el producto de la fermentación del Clostridium Botulinum, una bacteria anaerobia Gram-positiva. Comercialmente, las TxB existen bajo las formas A y B, agentes biológicos obtenidos laboratorialmente. La TxB, una neurotoxina que posee una alta afinidad por las sinapsis colinérgicas, ocasiona un bloqueo en la liberación de acetilcolina por el terminal nervioso, sin alterar la conducción neural de las señales eléctricas o la síntesis y el almacenaje de acetilcolina. Se ha comprobado que la TxB puede debilitar selectivamente la musculatura dolorosa, interrumpiendo el ciclo espasmo-dolor. Con relación a él, varias publicaciones han demostrado la eficacia y la seguridad de la TxB-A en el tratamiento de la cefalea tipo tensión, migraña, dolor lumbar crónico y dolor miofacial. CONCLUSIONES: La TxB-A es segura y se tolera muy bien en los desórdenes dolorosos crónicos, donde los regímenes de farmacoterapia pueden de hecho provocar efectos colaterales. Otra ventaja es la reducción del uso de analgésicos y el tiempo de acción de 3 a 4 meses por dosis. Sin embargo, investigaciones futuras serán necesarias para establecer la eficacia de la TxB-A en los desórdenes dolorosos crónicos y su exacto mecanismo en el alivio del dolor, como también su potencial en tratamientos multifactoriales.BACKGROOUND AND OBJECTIVES: Botulinum toxin (BTX is one of the most potent bacterial toxins known and its effectiveness in the treatment of some pain syndromes is well known. However, the efficacy of some of its indications is still in the process of being confirmed. The objective of this study was to review the history, pharmacological properties, and clinical applications of BTX in the

  18. Petrological constraints on the recycling of mafic crystal mushes, magma ascent and intrusion of braided sills in the Torres del Paine mafic complex (Patagonia)

    Science.gov (United States)

    Leuthold, Julien; Müntener, Othmar; Baumgartner, Lukas; Putlitz, Benita

    2014-05-01

    Cumulate and crystal mush disruption and reactivation are difficult to recognise in coarse grained shallow plutonic rocks. Mafic minerals included in hornblende and zoned plagioclase provide snapshots of early crystallization and cumulate formation, but are difficult to interpret in terms of the dynamics of magma ascent and possible links between silicic and mafic rock emplacement. We will present the field relations, the microtextures and the mineral chemistry of the Miocene mafic sill complex of the Torres del Paine intrusive complex (Patagonia, Chile) and its sub-vertical feeder-zone. The mafic sill complex was built up by a succession of braided sills of shoshonitic and high-K calc-alkaline porphyritic hornblende-gabbro and fine grained monzodioritic sills. The mafic units were over-accreted over 41±11 ka, underplating the overlying granite. Local diapiric structures and felsic magma accumulation between sills indicate limited separation of intercumulus liquid from the mafic sills. Anhedral hornblende cores, with olivine + clinopyroxene ± plagioclase ± apatite inclusions, crystallized at temperatures >900°C and pressures of ~300 to ~500 MPa. The corresponding rims and monzodiorite matrix crystallized at 950°C) from the middle crust reservoir to the emplacement level. We show that hornblende-plagioclase thermobarometry is a useful monitor for the determination of segregation conditions of granitic magmas from gabbroic crystal mushes, and for monitoring the evolution of shallow crustal magmatic crystallization, decompression and cooling.

  19. Ocurrence of the sea anemone Telmatactis panamensis (Verrill, 1869 (Cnidaria: Anthozoa: Actiniaria at Isla del Coco National Park, Costa Rica

    Directory of Open Access Journals (Sweden)

    Fabián H. Acuña

    2012-11-01

    Full Text Available The sea anemone fauna of Isla del Coco National Park (also known as Cocos Island Nacional Park, Pacific Costa Rica is poorly known. In the present work we report the first occurrence of the species Telmatactis panamensis. Individuals of this sea anemone (n=24 were collected at Chatham Bay intertidal and at 15m depth in Punta Ulloa, in both cases attached to rocks; during the expedition UCR-UNA-COCO-I in April 2010. We provide photographs of live individuals, external anatomy and an inventory of cnidae of the studied specimens. Possibly this species is extended to greater depth as observed by other authors in the Galápagos Islands.La fauna de anémonas de mar es prácticamente desconocida para el Parque Nacional Isla del Coco (Costa Rica. En el presente trabajo se reporta por primera vez la presencia de la especie Telmatactis panamensis. Individuos de esta anémona de mar fueron colectados en el intermareal de Bahía Chatham y a 15m de profundidad en Punta Ulloa, en ambos casos adheridas a rocas; durante la expedición UCR-UNA-COCO-I en Abril de 2010. Se proveen fotografías de ejemplares vivos, datos de su anatomía externa y un inventario del cnidae de los especímenes estudiados. Posiblemente esta especie se extienda a mayor profundidad, tal como fue observado por otros autores para ejemplares de las Islas Galápagos.

  20. Health care utilisation and out-of-pocket expenditure associated with back pain: a nationally representative survey of Australian women.

    Directory of Open Access Journals (Sweden)

    Emma R Kirby

    Full Text Available BACKGROUND: Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and self-prescribed treatment options, and the out-of-pocket costs associated with consultations and self-prescribed treatments have not been examined to date. OBJECTIVE: To analyse the extent of health care practitioner consultations and self-prescribed treatment for back pain care among Australian women, and to assess the self-reported costs associated with such usage. METHODS: Survey of 1,310 women (response rate 80.9% who reported seeking help for back pain from the '1946-51 cohort' of the Australian Longitudinal Study on Women's Health. Women were asked about their use of health care practitioners and self-prescribed treatments for back pain and the costs associated with such usage. RESULTS: In the past year 76.4% consulted a complementary and alternative practitioner, 56% an allied health practitioner and 59.2% a GP/medical specialist. Overall, women consulted with, on average, 3.0 (SD = 2.0 different health care practitioners, and had, on average, 12.2 (SD = 9.7 discrete health care practitioner consultations for back pain. Average self-reported out-of-pocket expenditure on practitioners and self-prescribed treatments for back pain care per annum was AU$873.10. CONCLUSIONS: Multiple provider usage for various but distinct purposes (i.e. pain/mobility versus anxiety/stress points to the need for further research into patient motivations and experiences of back pain care in order to improve and enhance access to and continuity of care. Our results suggest that the cost of back pain care represents a significant burden, and may ultimately limit women's access to multiple providers. We extrapolate that for Australian working-age women, total out-of-pocket expenditure on back pain care per annum is in

  1. Distribution of shallow water soft and hard bottom seabeds in the Isla del Coco National Park, Pacific Costa Rica

    Directory of Open Access Journals (Sweden)

    Jeffrey A. Sibaja-Cordero

    2012-11-01

    Full Text Available Geographic Information Systems (GIS applications used in marine habitats are powerful tools for management and monitoring of marine reserves and resources. Here, we present a series of maps of the soft and hard substrates in the shallow waters (>80 m depth of Parque Nacional Isla del Coco (PNIC= Isla del Coco National Park. We use bathymetry data and field data as input for a GIS, GAM, and kriging methods to generate a series of maps that describe the bottom characteristics. Eight types of bottom were found in the PNIC by composition and grain size. The shore of the island and islets consisted of rocky formations (mainly basalts, with coral reefs in the subtidal of some areas. Rhodolith beds had a dispersing distribution. The bottom on the southern and southwestern region is hard substrate, while sediments cover the northern and northeastern zones. Slightly gravelly sand dominated the bays, while gravelly sand (with more coarse grains was frequent offshore. The inner areas of Chatham and Wafer bays have mud and organic matter. The sediments in the area are mostly carbonates, except in Bahía Yglesias where clastic sediments (from the erosion of basalts are presented. The information generated in this study could be a valuable input for future monitoring in the PNIC.

  2. Structure of Mesita del Buey at TA-54, Los Alamos National Laboratory, New Mexico

    International Nuclear Information System (INIS)

    Reneau, S.L.; Broxton, D.E.; Carney, J.S.; LaDelfe, C.

    1998-01-01

    The geological structure of Mesita del Buey at Technical Area 54 (TA-54) was examined using precise surveying of the contact between units 1v and 2 of the Tshirege Member of the Bandelier Tuff at 3.5 km along the north wall of Pajarito Canyon and 0.6 km along the north wall of a tributary to Canada del Buey. Estimated structure contours on this contact indicate typical strikes of N40E to N70E along this part of Mesita del Buey, although the apparent strike of the tuff is E-W at the western part of the survey. Typical dips are 1.0 degree to 2.0 degree to the east or southeast, with an estimated maximum dip of 3.2 degree near the west end of Material Disposal Area G. Thirty seven faults with vertical displacements of 5 to 65 cm were observed in outcrop along the Pajarito Canyon traverse, and, due to the incomplete exposure of the unit 1v-unit 2 contact, many more faults of this magnitude undoubtedly exist. The faults have a wide range in strike and have either down-to-the-west and down-to-the-east components of offset, although about 65% of the observed displacement is down-to-the-west or northwest. These faults are not clearly associated with major fault zones, indicated by the general absence of larger-scale offsets or inflections along the unit 1v-unit 2 contact in areas where the small-scale faults were observed; they may instead record distributed secondary deformation across the Pajarito Plateau associated with large earthquakes on the main Pajarito fault zone 8--11 km to the west, or perhaps other faults in the region. The survey data also suggest that a 150--250 m wide zone of greater magnitude faulting is present near the west end of the traverse associated with a horst-and-graben structure displaying about 1.5--3.5 m of offset on individual faults, although the total amount of offset across this structure and its orientation are not known

  3. Records of new or poorly known migratory birds from Laguna del Otun, Los Nevados National Natural Park, Risaralda, Colombia

    International Nuclear Information System (INIS)

    Acevedo Charry, Orlando; Matta Camacho, Nubia E; Moncada Alvarez, Ligia Ines

    2013-01-01

    Colombia is important for migratory birds. Despite this, we do not know where they are during their crossing or residency in the country, and which species use paramo. We registered new migratory bird species for Laguna Del Otun, immersed in a complex of wetlands declared a Ramsar site since 2008. The lagoon is located in the Los Nevados National Natural Park at 3932 m asl, in paramo ecosystems of the Central Andes of Colombia. During five field trips between 2010-2012 we recorded four new migratory bird species for the park: Anas acuta, Pandion haliaetus, Riparia riparia, and Dendroica petechia. We also registered an altitudinal range extension for two additional migratory species which had only been recorded below 3500 m: Tringa flavipes and Hirundo rustica. These findings suggest these species could tolerate high mountain conditions and use the paramo. It's needed inquiry about migratory dynamics and high mountain habitat use by migratory birds.

  4. National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy

    DEFF Research Database (Denmark)

    Kjær, Per; Kongsted, Alice; Hartvigsen, Jan

    2017-01-01

    PURPOSE: To summarise recommendations about 21 selected non-surgical interventions for recent onset (pain (NP) and cervical radiculopathy (CR) based on two guidelines from the Danish Health Authority. METHODS: Two multidisciplinary working groups formulated...

  5. Riqueza de mamíferos del Parque Nacional Barranca del Cupatitzio, Michoacán, México Mammal richness from Barranca del Cupatitzio National Park, Michoacán, Mexico

    Directory of Open Access Journals (Sweden)

    Gilberto Chávez-León

    2009-04-01

    Full Text Available En este trabajo se documenta la riqueza de mamíferos del Parque Nacional Barranca del Cupatitzio, Michoacán, México, registrada de abril de 2003 a octubre de 2004 mediante diversos métodos de campo. Se identificaron 43 especies, pertenecientes a 8 órdenes, 16 familias y 32 géneros. El estimador no paramétrico ACE indicó que podrían registrarse al menos 13 especies más y que se logró detectar el 77% de las que posiblemente existen en el parque. Los mamíferos voladores constituyeron el 25.6% del total de las especies y los no voladores el 74.4%. Hay 7 especies (16.3% endémicas de México, 5 (11.6% endémicas de Mesoamérica, 10 (23.3% compartidas con Norteamérica, 7 (16.3% con Sudamérica, 13 (30.2% con Norte y Sudamérica, y 1 es exótica (2.3%. Por sus afinidades biogeográficas, 22 especies (52.4% son neárticas, 16 (38.1% neotropicales y 4 (9.5% transicionales. (4.7% La lista de la Norma Oficial Mexicana 059 incluye 2 especies:, 1 en peligro de extinción (Leopardus wiedii y 1 amenazada (Crateogomys fumosus. Se identificaron 8 especies prioritarias para su conservación considerando criterios de riesgo, endemismo y restricción de distribución. No obstante su poca superficie y ubicación en una zona de crecimiento urbano, Barranca del Cupatitzio es un área de importancia para la conservación de la diversidad de mamíferos, ya que protege poco más de la cuarta parte de las especies de Michoacán.In this paper we present field information on mammal richness from Barranca del Cupatitzio National Park, Michoacán, Mexico, recorded from April 2003 to October 2004, by means of specimen collection, visual detection, photo trapping and search of remains, signs and tracks. The area is covered mainly by closed canopy conifer forests. The mammal richness of this park was 43 species belonging to 8 orders, 16 families and 31 genera. The non-parametric ACE estimator indicated that 77% of all possible species were recorded and at least 13

  6. Análisis crítico del discurso de la identidad de los colombianos en National Geographic Magazine (1903-1926

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    Mónica Pérez-Marín

    2017-01-01

    Full Text Available Este artículo analiza los encuadres mediáticos desde los cuales la National Geographic Magazine —NGM— (1903-1926 contribuyó a la construcción de la identidad de los colombianos a comienzos del siglo XX. El argumento central del artículo es que los encuadres mediáticos encontrados están soportados por las ideologías del Destino manifiesto y del positivismo. A través de la estrategia retórica de la apropiación, los encuadres encontrados promueven dos valores asociados al Destino manifiesto: la virtud de las instituciones de Estados Unidos y la misión de transformar el mundo de acuerdo con los valores profesados por este país. En relación con la ideología del positivismo, los encuadres mediáticos la reproducen a través de la estrategia retórica de la clasificación, ya que los reportajes observan la identidad de los colombianos a través del lente de la teoría científica del darwinismo.

  7. Fra Bartolomeo della Porta detto Fra Bartolomeo, Adorazione del Bambino, National Gallery, London

    DEFF Research Database (Denmark)

    Fischer, Chris

    2014-01-01

    En artikel om et maleri af Fra Bartolomeo i National Gallery i London udlånt til en udstilling i Museo Tosio Martinengo I Brescia i forbindelse med opdagelsen af et fuldstændigt overensstemmende maleri i dette museums magasiner. Hypotesen var at Bresciabilledet var et værkstedsarbejde lavet på ba...

  8. Elasmobranchs observed in deepwaters (45-330m at Isla del Coco National Park, Costa Rica (Eastern Tropical Pacific

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    Jorge Cortés

    2012-11-01

    Full Text Available Isla del Coco is an oceanic island 500km off the Pacific coast of Costa Rica. It is a National Park and its marine fauna has been relatively well protected. The island is famous for its elasmobranch (sharks, rays and skates sightings in shallow waters. Here we present a catalogue of the deepwater elasmobranchs observed with the DeepSee submersible. Five species of sharks, six species of skates and one ray have been observed between 45 and 330m depth. Triaenodon obesus, the white tip reef shark, was commonly observed between 80 and 301m, but only in the afternoons. Sphyrna lewini, the scalloped hammerhead shark, was observed as deep a 303m, but commonly between 45 and 90m, and close to the island. Odontaspis ferox, the smalltooth sand tiger shark, was observed between 82 and 316m. Echinorhinus cookei, the prickly shark, was observed between 91 and 320m. Rhincodon typus, the whale shark, was observed only close to the island, between 77 and 80m. Taeniura meyeni, the marbled ray, was observed only close to the island, between 45 and 90m. A Dasyatis sp., similar to the the diamond stingray, was observed only once close to the island at 60m; this is the first report of this genus at Isla del Coco National Park. Manta birostris, the giant manta, was only observed close to the island at 90m. Mobula tarapacana, the sicklefin devil ray, was observed between 60 and 326m, extending its maximum depth almost 10 times what has been reported. Aetobatus narinari, the spotted eagle ray, was observed only close to the island between 60 and 82m. Torpedo peruana, the Peruvian torpedo ray, was observed only once at 313m, and is the first record of this species from Isla del Coco National Park.La Isla del Coco es una isla oceánica a 500km de la costa Pacífica de Costa Rica. Es un Parque Nacional donde la fauna marina ha estado relativamente bien protegida. La isla es famosa por los elasmobranquios (tiburones y rayas en aguas poco profundas. Aquí presentamos un cat

  9. High volume acupuncture clinic (HVAC) for chronic knee pain--audit of a possible model for delivery of acupuncture in the National Health Service.

    Science.gov (United States)

    Berkovitz, Saul; Cummings, Mike; Perrin, Chris; Ito, Rieko

    2008-03-01

    Recent research has established the efficacy, effectiveness and cost effectiveness of acupuncture for some forms of chronic musculoskeletal pain. However, there are practical problems with delivery which currently prevent its large scale implementation in the National Health Service. We have developed a delivery model at our hospital, a 'high volume' acupuncture clinic (HVAC) in which patients are treated in a group setting for single conditions using standardised or semi-standardised electroacupuncture protocols by practitioners with basic training. We discuss our experiences using this model for chronic knee pain and present an outcome audit for the first 77 patients, demonstrating satisfactory initial (eight week) clinical results. Longer term (one year) data are currently being collected and the model should next be tested in primary care to confirm its feasibility.

  10. Non-specific low back pain in primary care in the Spanish National Health Service: a prospective study on clinical outcomes and determinants of management

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    Muriel Alfonso

    2006-05-01

    Full Text Available Abstract Background The Spanish National Health Service is a universal and free health care system. Non-specific low back pain (LBP is a prevalent disorder, generating large health and social costs. The objectives of this study were to describe its management in primary care, to assess patient characteristics that influence physicians' decisions, and to describe clinical outcome at 2 months. Methods A cross-sectional sample of 648 patients with non-specific low back pain was recruited by 75 physicians (out of 361 – 20.8% working in 40 primary care centers in 10 of the 17 administrative regions in Spain, covering 693,026 out of the 40,499,792 inhabitants. Patients were assessed on the day they were recruited, and prospectively followed-up 14 and 60 days later. The principal patient characteristics that were analyzed were: sex, duration of the episode, history of LBP, working status, severity of LBP, leg pain and disability, and results of straight leg raising test. Descriptors of management were: performance of the straight leg raising test, ordering of diagnostic procedures, prescription of drug treatment, referral to physical therapy, rehabilitation or surgery, and granting of sick leave. Regression analysis was used to analyze the relationship between patients' baseline characteristics and physicians' management decisions. Only workers were included in the models on sick leave. Results Mean age (SD of included patients was 46.5 (15.5 years, 367 (56.6% were workers, and 338 (52.5% were females. Median (25th–75th interquartile range duration of pain when entering the study was 4 (2–10 days and only 28 patients (4.3% had chronic low back pain. Diagnostic studies included plain radiographs in 43.1% of patients and CT or MRI scans in 18.8%. Drug medication was prescribed to 91.7% of patients, 19.1% were sent to physical therapy or rehabilitation, and 9.6% were referred to surgery. The main determinants of the clinical management were duration

  11. Consequences of interstitial cystitis/bladder pain symptoms on women's work participation and income: results from a national household sample.

    Science.gov (United States)

    Beckett, Megan K; Elliott, Marc N; Clemens, J Quentin; Ewing, Brett; Berry, Sandra H

    2014-01-01

    We describe differences in work participation and income by bladder symptom impact and comorbidities among women with interstitial cystitis/bladder pain syndrome. Cross-sectional data from 2,767 respondents younger than 65 years identified with interstitial cystitis/bladder pain syndrome symptoms were analyzed. The data were taken from the RAND Interstitial Cystitis Epidemiology (RICE) survey, and included retrospective self-reports of interstitial cystitis/bladder pain syndrome impact, severity, years since onset, related comorbidities (depressive symptomatology, number of conditions), work participation and income, and personal characteristics. Multiple regressions predicted 5 current work outcomes of works now, kept from working by pain, missed work days, days worked when bothered by symptoms and real income change since symptom onset. Controlling for work status at symptom onset and personal characteristics, greater bladder symptom impact predicted a greater likelihood of not now working, kept more days from working by pain, missed more work days and working more days with symptoms. More depressive symptomatology and greater number of comorbidities predicted reduced work participation. Women experienced no growth in real income since symptom onset. Measures of symptom severity were not associated with any of the economic outcomes. Greater interstitial cystitis/bladder pain syndrome symptom impact, depressive symptomatology and count of comorbidities (but not symptom severity) were each associated with less work participation and leveling of women's long-term earnings. Management of bladder symptom impact on nonwork related activities and depressive symptomatology may improve women's work outcomes. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Loin pain hematuria syndrome.

    Science.gov (United States)

    Taba Taba Vakili, Sahar; Alam, Tausif; Sollinger, Hans

    2014-09-01

    Loin pain hematuria syndrome is a rare disease with a prevalence of ∼0.012%. The most prominent clinical features include periods of severe intermittent or persistent unilateral or bilateral loin pain accompanied by either microscopic or gross hematuria. Patients with loin pain hematuria syndrome initially present with hematuria, flank pain, or most often both hematuria and flank pain. Kidney biopsies from patients with loin pain hematuria typically reveal only minor pathologic abnormalities. Further, loin pain hematuria syndrome is not associated with loss of kidney function or urinary tract infections. Loin pain hematuria syndrome-associated hematuria and pain are postulated to be linked to vascular disease of the kidney, coagulopathy, renal vasospasm with microinfarction, hypersensitivity, complement activation on arterioles, venocalyceal fistula, abnormal ureteral peristalsis, and intratubular deposition of calcium or uric acid microcrystals. Many patients with loin pain hematuria syndrome also meet criteria for a somatoform disorder, and analgesic medications, including narcotics, commonly are used to treat loin pain hematuria syndrome-associated pain. Interventional treatments include renal denervation, kidney autotransplantation, and nephrectomy; however, these methods should be used only as a last resort when less invasive measures have been tried unsuccessfully. In this review article, we discuss and critique current clinical practices related to loin pain hematuria syndrome pathophysiology, diagnosis, treatment, and prognosis. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  13. La sostenibilidad del Sistema Nacional de Salud en España The sustainability of the Spanish National Health System

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    José Jesús Martín Martín

    2011-06-01

    Full Text Available El Sistema Nacional de Salud (SNS español presenta problemas de sostenibilidad derivados de deficiencias en su diseño institucional y de gobierno, agravadas por la crisis económica que padece. La crisis económica mundial ha tenido una repercusión especialmente virulenta en España, caracterizada por altos niveles de desempleo y de deuda pública y privada. Las políticas de ajuste fiscal emprendidas pueden deteriorar el SNS significativamente. Junto a problemas de financiación general, la fuerte descentralización territorial de competencias sanitarias en las Comunidades Autónomas no ha sido acompañada de un marco eficaz de coordinación sanitaria a nivel de Estado. El SNS adolece de problemas en sus reglas de gobierno, su sistema de financiación autonómica, las políticas de recursos humanos y la diversidad de formas de gestión directa e indirecta que funcionan en las distintas Comunidades Autónomas. Una estrategia de reformas en el gobierno de la sanidad española debe articularse en el marco de una revisión más amplia de las políticas públicas que permita estabilizar las líneas de defensa del Estado del Bienestar. En el ámbito del sector sanitario se debe mejorar su sistema de financiación y desarrollar cambios institucionales para aumentar la eficiencia.The Spanish National Health System (SNHS has sustainability problems resulting from weaknesses in institutional design and governance compounded by the economic crisis it faces. The global economic crisis has had a particularly virulent impact in Spain, characterized by high levels of unemployment and public and private debt. Fiscal adjustment policies implemented may significantly compromise the SNHS. Along with general funding problems, the strong territorial decentralization of health jurisdictions in the Autonomous Communities has not been backed up by efficient State-level health coordination. The SNHS suffers from problems in its rules of governance, its autonomous

  14. Dentists' Preferences for Diagnosis, Management and Referral of Chronic Oro-Facial Pain: Results from a National Survey

    Science.gov (United States)

    Aggarwal, Vishal R.; Joughin, Amy; Zakrzewska, Joanna; Appelbe, Priscilla; Tickle, Martin

    2012-01-01

    Aim: To explore the diagnosis, treatment and referral patterns of chronic oro-facial pain patients by generalist primary care dentists (GDPs) in the UK. Methods: A cross-sectional survey was conducted using a non-stratified random sample of 500 GDPs who were selected from the General Dental Council register. A self-complete postal questionnaire…

  15. Las orquídeas de la Reserva de la Biosfera Torres del Paine: La necesidad de implementar monitoreo de especies y planificación ecoturística para la conservación de la biodiversidad

    OpenAIRE

    Vidal, Osvaldo J; San Martín, Cristina; Mardones, Sofía; Bauk, Viviana; Vidal, Claudio F

    2012-01-01

    Se describen las orquídeas de la Reserva de la Biosfera Torres del Paine sobre la base de exploraciones botánicas, registros fotográficos y colecciones de herbario llevadas a cabo por los autores. Esta lista comprende 3 géneros y 9 especies: Chloraea chica, Chloraea leptopetala, Chloraea magellanica, Codonorchis lessonii, Gavilea araucana, Gavilea gladysiae, Gavilea littoralis, Gavilea lutea y Gavilea supralabellata. G. gladysiae es un registro nuevo para esta área protegida y se reporta el p...

  16. Chronic Pain

    Science.gov (United States)

    ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. × ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. ...

  17. Evolution of the mantle source in an evolving arc-backarc system (Torres del Paine, Patagonia): Evidence from Hf isotopes in zircon

    Science.gov (United States)

    Ewing, T. A.; Muntener, O.; Leuthold, J.; Baumgartner, L. P.; Putlitz, B.; d'Abzac, F. X.; Chiaradia, M.

    2015-12-01

    The Miocene Torres del Paine intrusive complex (TPIC) in Patagonia is a transitional alkaline backarc intrusion1 emplaced on short timescales of 162 ± 11 ka2. It is subdivided into two units with distinct ages of ~12.6 Ma and ~12.45 Ma1. Smaller intrusive bodies in the area record a change in chemistry from calc-alkaline at ~16 Ma, to transitional alkaline at ~12.5 Ma. Zircons from ~16 Ma intrusives and the 12.6 Ma part of the TPIC have remarkably consistent, slightly enriched Hf isotope compositions with ɛHf(i) of -1 to +2. An abrupt shift towards more juvenile Hf isotope compositions is observed in the ~12.45 Ma part of the TPIC, with ɛHf(i) of +3 to +6. Bulk rock Nd and Sr isotopes for the TPIC show the same shift towards more juvenile compositions at this time1. The long-term consistency of ɛHf(i) from 16 to 12.6 Ma is surprising, given that in the same period the bulk rock chemistry changes from calc-alkaline to transitional alkaline. Conversely, the major shift in ɛHf(i) is not correlated with any change in bulk rock chemistry, which remains transitional alkaline from 12.6 to 12.45 Ma. The decoupling of major element chemical evolution and Hf isotope signatures suggests that the subsequent rapid influx of juvenile material recorded by our Hf isotope data must have occurred by renewed mantle melting. Subduction of the Chile ridge at ~12.5 Ma in this area caused arc magmatism to move westwards and back-arc extension to initiate. We propose that the first TPIC magmas (12.6 Ma) came from a mantle wedge with a residual subduction signature. Subsequent melting of more juvenile mantle, less contaminated by a subduction component, generated the 12.45 Ma TPIC magmas. These results demonstrate that magmatic complexes such as the TPIC may tap distinct mantle sources even on very short timescales, fingerprinting arc-backarc transition processes. 1Leuthold et al., 2013, JPET, 54: 273-303 2Leuthold et al., 2012, EPSL, 325: 85-92

  18. The building of Timorese nationalism | La construcción del nacionalismo timorense

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    José Antonio Rocamora Rocamora

    2003-12-01

    Full Text Available With just three decades of existence, Timorese Nationalism stands out among nationalist movements. It has achieved a surprising spread in a short time, due not only to its wide coverage but also to its intensity, and despite its small demographic and territorial base, for many years it has posed a serious problem for a country of two hundred million inhabitants. This study focuses on the first two decades of this nationalist movement, which witnessed its emergence and consolidation. | Con apenas tres décadas de existencia, el nacionalismo timorense llama poderosamente la atención entre los movimientos nacionalistas. En un corto plazo ha conseguido una difusión sorprendente, tanto por su amplitud como por su intensidad, llegando a constituir durante años (pese a su reducida base demográfica y territorial un grave problema para un país con 200 millones de habitantes. El presente estudio se centra en sus dos primeras décadas, que fueron las de su aparición y consolidación.

  19. Effects of a psychoeducational program for chronic pain management Efectos de un programa psicoeducativo en el control del dolor crónico Efeitos de um programa psicoeducativo no controle da dor crônica

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    Marina de Góes Salvetti

    2012-10-01

    Full Text Available AIMS: to evaluate the impact of an eight-week psychoeducational program focused on pain intensity, disability and depressive symptoms of patients with chronic pain. METHOD: 79 patients with chronic pain of different etiologies composed the sample. Patients were assessed before, at the end of the intervention and six months after the intervention. The program was developed by a nurse using cognitive-behavioral strategies and was conducted by a multidisciplinary team. The Wilcoxon test was used to compare repeated measures. RESULTS: the participants' mean age was 53 years old, most were female (91%, with an average of 9.5 years of schooling and an average pain duration of 9.9 years. Significant reduction in pain intensity (pOBJETIVOS: evaluar el impacto de un Programa psicoeducativo de ocho semanas en la intensidad del dolor, incapacidad y síntomas depresivos de pacientes con dolor crónico. MÉTODO: 79 pacientes con dolor crónico de diferentes etiologías compusieron la muestra. Los participantes fueron evaluados antes y al final del Programa y seis meses después. El Programa fue desarrollado por una enfermera, utilizó estrategias cognoscitivo-comportamentales y fue aplicado por un equipo multidisciplinar. La prueba no paramétrico de Wilcoxon fue utilizado para comparar medidas repetidas. RESULTADOS: la mayoría de los participantes eran del sexo femenino (91%, con edad media de 53 años, escolaridad media de 9,5 años y duración media del dolor de 9,9 años. Al final del Programa se observó reducción significativa en la intensidad del dolor (pOBJETIVOS: avaliar o impacto de um programa programa psicoeducativo de oito semanas na intensidade da dor, incapacidade e sintomas depressivos de pacientes com dor crônica. MÉTODO: 79 setenta e nove pacientes com dor crônica de diferentes etiologias compuseram a amostra. Os participantes foram avaliados antes e ao final do pPrograma e seis meses após. O pPrograma foi desenvolvido por uma

  20. Abundance and Distribution Patterns of Thunnus albacares in Isla del Coco National Park through Predictive Habitat Suitability Models.

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    Cristina Gonzáles-Andrés

    Full Text Available Information on the distribution and habitat preferences of ecologically and commercially important species is essential for their management and protection. This is especially important as climate change, pollution, and overfishing change the structure and functioning of pelagic ecosystems. In this study, we used Bayesian hierarchical spatial-temporal models to map the Essential Fish Habitats of the Yellowfin tuna (Thunnus albacares in the waters around Isla del Coco National Park, Pacific Costa Rica, based on independent underwater observations from 1993 to 2013. We assessed if observed changes in the distribution and abundance of this species are related with habitat characteristics, fishing intensity or more extreme climatic events, including the El Niño Southern Oscillation, and changes on the average sea surface temperature. Yellowfin tuna showed a decreasing abundance trend in the sampled period, whereas higher abundances were found in shallow and warmer waters, with high concentration of chlorophyll-a, and in surrounding seamounts. In addition, El Niño Southern Oscillation events did not seem to affect Yellowfin tuna distribution and abundance. Understanding the habitat preferences of this species, using approaches as the one developed here, may help design integrated programs for more efficient management of vulnerable species.

  1. Tolerância à dor no infarto do miocárdio Tolerancia al dolor en infarto del miocárdio Pain tolerance during myocardium infarction

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    Fernanda Carneiro Mussi

    2010-01-01

    Full Text Available OBJETIVO: Analisar a tolerância à dor como sintoma prodrômico do infarto do miocárdio na perspectiva dos gêneros masculino e feminino em pacientes que vivenciaram esse evento cardiovascular. MÉTODOS: Estudo exploratório de natureza quanti-qualitativa. Entrevistou-se 43 mulheres e 54 homens em hospital público. Os dados sóciodemográficos foram analisados em percentuais e os qualitativos com base na análise de conteúdo e da categoria gênero. RESULTADOS: A mediana de idade para homens foi 55,3 e mulheres de 61,5 anos. Predominou para os gêneros a baixa escolaridade e inatividade profissional. Os homens tinham renda familiar maior e viviam mais em companhia de alguém. Evidenciou-se que homens e mulheres demonstraram igualmente enfrentamento e resistência à dor, visando manter o controle da própria existência e reproduzindo construções sociais sobre o masculino e o feminino em suas vidas cotidianas. CONCLUSÃO: O desafio profissional é atuar no plano simbólico dos gêneros para reduzir o retardo na decisão de buscar atenção médica e possibilitar os benefícios imediatos das terapias de reperfusão coronária.OBJETIVO: Analizar la tolerancia al dolor como síntoma prodrómico del infarto del miocardio en la perspectiva de los géneros masculino y femenino en pacientes que experimentaron ese evento cardiovascular. MÉTODOS: Estudio exploratorio de naturaleza cuantitativa cualitativa. Se entrevistaron 43 mujeres y 54 hombres en un hospital público. Los datos sociodemográficos fueron analizados en porcentajes y los cualitativos con base en el análisis de contenido y de la categoría género. RESULTADOS: El promedio de edad para hombres fue 55,3 y mujeres de 61,5 años. Predominó para los dos géneros la baja escolaridad e inactividad profesional. Los hombres tenían renta familiar mayor y vivían más en compañía de alguien. Se evidenció que los hombres y mujeres demostraron igualmente enfrentamiento y resistencia al

  2. Associations of types of pain with crack-level, tooth-level and patient-level characteristics in posterior teeth with visible cracks: Findings from the National Dental Practice-Based Research Network.

    Science.gov (United States)

    Hilton, Thomas J; Funkhouser, Ellen; Ferracane, Jack L; Gordan, Valeria V; Huff, Kevin D; Barna, Julie; Mungia, Rahma; Marker, Timothy; Gilbert, Gregg H

    2018-03-01

    The objective of this study was to determine which patient traits, behaviors, external tooth and/or crack characteristics correlate with the types of symptoms that teeth with visible cracks exhibit, namely pain on biting, pain due to cold stimuli, or spontaneous pain. Dentists in the National Dental Practice-Based Research Network enrolled a convenience sample of subjects each of whom had a single, vital posterior tooth with at least one observable external crack (cracked teeth); 2858 cracked teeth from 209 practitioners were enrolled. Data were collected at the patient-, tooth-, and crack-level. Generalized estimating equations were used to obtain significant (p cracked teeth had one or more symptoms. Pain to cold was the most common symptom, which occurred in 37% of cracked teeth. Pain on biting (16%) and spontaneous pain (11%) were less common. Sixty-five percent of symptomatic cracked teeth had only one type of symptom, of these 78% were painful only to cold. No patient-, tooth- or crack-level characteristic was significantly associated with pain to cold alone. Positive associations for various combinations of pain symptoms were present with cracks that: (1) were on molars; (2) were in occlusion; (3) had a wear facet through enamel; (4) had caries; (5) were evident on a radiograph; (6) ran in more than one direction; (7) blocked transilluminated light; (8) connected with another crack; (9) extended onto the root; (10) extended in more than one direction; or (11) were on the distal surface. Persons who were cracks or exposed roots, or in non-Hispanic whites. Although pain to cold was the most commonly noted pain associated with symptomatic cracked teeth, no patient-, tooth- or crack-level characteristic was significantly associated with pain to cold alone. Characteristics were only associated with pain on biting and/or spontaneous pain with or without pain to cold. Although often considered the most reliable diagnosis for a cracked tooth, pain on biting is not

  3. Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain? ¿Se debe incluir la ecografía rectoanal como prueba diagnóstica del dolor anal crónico?

    Directory of Open Access Journals (Sweden)

    M. J. García-Montes

    2010-01-01

    Full Text Available Objective: to assess the efficiency of endorectal ultrasound (ERUS in the study of chronic idiopathic anal pain (CIAP. Material and method: this is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months' duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz was used. Results: one patient could not tolerate the examination. In 8 patients (20% of cases alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women internal anal sphincter (IAS hypertrophy, and in 5 patients (4 women and 1 man a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman. Conclusions: ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.Objetivo: evaluar el rendimiento de la ecografía rectoanal (ERA en el estudio del dolor anal crónico idiopático (DACI. Material y método: se trata de un estudio prospectivo y descriptivo en el que se han incluido 40 pacientes, 18 hombres y 22 mujeres, con edad media de 47 años, con clínica de dolor anal crónico de al menos 3 meses de evolución. A todos los pacientes se les había realizado una colonoscopia completa, en la que no se encontró anomalía que justificara la clínica. Se

  4. Vivências de mulheres à dor no infarto do miocárdio Vivencias de mujeres frente al dolor en el infarto del miocardio Experiences of women in face of pain from acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Fernanda Carneiro Mussi

    2006-06-01

    Full Text Available O estudo objetivou compreender os significados da experiência da dor em mulheres que sofreram infarto do miocárdio e identificar as suas ações imediatas diante da mesma. A pesquisa qualitativa utilizou a teoria do Interacionismo Simbólico e a metodologia da Teoria Fundamentada nos Dados. Quarenta e três mulheres foram entrevistadas em Hospital Universitário. A categoria central que expressou o sentido da experiência foi "Tendo uma ruptura com a vida cotidiana". As categorias que revelaram essa ruptura mostraram que diante da dor crescente as mulheres se sentiram dominadas e com medo de morrer, pois perderam o controle pessoal sobre o corpo e a vida. Não reconheceram o infarto e resistiram, a princípio, à procura de atendimento, fazendo tentativas para minorar a dor. Interagindo com a dor insuportável e com a impotência no seu controle, pediram a salvação Divina, ajuda às pessoas e recorreram a tratamento médico.En el presente estudio se tuvo como objetivo comprender los significados de la experiencia del dolor en mujeres que sufrieron infarto del miocardio e identificar sus acciones inmediatas frente a la misma. En esta investigación cualitativa se utilizó la teoría del Interaccionismo Simbólico y la metodología de la Teoría Fundamentada en los Datos. Fueron entrevistadas cuarenta y tres mujeres del Hospital Universitario. La categoría central que expresó el sentido de la experiencia fue "Teniendo una ruptura con la vida cotidiana". Las categorías que revelaron esa ruptura mostraron que frente al creciente dolor las mujeres se sintieron dominadas y con miedo de morir, pues perdieron el control personal sobre el cuerpo y la vida. No reconocieron el infarto y se resistieron, al principio, a procurar atención, haciendo intentos para aminorar el dolor. Ante el dolor insoportable y la impotencia en su control, pidieron la salvación Divina, ayuda a las personas y recurrieron al tratamiento médico.The aim of this study was

  5. Recurrent back pain after diskectomy: MRI findings MR of the postoperative lumbar spine; Recurrencia del dolor lumbar en la columna operada: Hallazgos en Resonancia Magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Aparicio, Rocio; Eguren, Leonor Z; Schinder, Humberto; Stur, Mariela [CIMA, Sanatorio Mapaci, Rosario, Santa Fe (Argentina)

    2008-07-01

    Purpose: To show the morphological changes in postoperative lumbar spine. Material and methods: We reviewed 128 Magnetic Resonance Imaging (MRI) studies of lumbar spine. All patients complained of low back pain and had a previous lumbar surgery (1 month to 8 years). All the examinations include axial and sagittal Gadopentate-dimeglumine enhanced T1 weighted imaging. Results: Only 7,8% have the normal appearance of the postoperative lumbar spine. Epidural scar was found in 69% of examinations; of this group, 72% showed radicular involvement, and 28% had no radicular involvement. Recurrent disc herniation was found in 14,8% of exams, using gadopentate-dimeglumine to assist the differentiation from epidural fibrosis; infections like spondylodiscitis and abscess in 12,5%. Other findings included arachnoiditis, pseudomeningoceles and seromas. Conclusions: MRI is a useful method to study the postoperative lumbar spine, specially when enhanced with gadopentate-dimeglumine. Enhanced images can differentiate two of the major complication like epidural fibrosis, and recurrent disc herniation. Spondylodiscitis are important and frequent too. Although the findings of complications in our series in the postoperative lumbar spine represent 92,18 %, these not always explain the symptomatology. Therefore, the interrelation is important with the surgeon to determine which abnormalities are clinically significant. (authors) [Spanish] Objetivo: Mostrar los hallazgos evidenciados en Resonancia Magnetica (RM) en pacientes operados de columna lumbar. Material y metodos: Se evaluaron retrospectivamente 128 estudios de RM de columna lumbar. Todos los pacientes consultaron por dolor lumbar y tenian antecedentes quirurgicos de un tiempo de evolucion que variaba entre 1 mes y 8 anos. En todos los casos el protocolo de estudio incluyo secuencias axiales y sagitales T1 con gadolinio, ademas del protocolo habitual. Resultados: Solo el 7,8 % de los estudios mostro los hallazgos postoperatorios

  6. Manejo da dor pós-operatória na visão dos pais da criança hospitalizada El manejo del dolor post-operatorio en la visión de los padres del niño hospitalizado Postoperative pain management: view of the hospitalized children's parents

    Directory of Open Access Journals (Sweden)

    Larissa Domingas Grispan e Silva

    2010-09-01

    padres. Las técnicas nofarmacológicas se mostraron extremadamente útiles, sin embargo es necesario que los padres sean estimulados a participar activamente en el manejo del dolor de sus hijos.Considering the harmful effects of the postoperative pain on children and their right to get relief, there is a need to research this subject. Qualitative study developed at a pediatric unit of a public hospital in Londrina-Paraná, aims to analyze the parent's perception about the postoperative pain management by the nursing team and their involvement in this process. Ten parents of children that were submitted to surgeries were interviewed. Data were grouped in two themes: characterization of the postoperative pain management and strategies used to get relief of postoperative pain. Pharmacological therapy was considered the main method used by the nursing team to analgesia. Concerning the parent's actuation, they referred nonpharmacological strategies such as: distraction, use of toys, among others. Pharmacological treatment is overestimated by professionals and parents. Non-pharmacological techniques have proved useful. However, it is necessary to encouraged the parents to participate in the pain management of their children.

  7. National Institutes of Health State-of-the-Science Conference Statement: Symptom management in cancer: pain, depression, and fatigue, July 15-17, 2002.

    Science.gov (United States)

    Patrick, Daniel L; Ferketich, Sandra L; Frame, Paul S; Harris, Jesse J; Hendricks, Carolyn B; Levin, Bernard; Link, Michael P; Lustig, Craig; McLaughlin, Joseph; Reid, L Douglas; Turrisi, Andrew T; Unützer, Jürgen; Vernon, Sally W

    2004-01-01

    Despite advances in early detection and effective treatment, cancer remains one of the most feared diseases. Among the most common side effects of cancer and treatments for cancer are pain, depression, and fatigue. Although research is producing increasingly hopeful insights into the causes and cures for cancer, efforts to manage the side effects of the disease and its treatments have not kept pace. The challenge that faces us is how to increase awareness of the importance of recognizing and actively addressing cancer-related distress. The National Institutes of Health (NIH) convened a State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue to examine the current state of knowledge regarding the management of pain, depression, and fatigue in individuals with cancer and to identify directions for future research. Specifically, the conference examined how to identify individuals who are at risk for cancer-related pain, depression, and/or fatigue; what treatments work best to address these symptoms when they occur; and what is the best way to deliver interventions across the continuum of care. STATE-OF-THE-SCIENCE PROCESS: A non-advocate, non-Federal, 14-member panel of experts representing the fields of oncology, radiology, psychology, nursing, public health, social work, and epidemiology prepared the statement. In addition, 24 experts in medical oncology, geriatrics, pharmacology, psychology, and neurology presented data to the panel and to the conference audience during the first 1.5 days of the conference. The panel then prepared its statement, addressing the five predetermined questions and drawing on submitted literature, the speakers' presentations, and discussions held at the conference. The statement was presented to the conference audience, followed by a press conference to allow the panel to respond to questions from the media. After its release at the conference, the draft statement was made available on the Internet

  8. Comparación del dolor secundario a lipoaspiración tradicional versus lipolisis láser: Estudio prospectivo Postoperative pain in suction assited lipoplasty versus laser lipolisis: Comparative prospective study

    Directory of Open Access Journals (Sweden)

    S. Llanos Olmedo

    2007-12-01

    Full Text Available La lipoaspiración, técnica tradicional usada para el tratamiento de las lipodistrofias con cicatrices mínimas, ha sido a través de los años mejorada con los avances anestésicos, farmacológicos y de instrumental. A su vez han aparecido otras técnicas que han publicitado ventajas respecto al tiempo de recuperación, sintomatología y resultados estéticos. Una de estas técnicas es la laserlipolisis a la que se atribuye menos dolor, menos equimosis y rápido postoperatorio. No se encuentran trabajos que acrediten estas ventajas, por lo que decidimos estudiar si existen ventajas de laserlipolisis en comparación con la lipoaspiración tradicional respecto del dolor, síntoma importante a considerar en el postoperatorio. Para esto se diseñó un trabajo prospectivo randomizado con una muestra de 60 pacientes a los cuales se aplicaron las dos técnicas en diferentes áreas y al mismo paciente. Se evaluó el dolor con escala numérica analógica a las 4 horas, 48 horas y 5 días de postoperatorio. Los resultados mostraron que la laserlipolisis presenta menos dolor en los muslos medido a las 48 horas y 5 días de la intervención. No hay diferencias entre estas dos técnicas en las otras zonas medidas como abdomen, áreas pretrocantéreas ("alforjas", zona lumbar y pectoral. Considerando todos los pacientes sin diferenciar la técnica usada, las "alforjas" a las 4 horas duelen menos que el abdomen y a los 5 días duelen menos los muslos que el abdomen. No encontramos relación entre volumen aspirado e intensidad del dolor.The traditional suction-assisted lipoplasty, is a well established and commonly performed technique used for the treatment of lipodystrophias, which has undergone improvements with advances in anesthetics, pharmacology and introduction of new instruments. New techniques have appeared, promising advantages in recovery periods, symptomathology and aesthetic results when compared to the traditional suction-assisted lipoplasty

  9. O cuidado do paciente oncológico com dor crônica na ótica do enfermeiro El cuidado del paciente oncológico con dolor crónico en la visión del enfermero The care to cancer patients with chronic pain in the view of nurses

    Directory of Open Access Journals (Sweden)

    Lili Marlene Hofstätter da Silva

    2001-01-01

    Full Text Available O objetivo deste estudo foi identificar como o enfermeiro interpreta o cuidado com o paciente oncológico com dor crônica. O estudo foi desenvolvido com oito enfermeiros de uma instituição hospitalar. Os dados foram coletados por entrevistas semi-estruturadas e na análise identificamos três categorias analíticas: a avaliação da dor crônica do paciente oncológico, a importância do cuidado multidisciplinar e as dificuldades para o cuidado do paciente. Os resultados mostram que os enfermeiros têm dificuldades em desenvolver o cuidado com o paciente devido à falta de conhecimentos específicos sobre o câncer, dor crônica e sua terapêutica, como também, nas habilidades expressivas para promoverem o apoio psicológico adequado.El objetivo de este estudio fue identificar como el enfermero interpreta el cuidado para el paciente oncológico con dolor crónico. El estudio fue desarrollado con ocho enfermeros de una institución hospitalaria. Los datos fueron recolectados por entrevistas semi-estructuradas y en el análisis identificamos tres categorías analíticas: la evaluación del dolor crónico del paciente oncológico, la importancia del cuidado multidisciplinario y las dificultades para el cuidado del paciente. Los resultados muestran que los enfermeros tienen dificultades para desarrollar el cuidado con el paciente debido a la falta de conocimientos específicos con respecto al cáncer, dolor crónico y su tratamiento, como también, en las habilidades expresivas para la promoción del apoyo psicológico adecuado.This study aims to understand how nurses interpret the care given to cancer patients with chronic pain. The informers were eight nurses from a public hospital. Data were collected on the basis of semi-structured interviews and the analysis identified three analytical categories: the evaluation of patients' pain, the importance of multidisciplinary care and nurses' difficulties to care for these patients. The results show

  10. Preliminary clinical outcomes from the Peruvian National Cataract Elimination Plan Resultados clínicos preliminares del Plan Nacional de Lucha contra la Ceguera por Catarata del Perú

    Directory of Open Access Journals (Sweden)

    Tomasz P. Stryjewski

    2010-10-01

    Full Text Available OBJECTIVE: To evaluate the clinical outcomes of a publicly funded cataract elimination program. METHODS: Outcomes of all patients (186 who received extracapsular cataract extraction (ECCE surgery free of charge at the Instituto Regional de Oftalmología in northern Peru in the first year (August 2008 to July 2009 of the Peruvian National Cataract Elimination Plan were compared retrospectively with the outcomes of all patients (68 who paid in the highest charge tier for ECCE surgery during the same period. Preoperatively, the median uncorrected visual acuity (UCVA of National Plan patients was Hand Motion; the UCVA of paying patients was Counting Fingers (P = 0.09. Complication frequency and visual acuity (uncorrected visual acuity, pinhole visual acuity, and best correct visual acuity were the primary outcome measures. The World Health Organization (WHO Vision 2020 goal is for 85% of operated eyes to achieve 20/60 vision; the Ministerio de Salud del Perú goal is for 75% of eyes to achieve 20/50. RESULTS: One month postoperatively, only 24% of National Plan patients achieved a UCVA of 20/60. The median UCVA for both groups was 20/100 (P = 0.23. Intraoperative complications occurred in 27% of all patients; postoperative complications occurred in 39%. Patients more likely to have a poor outcome (UCVA OBJETIVO: Evaluar los resultados clínicos de un programa de lucha contra la ceguera por catarata con financiamiento público. MÉTODOS: Los resultados obtenidos de todos los pacientes (186 sometidos a una operación gratuita de extracción extracapsular de catarata (EECC en el Instituto Regional de Oftalmología del norte del Perú, durante el primer año (de agosto del 2008 a julio del 2009 de la ejecución del Plan Nacional de Lucha contra la Ceguera por Catarata del Perú, se compararon retrospectivamente con los resultados de los pacientes (68 que pagaron los honorarios más elevados por una operación quirúrgica de EECC durante el mismo per

  11. Postoperative pain

    DEFF Research Database (Denmark)

    Kehlet, H; Dahl, J B

    1993-01-01

    also modify various aspects of the surgical stress response, and nociceptive blockade by regional anesthetic techniques has been demonstrated to improve various parameters of postoperative outcome. It is therefore stressed that effective control of postoperative pain, combined with a high degree......Treatment of postoperative pain has not received sufficient attention by the surgical profession. Recent developments concerned with acute pain physiology and improved techniques for postoperative pain relief should result in more satisfactory treatment of postoperative pain. Such pain relief may...

  12. Día Nacional Latino para la Concientización del SIDA (National Latino AIDS Awareness Day)

    Centers for Disease Control (CDC) Podcasts

    Este podcast destaca el Día Nacional Latino para la Concientización acerca del SIDA, para aumentar el conocimiento sobre el impacto desproporcionado del VIH en la población hispana o latina en los Estados Unidos y sus territorios dependientes. El podcast hace recordar a los hispanos o latinos que ellos tienen el poder de tomar el control de su salud y protegerse contra el VIH.

  13. Importancia de la semiología del dolor en el diagnóstico de un proceso inflamatorio pulpar Significance of pain's Symptomatology in the diagnosis of pulpal inflammatory process

    Directory of Open Access Journals (Sweden)

    Andrés 0 Pérez Ruiz

    2011-09-01

    Full Text Available El dolor es un síntoma de extraordinaria importancia en la práctica estomatológica y particularmente en lo concerniente a las alteraciones de la pulpa dentaria. Con el objetivo de profundizar en el conocimiento de las fases por las que atraviesa un proceso inflamatorio pulpar, que permiten predecir sus manifestaciones dolorosas, se realizó una revisión bibliográfica sobre el tema con un enfoque multidisciplinario y básico-clínico. Se utilizó el método documental para el análisis y tratamiento de la información ofrecida por las fuentes teóricas. El sitio en Internet Google fue empleado como fundamental motor de búsqueda y Lilacs, Hinari, Medline y PubMed fueron las bases de datos más revisadas. La clasificación del estado de inflamación pulpar, que atiende a eventos histopatológicos que no se pueden visualizar, resulta más difícil. Se podría lograr mayor precisión en un diagnóstico basado en el curso que sigue el dolor, de acuerdo a la magnitud del compromiso inflamatorio y apoyado en la rica semiología que se puede obtener si se sigue la trayectoria de las variables del estímulo nociceptivo. El incremento y profundización de los conocimientos en este campo contribuiyó significativamente a un mejor diagnóstico y tratamiento de los procesos inflamatorios pulpares.Pain is a symptom very important in the stomatologic practice and particularly in that concerning to dental pulp alterations. To deep in the knowledge of phases crossed by a pulpal inflammatory process allowing predicting its painful manifestations, authors made a bibliographic review on this subject with a multidisciplinary and basic-clinical approach, using the documentary method for analysis and management of information offered by theoretical sources. Google was used as a fundamental search tool and LILACS, HINARI, Medline and PubMed were the more reviewed databases. The classification of pulpal inflammation state, taking into account non

  14. The shallow-water fish assemblage of Isla del Coco National Park, Costa Rica: structure and patterns in an isolated, predator-dominated ecosystem

    Directory of Open Access Journals (Sweden)

    Alan M. Friedlander

    2012-11-01

    Full Text Available Fishes at Isla del Coco National Park, Costa Rica, were surveyed as part of a larger scientific expedition to the area in September 2009. The average total biomass of nearshore fishes was 7.8 tonnes per ha, among the largest observed in the tropics, with apex predators such as sharks, jacks, and groupers accounting for nearly 40% of the total biomass. The abundance of reef and pelagic sharks, particularly large aggregations of threatened species such as the scalloped hammerhead shark (up to 42 hammerheads ha-1 and large schools of jacks and snappers show the capacity for high biomass in unfished ecosystems in the Eastern Tropical Pacific. However, the abundance of hammerhead and reef whitetip sharks appears to have been declining since the late 1990s, and likely causes may include increasing fishing pressure on sharks in the region and illegal fishing inside the Park. One Galapagos shark tagged on September 20, 2009 in the Isla del Coco National Park moved 255km southeast towards Malpelo Island in Colombia, when it stopped transmitting. These results contribute to the evidence that sharks conduct large-scale movements between marine protected areas (Isla del Coco, Malpelo, Galápagos in the Eastern tropical Pacific and emphasize the need for regional-scale management. More than half of the species and 90% of the individuals observed were endemic to the tropical eastern Pacific. These high biomass and endemicity values highlight the uniqueness of the fish assemblage at Isla del Coco and its importance as a global biodiversity hotspot.La biomasa promedio de peces costeros en el Parque Nacional Isla del Coco en septiembre de 2010 fue de 7,8 toneladas por hectárea, entre las más elevadas halladas jamás en zonas tropicales. Los grandes depredadores representaron el 40% de la biomasa total. La abundancia de tiburones costeros y pelágicos, particularmente las enormes agregaciones de tiburón martillo (hasta 42 individuos por hectárea y los

  15. The shallow-water fish assemblage of Isla del Coco National Park, Costa Rica: structure and patterns in an isolated, predator-dominated ecosystem

    Directory of Open Access Journals (Sweden)

    Alan M. Friedlander

    2012-11-01

    Full Text Available Fishes at Isla del Coco National Park, Costa Rica, were surveyed as part of a larger scientific expedition to the area in September 2009. The average total biomass of nearshore fishes was 7.8 tonnes per ha, among the largest observed in the tropics, with apex predators such as sharks, jacks, and groupers accounting for nearly 40% of the total biomass. The abundance of reef and pelagic sharks, particularly large aggregations of threatened species such as the scalloped hammerhead shark (up to 42 hammerheads ha-1 and large schools of jacks and snappers show the capacity for high biomass in unfished ecosystems in the Eastern Tropical Pacific. However, the abundance of hammerhead and reef whitetip sharks appears to have been declining since the late 1990s, and likely causes may include increasing fishing pressure on sharks in the region and illegal fishing inside the Park. One Galapagos shark tagged on September 20, 2009 in the Isla del Coco National Park moved 255km southeast towards Malpelo Island in Colombia, when it stopped transmitting. These results contribute to the evidence that sharks conduct large-scale movements between marine protected areas (Isla del Coco, Malpelo, Galápagos in the Eastern tropical Pacific and emphasize the need for regional-scale management. More than half of the species and 90% of the individuals observed were endemic to the tropical eastern Pacific. These high biomass and endemicity values highlight the uniqueness of the fish assemblage at Isla del Coco and its importance as a global biodiversity hotspot.

  16. Evolución clínica del síndrome de disfunción dolorosa de la articulación temporomandibular con acupuntura Clinical evolution of the pain dysfunction of the temporomandibular joint using acupuncture

    Directory of Open Access Journals (Sweden)

    Felicia C Morejón Alvarez

    2008-12-01

    Full Text Available Se realizó un estudio longitudinal y prospectivo con el objetivo de determinar la efectividad del tratamiento con acupuntura en el síndrome de disfunción dolorosa de la articulación temporomandibular, patología que aqueja a un por ciento elevado de la población y debido a su etiología multifactoria,l se hace difícil establecer un tratamiento. Esta investigación se desarrolló en el Hospital Universitario Abel Santamaría Cuadrado, durante el período de febrero a septiembre de 2006. La muestra estuvo constituida por 104 pacientes que asistieron a la consulta de cirugía maxilofacial, por presentar síntomas y signos propios del síndrome de disfunción dolorosa de la articulación temporomandibular. De manera aleatoria quedó la muestra dividida en dos grupos: un grupo control que se trató con el tratamiento convencional y uno de estudio, tratado con acupuntura. Los datos fueron recogidos en tablas y tabulados por el método estadístico de chi cuadrado. Se concluye que en la terapia con acupuntura no existieron reacciones adversas y a los cinco días de tratamiento solo un 29% presentó dolor a la masticación y un 27% a la palpación de la musculatura, mientras que por el tratamiento convencional un 40,4% y un 50% respectivamente tenían estas alteraciones. Con acupuntura el promedio de sesiones necesarias para la remisión de los síntomas fue de 9, quedó demostrada la efectividad de esta terapia en el tratamiento del dolor disfunción temporomandibular.A longitudinal prospective study is carried out aimed at studying the effectivity of the treatment with acupuncture in presence of pain temporomandibular joint dysfunction, present in a high percentage of patients.Due to the multifactorial etiology is hard to establish the treatment.The present research was carried out in "Abel Santamaría Cuadrado"University Hospital during February _September 2006. The sample was comprised of 104 patients attending to the dental surgeon office

  17. Prevalence and social burden of active chronic low back pain in the adult Portuguese population: results from a national survey.

    Science.gov (United States)

    Gouveia, Nélia; Rodrigues, Ana; Eusébio, Mónica; Ramiro, Sofia; Machado, Pedro; Canhão, Helena; Branco, Jaime C

    2016-02-01

    To determine the prevalence of active chronic low back pain (CLBP) in the adult Portuguese population; to compare the active CLBP population with the population without CLBP; and to explore factors associated with active CLBP. The present study was conducted under the scope of EpiReumaPt a population-based study. Active CLBP was self-reported and considered if present on the day of the interview and for ≥90 days. Prevalence estimates were calculated. Association of active CLBP with quality of life, functional ability and healthcare consumption were evaluated. Factors associated with active CLBP were identified through logistic regression. Among 10.661 EpiReumaPt subjects, 1487 self-reported active CLBP. The prevalence of active CLBP was 10.4 % (95 % CI 9.6; 11.9 %). After adjustment, active CLBP subjects had a higher likelihood for anxiety symptoms (OR 2.77), early retirement due to disease (OR 1.88) and more physician visits (β = 2.65). Factors significantly and independently associated with the presence of active CLBP were: female gender (OR 1.34), overweight/obesity (OR 1.27), presence of self-reported rheumatic musculoskeletal disease (RMD) (OR 2.93), anxiety symptoms (OR 2.67), age (OR 1.02) and higher number of self-reported comorbidities (OR 1.12). Active CLBP is highly prevalent in the Portuguese population and is associated with disability and with a high consumption of healthcare resources. Female gender, older age, anxiety symptoms, overweight/obesity, the presence of other RMD and the number of comorbidities were independently associated with the presence of active CLBP. These factors should be taken into account when new cohort prospective studies will be developed.

  18. Avaliação do efeito antinociceptivo do fentanil transdérmico no controle da dor lombar pós-operatória Evaluación del efecto antinociceptivo del fentanil transdérmico en el control del dolor lumbar postoperatorio Efficacy of fentanyl transdermal delivery system for acute postoperative pain after posterior laminectomy

    Directory of Open Access Journals (Sweden)

    Gabriela Rocha Lauretti

    2009-12-01

    ía posterior sobre anestesia general estandarizada. Los adhesivos transdérmicos fueron colocados en los pacientes diez horas antes del inicio de la cirugía y removidos 24 horas después de haber terminado la misma. Cetoprofeno por vía venosa fue administrado por vía venosa en el inicio de la cirugía. Dipirona estaba disponible para analgesia de rescate, si era necesario, a intervalos mínimos de seis horas. RESULTADOS: los pacientes que recibieron F transdérmico presentaron reducción de 60% en el consumo de dipirona en el periodo postoperatorio (pObjectives: patients who are submitted to posterior laminectomy often complain of severe pain that is difficult to treat. The transdermal application of the potent opioid fentanyl results in its continuous liberation and consequently could be useful in controlling the pain. This study evaluated the efficacy of transdermal fentanyl (F delivery system for acute postoperative pain after posterior laminectomy. METHODS: the study was approved by the local Ethic Committee and conducted in the Teaching Hospital. After the patient's consent, 24 patients were randomized to either transdermic F 25 mg/h (n=12 or transdermic placebo (n=12. All patients were submitted to posterior laminectomy under a standard general anesthesia. Transdermic systems were placed during 10 hours preoperatively and removed 24 hours later; 20 minute IV ketoprofen, 2.5 mg/kg was administered following traqueal intubation with propofol, alfentanil and atracurium. IV 20 mg/kg dipyrone act as rescue at a minimum six hours interval. Data was recorded for 36 hours. RESULTS: the transdermic F Group showed 60% of reduction in the rescue dipyrone consumption (p<0.05; and displayed lesser VAS scores after the 12th hour, which was maintained until the 36th hour (p<0.02. All physiological parameters fluctuated within normal range and no differences were observed between the treatments. The incidence of adverse events was similar between the groups, there was local erythema

  19. National Drug IQ Challenge

    Science.gov (United States)

    ... National Drug IQ Challenge 2017 Reto nacional del coeficiente intelectual (CI) sobre las drogas y el alcohol 2016 National Drug IQ Challenge 2016 Reto nacional del coeficiente intelectual (CI) sobre las drogas y el alcohol 2015 ...

  20. O modelo bioético principialista aplicado no manejo da dor El principialismo bioético modelo aplicado en el tratamiento del dolor The bioethical principlism model applied in pain management

    Directory of Open Access Journals (Sweden)

    Layz Alves Ferreira Souza

    2013-03-01

    Full Text Available Trata-se de revisão integrativa da literatura, com o objetivo de analisar a produção científica referente às relações entre a dor e os princípios da bioética: autonomia, beneficência, não maleficência e justiça. Foram utilizados descritores controlados em três bases de dados internacionais (LILACS, SciELO, MEDLINE, em abril de 2012, resultando em 14 publicações, distribuídas nas categorias Dor e autonomia, Dor e beneficência, Dor e não maleficência, Dor e justiça. O alívio adequado da dor é um direito humano e uma questão moral que se relaciona diretamente com a bioética principialista. Entretanto, muitos profissionais negligenciam a dor de seus pacientes, desconsiderando seu papel ético frente ao sofrimento.Concluiu-se que o principialismo tem sido negligenciado no atendimento aos pacientes com dor, evidenciando a necessidade de novas práticas para mudança desse panorama.Se realizó una revisión de la literatura para analizar la producción científica relacionadas con el dolor y los principios de la bioética (autonomía, beneficencia, no maleficencia y justicia. Se utilizaron descriptores controlados en tres fuentes de datos internacionales (LILACS, SciELO, MEDLINE, en abril de 2012, totalizando14 publicaciones, distribuidas en las clases: el dolor y la autonomía, el dolor y la beneficencia, el dolor y no maleficencia, el dolor y la justicia. El adecuado alivio del dolor es un derecho humano y un problema moral relacionado directamente con el principialismo bioético (beneficencia, no maleficencia, autonomía y justicia. Sin embargo, muchos profesionales negligencian el dolor de sus pacientes, ignorando su papel ético frente al sufrimiento. Se concluyó que el principialismo ha sido descuidado en la atención de los pacientes con dolor evidenciando la necesidad de nuevas prácticas para cambiar este panorama.An integrative literature review was developed with the purpose to analyze the scientific production

  1. Vision of the Training Department of the National Institute of Nuclear Research; Vision del Departamento de Capacitacion del Instituto Nacional de Investigaciones Nucleares

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez A, C. E. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2008-12-15

    The availability of skilled personnel is an essential element of the national infrastructure, to ensure the safety and security through the strong principles of management and good technology, quality assurance, training and qualification of new personnel, thorough safety evaluations and building on lessons of experience and research. In the national case the General Regulation of Radiation Safety requires that the Radiation Safety Responsible (RSR) must be experienced in issues of radiation safety of the facility in which employed. As experience has been found by chance that some people who have attended courses offered by the National Institute of Nuclear Research and have not achieved a result approval, obtain approval at the respective courses offered by other entities, which may have a potential dilemma (not at all cases since then), in the sense that the aspiration to become experts in the safety basic standards, can be addressed only after ensuring that there is an acceptance at the level of the course and evaluation ways of the present courses to RSR. Viewed another way, one can consider the formation of RSR experience in planning for better training of experts in the safety basic standards. It happens that the courses offered to RSR some of them do not cover the requirements of time, content and practices established in the regulations. The Mexican Society of Radiological Safety can affect as a partner to improve the courses quality. (Author)

  2. Nation

    DEFF Research Database (Denmark)

    Østergaard, Uffe

    2014-01-01

    Nation er et gammelt begreb, som kommer af det latinske ord for fødsel, natio. Nationalisme bygger på forestillingen om, at mennesker har én og kun én national identitet og har ret til deres egen nationalstat. Ordet og forestillingen er kun godt 200 år gammel, og i 1900-tallet har ideologien bredt...

  3. High genotypic diversity of the reef-building coral Porites lobata (Scleractinia: Poritidae in Isla del Coco National Park, Costa Rica

    Directory of Open Access Journals (Sweden)

    Jennifer N. Boulay

    2012-11-01

    spawners like P. lobata. Frequent sexual reproduction at Isla del Coco National Park might represent a resource for rapid recovery following extreme El Niño-Southern Oscillation (ENSO disturbance events. In contrast, larger, asexually-produced fragments rather than smaller, sexually-produced larvae appear to have the advantage at some coastal sites. The high frequency of sexual reproduction at Isla del Coco indicates that not only are sexual partners available but also current conditions are favorable for the delivery of larvae and the rate of predation on small larval recruits must be moderate.

  4. Sexual pain.

    Science.gov (United States)

    Boardman, Lori A; Stockdale, Colleen K

    2009-12-01

    Sexual pain is an underrecognized and poorly treated constellation of disorders that significantly impact affected women and their partners. Recognized as a form of chronic pain, sexual pain disorders are heterogeneous and include dyspareunia (superficial and deep), vaginismus, vulvodynia, vestibulitis, and noncoital sexual pain disorder. Women too often tolerate pain in the belief that this will meet their partners' needs. This article provides a review of the terminology and definition of the condition, theories on the pathophysiology, diagnostic considerations, and recommendations on the management of female sexual pain.

  5. Comportamiento clínico del síndrome dolor disfunción del aparato temporomandibular en una consulta de urgencias estomatológicas Clinical behavior of the dysfunction pain temporomandibular joint syndrome assessed in a Stomatology emergence consultation

    Directory of Open Access Journals (Sweden)

    Yudit Algozaín Acosta

    2009-06-01

    Full Text Available Introducción: el síndrome dolor disfunción del aparato temporomandibular (SDDAT comprende el conjunto de signos y síntomas como resultado de las alteraciones cuantitativas y cualitativas de la función de los componentes del aparato masticatorio. Se presenta con frecuencia y resulta molesto para el paciente, por lo que se realiza este estudio, con el objetivo de caracterizarlo clínicamente. Métodos: se realizó un estudio prospectivo, descriptivo, de corte transversal, con los pacientes que acudieron al Servicio de Urgencias de la Clínica Estomatológica de Artemisa, en el período comprendido entre julio de 2007 hasta marzo de 2008 con el diagnóstico de SDDAT. Resultados: del total de pacientes atendidos solo el 1,1 % presentó un diagnóstico de SDDAT. El intervalo de edad de mayor frecuencia fue el de 22 a 59 años, el dolor a la masticación y el ruido articular fueron el síntoma y el signo predominante, respectivamente. Se identificaron como factores de riesgo principales el estrés y el bruxismo. Más del 67 % de los pacientes eran del sexo femenino, en las cuales apareció la mayor recurrencia del síndrome. Conclusiones: la población del municipio de Artemisa presentó una baja incidencia del SDDAT en la consulta de urgencias estomatológicas, encontrándose una asociación estadísticamente significativa entre el sexo femenino y la aparición de este síndrome, donde el estrés desempeña un papel importante.Introduction: Dysfunction pain temporomandibular joint syndrome (DPTJS includes signs and symptoms as a result of quantitative and qualitative alterations of the masticatory tract component function. Is frequently present and annoying for patient, thus we made this study to clinically characterize it. Methods: We made a cross-sectional, descriptive and prospective study of patients seen in Emergence Service of Stomatology Clinic in Artemisa municipality from July, 2007 and March, 2008 diagnosing DPTJS. Results: From the

  6. A new Lepeophtheirus (Copepoda: Siphonostomatoida: Caligidae from Isla del Coco National Park, Costa Rica, Eastern Tropical Pacific

    Directory of Open Access Journals (Sweden)

    Eduardo Suárez-Morales

    2012-11-01

    Full Text Available Among the several groups of copepods that are teleost parasites, the siphonostomatoid family Caligidae is by far the most widespread and diverse. With more than 108 nominal species, the caligid genus Lepeophtheirus von Nordmann is one of the most speciose. There are no reports of this genus in Costa Rican waters. A new species of Lepeophtheirus is herein described based on female specimens collected from plankton samples in waters off Bahía Wafer, isla del Coco, an oceanic island in the Eastern Tropical Pacific. The new species, L. alvaroi sp. nov., has some affinities with other congeners bearing a relatively short abdomen, a wider than long genital complex and a 3-segmented exopod of leg 4. it differs from most of these species by the presence of an unbranched maxillular process and by the relative lengths of the terminal claws of leg 4, with two equally long elements. it is most closely related to two other Eastern Pacific species: L. dissimulatus Wilson, 1905 and L. clarionensis Shiino, 1959. it differs from these species by the proportions and shape of the genital complex, the shape of the sternal furca, the relative length of the maxillar segments, the absence of a pectiniform process on the distal maxillar segment, the length of leg 4 and the armature of leg 5. The new species represents the first Lepeophtheirus described from Costa Rican waters of the Pacific. The low diversity of this genus in this tropi- cal region is explained by its tendency to prefer hosts from temperate latitudes. Until further evidence is found, the host of this Lepeophtheirus species remains unknown.Entre los varios grupos de copépodos que son parásitos de teleósteos, la familia sifonostomatoide Caligidae incluye los más dispersos y diversos. Con más de 108 especies nominales, el género de calígidos Lepeophtheirus von Nordmann es uno de los más diversos. No existen registros previos de este género en aguas de Costa Rica. Se describe una nueva especie de

  7. A diferenciação da dor do infarto agudo do miocárdio entre pacientes diabéticos e não-diabéticos Diferenciación del dolor del infarto agudo de miocardio entre pacientes diabéticos y no diabéticos The difference in acute myocardial infarction pain between diabetic and non diabetic patients

    Directory of Open Access Journals (Sweden)

    Leandra de Gouveia Pacheco Gondim

    2003-12-01

    Full Text Available O estudo teve como objetivo comparar a dor do infarto agudo do miocárdio (IAM entre pacientes diabéticos e não-diabéticos. Uma amostra de 80 pacientes com IAM, divididos em 2 grupos com e sem diabetes mellitus (DM, sendo 29% diabéticos e 71% não-diabéticos. Os pacientes com DM referiram ausência de dor (pEl objetivo de este estudio fue comparar el dolor del infarto agudo de miocardio (IAM entre pacientes diabéticos y no diabéticos. La muestra la conformaron 80 pacientes con IAM divididos en dos grupos: con y sin diabetes mellitus (DM, siendo el 29% diabéticos y el 71% no diabéticos. Los pacientes con DM manifestaron ausencia de dolor (pThe goal of this study was to compare the acute myocardial infarction (AMI pain between diabetic and non diabetic patients. A sample of 80 AMI patients was divided in two groups, with and without diabetes mellitus (DM, being 29% diabetic and 71% non diabetic patients. The patients with DM said they had no pain (p<0.05 and gave lower scores for pain when compared with patients without DM. There was a significant difference between average scores for pain among diabetic and non diabetic patients (p<0.001. In conclusion, the diabetic patients presented no pain or diminished pain when compared with patients without diabetes.

  8. Pelvic Pain

    Science.gov (United States)

    ... OLPP) Office of Science Policy, Reporting, and Program Analysis (OSPRA) Division of Extramural Research (DER) Extramural Scientific ... treat my pain? Can pelvic pain affect my emotional well-being? How can I cope with long- ...

  9. Neck pain

    Science.gov (United States)

    ... cause of neck pain is muscle strain or tension. Most often, everyday activities are to blame. Such ... of a heart attack , such as shortness of breath, sweating, nausea, vomiting, or arm or jaw pain. ...

  10. The prevalence of inflammatory back pain: population-based estimates from the US National Health and Nutrition Examination Survey, 2009-10.

    Science.gov (United States)

    Weisman, Michael H; Witter, James P; Reveille, John D

    2013-03-01

    To estimate the current US inflammatory back pain (IBP) prevalence using four published case definitions. Analysis of an IBP data collection instrument specifically designed for the 2009-10 National Health and Nutrition Examination Survey. Subjects were 5103 US adults ages 20-69 with complete data. IBP prevalence as determined by Calin et al criteria, European Spondylarthropathy Study Group (ESSG) criteria, and Berlin criteria 8a and 7b. Age-adjusted US prevalence of IBP by Calin criteria was 5.0% (95% CI 4.2% to 5.8%). Prevalence of IBP was 5.6% (95% CI 4.7% to 6.5%) by ESSG criteria, and 5.8% (95% CI 5.2% to 6.4%) and 6.0% (95% CI 4.9% to 7.1%) by Berlin Criteria 8a and 7b, respectively. IBP prevalence did not differ significantly by age groups or between men and women. IBP prevalence was significantly lower among non-Hispanic black persons compared with non-Hispanic white persons for the Calin and ESSG IBP criteria. For the ESSG and Berlin 7b criteria, non-Hispanic white persons had significantly higher IBP prevalences compared with Mexican Americans. IBP is associated with spondyloarthritis. Awareness of the prevalence of IBP may be useful for planning future epidemiological studies as well as development and validation of diagnostic and classification criteria for specific clinically defined diseases.

  11. Patellofemoral Pain.

    Science.gov (United States)

    Dutton, Rebecca A; Khadavi, Michael J; Fredericson, Michael

    2016-02-01

    Patellofemoral pain is characterized by insidious onset anterior knee pain that is exaggerated under conditions of increased patellofemoral joint stress. A variety of risk factors may contribute to the development of patellofemoral pain. It is critical that the history and physical examination elucidate those risk factors specific to an individual in order to prescribe an appropriate and customized treatment plan. This article aims to review the epidemiology, risk factors, diagnosis, and management of patellofemoral pain. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Phantom Pain

    Science.gov (United States)

    ... Because this is yet another version of tangled sensory wires, the result can be pain. A number of other factors are believed to contribute to phantom pain, including damaged nerve endings, scar tissue at the site of the amputation and the physical memory of pre-amputation pain in the affected area. ...

  13. Contextualized pain management in newborns

    Directory of Open Access Journals (Sweden)

    Carlo Valerio Bellieni

    2016-08-01

    Full Text Available Neonatal pain treatment requires personalization, and pain assessment should be contextualized to be effective. Here we summarize the available tools in neonatal analgesia, paying a special attention to highlight the personalization of antalgic behavior, both in assessment and in treatment of neonatal pain. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

  14. Evaluation of the national cogeneration potential as an option for the expansion of the national electric system; Evaluacion del potencial nacional de cogeneracion como opcion en la expansion del sistema electrico nacional

    Energy Technology Data Exchange (ETDEWEB)

    Nieva Gomez, Rolando; Hernandez Galicia, Julio Alberto [Instituto de Investigaciones Electricas, Cuernavaca (Mexico); Portes Mascorro, Enrique; Alvarez Chavez, Jose Maria [Comision Nacional para el Ahorro de Energia (CONAE), Mexico, D. F. (Mexico)

    1997-12-31

    The Comision Nacional para el Ahorro de Energia (CONAE) carried out a study to determine the amount of electric energy available by cogeneration in the industrial sector of our country. This study is based in a survey among the enterprises with the largest fuel consumption belonging to the industrial and commercial sectors and to the petrochemical branch of Petroleos Mexicanos (PEMEX). The results of the study are presented, which show the location of the cogeneration potential by the following estimates: a) The scenario under a potential of 5770 MW to generate annually 4.55 x 107 MWh of electric energy. b) The scenario with a potential of 10819 MW to generate annually 9.47 x 107 Mwh of electric energy [Espanol] La Comision Nacional para el Ahorro de Energia (CONAE) llevo acabo un estudio para determinar la cantidad de energia electrica disponible por cogeneracion en el sector industrial de nuestro pais. El estudio se fundamenta en una encuesta entre las empresas con mayor consumo de combustibles pertenecientes a los sectores industrial y comercial y al ramo petroquimico de Petroleos Mexicanos (PEMEX). Se presentan los resultados del estudio, el cual muestra la ubicacion del potencial de cogeneracion por los siguientes estimados: a) El escenario bajo con un potencial de 5770 MW para producir anualmente 4.55 x 107 Mwh de energia electrica. b) El escenario alto con un potencial de 10819 MW para producir anualmente 9.47 x 107 MWh de energia electrica

  15. Evaluation of the national cogeneration potential as an option for the expansion of the national electric system; Evaluacion del potencial nacional de cogeneracion como opcion en la expansion del sistema electrico nacional

    Energy Technology Data Exchange (ETDEWEB)

    Nieva Gomez, Rolando; Hernandez Galicia, Julio Alberto [Instituto de Investigaciones Electricas, Cuernavaca (Mexico); Portes Mascorro, Enrique; Alvarez Chavez, Jose Maria [Comision Nacional para el Ahorro de Energia (CONAE), Mexico, D. F. (Mexico)

    1998-12-31

    The Comision Nacional para el Ahorro de Energia (CONAE) carried out a study to determine the amount of electric energy available by cogeneration in the industrial sector of our country. This study is based in a survey among the enterprises with the largest fuel consumption belonging to the industrial and commercial sectors and to the petrochemical branch of Petroleos Mexicanos (PEMEX). The results of the study are presented, which show the location of the cogeneration potential by the following estimates: a) The scenario under a potential of 5770 MW to generate annually 4.55 x 107 MWh of electric energy. b) The scenario with a potential of 10819 MW to generate annually 9.47 x 107 Mwh of electric energy [Espanol] La Comision Nacional para el Ahorro de Energia (CONAE) llevo acabo un estudio para determinar la cantidad de energia electrica disponible por cogeneracion en el sector industrial de nuestro pais. El estudio se fundamenta en una encuesta entre las empresas con mayor consumo de combustibles pertenecientes a los sectores industrial y comercial y al ramo petroquimico de Petroleos Mexicanos (PEMEX). Se presentan los resultados del estudio, el cual muestra la ubicacion del potencial de cogeneracion por los siguientes estimados: a) El escenario bajo con un potencial de 5770 MW para producir anualmente 4.55 x 107 Mwh de energia electrica. b) El escenario alto con un potencial de 10819 MW para producir anualmente 9.47 x 107 MWh de energia electrica

  16. Spinal pain

    International Nuclear Information System (INIS)

    Izzo, R.; Popolizio, T.; D’Aprile, P.; Muto, M.

    2015-01-01

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  17. Spinal pain

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, R., E-mail: roberto1766@interfree.it [Neuroradiology Department, A. Cardarelli Hospital, Naples (Italy); Popolizio, T., E-mail: t.popolizio1@gmail.com [Radiology Department, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Fg) (Italy); D’Aprile, P., E-mail: paoladaprile@yahoo.it [Neuroradiology Department, San Paolo Hospital, Bari (Italy); Muto, M., E-mail: mutomar@tiscali.it [Neuroradiology Department, A. Cardarelli Hospital, Napoli (Italy)

    2015-05-15

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  18. The nation in 21st century Spain: an unendable debate | La nación en la España del siglo XXI: un debate inacabable

    Directory of Open Access Journals (Sweden)

    Xosé Manoel Núñez Seixas

    2010-12-01

    Full Text Available This article presents an interpretation of the recent evolution of the issue of nationality in contemporary Spain from an historical perspective, beginning with the approval of the 1978 Constitution and the ensuing implementation of the State of the Autonomous Communities at the politico-institutional level. It then goes on to examine the challenges faced by substate and state nationalisms in present-day Spain, which may be summed up in the growing plurality of sentiments of multiple belonging on the part of Spanish citizens, as well as the impact of globalization and foreign immigration. All these phenomena have transformed the conditions in which nationalisms interact, and will require0 political elites to rethink the theoretical frameworks of nationalist doctrines. | El artículo ofrece una interpretación en clave histórica de la evolución reciente de la cuestión nacional en la España contemporánea, desde la aprobación de la Constitución de 1978 y la articulación político-institucional del Estado de las Autonomías, y a continuación expone los retos a los que los nacionalismos subestatales y de Estado que conviven en territorio español se enfrentan en la primera década del siglo XXI, subrayando el hecho de que la pluralidad de opciones y pertenencias identitarias de los ciudadanos, el impacto de la globalización y de la inmigración han transformado las coordenadas básicas de la cuestión nacional y obligan a las élites a repensar los marcos teóricos de las doctrinas nacionalistas.

  19. Patient protection in radiotherapy (Radio neurosurgery National Service of the Social Security Mexican Institute); Proteccion del paciente en radioterapia (Servicio Nacional de Radioneurocirugia del IMSS)

    Energy Technology Data Exchange (ETDEWEB)

    Espiritu R, R. [Centro Medico Nacional de Occidente, IMSS, Servicio Nacional de Radioneurocirugia, Belisario Dominguez 735, Sector Libertad, 44340 Guadalajara, Jalisco (Mexico)

    2008-12-15

    The perspective of patient protection at the Radio neurosurgery National Service of the Social Security Mexican Institute is divided into three parts: the testing program for equipment acceptance, an assurance quality program based on periodic tests, an also other assurance quality based on tests during the application. Among the technical aspects that influence in the equipment acceptance tests, it is the collimation type, the characteristics of the lineal accelerator, the platform for planning and the network type. In the case of the collimation system and the accelerator characteristics, we consider the manufacturer's specifications and requirements of Mexican Official Standard NOM-033-NUCL-1999, {sup T}echnical Specifications for the Teletherapy Units Operation, Linear Accelerators{sup .} Planning for the platform takes into account the manufacturer's specifications. In the case of computed tomography as well as review the calibration according to manufacturer's specifications should be considered the standard NOM-229-SSA1-2002. In the case of the linear accelerator must be the radiological characterization of radiation beam as part of this, the absolute dose determination. As for the periodic tests is verified the dose constancy, as well as the flattening and symmetry of X-rays beam. There are also tests battery with daily, monthly and yearly frequencies, which make up the assurance quality program. (Author)

  20. Spontaneous pain attacks: neuralgic pain

    NARCIS (Netherlands)

    de Bont, L.G.

    2006-01-01

    Paroxysmal orofacial pains can cause diagnostic problems, especially when different clinical pictures occur simultaneously. Pain due to pulpitis, for example, may show the same characteristics as pain due to trigeminal neuralgia would. Moreover, the trigger point of trigeminal neuralgia can either

  1. The National Police Forces TEDAX-NRBQ speciality; La especialidad TEDAX-NRBQ del Cuerpo Nacional de Policia

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, A.

    2010-07-01

    The National Police Force has a group specialising in nuclear, radiological, biological and chemical incidents, known as TEDAXNRBQ. The Nuclear Safety Council cooperates closely with this group on nuclear safety and radiological protection matters. (Author)

  2. Evolution of short circuit levels in the National Electric System, years 2007 to 2011; Evolucion de los niveles de cortocircuito del Sistema Electrico Nacional, anos 2007 al 2011

    Energy Technology Data Exchange (ETDEWEB)

    Quintana Castaneda, J; Reyes Escobedo, G [Instituto de Investigaciones Electricas (Mexico)]. E-mails: jqc@iie.org.mx; gustavo.reyes@iie.org.mx; Ibarra Romo, F.G. [Comision Federal de Electricidad (Mexico)]. E-mail: federico.ibarra@cfe.gob.mx

    2013-03-15

    The present document shows an analysis of 2011 short-circuit levels on the different nodes (substations) that integrate the National Electric System. This analysis presents the figures of short-circuit levels on past years, stating on 2007, with the purpose of detecting the variation on each one of these nodes and identify the cases that because it's high levels are considered as critical nodes of the transmission system. At the end of the analysis some recommendations to minimize the potential risks are given on those substations classified as critical nodes. [Spanish] En este documento se expone un analisis de los niveles de cortocircuito que se presentaron en el 2011 en los distintos nodos (subestaciones) que conforman la red del Sistema Electrico Nacional (SEN). Este analisis muestra las cifras de los niveles de cortocircuito que se han presentado desde el ano 2007, a fin de estudiar el comportamiento y evolucion que han tenido los nodos de la red electrica, identificando aquellos puntos que por sus altos niveles de cortocircuito se consideran como nodos criticos. En la parte final del analisis se dan algunas recomendaciones para disminuir los riesgos que se pudieran presentar en aquellas subestaciones clasificadas como nodos criticos.

  3. Radiotherapy in painful gonarthrosis. Results of a national patterns-of-care study; Strahlentherapie bei schmerzhafter Kniegelenkarthrose (Gonarthrose). Ergebnisse einer deutschen Patterns-of-Care-Studie

    Energy Technology Data Exchange (ETDEWEB)

    Muecke, Ralph; Schaefer, Ulrich [Klinik fuer Strahlentherapie, Klinikum Lippe-Lemgo (Germany); Seegenschmiedt, M. Heinrich [Klinik fuer Radioonkologie, Strahlentherapie und Nuklearmedizin, Alfried Krupp Krankenhaus, Essen (Germany); Heyd, Reinhard [Strahlenklinik, Klinikum Offenbach GmbH (Germany); Prott, Franz-Josef [GMP fuer Radiologie und Strahlentherapie am St. Josefs-Hospital, Wiesbaden (Germany); Glatzel, Michael [Klinik fuer Strahlentherapie und Radioonkologie, Klinikum Suhl (Germany); Micke, Oliver [Klinik fuer Strahlentherapie und Radioonkologie, Franziskus Hospital, Bielefeld (Germany)

    2010-01-15

    Backgroud and Purpose: After a patterns-of-care study (PCS) in 2003/2004 addressing benign disorders in general, the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD) conducted several multicenter cohort studies including the use of radiotherapy (RT) in painful gonarthrosis (GNA). Material and Methods: From 2006 to 2008, a PCS for GNA was conducted in all German RT institutions using a standardized structured questionnaire. Patient accrual, patient number, pretreatment, pain record, treatment indications, RT technique, and target volume concepts for painful GNA were assessed. In addition, the long-term functional and subjective outcomes were evaluated. Results: 238/248 institutions (95.9%) returned the questionnaire: 50 (21%) reported no clinical experience with RT in GNA, while 188 (79%) institutions treated 4,544 patients annually (median 15; range one to 846 cases per institution). Indications for treatment were acute pain symptoms in 18.9%, chronic pain in 95.3%, and treatment-refractory pain in 81.1%. The median total dose was 6 Gy (range 3-12 Gy), with a median single dose of 1 Gy (0.25-3 Gy). 40.4% of the institutions applied two fractions and 51.4% three fractions weekly. RT was delivered with orthovoltage units (25%), linear accelerators (79.6%), and cobalt-60 units (8.3%). 42 institutions evaluated the long-term clinical outcome in a total of 5,069 cases. Median pain reduction for at least 3 months was reported in 60% (5-100%), median pain reduction for at least 12 months in 40% (10-100%), and median persistent pain reduction in 27.8% (10-85%) of the treated patients. In 30% of patients (7-100%), a second RT series was applied for inadequate pain response or early pain recurrence. No radiogenic acute or chronic side effects were observed. Conclusion: This PCS comprises the largest number of cases reported for RT in painful and refractory GNA. Despite variations in daily RT practice, high response and low toxicity for this treatment in

  4. Pain genes.

    Directory of Open Access Journals (Sweden)

    Tom Foulkes

    2008-07-01

    Full Text Available Pain, which afflicts up to 20% of the population at any time, provides both a massive therapeutic challenge and a route to understanding mechanisms in the nervous system. Specialised sensory neurons (nociceptors signal the existence of tissue damage to the central nervous system (CNS, where pain is represented in a complex matrix involving many CNS structures. Genetic approaches to investigating pain pathways using model organisms have identified the molecular nature of the transducers, regulatory mechanisms involved in changing neuronal activity, as well as the critical role of immune system cells in driving pain pathways. In man, mapping of human pain mutants as well as twin studies and association studies of altered pain behaviour have identified important regulators of the pain system. In turn, new drug targets for chronic pain treatment have been validated in transgenic mouse studies. Thus, genetic studies of pain pathways have complemented the traditional neuroscience approaches of electrophysiology and pharmacology to give us fresh insights into the molecular basis of pain perception.

  5. Aceptabilidad de los suplementos alimenticios del programa Oportunidades Acceptability of dietary supplements of the national Mexican program "Oportunidades"

    Directory of Open Access Journals (Sweden)

    Angel Zarco

    2006-08-01

    Full Text Available OBJETIVO: Identificar usos y prácticas culturales para evaluar la aceptabilidad de los suplementos alimenticios del programa Oportunidades. MATERIAL Y MÉTODOS: Estudio etnográfico con entrevistas a profundidad (43 -madres de niños menores de cinco años y mujeres embarazadas y en periodo de lactancia (MEPL-; informantes clave (9; grupos focales (8 y observación directa en cuatro comunidades del norte, centro, rur y sureste de México. RESULTADOS: El suplemento se prepara en distintas formas. Se consumió más en forma líquida que en solución de consistencia espesa. En las primeras ingestas causa vómito, diarrea y náuseas, pero estos malestares se superan posteriormente. Debido a la preferencia por la forma líquida, el suplemento se combina con leche. Entre las MEPL la aceptación fue generalizada. CONCLUSIONES: El suplemento tiende a sustituir a la leche como un alimento en la dieta diaria. Se recomiendan evaluaciones en regiones con prácticas alimenticias culturalmente diferentes y considerar su relación con otros componentes del programa.OBJECTIVE: To identify cultural beliefs and practices to evaluate the acceptability of dietary supplements of Oportunidades Program. MATERIAL AND METHODS: Ethnographic study with in-depth interviews (n= 43 -mothers of children less than five years of age and pregnant and breasfeeding women (PBW-, key informants (n= 9; focus groups (n= 8 and direct observation, in four communities from North, Central, South and Southwest of Mexico. RESULTS: The supplement was prepared in several different ways. The liquid preparation was best accepted; generally the supplement was mixed with milk. Initially, the supplement caused nausea, vomiting and diarrhea, but these symptoms disappeared with continued consumption. Acceptance was highest among PBW. CONCLUSIONS: The supplement tends to replace milk as a food product in the daily diet. There is a necessity to develop culturally specific evaluations in regions with

  6. Annual incidence of non-specific low back pain as an occupational disease attributed to whole-body vibration according to the National Dutch Register 2005-2012.

    Science.gov (United States)

    Kuijer, P Paul F M; van der Molen, Henk F; Schop, Astrid; Moeijes, Fred; Frings-Dresen, Monique H W; Hulshof, Carel T J

    2015-01-01

    Non-specific low back pain (nLBP) is the second most important reason for sick leave in the Netherlands, and more than 50% of the workers on sick leave attribute these complaints to their work. To stimulate recognition and prevention, an occupational disease (OD) registration-guideline was implemented for the assessment of the work-relatedness of nLBP in the Netherlands in 2005. The aim of this study is to present the annual incidence of nLBP as an OD and specifically for whole-body vibration (WBV) including patient characteristics such as age, sick leave and actions initiated by the occupational physician (OP). The data were retrieved from the National Dutch Register for 2005-2012. Each year about 118 OPs reported 509 cases (SD 139) of nLBP as an OD in a Dutch working population of 7.5 million workers (8% of all annual reported ODs). Less than 1% of these cases were attributed to WBV: 94% were men, 45% were between 51 and 60 years and 35% were on sick leave for more than 2 weeks. Most initiated actions were ergonomic interventions (35%). The number of notified cases of nLPB as an occupational disease attributed to whole-body vibration is low with less than 1% of all cases in the Netherlands. An explanation is that other work-related risk factors for nLBP such as lifting are more frequently occurring, more visible and have a higher attributable risk than WBV. However, continuing attention for WBV remains warranted given a higher percentage of cases with sick leave of more than 2 weeks.

  7. Dosimetric aspects of the treatment of metastatic bone pain with radiopharmaceuticals; Aspectos dosimetricos de los tratamientos del dolor oseo metastasico con radiofarmacos

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, T.; Marti, J. F.; Olivas, C.; Vercher, J. L.; Repetto, R.; Bello, P.

    2014-02-01

    Within the context of treatment of metastatic bone pain with bone seeking radiopharmaceuticals, this paper expounds the results of an analysis of available molecules (both approved for clinical use or still under study) intended to obtain a detailed comparison of their dosimetric characteristics. These can be used to supplement the list of already know differences between them, such as efficacy, appearance and length of the palliative effect, eventual tumoricidal effect, myelotoxicity, sale price and availability. Seven radiopharmaceuticals have been analysed, five of them are based on beta emission radionuclides: {sup 3}2P, {sup 1}53Sm, {sup 1}86Re and {sup 1}88Re and the other two ones are based on high Linear energy Transference emission radionuclides: {sup 1}17mSn and {sup 2}23Ra a series of estimates of the main dosimetric parameters for each radiopharmaceutical analysed have been obtained. The values obtained might be worth being incorporated to the risk/benefit analysis that precedes every choice of the specific radiopharmaceutical to be used with an individual patient. In this way, we hope these results will be of some help for those Nuclear Medicine specialists interested in the treatment of oncological bone pathologies. (Author)

  8. Bone pain

    DEFF Research Database (Denmark)

    Frost, Charlotte Ørsted; Hansen, Rikke Rie; Heegaard, Anne-Marie

    2016-01-01

    Skeletal conditions are common causes of chronic pain and there is an unmet medical need for improved treatment options. Bone pain is currently managed with disease modifying agents and/or analgesics depending on the condition. Disease modifying agents affect the underlying pathophysiology...... of the disease and reduce as a secondary effect bone pain. Antiresorptive and anabolic agents, such as bisphosphonates and intermittent parathyroid hormone (1-34), respectively, have proven effective as pain relieving agents. Cathepsin K inhibitors and anti-sclerostin antibodies hold, due to their disease...... modifying effects, promise of a pain relieving effect. NSAIDs and opioids are widely employed in the treatment of bone pain. However, recent preclinical findings demonstrating a unique neuronal innervation of bone tissue and sprouting of sensory nerve fibers open for new treatment possibilities....

  9. Back Pain - Multiple Languages

    Science.gov (United States)

    ... List of All Topics All Back Pain - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 31 May 2018

  10. The Epidemiology of Chronic Pain in Canadian Men and Women between 1994 and 2007: Results from the Longitudinal Component of the National Population Health Survey

    Directory of Open Access Journals (Sweden)

    Michelle L Reitsma

    2012-01-01

    Full Text Available BACKGROUND: The epidemiology of chronic pain is poorly understood due to a paucity of longitudinal studies limiting the ability to develop prevention strategies for a condition resistant to many current therapies.

  11. The characteristics of women who use hypnotherapy for intrapartum pain management: Preliminary insights from a nationally-representative sample of Australian women.

    Science.gov (United States)

    Steel, A; Frawley, J; Sibbritt, D; Broom, A; Adams, J

    2016-04-01

    This manuscript presents a preliminary examination of the characteristics of women who choose intrapartum hypnosis for pain management. Cross-sectional analysis of 2445 women (31-36 years) from a sub-study of the Australian Longitudinal Study on Women's Health (ALSWH), employing Fisher exact tests. Australia. Use of intrapartum hypnosis, or hypnobirthing, for pain management during labour and birth. Women using hypnobirthing were more likely to have consulted with an acupuncturist or naturopath, or attended yoga/meditation classes during pregnancy (phypnotherapy for intrapartum pain management less commonly identified as feeling safer knowing that an obstetrician is providing their care (phypnotherapy for intrapartum pain management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Multicolumn spinal cord stimulation for significant low back pain in failed back surgery syndrome: design of a national, multicentre, randomized, controlled health economics trial (ESTIMET Study).

    Science.gov (United States)

    Roulaud, M; Durand-Zaleski, I; Ingrand, P; Serrie, A; Diallo, B; Peruzzi, P; Hieu, P D; Voirin, J; Raoul, S; Page, P; Fontaine, D; Lantéri-Minet, M; Blond, S; Buisset, N; Cuny, E; Cadenne, M; Caire, F; Ranoux, D; Mertens, P; Naous, H; Simon, E; Emery, E; Gadan, B; Regis, J; Sol, J-C; Béraud, G; Debiais, F; Durand, G; Guetarni Ging, F; Prévost, A; Brandet, C; Monlezun, O; Delmotte, A; d'Houtaud, S; Bataille, B; Rigoard, P

    2015-03-01

    Many studies have demonstrated the efficacy of spinal cord stimulation (SCS) for chronic neuropathic radicular pain over recent decades, but despite global favourable outcomes in failed back surgery syndrome (FBSS) with leg pain, the back pain component remains poorly controlled by neurostimulation. Technological and scientific progress has led to the development of new SCS leads, comprising a multicolumn design and a greater number of contacts. The efficacy of multicolumn SCS lead configurations for the treatment of the back pain component of FBSS has recently been suggested by pilot studies. However, a randomized controlled trial must be conducted to confirm the efficacy of new generation multicolumn SCS. Évaluation médico-économique de la STImulation MEdullaire mulTi-colonnes (ESTIMET) is a multicentre, randomized study designed to compare the clinical efficacy and health economics aspects of mono- vs. multicolumn SCS lead programming in FBSS patients with radicular pain and significant back pain. FBSS patients with a radicular pain VAS score≥50mm, associated with a significant back pain component were recruited in 14 centres in France and implanted with multicolumn SCS. Before the lead implantation procedure, they were 1:1 randomized to monocolumn SCS (group 1) or multicolumn SCS (group 2). Programming was performed using only one column for group 1 and full use of the 3 columns for group 2. Outcome assessment was performed at baseline (pre-implantation), and 1, 3, 6 and 12months post-implantation. The primary outcome measure was a reduction of the severity of low back pain (bVAS reduction≥50%) at the 6-month visit. Additional outcome measures were changes in global pain, leg pain, paraesthesia coverage mapping, functional capacities, quality of life, neuropsychological aspects, patient satisfaction and healthcare resource consumption. Trial recruitment started in May 2012. As of September 2013, all 14 study centres have been initiated and 112

  13. The implementation and evaluation of an evidence-based statewide prehospital pain management protocol developed using the national prehospital evidence-based guideline model process for emergency medical services.

    Science.gov (United States)

    Brown, Kathleen M; Hirshon, Jon Mark; Alcorta, Richard; Weik, Tasmeen S; Lawner, Ben; Ho, Shiu; Wright, Joseph L

    2014-01-01

    In 2008, the National Highway Traffic Safety Administration funded the development of a model process for the development and implementation of evidence-based guidelines (EBGs) for emergency medical services (EMS). We report on the implementation and evaluation of an evidence-based prehospital pain management protocol developed using this model process. An evidence-based protocol for prehospital management of pain resulting from injuries and burns was reviewed by the Protocol Review Committee (PRC) of the Maryland Institute for Emergency Medical Services Systems (MIEMSS). The PRC recommended revisions to the Maryland protocol that reflected recommendations in the EBG: weight-based dosing and repeat dosing of morphine. A training curriculum was developed and implemented using Maryland's online Learning Management System and successfully accessed by 3,941 paramedics and 15,969 BLS providers. Field providers submitted electronic patient care reports to the MIEMSS statewide prehospital database. Inclusion criteria were injured or burned patients transported by Maryland ambulances to Maryland hospitals whose electronic patient care records included data for level of EMS provider training during a 12-month preimplementation period and a 12-month postimplementation period from September 2010 through March 2012. We compared the percentage of patients receiving pain scale assessments and morphine, as well as the dose of morphine administered and the use of naloxone as a rescue medication for opiate use, before and after the protocol change. No differences were seen in the percentage of patients who had a pain score documented or the percent of patients receiving morphine before and after the protocol change, but there was a significant increase in the total dose and dose in mg/kg administered per patient. During the postintervention phase, patients received an 18% higher total morphine dose and a 14.9% greater mg/kg dose. We demonstrated that the implementation of a revised

  14. Tecnologia tátil para a avaliação da dor em cegos Tecnología táctil para la evaluación del dolor en ciegos Tactile technology for pain evaluation in blind people

    Directory of Open Access Journals (Sweden)

    Ana Cláudia de Souza Toniolli

    2003-03-01

    Full Text Available Trata-se de um estudo descritivo e exploratório das percepções dos cegos acerca do protótipo chamado Escala Tátil, para avaliação da intensidade da dor. Por meio de uma entrevista semi-estruturada, foram obtidos os relatos de cegos da Associação dos Cegos do Ceará, para descrever a natureza do protótipo, estabelecendo relações entre as suas experiências dolorosas e buscando significados para a sua utilização na cultura dos cegos. Dos relatos, foram identificados e analisados três temas: intensidade da dor na ponta dos dedos, percepção da escala tátil da dor, destacando-se textura, forma e tamanho, lapidando-se a Escala Tátil. A percepção sensorial tátil dos cegos gerou novos parâmetros de reflexão para o estudo da dor e direcionou a performance do protótipo para um processo de comunicação da dor mais satisfatório.Este es un estudio descriptivo de las percepciones de los ciegos acerca del prototipo llamado Escala Táctil para evaluación de la intensidad del dolor. A través de una entrevista semi-estructurada, se obtuvieron relatos de ciegos de la Asociación del Ciegos de la ciudad de Ceará-BR para describir la naturaleza del prototipo, estableciendo relaciones entre sus experiencias dolorosas y buscando significados para su utilización en la cultura de los ciegos. De los relatos fueron identificados y analizados tres temas: intensidad del dolor en la punta de los dedos, percepción de la escala táctil del dolor: textura, forma y tamaño y puliendo la Escala Táctil. La percepción sensorial de las personas ciegas generó nuevos parámetros de reflexión para el estudio del dolor y orientó la performance del prototipo hacia un proceso de comunicación del dolor más satisfactorio.This is a descriptive study of blind people perceptions about a prototype called Tactile Scale for pain intensity evaluation. By means of a half-structured interview, reports were collected from blind people from the Ceará Blind

  15. Intra-Articular Injections of Platelet-Rich Plasma versus Hyaluronic Acid in the Treatment of Osteoarthritic Knee Pain: A Randomized Clinical Trial in the Context of the Spanish National Health Care System.

    Science.gov (United States)

    Montañez-Heredia, Elvira; Irízar, Sofia; Huertas, Pedro J; Otero, Esperanza; Del Valle, Marta; Prat, Isidro; Díaz-Gallardo, Macarena S; Perán, Macarena; Marchal, Juan A; Hernandez-Lamas, María Del Carmen

    2016-07-02

    Intra-articular injection of platelet-rich plasma (PRP) has been established as a suitable treatment for knee osteoarthritis. Here, we present a double-blind randomized controlled clinical trial, conducted in a public Hospital of the Spanish National Health Care System, to evaluate the efficacy of injecting autologous PRP versus hyaluronic acid (HA) in knee osteoarthritis. PRP was manufactured in Malaga's Regional Blood Center (Spain). Patients that met the eligibility criteria were randomized into a PRP group or a HA group. Pain and functional improvements were assessed pre- and post-treatment (three and six months follow-up) using the Visual Analogue Scale (VAS); the Knee and Osteoarthritis Outcome System (KOOS) scale and the European Quality of Life scale (EUROQOL). Both groups presented pain reduction at six months. The VAS scores for the PRP group improved by at least 50% from their initial value, particularly at three months following the final infiltration, with results resembling those of the HA group at six months. PRP was more effective in patients with lower osteoarthritis grades. Both treatments improved pain in knee osteoarthritis patients without statistically significant differences between them. However, PRP injection was proved to improve pain three months after the final infiltration and to be more effective in lower osteoarthritis grades.

  16. Ejaculatory pain

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Møhl, Bo; Kehlet, Henrik

    2007-01-01

    . The psychosexual interview revealed no major psychosexual disturbances and concluded that the pain was of somatic origin. All patients with ejaculatory pain had experienced major negative life changes and deterioration in their overall quality of life and sexual function as a result of the hernia operation...

  17. Breast Pain

    Science.gov (United States)

    ... result in the development of breast cysts. Breast trauma, prior breast surgery or other factors localized to the breast can lead to breast pain. Breast pain may also start outside the breast — in the chest wall, muscles, joints or heart, for example — and ...

  18. Neuropathic pain

    Directory of Open Access Journals (Sweden)

    Giuseppe Re

    2009-02-01

    Full Text Available Neuropathic pain is the expression of a dysfunction or primary lesion of a nerve in the peripheral or central nervous system, or both, rather than the biological signal transmitted by the nerve following peripheral nociceptor activation. It represents about 20% of all painful syndromes, with an estimated prevalence of 1.5%, however is actual incidence is hard to pinpoint due to the difficulties encountered in distinguishing it from chronic pain, of which it represents a significant percentage, on account of the not infrequent concurrence of conditions. It is crucial to recognise the variety of symptoms with which it can present: these can be negative and positive and, in turn, motor, sensitive and autonomic. In public health terms, it is important to emphasise that the diagnosis of neuropathic pain does not in most cases require sophisticated procedures and does not therefore weigh on health expenditure. In clinical practice, a validated scale (the LANSS is mentioned is useful for identifying patients presenting neuropathic pain symptoms. Therapy is based on three categories of medication: tricyclic antidepressants, anti-epileptics and opioids at high doses: neuropathic pain has a bad reputation for often resisting common therapeutic approaches and responding less well that nociceptor pain to monotherapy. Therapeutic strategies are all the more adequate the more they are based on symptoms and therefore on the pain generation mechanisms, although the recommendations are dictated more by expert opinions that double-blind randomised trials.

  19. Painful shoulder

    Directory of Open Access Journals (Sweden)

    Benno Ejnismann

    2008-03-01

    Full Text Available Many factors can be involved in the painful shoulder. Beyond articularcauses other pathologies such as artrosis, periarticular diseases as rotadorcuff tears, long head of the biceps tendinitis, adhesive capsulitis, calcifyingtendinitis, degenerative arthritis of the acromioclavicular joint, cervicalradiculopathy and nervous injuries can cause pain in the shoulder.

  20. Orofacial Pain

    Science.gov (United States)

    ... aligned teeth can have trouble because the muscles work harder to bring the teeth together, causing strain. Pain also can be caused by clenching or grinding teeth, trauma to the head and neck or poor ergonomics. ; Some people may experience pain in the ears, ...

  1. Neck Pain

    Science.gov (United States)

    ... Vomiting Nausea and Vomiting in Infants and Children Neck Pain Neck Swelling Shortness of Breath Shortness of Breath ... worse or doesn’t get better. Start OverDiagnosisYour pain may be from DEGENERATIVE CERVICAL ARTHRITIS, a disorder that affects the bones and ...

  2. Post-Amputation Pain Is Associated with the Recall of an Impaired Body Representation in Dreams—Results from a Nation-Wide Survey on Limb Amputees

    Science.gov (United States)

    Bekrater-Bodmann, Robin; Schredl, Michael; Diers, Martin; Reinhard, Iris; Foell, Jens; Trojan, Jörg; Fuchs, Xaver; Flor, Herta

    2015-01-01

    The experience of post-amputation pain such as phantom limb pain (PLP) and residual limb pain (RLP), is a common consequence of limb amputation, and its presence has negative effects on a person’s well-being. The continuity hypothesis of dreams suggests that the presence of such aversive experiences in the waking state should be reflected in dream content, with the recalled body representation reflecting a cognitive proxy of negative impact. In the present study, we epidemiologically assessed the presence of post-amputation pain and other amputation-related information as well as recalled body representation in dreams in a sample of 3,234 unilateral limb amputees. Data on the site and time of amputation, residual limb length, prosthesis use, lifetime prevalence of mental disorders, presence of post-amputation pain, and presence of non-painful phantom phenomena were included in logistic regression analyses using recalled body representation in dreams (impaired, intact, no memory) as dependent variable. The effects of age, sex, and frequency of dream recall were controlled for. About 22% of the subjects indicated that they were not able to remember their body representation in dreams, another 24% of the amputees recalled themselves as always intact, and only a minority of less than 3% recalled themselves as always impaired. Almost 35% of the amputees dreamed of themselves in a mixed fashion. We found that lower-limb amputation as well as the presence of PLP and RLP was positively associated with the recall of an impaired body representation in dreams. The presence of non-painful phantom phenomena, however, had no influence. These results complement previous findings and indicate complex interactions of physical body appearance and mental body representation, probably modulated by distress in the waking state. The findings are discussed against the background of alterations in cognitive processes after amputation and hypotheses suggesting an innate body model. PMID

  3. Post-amputation pain is associated with the recall of an impaired body representation in dreams-results from a nation-wide survey on limb amputees.

    Science.gov (United States)

    Bekrater-Bodmann, Robin; Schredl, Michael; Diers, Martin; Reinhard, Iris; Foell, Jens; Trojan, Jörg; Fuchs, Xaver; Flor, Herta

    2015-01-01

    The experience of post-amputation pain such as phantom limb pain (PLP) and residual limb pain (RLP), is a common consequence of limb amputation, and its presence has negative effects on a person's well-being. The continuity hypothesis of dreams suggests that the presence of such aversive experiences in the waking state should be reflected in dream content, with the recalled body representation reflecting a cognitive proxy of negative impact. In the present study, we epidemiologically assessed the presence of post-amputation pain and other amputation-related information as well as recalled body representation in dreams in a sample of 3,234 unilateral limb amputees. Data on the site and time of amputation, residual limb length, prosthesis use, lifetime prevalence of mental disorders, presence of post-amputation pain, and presence of non-painful phantom phenomena were included in logistic regression analyses using recalled body representation in dreams (impaired, intact, no memory) as dependent variable. The effects of age, sex, and frequency of dream recall were controlled for. About 22% of the subjects indicated that they were not able to remember their body representation in dreams, another 24% of the amputees recalled themselves as always intact, and only a minority of less than 3% recalled themselves as always impaired. Almost 35% of the amputees dreamed of themselves in a mixed fashion. We found that lower-limb amputation as well as the presence of PLP and RLP was positively associated with the recall of an impaired body representation in dreams. The presence of non-painful phantom phenomena, however, had no influence. These results complement previous findings and indicate complex interactions of physical body appearance and mental body representation, probably modulated by distress in the waking state. The findings are discussed against the background of alterations in cognitive processes after amputation and hypotheses suggesting an innate body model.

  4. Post-amputation pain is associated with the recall of an impaired body representation in dreams-results from a nation-wide survey on limb amputees.

    Directory of Open Access Journals (Sweden)

    Robin Bekrater-Bodmann

    Full Text Available The experience of post-amputation pain such as phantom limb pain (PLP and residual limb pain (RLP, is a common consequence of limb amputation, and its presence has negative effects on a person's well-being. The continuity hypothesis of dreams suggests that the presence of such aversive experiences in the waking state should be reflected in dream content, with the recalled body representation reflecting a cognitive proxy of negative impact. In the present study, we epidemiologically assessed the presence of post-amputation pain and other amputation-related information as well as recalled body representation in dreams in a sample of 3,234 unilateral limb amputees. Data on the site and time of amputation, residual limb length, prosthesis use, lifetime prevalence of mental disorders, presence of post-amputation pain, and presence of non-painful phantom phenomena were included in logistic regression analyses using recalled body representation in dreams (impaired, intact, no memory as dependent variable. The effects of age, sex, and frequency of dream recall were controlled for. About 22% of the subjects indicated that they were not able to remember their body representation in dreams, another 24% of the amputees recalled themselves as always intact, and only a minority of less than 3% recalled themselves as always impaired. Almost 35% of the amputees dreamed of themselves in a mixed fashion. We found that lower-limb amputation as well as the presence of PLP and RLP was positively associated with the recall of an impaired body representation in dreams. The presence of non-painful phantom phenomena, however, had no influence. These results complement previous findings and indicate complex interactions of physical body appearance and mental body representation, probably modulated by distress in the waking state. The findings are discussed against the background of alterations in cognitive processes after amputation and hypotheses suggesting an innate

  5. A new Lepeophtheirus (Copepoda: Siphonostomatoida: Caligidae from Isla del Coco National Park, Costa Rica, Eastern Tropical Pacific

    Directory of Open Access Journals (Sweden)

    Eduardo Suárez-Morales

    2012-11-01

    Full Text Available Among the several groups of copepods that are teleost parasites, the siphonostomatoid family Caligidae is by far the most widespread and diverse. With more than 108 nominal species, the caligid genus Lepeophtheirus von Nordmann is one of the most speciose. There are no reports of this genus in Costa Rican waters. A new species of Lepeophtheirus is herein described based on female specimens collected from plankton samples in waters off Bahía Wafer, isla del Coco, an oceanic island in the Eastern Tropical Pacific. The new species, L. alvaroi sp. nov., has some affinities with other congeners bearing a relatively short abdomen, a wider than long genital complex and a 3-segmented exopod of leg 4. it differs from most of these species by the presence of an unbranched maxillular process and by the relative lengths of the terminal claws of leg 4, with two equally long elements. it is most closely related to two other Eastern Pacific species: L. dissimulatus Wilson, 1905 and L. clarionensis Shiino, 1959. it differs from these species by the proportions and shape of the genital complex, the shape of the sternal furca, the relative length of the maxillar segments, the absence of a pectiniform process on the distal maxillar segment, the length of leg 4 and the armature of leg 5. The new species represents the first Lepeophtheirus described from Costa Rican waters of the Pacific. The low diversity of this genus in this tropi- cal region is explained by its tendency to prefer hosts from temperate latitudes. Until further evidence is found, the host of this Lepeophtheirus species remains unknown.

  6. LOW-BACK PAIN DISORDERS AS OCCUPATIONAL DISEASES IN THE CZECH REPUBLIC AND 22 EUROPEAN COUNTRIES: COMPARISON OF NATIONAL SYSTEMS, RELATED DIAGNOSES AND EVALUATION CRITERIA.

    Science.gov (United States)

    Laštovková, Andrea; Nakládalová, Marie; Fenclová, Zdenka; Urban, Pavel; Gad'ourek, Petr; Lebeda, Tomáš; Ehler, Edvard; Ridzoň, Petr; Hlávková, Jana; Boriková, Alena; Kuijer, P Paul F M; Bátora, Igor; Scholz-Odermatt, Stefan M; Moldovan, Horatiu; Godderis, Lode; Leijon, Ola; Campo, Giuseppe; Vaněčková, Manuela; Bonneterre, Vincent; Stikova, Elisaveta Jasna; Pelclová, Daniela

    2015-09-01

    Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a statistically significant association between LBPD and certain types of occupational burden. However, in the Czech Republic, LBPD caused by overload and/or whole-body vibrations have not yet been included in the list of occupational diseases. The aim of this study was to collect and compare the systems, criteria and diagnoses used to recognize LBPD as occupational diseases in other European countries. A questionnaire focused on LBPD was distributed and answered by specialists in occupational diseases in European countries. It included items concerning LBPD in the national list of occupational diseases, and work-related and diagnostic criteria that need to be fulfilled for recognizing LBPD as occupational diseases and possible awarding compensations to the patients. In 13 countries out of the 23 countries studied, LBPD caused by overload can be recognized as occupational, providing that the diagnosis is sufficiently proven and exposure criteria and/or listed occupation are met and duration of exposure is confirmed (Belgium, Denmark, France, Germany, Hungary, Italy, Lithuania, Macedonia, Netherlands, Romania, Slovakia, Sweden, and Switzerland). LBPD due to vibrations can be also recognized as occupational in 14 countries. In 8 countries LBPD are not accepted as occupational unless they are caused by an injury at work. Specific criteria to evaluate occupational exposure of patients with LBPD were set in Belgium, Denmark, France, Germany, Lithuania, Macedonia, Netherlands, and Slovakia. In other countries, the evaluation is done at an individual basis. In practice, the assessment of occupational overload and its contribution to the development of LBPD as well as its inclusion in the

  7. The Purge of National Teaching in Morella (1936-1945 | La depuración del magisterio nacional en Morella (1936-1945

    Directory of Open Access Journals (Sweden)

    Marta García Monfort

    2015-12-01

    Full Text Available The outbreak of the Civil War, apart from spreading havoc and blood all through Spain, caused some kind of deeply rooted social breakdown generating an endless thirst for revenge. While the military structures were deploying their strategy on the battlefield, the apparatus of power of both sides was establishing mechanisms of coercion and control mainly aimed at the submission of controlled territory. In this context, the purge of National Teachers favoured an ideological selection based on terror with preventive and punitive purposes. After the military conflict, under Francoist authorities the purge continued systematically, and with a repressive orientation, until the fifties. This analysis seeks to describe the idiosyncrasies of the purging processes developed in Republican Morella (1936-1938 and further in Franco’s regime (1939-1945. | El estallido de la Guerra Civil, además de sembrar de dolor y sangre la geografía española, provocará una ruptura social de hondo raigambre que generará en la sociedad una interminable sed de venganza. Al mismo tiempo que las estructuras militares desplegaban su estrategia en el campo de batalla, los aparatos de poder de los dos bandos establecieron unos mecanismos de coacción y control encaminados en primera instancia a la sumisión del territorio dominado. En este contexto, la depuración del Magisterio Nacional propiciará una selección ideológica con unos fines preventivos y punitivos. Finalizada la contienda bélica, la purga continuará sistematizada y con un carácter represivo de la mano de las autoridades franquistas hasta la década de los cincuenta aproximadamente. Este análisis trata de describir la idiosincrasia de los procesos depuradores desarrollados en la Morella republicana (1936-1938 y, posteriormente, en la franquista (1939-1945.

  8. Checklist of the Mycobiota of Iguazú National Park (Misiones, Argentina Catálogo de los hongos del Parque Nacional Iguazú (Misiones, Argentina

    Directory of Open Access Journals (Sweden)

    Jorge E. Wright

    2005-07-01

    Full Text Available A check-list of the fungi recorded from Iguazú National Park, one of the best known preserved areas in South America, has been compiled mainly on the basis of Rolf Singer´s and our own collections and publications. Ten species of Dictyosteliales, 4 of Myxomycetes, 4 of Pezizales, 9 of Hypocreales, 31 of other Ascomycetes, 3 Deuteromycotina and 314 of Basidiomycetes are annotated. This last group is by far the best known, and includes 13 species of jelly-fungi, 6 coral fungi, 84 resupinates, 90 Agaricales s. l., 111 polypores of which 26 are poroid Hymenochaetaceae, and 11 of Gasteromycetes. Furthermore, 8 Ascomycetes, 58 Basidiomycetes and 2 Deuteromycotina were determined to genus. Lichens have been excluded. The microfungi of the Park have hardly been explored, and no phycomycetes are recorded, so the number of species included in this checklist is but a mere sample of the rich mycobiota of the Park.Este catálogo de los hongos registrados para el Parque Nacional Iguazú, una de las áreas preservadas mejor conocidas en América del Sur, ha sido confeccionado principalmente sobre la base de las colecciones y publicaciones de Rolf Singer y las propias. Diez especies de Dictyosteliales, 4 de Myxomycetes, 4 de Pezizales, 9 de Hypocreales, 31 de otros Ascomycetes, 3 Deuteromycotina, y 314 de Basidiomycetes han sido anotadas. Este último grupo es de lejos el mejor conocido, e incluye 13 especies de hongos gelatinosos, 6 de hongos clavarioides, 84 de resupinados, 90 de Agaricales s. l., 111 de políporos, de los cuales 26 son Hymenochaetaceae poroides, y 11 de Gasteromycetes. Además, 8 Ascomycetes, 58 Basidiomycetes y 2 Deuteromycotina fueron solo determinados a nivel de género. Los líquenes han sido excluídos. Los microhongos del Parque apenas han sido explorados, y no se han registrado 'ficomicetes', de modo que el número de especies que se presenta aquí son tan sólo un mero muestreo de la micobiota del Parque.

  9. Investigation of the Practices, Legislation, Supply Chain, and Regulation of Opioids for Clinical Pain Management in Southern Africa: A Multi-sectoral, Cross-National, Mixed Methods Study.

    Science.gov (United States)

    Namisango, Eve; Allsop, Matthew J; Powell, Richard A; Friedrichsdorf, Stefan J; Luyirika, Emmanuel B K; Kiyange, Fatia; Mukooza, Edward; Ntege, Chris; Garanganga, Eunice; Ginindza-Mdluli, Mavis Ntombifuthi; Mwangi-Powell, Faith; Mondlane, Lidia Justino; Harding, Richard

    2018-03-01

    Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. To identify country-specific and broader regional barriers to access, as well as the administration of opioids, and generate recommendations for advancing pain management in Southern Africa. A parallel mixed methods design was used across three countries: Mozambique, Swaziland, and Zimbabwe. Three activities were undertaken: 1) a review of regulatory and policy documentation, 2) group interviews, and 3) a self-administered key informant survey. Barriers to accessing opioid analgesics for medical use include overly restrictive controlled medicines' laws; use of stigmatizing language in key documents; inaccurate actual opioid consumption estimation practices; knowledge gaps in the distribution, storage, and prescription of opioids; critical shortage of prescribers; and high out-of-pocket financial expenditures for patients against a backdrop of high levels of poverty. Policies and relevant laws should be updated to ensure that the legislative environment supports opioid access for pain management. Action plans for improving pain treatment for patients suffering from HIV or non-communicable diseases should address barriers at the different levels of the supply chain that involve policymakers, administrators, and service providers. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. Mega wildfire in the World Biosphere Reserve (UNESCO), Torres del Paine National Park, Patagonia - Chile 2012: Work experience in extreme behavior conditions in the context of global warming

    Science.gov (United States)

    René Cifuentes Medina

    2013-01-01

    Mega wildfires are critical, high-impact events that cause severe environmental, economic and social damage, resulting, in turn, in high-cost suppression operations and the need for mutual support, phased use of resources and the coordinated efforts of civilian government agencies, the armed forces, private companies and the international community. The mega forest...

  11. Biodiversidad del Parque Nacional Pre-Delta (Entre Ríos, Argentina: II. Estudio cuantitativo del fitoplancton Biodiversity of Pre-Delta National Park (Entre Ríos, Argentina: II. Phytoplankton quantitative study

    Directory of Open Access Journals (Sweden)

    V. Mirande

    2009-07-01

    Full Text Available La falta de antecedentes ficológicos vinculados al Parque Nacional Pre-Delta nos condujo a realizar este estudio. El objetivo fue conocer la abundancia del fitoplancton en ambientes leníticos y lóticos de dicha área protegida, la cual está situada en la ciudad de Diamante (Entre Ríos. Se estudiaron siete zonas (tres lagunas, un arroyo y dos riachos y las variables abundancia absoluta algal, biomasa y diversidad, empleándose para la ordenación de los sitios el análisis de componentes principales (ACP. Los resultados obtenidos evidenciaron a las diatomeas como el grupo dominante a través de las pennadas. Si se consideran a nivel de individuos aportados por las especies, Aulacoseira granulata fue dominante en líneas generales en los sistemas lóticos estudiados, no así en los sistemas lénticos. El empleo de variables específicamente vinculadas al fitoplancton como densidad absoluta, biomasa y diversidad posibilitó la separación de los sitios a través del ACP.This paper was realized because of lack of phycologic dates from Pre-Delta National Park. The aim of this paper was to know abundance phytoplankton in lentic and lotic environments from this area, which is located in Diamante City (Entre Ríos. Seven sampling sites (three lakes, one stream and two rivers and absolute algal abundance, biomass and diversity of phytoplankton were studied, employing the Principal Component Analyse (PCA in the ordination of the sites. Our results have showed to diatoms as dominant across pennate group. The PCA separated the lotic and lentic water bodies in base of considered variables. If we consider to individual level given by species, Aulacoseira granulata was generally dominant in lotic systems but not in lentic systems. The absolute algal abundance, biomass and diversity variables permitted to separate the lentic and lotic sampling sites by means of the PCA utilization.

  12. National audit of the quality of pain relief provided in emergency departments in Aotearoa, New Zealand: The PRiZED 1 Study.

    Science.gov (United States)

    2017-04-01

    Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006-2012) from 26 New Zealand public hospital EDs. Of the 1685 charts randomly selected, 1547 (91%) were reviewed from 21 EDs. There were 866 ED presentations with painful conditions, of whom 132 (15%) did not have pain recorded, 205 (24%) did not receive pain relief and 19 (2%) did not have time of analgesia documented leaving 510 (59%) for the analysis of time to analgesia. Four hundred and fifty-seven (53%) did not have pain well documented sufficiently to assess adequacy, leaving 277 (32%) for the analysis of adequacy of analgesia. The median (interquartile range) time to analgesia was 62 (30-134) min and the provision of adequate analgesia was 141/277 (51%, 95% CI: 45-57%); however, there was some variation between hospitals for both outcomes. Although these outcomes are on a par with other countries, this baseline audit has shown both poor documentation and variation in the provision of timely and adequate pain relief in New Zealand EDs, with room for improvement with respect to this quality indicator. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  13. Cost-effectiveness analysis for joint pain treatment in patients with osteoarthritis treated at the Instituto Mexicano del Seguro Social (IMSS: Comparison of nonsteroidal anti-inflammatory drugs (NSAIDs vs. cyclooxygenase-2 selective inhibitors

    Directory of Open Access Journals (Sweden)

    Mejía-Aranguré Juan

    2008-11-01

    Full Text Available Abstract Background Osteoarthritis (OA is one of the main causes of disability worldwide, especially in persons >55 years of age. Currently, controversy remains about the best therapeutic alternative for this disease when evaluated from a cost-effectiveness viewpoint. For Social Security Institutions in developing countries, it is very important to assess what drugs may decrease the subsequent use of medical care resources, considering their adverse events that are known to have a significant increase in medical care costs of patients with OA. Three treatment alternatives were compared: celecoxib (200 mg twice daily, non-selective NSAIDs (naproxen, 500 mg twice daily; diclofenac, 100 mg twice daily; and piroxicam, 20 mg/day and acetaminophen, 1000 mg twice daily. The aim of this study was to identify the most cost-effective first-choice pharmacological treatment for the control of joint pain secondary to OA in patients treated at the Instituto Mexicano del Seguro Social (IMSS. Methods A cost-effectiveness assessment was carried out. A systematic review of the literature was performed to obtain transition probabilities. In order to evaluate analysis robustness, one-way and probabilistic sensitivity analyses were conducted. Estimations were done for a 6-month period. Results Treatment demonstrating the best cost-effectiveness results [lowest cost-effectiveness ratio $17.5 pesos/patient ($1.75 USD] was celecoxib. According to the one-way sensitivity analysis, celecoxib would need to markedly decrease its effectiveness in order for it to not be the optimal treatment option. In the probabilistic analysis, both in the construction of the acceptability curves and in the estimation of net economic benefits, the most cost-effective option was celecoxib. Conclusion From a Mexican institutional perspective and probably in other Social Security Institutions in similar developing countries, the most cost-effective option for treatment of knee and/or hip OA

  14. How Is Pain Managed?

    Science.gov (United States)

    ... Detection- Goggins Lab Sol Goldman Center Discussion Board Pain Management Pain is a very common symptom in patients ... of pain. Pain Assessment The first step in pain management is a thorough assessment. Your healthcare provider will ...

  15. Pain Management

    Science.gov (United States)

    ... Funding Funding Opportunities (NIH Guide) Forms and Deadlines Electronic Research Admin (eRA) Grants Policy OER News About ... remains the most commonly used pain reliever. The French physician, Dr. Albert Schweitzer, proclaimed in 1931 that, “ ...

  16. Back Pain

    Science.gov (United States)

    ... addition, there doesn't appear to be one type of mattress that's best for people with back pain. It's probably a ... of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization ...

  17. Ankle Pain

    Science.gov (United States)

    ... home remedies for a while. Seek immediate medical attention if you: Have severe pain or swelling Have ... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization ...

  18. Abdominal Pain

    Science.gov (United States)

    ... or pain in your chest Seek immediate medical attention Have someone drive you to urgent care or ... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization ...

  19. Testicle Pain

    Science.gov (United States)

    ... is more common in adolescents. Seek immediate medical attention if you have: Sudden, severe testicle pain Testicle ... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization ...

  20. Gastric pain

    African Journals Online (AJOL)

    drugs and drug classes are also linked to a range of mechanisms through which the drugs ... meal, occurring several times per ... Burning or distressing pain, relieved by food ..... antimicrobial agents, and several other drug interactions are.

  1. Penis pain

    Science.gov (United States)

    Pain - penis ... Bites, either human or insect Cancer of the penis Erection that does not go away (priapism) Genital herpes Infected hair follicles Infected prosthesis of the penis Infection under the foreskin of uncircumcised men ( balanitis ) ...

  2. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: Gout (especially ...

  3. Elbow pain

    Science.gov (United States)

    ... the cause, but may involve: Antibiotics Corticosteroid shots Manipulation Pain medicine Physical therapy Surgery (last resort) Alternative ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  4. Knee pain

    Science.gov (United States)

    ... Fracture of the kneecap or other bones. Iliotibial band syndrome . Injury to the thick band that runs from your hip to the outside ... of your knee pain. When to Contact a Medical Professional Call your provider if: You cannot bear ...

  5. Abdominal Pain

    Science.gov (United States)

    ... I find more information and related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Gastro Kids , a ...

  6. Flank pain

    Science.gov (United States)

    ... how to do these exercises at home. Nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy may be prescribed for flank pain caused by spinal arthritis. Antibiotics are used to treat most kidney infections. You ...

  7. Elbow Pain

    Science.gov (United States)

    ... tear damage than are many other joints. Seek emergency care if you have: An obvious deformity in ... http://www.mayoclinic.org/symptoms/elbow-pain/basics/definition/SYM-20050874 . Mayo Clinic Footer Legal Conditions and ...

  8. Arm Pain

    Science.gov (United States)

    ... be a sign of a heart attack. Seek emergency treatment if you have: Arm, shoulder or back ... http://www.mayoclinic.org/symptoms/arm-pain/basics/definition/SYM-20050870 . Mayo Clinic Footer Legal Conditions and ...

  9. Pain Relievers: MedlinePlus Health Topic

    Science.gov (United States)

    ... Health) ClinicalTrials.gov: Narcotics (National Institutes of Health) Journal Articles References and abstracts from MEDLINE/PubMed (National ... Concentration Before Giving Acetaminophen to Infants (Food and Drug Administration) ... Related Health Topics Chronic Pain Medicines Opioid Abuse and Addiction Over-the-Counter Medicines Pain Other ...

  10. Cuidados paliativos: a avaliação da dor na percepção de enfermeiras Cuidados paliativos: la percepción de enfermeras cerca de la evaluación del dolor Palliative care: the nurses contributions in pain assessment

    Directory of Open Access Journals (Sweden)

    Roberta Waterkemper

    2010-03-01

    Full Text Available Objetivou-se revelar as concepções e contribuições de enfermeiras sobre a avaliação da dor em pacientes com câncer em cuidados paliativos, através de uma proposta de educação no trabalho fundamentada nos pressupostos da educação problematizadora de Paulo Freire. Utilizou-se como estratégia para a coleta de dados o "arco da problematização" de Juan Charles Maguerez. Participaram deste estudo seis enfermeiras. Os resultados apontaram para três categorias: o significado da dor, a forma de avaliação da dor praticada pelas enfermeiras e as contribuições para o cuidado. A dor no câncer é uma dor total. Ultrapassa o limite da dimensão física de doença e estende-se para as dimensões psicológicas e sociais. A implantação de condutas sistematizadas de cuidado a dor englobadas na sistematização da assistência de enfermagem possibilita redirecionar melhor as ações e desta forma, um manejo da dor mais completo e eficaz.Se objetivó revelar las ideas y contribuciones de las enfermeras en la evaluación del dolor en pacientes con cáncer en los cuidados paliativos a través de una propuesta de educación en el trabajo basado en los preceptos de la educación problematizadora de Paulo Freire. Se utilizó como estrategia para la recolección de datos el "arco de la problematización" de Juan Carlos Maguerez. El estudio incluyó a seis enfermeras. Los resultados apuntaron a tres categorías: el significado del dolor, ¿cómo la evaluación del dolor practicado por personal de enfermería y las contribuciones a la atención. El dolor del cáncer es un dolor total. Supera la dimensión física de la enfermedad y se extiende hasta psicológicos y sociales. El despliegue de la conducta del dolor de atención sistemática, dentro de la sistematización de los cuidados de enfermería posible, para reorientar las acciones y mejor de esta manera, un tratamiento del dolor más completa y eficaz.The purpose of this study is to reveal

  11. The development of pain medicine in Italy and the rest of Europe 40 years after the first International Association for the Study of Pain Congress.

    Science.gov (United States)

    Varrassi, Giustino; Paladini, Antonella

    2017-01-01

    Professor Giustino Varrassi and Antonella Paladini speak to Jade Parker, Commissioning Editor: Professor Giustino Varrassi is Full Professor of Anesthesiology and Pain Medicine in the LUdeS University, Valletta, Malta. He graduated at the Medical School of the University 'La Sapienza' (Rome, Italy) in 1973, and became board certified in Anesthesiology and Intensive Care in 1976 and in Pneumology in 1978, both in the same Medical School. He is currently President of the European League Against Pain and of the Paolo Procacci Foundation, and is a founding member of both of these. He is also a member of the World Institute of Pain, and a member of the Board of the Associazione Italiana per lo Studio del Dolore. He has been an invited speaker at more than 500 congresses (national and international), mainly in obstetric anesthesia and pain medicine. He is also the author of approximately 500 papers, published in international and national scientific journals, and 46 book chapters, mainly on obstetric anesthesia and pain medicine. He is the editor of 31 books and congress proceedings, including a textbook on obstetric anesthesia. He has also been the organizer of around 40 congresses, including European and World congresses on Pain Medicine. Professor Antonella Paladini is an Assistant Professor of Anesthesiology and Pain Medicine at the L'Aquila University, Italy. She has recently been nominated as Associate Professor of Anesthesiology in the LUdeS University, in Valletta, Malta. She graduated in medicine at L'Aquila University in 1989, and has got her Board Certification with laude in Anesthesia in 1992 and served as anesthetist in few teaching hospitals, mainly in cardiac surgery departments. Since 2000, she is in charge of the L'Aquila University, and has addressed her interests toward pain medicine. In 2004, she got the Board Certificate in Pain Medicine, with laude, in the University of Verona. She has a huge scientific production, with over 60 papers published in

  12. LOW-BACK PAIN DISORDERS AS OCCUPATIONAL DISEASES IN THE CZECH REPUBLIC AND 22 EUROPEAN COUNTRIES: COMPARISON OF NATIONAL SYSTEMS, RELATED DIAGNOSES AND EVALUATION CRITERIA

    NARCIS (Netherlands)

    Laštovková, Andrea; Nakládalová, Marie; Fenclová, Zdenka; Urban, Pavel; Gad'ourek, Petr; Lebeda, Tomáš; Ehler, Edvard; Ridzoň, Petr; Hlávková, Jana; Boriková, Alena; Kuijer, P. Paul F. M.; Bátora, Igor; Scholz-Odermatt, Stefan M.; Moldovan, Horatiu; Godderis, Lode; Leijon, Ola; Campo, Giuseppe; Vaněčková, Manuela; Bonneterre, Vincent; Stikova, Elisaveta Jasna; Pelclová, Daniela

    2015-01-01

    Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a

  13. Neonatal pain

    Science.gov (United States)

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  14. Pain locations in the postoperative period after cardiac surgery: Chronology of pain and response to treatment.

    Science.gov (United States)

    Roca, J; Valero, R; Gomar, C

    Postoperative pain after cardiac surgery (CS) can be generated at several foci besides the sternotomy. Prospective descriptive longitudinal study on the chronological evolution of pain in 11 sites after CS including consecutive patients submitted to elective CS through sternotomy. The primary endpoints were to establish the main origins of pain, and to describe its chronological evolution during the first postoperative week. Secondary endpoints were to describe pain characteristics in the sternotomy area and to correlate pain intensity with other variables. Numerical Pain Rating Scale from 0 to 10 at rest and at movement on postoperative days 1, 2, 4 and 6. Numerical Pain Rating Scale>3 was considered moderate pain. Statistical analysis consisted in Mann-Whitney U-test, a Chi-squared, a Fisher exact text and Pearson's correlations. Forty-seven patients were enrolled. In 4 of 11 locations pain was reported as Numerical Pain Rating Scale>3 (sternotomy, oropharynx, saphenectomy and musculoskeletal pain in the back and shoulders). Maximum intensity of pain on postoperative days 1 and 2 was reported in the sternotomy area, while on postoperative days 4 and 6 it was reported at the saphenectomy. Pain at rest and at movement differed considerably in the sternotomy, saphenectomy and oropharynx. Pain at back and shoulders and at central venous catheter entry were not influenced by movement. Pain in the sternotomy was mainly described as oppressive. Patients with arthrosis and younger patients presented higher intensity of pain (P=.004; P=.049, respectively). Four locations were identified as the main sources of pain after CS: sternotomy, oropharynx, saphenectomy, and back and shoulders. Pain in different focuses presented differences in chronologic evolution and was differently influenced by movement. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. La función de la Oficina Nacional para el Control del Tabaco en México The role of the National Office for Tobacco Control in Mexico

    Directory of Open Access Journals (Sweden)

    Justino Regalado-Pineda

    2008-01-01

    Full Text Available El tabaquismo, como la primera causa de muerte prevenible en el mundo, impone la implementación de políticas públicas acordes a la dimensión el problema. El Convenio Marco para el Control del Tabaco (CMCT de la Organización Mundial de la Salud establece una guía para este propósito. El solo hecho de haber firmado y ratificado el convenio no garantiza la consecución de los objetivos centrales, su éxito depende del compromiso y de las acciones implementadas por cada uno de los países que lo han adoptado. Es necesaria la construcción de las capacidades necesarias para el desarrollo de políticas sustentables de control del tabaco. La "capacidad nacional" consiste en el desarrollo de recursos humanos expertos y la creación de una estructura de ingeniería organizacional que le dé sustento a los programas sobre los que operará la implementación del tratado. La creación de la Oficina Nacional para el Control del Tabaco (ONCT permitirá fortalecer las acciones del Gobierno Federal encaminadas a la aplicación de políticas públicas de acuerdo con los lineamientos del CMCT de manera sustentable y permanente. En este ensayo se plantea la importancia de la ONCT para la implementación de políticas públicas para el control del tabaco, las funciones que desempeñará y los objetivos a mediano y largo plazo.Tobacco smoking as the first cause of preventable dead in the world requires the implementation of proper public policies. The WHO Framework Convention on Tobacco Control (FCTC sets the basis for this purpose at the national level. But the successful implementation of FCTC depends on a series of actions of every single member of the convention for the development of National Capacity. Building capacity implies the construction of human resources and organizational engineering or "institutional building" in order to enforce and guarantee the Plan of Action for the implementation of FCTC. The creation of the National Office for Tobacco

  16. A dor durante a punção do canal vertebral e sua relação com a inervação do ligamento amarelo, da dura-máter e do ligamento longitudinal posterior El dolor durante la punción del canal vertebral y su relación con la inervación del ligamento amarillo, de la dura-máter y del ligamento longitudinal posterior Pain during spinal canal puncture and its relationship with ligamentum flavum, dura-mater and posterior longitudinal ligament innervation

    Directory of Open Access Journals (Sweden)

    Edmundo Zarzur

    2004-12-01

    écnica. La solución anestésica no deberá ser inyectada para evitar una posible lesión de la raíz nerviosa o de la médula espinal. Se debe retroceder la aguja y alterar su dirección antes de nuevo avance. El relato de dolor es totalmente imposible si el paciente está adormecido bajo influencia de la anestesia general y, por este motivo, es recomendable que bloqueos sean realizados con el paciente consciente. El dolor solamente es referido cuando la punta de la aguja o la punta del catéter se desvían del plano medio sagital para alcanzar el compartimiento peridural antero-lateral, pudiendo, de esta forma tocar las radículas nerviosas situadas próximas a los forames intervertebrales. Excluyéndose los estudios sobre la inervación de la piel, del tejido celular subcutáneo y del ligamento interespinoso, el objetivo de este trabajo es el de rever la inervación de algunas estructuras del canal vertebral: del ligamento amarillo, del ligamento longitudinal posterior, de la dura-máter y del disco intervertebral. CONTENIDO: Estudios sobre la inervación del canal vertebral serán presentados en esta revisión de la literatura, con la intención de querer entender la razón del origen del dolor durante la punción del canal raquidiano. CONCLUSIONES: El ligamento amarillo es desprovisto de inervación, explicando la ausencia de dolor durante su punción. Otros dolores, durante la punción, pueden ser atribuidos al nervio de Luschka que inerva el ligamento longitudinal posterior y la porción ventral de la dura-máter.BACKGROUND AND OBJECTIVES: Pain during spinal puncture is a warning that needle tip has touched a nervous structure. If patients refer pain during puncture, it is mandatory to interrupt the technique. Anesthetic solution should not be injected to prevent potential nervous root or spinal cord injury. Needle should be drawn back and have its direction changed before a new advance is attempted. Pain complain is totally impossible if patients are asleep under the

  17. Peces del Noroeste del Ecuador

    OpenAIRE

    Barriga, Ramiro

    1994-01-01

    La ictiofauna del occidente del Ecuador es poco conocida. Los peces del noroccidente son diferentes a los del suroccidente del Ecuador. 34 familias y 82 especies fueron colectadas que equivale al 11 % de las especies de peces continentales registradas en el Ecuador. Icteogeográficamente se sabe que la costa ecuatoriana posee dos provincias: la del Pacifico Norte y la del Guayas, se determinó que el límite de las dos provincias es el río Santiago ya que las especies del mencionado río so...

  18. Low back pain - acute

    Science.gov (United States)

    Backache; Low back pain; Lumbar pain; Pain - back; Acute back pain; Back pain - new; Back pain - short-term; Back strain - new ... lower back supports most of your body's weight. Low back pain is the number two reason that Americans see ...

  19. Variabilidad en la utilización de los servicios de urgencias hospitalarios del Sistema Nacional de Salud Variability in Spanish National Health System hospital emergency services utilization

    Directory of Open Access Journals (Sweden)

    Salvador Peiró

    2010-01-01

    Full Text Available Objetivo: Los objetivos de este estudio fueron estimar las tasas de frecuentación a los servicios de urgencias hospitalarios (SUH del Sistema Nacional de Salud (SNS por áreas de salud, el porcentaje de ingresos, las razones estandarizadas de utilización de urgencias y analizar la relación con los recursos hospitalarios. Métodos: Estudio ecológico combinando información de diversas fuentes (Encuesta de Establecimientos Sanitarios con Régimen de Internado 2006 y Conjunto Mínimo de Datos Básicos 2006 para estimar la frecuentación a los SUH y el porcentaje de ingresos asociado en 164 áreas de salud de 14 comunidades autónomas (CC.AA.. Resultados: Los 35,3 millones de habitantes de las 164 áreas de salud incluidas realizaron 16,2 millones de visitas (45,7 por 100 habitantes a los SUH del SNS, y de ellos ingresaron algo más de 2 millones (12,6%. Excluyendo el 5% de áreas extremas por cada cola, la frecuentación osciló entre 31,6 y 78,7 urgencias/100 habitantes y el porcentaje de ingresos entre el 7,6% y el 27,9%. Estas diferencias apenas se atenuaron al estandarizar. El factor CC.AA. explicó un 29% de la varianza en frecuentación y un 82% en ingresos. La frecuentación no se asoció al volumen poblacional de camas o médicos de plantilla, aunque sí al de médicos de urgencias, hospitales de menor tamaño y no docentes. Conclusiones: Las áreas de salud del SNS mantienen una gran variabilidad en frecuentación a urgencias e ingresos por urgencias, que parece asociarse a un uso diferencial por problemas de menor entidad.Objective: The aims of this study were to estimate the rate of hospital emergency services (HES visits per health area, the associated percentage of admissions and the standardized HES utilization ratio, and to analyze their relationship with hospital resources. Methods: We performed an ecological study that combined information from distinct sources (Survey of Health Care Hospitalization Establishments 2006 and

  20. Painful menstrual periods

    Science.gov (United States)

    Menstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual cramps ... into two groups, depending on the cause: Primary dysmenorrhea Secondary dysmenorrhea Primary dysmenorrhea is menstrual pain that ...

  1. Alternative medicine - pain relief

    Science.gov (United States)

    Acupuncture - pain relief; Hypnosis - pain relief; Guided imagery - pain relief ... neck, shoulder, knee, or elbow) Osteoarthritis Rheumatoid arthritis Hypnosis is a focused state of concentration. With self- ...

  2. Chest pain

    International Nuclear Information System (INIS)

    Martinez A, Juan Carlos; Saenz M, Oscar; Martinez M, Camilo; Gonzales A Francisco; Nicolas R, Jose; Vergara V, Erika P; Pereira G, Alberto M

    2010-01-01

    In emergency departments, chest pain is one of the leading motives of consultation. We thus consider it important to review aspects such as its classification, causes, and clinical profiles. Initial assessment should include a full clinical history comprising thorough anamnesis and physical examination. Adequate interpretation of auxiliary tests, ordered in accordance with suspected clinical conditions, should lead to accurate diagnosis. We highlight certain symptoms and clinical signs, ECG and X-ray findings, cardiac bio markers, arterial blood gases, and CT-scanning. Scores of severity and prognosis such as TIMI are assessed. Optimal treatment of the clinical conditions leading to chest pain depends on adequate initial approach and assessment.

  3. Chronic Pain and PTSD: A Guide for Patients

    Science.gov (United States)

    ... Chronic Pain and PTSD: A Guide for Patients PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... here Enter ZIP code here Chronic Pain and PTSD: A Guide for Patients Public This section is ...

  4. Pain Control After Surgery: Pain Medicines

    Science.gov (United States)

    ... Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids and Teens ... Bracing: What Works? Home Prevention and Wellness Pain Control After Surgery: Pain Medicines Pain Control After Surgery: ...

  5. Breast pain

    Science.gov (United States)

    ... that reducing the amount of fat, caffeine, or chocolate in your diet helps reduce breast pain. Vitamin ... harmful, but most studies have not shown any benefit. Talk to your provider before starting any medicine or ... Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by ...

  6. Foot pain

    Science.gov (United States)

    ... that you were born with or develops later Injury Shoes that fit poorly or do not have much cushioning Too much walking or other sports activity Trauma The following can cause foot pain: Arthritis and gout . Common in the big toe, which becomes red, swollen, ...

  7. Pain (PDQ)

    Science.gov (United States)

    ... intravenous chemotherapy. Mucositis (sores or inflammation in the mouth or other parts of the digestive system ) caused by chemotherapy or targeted therapy. Skin pain, rash, or hand-foot syndrome (redness, tingling, or burning in the palms of the hands and/or ...

  8. Achilles Pain.

    Science.gov (United States)

    Connors, G. Patrick

    Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

  9. [Social pain].

    Science.gov (United States)

    Shimoyama, Naohito; Shimoyama, Megumi

    2011-09-01

    This chapter focuses on what social pain is and how it should be managed. In order to understand social pain in a cancer patient, it is necessary to recognize the change in the patient's daily life after the diagnosis of cancer. Because the degree of suffering and the relationships with family members and the people he or she worked with differ from patient to patient, it is important to note that the context of social pain is different in each patient. Five points shown below are essential in managing social pain. 1. Economical suffering may be alleviated by utilization of the social security system while taking into account each patient's standard of living. 2. Burdens on family members should be lessened, such as by not having them stay at the patient's bedside every day and letting them go home occasionally. 3. The normal patterns of communication, support, and conflict in the family should be identified, and the extent to which they have been disrupted by the illness should be assessed. 4. It is important to understand the ethnic, cultural, and religious background of the patient and the potential impact of their influence on the individual and the illness. 5. Practical or emotional unfinished business that the patient has needs to be identified, and efforts should be made to support fulfillment.

  10. Leg pain

    Science.gov (United States)

    ... in the blood Medicines (such as diuretics and statins) Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time An injury can also cause leg pain from: A torn or overstretched muscle ( strain ) Hairline ...

  11. Habituating pain

    DEFF Research Database (Denmark)

    Ajslev, Jeppe Zielinski Nguyen; Lund, Henrik Lambrecht; Møller, Jeppe Lykke

    2013-01-01

    and pain as unavoidable conditions in construction work. Based on 32 semi-structured interviews performed in eight case studies within four different construction professions, workers’ descriptions of physical strain and its relation to the organizational and social context are analyzed through concepts...

  12. Orofacial pain

    Directory of Open Access Journals (Sweden)

    Marjolijn Oomens

    2016-06-01

    Full Text Available In the primary care sector, diagnosis and initial management of orofacial pain are often performed by familydoctors and dentists. Knowledge of the different types of orofacial pain and headache disorders is therefor of great importance. The International Classification of Headache Disorders (ICHD-3 provides an overview of the different types of orofacial pain and will be discussed in this lecture. The main focus will be on trigeminal neuralgia and cluster headache and the current research in this field. Trigeminal Neuralgia (TN is defined as a disorder characterized by recurrent, unilateral, brief, electricshock-like pains, abrupt in onset and termination, limited to the distribution of one or more divisions of thetrigeminal nerve and triggered by innocuous stimuli. Unfortunately, most TN is idiopathic, and the aetiology isnot clear. The guidelines on pharmaceutical TN management published by the American Academy of Neurology (AAN and the European Federation of Neurological Societies (EFNS recommend carbamazepine (CBZ; 200–1200 mg/day or oxcarbazepine (OXC; 600–1800 mg/day as first-line therapy. Both are antiepileptics with well known interactions with other drugs and safety problems. An overview of the currently available literature on the pharmaceutical management of TN patients is discussed. Cluster headache (CH is one of the most painful primary headache disorders. It is characterized by daily or almost daily attacks of unilateral excruciating periorbital pain associated with ipsilateral cranial autonomic symptoms, typically lasting between 15 and 180 minutes if untreated. Cluster headache is caused by the relaesement of neurotransmitters and vasodilators from the sphenopalatine ganglion (SPH. The SPG is a large extracranial parasympathetic ganglion located in the pterygopalatine fossa (PPF. The current treatments for CH attacks are injectable sumatriptan and oxygen inhalation. Both treatments have well known side effects and

  13. Manejo da dor pós-operatória na Enfermagem Pediátrica: em busca de subsídios para aprimorar o cuidado El manejo del dolor postoperatorio en la Enfermería Pediátrica: en búsqueda de apoyo para mejorar el cuidado Managing postoperative pain in Pediatric Nursing: searching for subsides to improve nursing care

    Directory of Open Access Journals (Sweden)

    Fernanda Cristina Queiroz

    2007-02-01

    Full Text Available O objetivo deste artigo é realizar uma revisão da literatura sobre o manejo da dor pelos profissionais de enfermagem no pós-operatório infantil, no período de 1993 a 2005. A revisão possibilitou identificar três temáticas: fatores que influenciam o manejo da dor da criança pelos enfermeiros, intervenções para o alívio da dor da criança e avaliação e resposta dos enfermeiros à experiência de dor da criança. O manejo da dor infantil é um ato complexo que engloba elementos das dimensões referentes à própria criança, aos profissionais de saúde e aos seus familiares. A carência de estudos nesta área revela a necessidade de se realizarem pesquisas, para que se possa (repensar o cuidado de enfermagem pediátrica.La finalidad de este artículo es realizar una revisión de la literatura sobre el manejo del dolor por los profesionales de enfermería en el postoperatorio infantil, en el período de 1993 a 2005. La revisión posibilitó identificar tres temáticas: factores que influencian el manejo del dolor del niño por los enfermeros, intervenciones para el alivio del dolor del niño y evaluación y respuesta de los enfermeros a la experiencia de dolor del niño. El manejo del dolor infantil es un acto complejo que abarca elementos de las dimensiones referentes al propio niño, a los profesionales de salud y a sus familiares.La falta de estudios en esta área revela la necesidad de llevar a cabo investigaciones, para que se pueda (repensar el cuidado de enfermería pediátrica.This study reports on a literature review about child postoperative pain management by nursing professionals, in the period from 1993 to 2005. Three themes were identified: factors influencing nurses' management of child pain, interventions to relieve child pain, and nurses' assessment and response to children's pain experience. Child pain management is a complex act that involves elements of the dimensions related to the children themselves, health

  14. When Sex Is Painful

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS GYNECOLOGIC PROBLEMS FAQ020 When Sex Is Painful • How common is painful sex? • What causes pain during sex? • Where is pain during sex felt? • When should ...

  15. Pain Information Brochure

    Science.gov (United States)

    ... Library Health Care Systems Research Collaboratory Pain Registries IOM Report: Relieving Pain in America HHS Pathways to ... Library Health Care Systems Research Collaboratory Pain Registries IOM Report: Relieving Pain in America HHS Pathways to ...

  16. NIH Pain Consortium

    Science.gov (United States)

    ... Library Health Care Systems Research Collaboratory Pain Registries IOM Report: Relieving Pain in America HHS Pathways to ... Library Health Care Systems Research Collaboratory Pain Registries IOM Report: Relieving Pain in America HHS Pathways to ...

  17. Back pain and sports

    Science.gov (United States)

    ... Running - back pain; Weightlifting - back pain; Lumbar pain - sports; Sciatica - sports; Low back pain - sports ... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: ...

  18. Back Pain During Pregnancy

    Science.gov (United States)

    ... Advocacy For Patients About ACOG Back Pain During Pregnancy Home For Patients Search FAQs Back Pain During ... FAQ115, January 2016 PDF Format Back Pain During Pregnancy Pregnancy What causes back pain during pregnancy? How ...

  19. Verificación del cumplimiento de los criterios CPS de la NERC en el SNI del Ecuador; Verification of the execution of the CPS approachies of NEPC in the national interconnected System of Ecuador

    Directory of Open Access Journals (Sweden)

    Marcelo Arias Castañeda

    2011-02-01

    Full Text Available En este artículo se describe el procedimiento utilizado para la evaluación del controlautomático de la generación en el Sistema Nacional Interconectado (SNI del Ecuador,tomando como marco de referencia los criterios CPS-1 y CPS-2 (Control PerformanceStandars por sus siglas en inglés. de la NERC. El artículo está dividido en secciones queexplican en detalle en qué consisten los criterios CPS de la NERC, cómo se calculan loslímites de estos criterios teniendo en consideración las condiciones específicas del sistemaeléctrico ecuatoriano (sección 2, y cómo se aplican los criterios en la evaluación del controlautomático de la generación en el SNI del Ecuador teniendo en cuenta la interconexión conColombia (sección 3. Además se sugiere el valor mínimo de BIAS a fijar en el sistemaecuatoriano para el cumplimiento del criterio CPS-2. This paper presents an analytic framework for the formulation and evaluation of automaticgeneration control in the Ecuadorian Electrical System (SNI taking like reference mark theapproaches CPS-1 and CPS-2 of NERC. The article is divided in sections that they explain indetail the approaches CPS of NERC, how the limits of these approaches are calculated havingin consideration the specific conditions of the electric Ecuadorian system (section 2, and howthe approaches are applied in the evaluation of the automatic control of the generation in SNIof Ecuador keeping in mind the interconnection with Colombia (section 3. The minimum valueof BIAS is also suggested to fix in the Ecuadorian system for the execution of the approachCPS-2.

  20. Políticas nacionales de salud y decisiones locales en México: el caso del Hospital Mixto de Cuetzalan, Puebla National health policies and local decisions in Mexico: the case of an intercultural hospital in Cuetzalan, Puebla

    Directory of Open Access Journals (Sweden)

    María Beatriz Duarte-Gómez

    2004-10-01

    el país y la disponibilidad de recursos internacionales del Plan Puebla Panamá. CONCLUSIONES: El análisis ratifica el carácter histórico del desarrollo de las organizaciones de salud, y las oportunidades que las coyunturas y políticas nacionales e internacionales constituyen para impulsar modelos alternativos e interculturales de atención para la salud de los pueblos indígenas que respondan a sus necesidades. A pesar de que la medicina indígena y la biomédica han sido consideradas por algunos como irreconciliables, existen ejemplos -nacionales e internacionales- de experiencias en materia de articulación entre ellas, que permiten vislumbrar la posibilidad de crear nuevos pactos que avancen en la creación de servicios de salud verdaderamente interculturales, que sirvan de ejemplo para el resto del país y del continente.OBJECTIVE: To identify the changes brought about by various national and international factors in an intercultural hospital of the municipality of Cuetzalán, Puebla. MATERIAL AND METHODS: A case study was conducted during 2000 and 2001 in two Intercultural Hospitals of Mexico; the Cuetzalán Hospital in Puebla and the Jesús María Hospital in Nayarit State. Data were collected by means of 72 semi-structured interviews with allopathic therapists, indigenous therapists, and authorities of the different health care levels. Moreover, documental research was carried out on national policies for indigenous peoples as well as on indigenist policies. These policies were related with the five organizational stages of the hospital. State authorities gave their permission and interviewees signed informed consent. RESULTS: The hospital was created in 1958 by the Ministry of Health as a biomedical institution, in agreement with the integrationist indigenist policies going on at the time. It remained so during the beginning of the administration by the National Indigenist Institute. In 1990, the new participative indigenist policy trends and the

  1. Increasing nursing treatment for pediatric procedural pain.

    Science.gov (United States)

    Bice, April A; Gunther, Mary; Wyatt, Tami

    2014-03-01

    Procedural pain management is an underused practice in children. Despite the availability of efficacious treatments, many nurses do not provide adequate analgesia for painful interventions. Complementary therapies and nonpharmacologic interventions are additionally essential to managing pain. Owing to the increasing awareness of inadequate nursing utilization of pharmacologic measures for procedural pain, this paper focuses only on analgesic treatments. The aim of this review was to examine how varying degrees of quality improvement affect nursing utilization of treatments for routine pediatric procedural pain. A comprehensive search of databases including Cinahl, Medline/Pubmed, Web of Science, Google Scholar, Psycinfo, and Cochrane Library was performed. Sixty-two peer-reviewed research articles were examined. Ten articles focusing on quality improvement in pediatric pain management published in English from 2001 to 2011 were included. Three themes emerged: 1) increasing nursing knowledge; 2) nursing empowerment; and 3) protocol implementation. Research critique was completed with the use of guidelines and recommendations from Creswell (2009) and Garrard (2011). The literature reveals that nurses still think that pediatric pain management is essential. Quality improvement increases nursing utilization of procedural pain treatments. Although increasing nursing knowledge improves pediatric pain management, it appears that nursing empowerment and protocol implementation increase nursing compliance more than just education alone. Nurses providing pain management can enhance their individual practice with quality improvement measures that may increase nursing adherence to institutional and nationally recommended pediatric procedural pain management guidelines. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  2. Impacts of global change on iberian forest ecosystems inferred from the spanish national forest inventory = Impactos del cambio global en ecosistemas forestales ibéricos a partir del inventario forestal nacional

    OpenAIRE

    Hernández Mateo, Laura

    2015-01-01

    Los efectos del cambio global sobre los bosques son una de las grandes preocupaciones de la sociedad del siglo XXI. Algunas de sus posibles consecuencias como son los efectos en la producción, la sostenibilidad, la pérdida de biodiversidad o cambios en la distribución y ensamblaje de especies forestales pueden tener grandes repercusiones sociales, ecológicas y económicas. La detección y seguimiento de estos efectos constituyen uno de los retos a los que se enfrentan en la actualidad científic...

  3. Día Nacional Latino para la Concientización del SIDA (NLAAD) (National Latino AIDS Awareness Day)

    Centers for Disease Control (CDC) Podcasts

    2014-10-14

    Este podcast destaca el Día Nacional Latino para la Concientización acerca del SIDA, para aumentar el conocimiento sobre el impacto desproporcionado del VIH en la población hispana o latina en los Estados Unidos y sus territorios dependientes. El podcast hace recordar a los hispanos o latinos que ellos tienen el poder de tomar el control de su salud y protegerse contra el VIH.  Created: 10/14/2014 by La Oficina de Equidad en Salud, Oficina del Director de la División de Prevención del VIH/SIDA, Centro Nacional para el VIH/SIDA, Hepatitis Viral, ETS y Tuberculosis.   Date Released: 10/14/2014.

  4. Una nota crítica a propósito del libro Why Nations Fail. The Origins of Power, Prosperity, and Poverty

    Directory of Open Access Journals (Sweden)

    Rubén Méndez

    2014-01-01

    Full Text Available Las instituciones conceptualizadas como reglas del juego 1(North, 1990, desarrollan los derechos de propiedad y representan un aspecto esencial para que se produzcan, asignen y utilicen los bienes económicos −entendidos como toda entidad tangible o intangible que potencialmente puede servir para satisfacer alguna necesidad humana−. Por lo tanto, nos encontramos frente a un fenómeno complejo (Hayek, 1964; 1967 que involucra la evolución del tejido social.

  5. Qualitative and quantitative aspects of pain in lateral posterior thoracotomy patients Aspectos cualitativo y cuantitativo del dolor de pacientes sometidos a la toracotomia postero-lateral Aspectos qualitativo e quantitativo da dor de pacientes submetidos à toracotomia póstero-lateral

    Directory of Open Access Journals (Sweden)

    Thaiza Teixeira Xavier

    2006-10-01

    Full Text Available Descriptive study that proposed to compare the qualitative and quantitative behavior of the pain in lateral posterior thoracotomy patients. The sample was consisted of 18 individuals with an average age of 44 years. The instruments used were physiotherapy evaluation form, numerical pain scale and McGill questionnaire for pain. The pain on the numerical pain scale was considered moderate(5 for both sexes. The descriptors of the McGill questionnaire choosen by the patients with higher frequency were: in the sensorial component, beat4, pointed1, shock2, final and pull2; in the afetive component, tired1, bored1, punishald1 and miserable1 and in the evaluative component was flat. The characteristics of pain in the sensorial group were more evidents on male group. No significant statistical difeferences were observed between quantitative answers concerning pain between the men and women. On the qualitative aspects , was observed an predominancy of the same descriptors of pain in afetive component for both sexes. Pain intensity was categorized as moderate. No significant statistical difference were observed between the pain on the post-operatory lateral posterior thoracotomy. These data demonstrate a necessity for an analysis with a larger study group.Estudio descriptivo que ha determinado comparar el comportamiento cualitativo y cuantitativo del dolor en pacientes sometidos a la Toracotomia Postero Lateral(TPL. La muestra fue constituida por 18 (dieciocho individuos, siendo 10 (diez hombres y 8 (ocho mujeres con edad media de 44 años. Como instrumento se utilizo la ficha de evaluacion fisioterapeutica, escala numerica moderada(5 para ambos los sexos. Los descriptores de los cuestionarios para dolor McGill escogidos con mayor frecuencia por los pacientes fueron: en el componente sensorial pungente4, puntada1, choque2, fina1, tirãn2; en el componente afectivo, cansacial1, mareante1, castigante1 y miserable1 y en el componente evaluativo fue pesada1

  6. Pain management in cancer survivorship

    DEFF Research Database (Denmark)

    Kurita, Geana Paula; Sjøgren, Per

    2015-01-01

    BACKGROUND: The number of patients surviving cancer disease has increased in last decades. Consequently, an emerging population with different needs due to long-term or late effects of cancer disease and/or treatment, e.g. chronic pain, is of major concern. EPIDEMIOLOGY: Chronic pain is one of th...... survivors. Pain management strategies are discussed according to the biopsychosocial model and with the rapidly growing number of cancer survivors the establishment of multidisciplinary clinics as a part of comprehensive cancer centers are proposed.......BACKGROUND: The number of patients surviving cancer disease has increased in last decades. Consequently, an emerging population with different needs due to long-term or late effects of cancer disease and/or treatment, e.g. chronic pain, is of major concern. EPIDEMIOLOGY: Chronic pain is one...... of the main problems in this population and prevalence varies between 16% and 50%. Most information derives from breast cancer patients assessed by surveys from national or local institutional databases. A Danish population-based survey estimated that 41.5% of all cancer survivors reported chronic pain. PAIN...

  7. Oxcarbazepine for neuropathic pain.

    Science.gov (United States)

    Zhou, Muke; Chen, Ning; He, Li; Yang, Mi; Zhu, Cairong; Wu, Fengbo

    2017-12-02

    Several anticonvulsant drugs are used in the management of neuropathic pain. Oxcarbazepine is an anticonvulsant drug closely related to carbamazepine. Oxcarbazepine has been reported to be efficacious in the treatment of neuropathic pain, but evidence from randomised controlled trials (RCTs) is conflicting. Oxcarbazepine is reportedly better tolerated than carbamazepine. This is the first update of a review published in 2013. To assess the benefits and harms of oxcarbazepine for different types of neuropathic pain. On 21 November 2016, we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE and Embase. We searched the Chinese Biomedical Retrieval System (January 1978 to November 2016). We searched the US National Institutes of Health (NIH) databases and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials in January 2017, and we wrote to the companies who make oxcarbazepine and to pain experts requesting additional information. All RCTs and randomised cross-over studies of oxcarbazepine for the treatment of people of any age or sex with any neuropathic pain were eligible. We planned to include trials of oxcarbazepine compared with placebo or any other intervention with a treatment duration of at least six weeks, regardless of administration route and dose. We used standard methodological procedures expected by Cochrane. Five multicentre, randomised, placebo-controlled, double-blind trials with a total of 862 participants were eligible for inclusion in this updated review. Three trials involved participants with painful diabetic peripheral neuropathy (DPN) (n = 634), one included people with neuropathic pain due to radiculopathy (n = 145), and one, which was newly identified at this update, involved participants with peripheral neuropathic pain of mixed origin (polyneuropathy, peripheral nerve injury or postherpetic neuralgia) (n = 83). Some studies did not report all outcomes of interest. For

  8. High genotypic diversity of the reef-building coral Porites lobata (Scleractinia: Poritidae in Isla del Coco National Park, Costa Rica

    Directory of Open Access Journals (Sweden)

    Jennifer N. Boulay

    2012-11-01

    Full Text Available The isolated Isla del Coco experiences periodic, extreme disturbances which devastate coral reefs surrounding the island. Scleractinian corals build the physical structure of the reef therefore ecosystem recovery relies on coral species recovery. Coral recruits can be of sexual or asexual origin, and the relative success of the two recruit types influences the speed and spread of recovery processes. Here we focus on the massive coral, Porites lobata, because it is the main reef-builder around Isla del Coco to describe the relative contribution of asexual and sexual recruits to population maintenance. P. lobata samples were collected using a spatially explicit random sampling design in three plots at Isla del Coco: Punta Ulloa (n=17, Bahía Weston (n=20 and Punta María (n=20 and samples were genotyped with 11 microsatellite markers. Additional sampling was conducted at three “coastal” sites near the Costa Rican mainland (Isla del Caño Biological Reserve: Caño1 (n=8, Caño2 (n=10, Caño5 (n=11 to compare the contributions of asexual and sexual recruits at Isla del Coco sites to coastal sites. Isla del Coco sites were characterized by small colony size (>60% of colonies Los ambientes marinos del Parque Nacional Isla del Coco experimentan perturbaciones extremas periódicamente como por ejemplo El Niño-Oscilación del Sur (ENOS que han devastado las comunidades coralinas. La cobertura coralino se redujo drásticamente durante El Niño de 1982-83. Los corales escleractinios construyen la estructura física de los arrecifes así que la recuperación de estos ecosistemas depende de que los corales se recuperen. Los corales pueden reproducirse sexual y asexualmente, y el éxito relativo de cada forma de reproducción va a guiar el proceso de recuperación con implicaciones potenciales a la diversidad de las comunidades asociadas. En la mayoría de los arrecifes alrededor de la Isla del Coco, el coral masivo, Porites lobata, es la especie

  9. "Jejenes" (Diptera: Simuliidae of Nahuel Huapi National Park, Patagonia, Argentina: Preliminary results "Jejenes" (Diptera: Simuliidae del Parque Nacional Nahuel Huapi, Patagonia, Argentina: Resultados preliminares

    Directory of Open Access Journals (Sweden)

    Luis M. Hernández

    2009-06-01

    Full Text Available The Simuliidae is a family of Diptera with approximately 2072 described species worldwide. The females of the majority of the species feed from vertebrates' blood, which makes them a significant plague that affects both men as well as cattle, birds, and other vertebrates. The objective of this paper is to create an inventory of Simuliidae and to reveal certain aspects of the biology and distribution of this family of aquatic insects in the Nahuel Huapi National Park. Moreover, information on the zoogeography of Simuliidae in Patagonia is provided. Five genera, 3 subgenera and 32 species Simuliidae are recorded from Patagonia: Cnesia (three spp., Cnesiamima (one sp., Gigantodax (14 spp., Paraustrosimulium (one sp., Simulium (Ectemnaspis (one sp., S. (Psaroniocompsa (one sp. and S. ( Pternaspatha (11 spp., At present, we have collected all five genera, one subgenus of Simulium (Pternaspatha, and 19 species of Simuliidae in the park, which amounts to 57% of the Simuliidae fauna in this area. Puerto Blest, a characteristic area of the High-Andean phytogeographical province (humid forest, showed the highest diversity of Simuliidae.Los simúlidos pertenecen a una familia de Diptera (Simuliidae con alrededor de 2.072 especies descritas a nivel mundial. Las hembras de la mayoría de las especies se alimentan con sangre de vertebrados, lo cual las convierte en importantes plagas que afectan tanto al hombre como al ganado, aves y otros vertebrados. Los objetivos de este trabajo son llevar a cabo un inventario de Simuliidae y dar a conocer algunos aspectos de la biología y la distribución de esta familia de insectos acuáticos en el Parque Nacional Nahuel Huapi, Argentina. Además, se proporciona información sobre la biogeografía de Simuliidae en la Patagonia. Cinco géneros, un subgénero y 32 especies de simúlidos han sido registrados para Patagonia: Cnesia (3 spp., Cnesiamima (1 sp., Gigantodax (14 spp., Paraustrosimulium (1 sp., Simulium

  10. Source and fractionation controls on subduction-related plutons and dike swarms in southern Patagonia (Torres del Paine area) and the low Nb/Ta of upper crustal igneous rocks

    Science.gov (United States)

    Müntener, Othmar; Ewing, Tanya; Baumgartner, Lukas P.; Manzini, Mélina; Roux, Thibaud; Pellaud, Pierre; Allemann, Luc

    2018-05-01

    The subduction system in southern Patagonia provides direct evidence for the variability of the position of an active continental arc with respect to the subducting plate through time, but the consequences on the arc magmatic record are less well studied. Here we present a geochemical and geochronological study on small plutons and dykes from the upper crust of the southern Patagonian Andes at 51°S, which formed as a result of the subduction of the Nazca and Antarctic plates beneath the South American continent. In situ U-Pb geochronology on zircons and bulk rock geochemical data of plutonic and dyke rocks are used to constrain the magmatic evolution of the retro-arc over the last 30 Ma. We demonstrate that these combined U-Pb and geochemical data for magmatic rocks track the temporal and spatial migration of the active arc, and associated retro-arc magmatism. Our dataset indicates that the rear-arc area is characterized by small volumes of alkaline basaltic magmas at 29-30 Ma that are characterized by low La/Nb and Th/Nb ratios with negligible arc signatures. Subsequent progressive eastward migration of the active arc culminated with the emplacement of calc-alkaline plutons and dikes 17-16 Ma with elevated La/Nb and Th/Nb ratios and typical subduction signatures constraining the easternmost position of the southern Patagonian batholith at that time. Geochemical data on the post-16 Ma igneous rocks including the Torres del Paine laccolith indicate an evolution to transitional K-rich calc-alkaline magmatism at 12.5 ± 0.2 Ma. We show that trace element ratios such as Nb/Ta and Dy/Yb systematically decrease with increasing SiO2, for both the 17-16 Ma calc-alkaline and the 12-13 Ma K-rich transitional magmatism. In contrast, Th/Nb and La/Nb monitor the changes in the source composition of these magmas. We suggest that the transition from the common calc-alkaline to K-rich transitional magmatism involves a change in the source component, while the trace element ratios

  11. Maltrato infantil y del adolescente registrado en un hospital de referencia nacional, 2006 - 2011 Child and adolescent abuse recorded at a national referral hospital, 2006 - 2011

    Directory of Open Access Journals (Sweden)

    Lorena Escalante-Romero

    2012-03-01

    Full Text Available Objetivos. Realizar una descripción de los registros del Instituto Nacional de Salud del Niño (INSN, desde enero de 2006 hasta septiembre de 2011, sobre maltrato infantil y del adolescente, lo cual permite la caracterización del agredido y del agresor. Materiales y métodos. Se realizó un análisis de fuentes secundarias, basado en registros de la "Ficha de evaluación de violencia familiar y maltrato infantil", aplicada por el Módulo de Atención al Maltrato Infantil y del Adolescente en Salud (MAMIS del INSN. La ficha incluye datos del agredido, del agresor y las características de la agresión. Se diferenció el tipo de agresión como: sexual, física, psicológica o por abandono. Se muestran los resultados en frecuencias y porcentajes. Resultados. Se incluyeron 1798 registros. El 63,9% eran niñas y el 39,9% fueron adolescentes. El 60,6% de los agresores fueron varones y el 65,8% de las agresiones ocurrieron en casa. El 48,6% fueron registros de agresión sexual, que fue más frecuente en niñas (73,2% y adolescentes (44,4%; en el 9,6% de los casos existió coito. Conclusiones. En los registros del MAMIS del INSN, la agresión en niñas fue la más frecuente; el agresor con frecuencia era un varón y la mayoría de las agresiones ocurrieron en el domicilio del menor. La agresión sexual fue casi la mitad de la serie.Objectives. To describe the records of child and adolescent abuse of the Instituto Nacional de Salud del Niño (INSN from January 2006 to September 2011, characterizing the victim and perpetrator. Materials and methods. A secondary sources analysis was performed, based on the domestic violence and child abuse records, from froms administered by Child Abuse and Adolescent Health Unit (MAMIS at the INSN. The records include data of the victim, offender and characteristics of the aggression. Types of aggression were categorized as: sexual, physical, psychological or neglection. Frequencies and percentages are presented

  12. Reseña del libro de H. Crawley y T. Lester, Comparative Analysis of Gender Related Persecution in National Asylum Legislation and Practice in Europe

    Directory of Open Access Journals (Sweden)

    Carmen Miguel Juan

    2012-03-01

    Full Text Available Es una publicación del Alto Comisionado de Naciones Unidas para los Refugiados (ACNUR de 2004. El ACNUR, a finales de 2003, encomendó a Heaven Crawley y Trine Lester un estudio para determinar en qué medida los países europeos habían incorporado a su práctica y legislación nacional las recomendaciones llevadas a cabo por dicho organismo de Naciones Unidas en orden a garantizar una interpretación con perspectiva de género de la Convención de Ginebra sobre los Refugiados de 1951 y el Protocolo de Nueva York de 1967 y en los procesos de determinación de la condición de refugiado. Estas recomendaciones, que ya se habían empezado a efectuar a mediados de la década de los ochenta mediante Conclusiones del Comité Ejecutivo del ACNUR, se recogen y amplían en un documento publicado en el año 2002 llamado Directrices de protección internacional: la persecución por motivos de género dentro del contexto del artículo 1 A (2 de la Convención de Ginebra de 1951 y/o su Protocolo.

  13. Sharing the IT pain.

    Science.gov (United States)

    Haugh, R

    2001-08-01

    Outsourcing info tech is too appealing a temptation for many hospitals to pass up. Information technology is costly, complex, prone to breakdowns and ever-changing. Many hospitals already outsource part of their IT operation, but there appears to be a trend toward outsourcing entire departments. Recently, a number of deals worth hundreds of millions of dollars were announced by some of the nation's largest systems and outsourcing companies. While outsourcing is the best alternative for certain operations, for others it may just be a trade-off between a short-term headache and long-term pain.

  14. Actividades socioeconómicas en el Parque Nacional Isla del Coco, Costa Rica y posibles efectos de la variabilidad climática Socio-economic activities at Isla del Coco National Park, Costa Rica and possible effects of climate variability

    Directory of Open Access Journals (Sweden)

    Mary Luz Moreno-Díaz

    2012-11-01

    Full Text Available Las actividades socioeconómicas y sus ingresos en el Parque Nacional Isla del Coco han sido poco evaluados y sistematizados, al igual que los efectos que sobre ellos pueda tener la variabilidad climática. empleó una metodología que combina análisis de conglomerados con una dinámica de valor agregado en una cadena productiva, para identificar las actividades socioeconómicas más importantes y cuantificar los ingresos que obtienen por la existencia del PNIC, además se analizó los posibles efectos de la variabilidad climática sobre estas actividades. Para lo anterior, se realizó una revisión bibliográfica detallada, consulta con empresarios, investigadores y turistas. Se obtuvo que los principales conglomerados de actividades alrededor del PNIC son la recreación y la vivencia espiritual, la investigación, las actividades económicas y la gestión y manejo del Parque. Se realizó una aproximación de las contribuciones de la existencia del PNIC en estos cuatro conglomerados en el 2010, y se obtuvo que la contribución el ámbito nacional fue de US$5.7 millones de dólares, el internacional de US$2.5 millones de dólares, el global del PNIC ascendió aproximadamente a US$8.3 millones de dólares. También se obtuvo que si los recursos naturales objeto de la visita de los turistas disminuyen debido a efectos de la variabilidad climática esto ingresos podrían disminuir en 30%.Socioeconomic activities and their gross income in Isla del Coco National Park have been poorly evaluated and systematized, as well as the effects on them climate variability may have. A methodology that combines cluster analysis with a dynamic value chain was developed to identify the most important socioeconomic activities and quantify the gross income derived by the existence of Isla del Coco National Park. The possible effects of climate variability on these activities were also analyzed. A detailed literature review, consultation and interviews with

  15. Experiencia en el manejo del paciente con VIH entre médicos de la Secretaría de Salud Experience in HIV patient care among physicians of the National Health Ministry

    Directory of Open Access Journals (Sweden)

    Carlos Magis-Rodríguez

    1999-12-01

    Full Text Available OBJETIVO: Conocer la experiencia que los médicos de la Secretaría de Salud (SSA han obtenido en el manejo del sujeto infectado por el VIH y en el uso de antirretrovirales. MATERIAL Y MÉTODOS: Se realizó un estudio transversal, con el apoyo del Consejo Nacional para la Prevención y el Control del SIDA (CONASIDA, en marzo-mayo de 1998. Se proporcionaron cuestionarios autoaplicables a médicos de la SSA con experiencia en el manejo clínico del paciente con VIH, al inicio de cinco simposios sobre VIH/SIDA, realizados en diversas ciudades del país. El análisis estadístico incluyó la prueba ji². RESULTADOS: Se recolectaron 181 encuestas. La mediana de pacientes con VIH atendidos fue de cuatro (intervalo 1-97. De los médicos encuestados, 36.5% manifestó administrar antirretrovirales (35.4% prescribía los análogos de los nucleósidos, y 9.9%, los inhibidores de proteasa. Los fármacos más usados fueron AZT y ddI (40.3%. Expresó 17.7% de los médicos haber utilizado la cuenta de linfocitos T CD4+, y 8.8% la carga viral como indicadores pronósticos y de respuesta a la farmacoterapia. CONCLUSIONES: Se observó una baja proporción de médicos de la SSA con experiencia en el manejo del paciente con VIH y en el uso de los antirretrovirales. Se deben enfocar esfuerzos para mejorar la atención de los pacientes VIH positivos mediante la capacitación del personal médico.OBJETIVE: To determine the experience of the National Health Ministry Physicians in the management of HIV infecetd patients and in the use of antiretrovirals. MATERIAL AND METHOD: A descriptive, observational and transversal study was performed, with support from the National AIDS Council from March to May 1998. Self-applicable questionnaires were filled by National Health Ministry physicians with experience in HIV patient clinical care, at the beginning of 5 different meetings on HIV/AIDS in several cities of the country. Statistical analysis included the chi² test. RESULTS

  16. Manejo da dor de pacientes com aids: análise da estrutura gerencial em hospital de referência Manejo del dolor en pacientes con sida: análisis de la estructura administrativa en hospital de referencia Pain management in patients with aids: analysis of the management structure of a reference hospital

    Directory of Open Access Journals (Sweden)

    Roberta Meneses Oliveira

    2013-04-01

    ón interdisciplinaria del dolor, capacitación de profesionales y mejora de historias clínicas para utilizar métodos de evaluación y tratamientos más eficaces.The objective of this study was to analyze the structure for the management of pain in patients with AIDS in a reference hospital in Fortaleza, Brazil. This is a descriptive study with a qualitative approach, developed in 2010. Twenty interviews were performed with health care professionals (physicians and nurses, and analyzed according to the methodology of content analysis. Data were organized into categories: favorable and unfavorable structural conditions. A prevalence of unfavorable conditions was found in the discourse of the interviewees, such as an emphasis on pharmacologic treatment, absence of specific care strategies for pain, lack of experienced professionals in handling pain, and a high demand and failure in the referral and counter-referral system. It is suggested that a new management care model be instituted for patients with AIDS, emphasizing an interdisciplinary approach to pain, training of health care professionals and improvement of chart records for use in evaluating pain relief methods and more effective treatments.

  17. Efetividade de estratégias não farmacológicas no alívio da dor de parturientes no trabalho de parto La efectividad de estratégias no farmacológicas en el alivio del dolor de parturientas en el trabajo de parto Effectiveness of non-pharmacological strategies in relieving labor pain

    Directory of Open Access Journals (Sweden)

    Rejane Marie Barbosa Davim

    2009-06-01

    aumentaba la dilatación del cuello del útero. Se concluye que las estrategias fueron efectivas para aliviar la intensidad del dolor de las parturientas de este estudio durante el trabajo de parto.The study objective was to evaluate the effectiveness of non-pharmacological strategies to relieve pain in parturients in labor. This is a before and after therapeutic intervention clinical trial, performed at a public maternity in the city of Natal, in the state of Rio Grande do Norte, Brazil, with 100 parturients applying breathing exercises, muscle relaxation, lumbosacral massage, and showers. A visual analogue scale was used for data collection. Most parturients were between 20 and 30 years old (60%, had incomplete primary-level education (85%, family income of up to 2 minimum salaries (74%, and 78% had a companion with them at the hospital. Oxytocine was administered in 81% of cases, but 15% did not receive any medication. A significant difference was observed in pain relief after using non-pharmacological strategies, showing reduced pain as cervix dilation increased. It was concluded that the strategies were effective in reducing the intensity of pain in the studied parturients in labor.

  18. Pain and the ethics of pain management.

    Science.gov (United States)

    Edwards, R B

    1984-01-01

    In this article I clarify the concepts of 'pain', 'suffering', 'pains of body', 'pains of soul'. I explore the relevance of an ethic to the clinical setting which gives patients a strong prima facie right to freedom from unnecessary and unwanted pain and which places upon medical professionals two concomitant moral obligations to patients. First, there is the duty not to inflict pain and suffering beyond what is necessary for effective diagnosis, treatment and research. Next, there is the duty to do all that can be done to relieve all the pain and suffering which can be alleviated. I develop in some detail that individuality of pain sensitivity must be taken into account in fulfilling these obligations. I explore the issue of the relevance of informed consent and the right to refuse treatment to the matter of pain relief. And I raise the question of what conditions, if any, should override the right to refuse treatment where pain relief is of paramount concern.

  19. O uso de opióides no tratamento da dor crônica não oncológica: o papel da metadona El uso de opioides en el tratamiento del dolor crónico no oncológica: el papel de la metadona Opioids for treating non malignant chronic pain: the role of methadone

    Directory of Open Access Journals (Sweden)

    Sady Ribeiro

    2002-09-01

    importante en los últimos años. En este estudio, objetivamos evaluar críticamente las informaciones disponibles en la literatura a respecto del uso de opioides para tratamiento del dolor crónico no oncológico y el papel de la metadona como opción terapéutica. CONTENIDO: Los estudios disponibles aun son limitados, más demuestran que determinadas subpoblaciones de pacientes portadores de dolor crónico, pueden alcanzar analgesia importante, con poca tolerancia y bajo potencial para adición, principalmente aquellos refractarios a los esquemas terapéuticos convencionales. Morfina es el opioide patrón, también otras alternativas pueden ser utilizadas como oxicodona, hidromorfona o fentanil. Metadona es un opioide sintético, inicialmente utilizado para prevenir síndrome de abstinencia en paciente dependientes, que también constituye una opción importante en el tratamiento del dolor crónico no oncológico, principalmente dolor neuropático. CONCLUSIONES: A pesar del creciente conocimiento sobre el uso de opioides en el dolor crónico no oncológico, nuevos estudios mejor controlados aun son necesarios para una discusión más científica a respecto del asunto. La metadona administrada por vía oral presenta una buena relación costeo-beneficio, representando una alternativa efectiva para mejor control del dolor en algunos pacientes.BACKGROUND AND OBJECTIVES: The use of opioids for cancer pain has already well established by several well-controlled clinical trials. However, there is a major controversy about long-term use of opioids in non-malignant chronic pain, which has been significantly intensified in the last few years. This study aimed at evaluating available data on the use of opioids for treating non-malignant chronic pain and the role of methadone as a therapeutic alternative. CONTENTS: There are few available studies, but they show that some subpopulations of chronic pain patients may achieve sustained analgesia with minor tolerance and low addiction

  20. Paediatric pain management

    African Journals Online (AJOL)

    patients is musculoskeletal pain, headache or abdominal pain.2. The pain ... Children older than four years of age can usually talk about their pain; at the age of six to eight years they can use the ... Pain presentation in children normally falls into one of the ... expression, body posture and movement.10 This scale is often.

  1. Pain and Nociception

    DEFF Research Database (Denmark)

    Falk, Sarah; Dickenson, Anthony H

    2014-01-01

    Cancer pain, especially pain caused by metastasis to bone, is a severe type of pain, and unless the cause and consequences can be resolved, the pain will become chronic. As detection and survival among patients with cancer have improved, pain has become an increasing challenge, because traditiona...

  2. Melanocortins and Neuropathic Pain

    NARCIS (Netherlands)

    Vrinten, Dorien Henriëtte

    2003-01-01

    Neuropathic pain (pain initiated by a lesion or dysfunction of the nervous system) is characterised by symptoms such as allodynia (pain due to a stimulus that does not normally provoke pain) and hyperalgesia (an increased response to a stimulus that is normally painful). It constitutes a major

  3. Composición y abundancia de artrópodos epígeos del Parque Nacional Llanos de Challe: impactos del ENOS de 1997 y efectos del hábitat pedológico Abundance and composition of epigean arthropods from Llanos de Challe National Park: impacts of ENSO-1997 and effects of the pedological habitat

    Directory of Open Access Journals (Sweden)

    JORGE CEPEDA-PIZARRO

    2005-12-01

    Full Text Available Mediante el uso de trampas de intercepción, se estudió el efecto de la precipitación y el tipo de hábitat sobre la denso-actividad del ensamble de artrópodos epígeos _en particular Tenebrionidae_ del Parque Nacional Llanos de Challe. Este parque está ubicado en el desierto costero transicional de Chile, en la III Región de Atacama. Los muestreos se realizaron durante tres días por mes (septiembre, octubre y diciembre en el período de máxima actividad biológica del sistema y en los años 1989 (año no-ENOS seco, 1997 (año ENOS intenso y 2000 (año no-ENOS húmedo. En las comparaciones se utilizaron dos sitios pedológicamente contrastantes: un hábitat dunario costero y un hábitat pedregoso interior. Se registró la presencia de 15 órdenes de Arthropoda. Los hexápodos constituyeron > 95 % del total de los especímenes capturados (9.065 individuos, siendo Collembola (36,1 % y Coleoptera (29,8 % los órdenes con mayor representatividad numérica. El número de órdenes con representantes activos varió ligeramente entre años: 13 órdenes se registraron en 1989 (44 % de precipitación bajo el promedio, 15 en 1997 (443 % sobre el promedio y 11 en 2000 (52 % sobre el promedio. El efecto del evento ENOS se reflejó claramente en la contribución numérica en la mayoría de los taxa registrados. Aunque más sutilmente, este efecto también se reflejó en la composición del ensamble de taxa dominantes y entre hábitat pedológicos, particularmente con Tenebrionidae y Formicidae. Especialmente en las dunas costeras, Tenebrionidae dominó claramente el ensamble de artrópodos epígeos, siendo Gyriosomus Guérin-Méneville el género más diverso y abundante. La dominancia de Gyriosomus plantea un conjunto de interrogantes respecto de su nivel de endemismo, diversidad y distribución de sus especies, y el papel funcional de estas en el ecosistema estudiadoBy using pitfall traps, the effects of rainfall and habitat type on the denso

  4. Impact of the clinical management of pain: evaluation of stress and coping among health professionals Impacto del manejo clínico del dolor en los profesionales de la salud: evaluación de estrés y enfrentamiento Impacto do manejo clínico da dor: avaliação de estresse e enfrentamento entre profissionais de saúde

    Directory of Open Access Journals (Sweden)

    Maíra Ribeiro de Oliveira Negromonte

    2011-04-01

    Full Text Available The specialist literature highlights that the clinical management of pain involves psychological difficulties associated with the pursuit of the alleviation of the suffering of patients. Therefore, an investigation was conducted into the perception of stress and coping strategies of 31 professionals of different categories from a severe burns care center (acute pain and a pain control and palliative care unit (chronic pain. For this, a sociodemographic questionnaire, the Job Stress Scale (short version and the Coping Strategies Inventory were applied. Compared to other categories, the nursing technicians indicated more stress factors. In compensation, they reported a greater diversity of coping strategies with significant differences between the services. These results corroborate previous studies, which warn of the adverse conditions that interfere in nursing practice. However, they also reveal the availability of protective factors, indicating perspectives of preventive intervention for the nursing team.La literatura especializada destaca que el manejo clínico del dolor produce dificultades psicológicas asociadas a las actividades realizadas para aliviar el sufrimiento de los pacientes. Siendo así, se investigaron la percepción del estrés y las estrategias para enfrentarlo en 31 profesionales de diferentes categorías en un centro de atención a quemaduras de gran tamaño (dolor agudo y una unidad de control del dolor y cuidados paliativos (dolor crónico. Para esto, se aplicó un cuestionario sociodemográfico, la Job Stress Scale (versión resumida y el Inventario de Estrategias de Coping. Comparado con las demás categorías, los técnicos de enfermería indicaron más factores de estrés. En compensación, informaron mayor diversidad de estrategias de enfrentamiento con diferencias significativas entre los servicios. Estos resultados corroboran estudios anteriores, los cuales alertan sobre las condiciones adversas que interfieren en

  5. PAIN METAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — METAR is a routine scheduled observation and is the primary observation code used in the United States to satisfy requirements for reporting surface meteorological...

  6. I Conferencia Nacional de Consenso sobre el Injerto Óseo del Seno Maxilar 1st National Consensus Conference on maxillar sinus bone grafts

    Directory of Open Access Journals (Sweden)

    P.M. Villarreal

    2010-06-01

    Full Text Available Objetivo: El objetivo de la I Conferencia Española de Consenso sobre el Injerto Óseo Sinusal era intentar llegar a puntos de acuerdo sobre las principales controversias de esta técnica, aplicada de forma muy variada y con el empleo de materiales muy diversos, y conseguir plasmar los mismos en un documento resumen consensuado por todos los autores. Material y método: Durante los días 17 y 18 de octubre de 2008 se celebró en Oviedo la citada conferencia, auspiciada por la Sociedad Española de Cirugía Oral y Maxilofacial. En ella se dieron cita un total de 50 ponentes de reconocido prestigio nacional e internacional que repasaron en 6 mesas de trabajo las principales controversias sobre los injertos óseos sinusales. Tras las conferencias de los ponentes, los moderadores establecían las principales conclusiones de cada mesa y se abría un turno de debate donde participaban todos los asistentes. Resultado: Este documento y sus conclusiones emanan de las presentaciones realizadas por los ponentes y de las deliberaciones y acuerdos de cada mesa de trabajo. Ambos han sido aprobados tras varias correcciones por todos los autores antes de ser enviados para su publicación. Además, han obtenido el reconocimiento científico oficial de la Sociedad Española de Cirugía Oral y Maxilofacial y deben servir como base para futuros estudios y reuniones científicas. Conclusiones: El objetivo fundamental cuando se realiza un injerto óseo sinusal es la formación de hueso vital en el seno maxilar, para conseguir la supervivencia a largo plazo de los implantes tras su carga protésica. Para ello, la técnica y la secuencia de tratamiento deben orientarse a conseguir resultados predecibles y estables en el tiempo, aunque esto suponga un mayor tiempo de espera hasta la colocación de la prótesis. La estabilidad inicial del implante es el factor clave para la osteointegración y debe ser el principal criterio para indicar implantes simultáneos o diferidos

  7. Conflict in the National Territory of Chaco: Agricultural Cooperatives in front of the Statute of the Rural Labourer Conflicto en el Territorio Nacional del Chaco: Las Cooperativas agrícolas frente al Estatuto del Peón Rural

    Directory of Open Access Journals (Sweden)

    Leandro Moglia

    2011-01-01

    Full Text Available The arrival to the presidency of Juan Peron in 1946, meant for the Argentine agro continuity of some policies developed before the Revolution of 1943 and deepened by it. A decision with such production and marketing joined those aimed at improving the rural working class, so far neglected area. The application of the Statute of the Rural Pawn (1947 in a territory of frontier production and labor as the Chaco, in a local context unfavorable woke one of the most turbulent clashes between the agricultural cooperatives-organizations on behalf of its partners, and the Administration responsible for local implementation. The aim of this work to study, from the documentation produced by cooperatives and local print media, the conflict in the Chaco awoke when implementing the Statute of the PawnLa llegada a la presidencia de Juan Perón en 1946, significó para el agro argentino la continuidad de algunas políticas desarrolladas antes de la Revolución de 1943 y profundizadas por ésta. A esas decisiones de carácter productivo y de comercialización se sumaron aquellas orientadas a la mejora de la clase trabajadora rural, sector descuidado hasta el momento. La aplicación del Estatuto del Peón Rural (1947 en un territorio de frontera productiva y ocupacional como el Chaco, en un contexto local desfavorable, despertó uno de los más agitados enfrentamientos entre las entidades Cooperativas agrícolas-en representación de sus asociados- y la Administración local encargada de su aplicación. Es objetivo de este trabajo estudiar, desde la documentación que produjeron las cooperativas y los medios gráficos locales, el conflicto que se despertó en el Chaco al momento de implementarse el Estatuto del Peón.

  8. specific low back pain

    African Journals Online (AJOL)

    2015-09-01

    Sep 1, 2015 ... SPECIFIC LOW BACK PAIN: IMPLICATION FOR DIRECT HEALTH. CARE COST ... abundant evidence suggesting the benefits of therapeu- tic exercise on pain and ... Exercise and behavioural therapies in chronic pain. 174.

  9. Low back pain - chronic

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007422.htm Low back pain - chronic To use the sharing features on this page, please enable JavaScript. Low back pain refers to pain that you feel in your ...

  10. Palliative care - managing pain

    Science.gov (United States)

    ... page, please enable JavaScript. Palliative care is a holistic approach to care that focuses on treating pain ... stressful for you and your family. But with treatment, pain can be managed. How Pain is Measured ...

  11. Side Effects: Pain

    Science.gov (United States)

    Controlling pain is an important part of your cancer treatment plan. Learn how to track levels of pain. Find out how pain, a side effect of cancer treatment, is treated using acupuncture, biofeedback, and physical therapy.

  12. Soul Pain

    Directory of Open Access Journals (Sweden)

    Sarah L. Jirek

    2015-07-01

    Full Text Available This study extends prior research on vicarious traumatization and emotion management by exploring a deeper, more life-altering effect of working with traumatized clients—namely, “soul pain.” Analyses of in-depth interviews with 29 advocates working with survivors of physical and sexual violence reveal that, as a direct consequence of hearing countless stories of human brutality, some staff members experience a profound wounding of their spirit. This finding expands our understanding of the occupational hazards of the helping professions by revealing another dimension of advocates’ lives—that of the soul or spirit—that may be affected by their work with trauma survivors.

  13. Valoración y estrategias no farmacológicas en el tratamiento del dolor neonatal Assessment and non-pharmacological strategies in the treatment of neonatal pain.

    Directory of Open Access Journals (Sweden)

    Ruth Pérez Villegas

    2006-09-01

    Full Text Available El neonato desde su nacimiento recibe diversos estímulos dolorosos que provocan alteraciones multisistémicas y psicológicas, lo que contribuye al aumento de la morbilidad y mortalidad neonatal. Las intervenciones ambientales y conductuales, conocidas también como estrategias no farmacológicas, tienen amplia aplicación en el tratamiento del dolor neonatal ya sea en forma aislada o en combinación con intervenciones farmacológicas. El propósito de estas estrategias es incrementar la comodidad, estabilidad del neonato y reducir el desestrés mediante acciones como mecerlos, acariciarlos, cantarles, arrullarlos, colocarles un chupete y música, las cuales son avaladas por diversos estudios. La sensibilización del equipo de salud junto con la familia es fundamental para aliviar el dolor neonatal.

  14. Central Pain Syndrome

    Science.gov (United States)

    ... such as neurontin (gabapentin) can be useful. Lowering stress levels appears to reduce pain. View Full Treatment Information Definition Central pain syndrome is a neurological condition caused ...

  15. Care delivery for the child to grow up despite the pain: the family's experience Cuidando para que el niño crezca a pesar del dolor: la experiencia de la familia Cuidando para a criança crescer apesar da dor: a experiência da família

    Directory of Open Access Journals (Sweden)

    Lisabelle Mariano Rossato

    2007-08-01

    Full Text Available This study aimed to understand the meaning of the experience of families having a child experiencing pain due to Juvenile Rheumatoid Arthritis and to construct a theoretical model representing this experience. Grounded Theory and Symbolic Interactionism were used as methodological framework and theoretical framework, respectively. Data were collected by semistructured interviews with 12 families. Data analysis allowed for the construction of the theoretical model Caring for the child to grow despite the pain, which describes an experience based on motivational elements: wanting to see the child without pain and wanting to see the child live a normal life, reviewing how the family lives the transition in its development cycles, retaking and integrating them in the family dynamic with the appearance of the disease and pain in the child. This theoretical model provides a framework for teaching, research and care, permitting advances in terms of theoretical nursing knowledge.Este trabajo tuvo como objetivos comprender el cotidiano de la familia del niño que vivencia la situación de dolor consecuente de la Artritis Reumatoidea Juvenil y construir un modelo teórico representativo de esa experiencia. La Teoría Fundamentada en los Datos y el Interacionismo Simbólico fueron utilizados como referenciales metodológico y teórico, respectivamente. Los datos fueron obtenidos por intermedio de entrevistas semi-estructuradas a 12 familias. El análisis de los datos permitió construir el modelo teórico Cuidando para que el niño crezca a pesar del dolor, que describe una experiencia estructurada en torno a los elementos motivadores: queriendo ver el niño libre del dolor y queriendo ver el niño llevar una vida normal, revelando como la familia vivencia las transiciones en sus ciclos de desarrollo, integrándolos en la dinámica familiar con la llegada de la enfermedad y del dolor en el niño. Este modelo proporciona un referencial que ayuda a la ense

  16. Opioid-induced constipation negatively impacts pain management, productivity, and health-related quality of life: findings from the National Health and Wellness Survey.

    Science.gov (United States)

    Bell, Timothy; Annunziata, Kathy; Leslie, John B

    2009-01-01

    To characterize the impact of opioid-induced constipation (OIC) on healthcare resource use, work productivity, and health-related quality of life (HRQOL) in patients receiving chronic opioid therapy. Data were collected via Internet questionnaires during the international National Health and Wellness Survey (NHWS) 2004 from individuals aged > or = 18 years who reported taking opioids for > or = 6 months. Healthcare resource utilization, Work Productivity, and Activity Impairment, and Short-Form 8 (SF-8) questionnaire responses were compared between those who did or did not report OIC. Data were available from 2,430 individuals receiving opioids, of whom 359 reported OIC. Participants with OIC reported significantly more physician visits (mean difference 3.84 visits; p hospitalization were observed. Respondents with OIC also reported significantly greater time missed from work, impairment while working, overall work impairment, and activity impairment (p constipation in patients receiving chronic opioid therapy.

  17. Luis Alcoriza o la mexicanización del exiliado cinematográfico republicano = Luis Alcoriza or the Mexican Nationalization of the Republican Cinematography Exile

    Directory of Open Access Journals (Sweden)

    Jorge Chaumel Fernández

    2016-03-01

    Full Text Available Luis Alcoriza,  exiliado republicano español en México, desarrolló su carrera como  actor, guionista y director en su patria de adopción dándola algunas de sus mejores películas. En su condición de exiliado dispuso de mayor objetividad para mostrar los cambios de la sociedad mexicana y de sus principales problemas políticos. Figura imprescindible de la evolución del Cine Mexicano  de  la segunda mitad del siglo XX, se configura como uno de los principales ejemplos del  fenómeno de mexicanización de los cineastas exiliados.Luis Alcoriza, Spanish republican exile in Mexico, developed his career as an actor, writer and director in his adopted country giving her some of his best films. In his exile he had before as objective to show the changes in Mexican society and its major political problems. Essential figure in the evolution of Mexican cinema in the second half of the twentieth century stands as one of the prime examples of the phenomenon of mexicanización of exiled filmmakers.

  18. El frustrado proyecto de avance territorial del estado nacional entre 1869 y 1872: Frustrated territorial expansion of the national state between 1869 and 1872

    Directory of Open Access Journals (Sweden)

    Silvia Ratto

    2011-01-01

    Full Text Available El objetivo de este trabajo es analizar la coyuntura del período 1869-1872, cuando se intentó llevar a adelante la conquista militar del territorio indígena del sur prevista en la Ley 215 promulgada en 1867. El análisis propone una visión de conjunto sobre las discusiones que se llevaron a cabo en torno a su realización y la respuesta que provocó en los principales líderes étnicos. Integra dos sectores fronterizos sobre los que se proyectaba avanzar -la frontera sur de Córdoba, Mendoza y San Luis y la frontera bonaerense- y las agrupaciones nativas más cercanas a esos espacios: los ranqueles y los salineros dirigidos por el cacique Calfucurá.The aim of this paper is to analyze the context during 1869-1872 when the central government attempted to carry out the military conquest of the Southern Indian Territory established by Law 215, issued in 1867. An overview of the discussions taken place around war conduct and the resistance of ethnic leaders are presented. It integrates two main border areas on which the conquest was expected: the southern border of Córdoba, Mendoza and San Luis and Buenos Aires and the strategies of the indigenous groups closer to these spaces: the ranqueles and the salineros.

  19. Brinquedo terapêutico: estratégia de alívio da dor e tensão durante o curativo cirúrgico em crianças El juguete terapéutico: estrategia de alivio del dolor y tensión durante la curación quirúrgica en niños Therapeutic toy: strategy for pain management and tension relief during dressing change in children

    Directory of Open Access Journals (Sweden)

    Mariana Toni Kiche

    2009-01-01

    Full Text Available OBJETIVO: Comparar as reações manifestadas pela criança durante o curativo realizado antes e após o preparo emocional com o brinquedo terapêutico instrucional (BTI. MÉTODOS: A amostra constituiu-se de 34 crianças internadas para cirurgia em um hospital público pediátrico da cidade de São Paulo. Os comportamentos da criança e a avaliação da dor foram considerados durante o curativo em dois momentos: antes e após o brinquedo terapêutico. RESULTADOS: Comportamentos indicativos de maior adaptação e aceitação ao procedimento tornaram-se mais freqüentes após o brinquedo, ao contrario daqueles que indicavam menor adaptação e aceitação. Os escores de dor também diminuíram após o brinquedo terapêutico. CONCLUSÃO: O brinquedo terapêutico se evidenciou como estratégia efetiva na redução do medo, da tensão e da dor da criança durante o curativo.OBJETIVO: Comparar las reacciones manifestadas por el niño durante la curación realizada antes y después de la preparación emocional con el juguete terapéutico instruccional (BTI. MÉTODOS: La muestra estuvo constituida por 34 niños internados para cirugía en un hospital público pediátrico de la ciudad de Sao Paulo. Los comportamientos del niño y la evaluación del dolor fueron considerados durante la curación en dos momentos: antes y después del uso del juguete terapéutico. RESULTADOS: Los comportamientos que indicaron mayor adaptación y aceptación del procedimiento se volvieron más frecuentes después del uso del juguete, al contrario de aquellos que indicaban menor adaptación y aceptación. Los escores de dolor también disminuyeron después del uso del juguete terapéutico. CONCLUSIÓN: El juguete terapéutico se evidenció como estrategia efectiva en la reducción del miedo, la tensión y del dolor del niño durante la curación.OBJECTIVE: To compare children's reactions during dressing change before and after emotional support by using an instructional

  20. Papel da lidocaína por via venosa no tratamento da dor na esclerodermia: relato de caso Papel de la lidocaína por vía venosa en el tratamiento del dolor en la esclerodermia: relato de un caso Intravenous lidocaine to treat scleroderma pain: case report

    Directory of Open Access Journals (Sweden)

    Durval Campos Kraychete

    2003-12-01

    , continua, diaria, acompañada de alteraciones tróficas, de color y de temperatura y pequeñas úlceras en las extremidades. La paciente fue sometida a una sesión semanal de lidocaína a 2% (400 mg sin vasoconstrictor por vía venosa durante 10 semanas con alivio del dolor, del turgor, de la elasticidad de la piel y de la perfusión periférica. CONCLUSIONES: El alivio del dolor y de otros síntomas después de la administración de lidocaína por vía venosa sugiere que los anestésicos locales pueden modular la respuesta inflamatoria en varios aprendizajes de la esclerodermia.BACKGROUND AND OBJECTIVES: Scleroderma or progressive systemic sclerosis is a systemic connective tissue disease of unknown origin, which normally courses with microangiopathy, extremities ischemia and severe pain. This report aimed at describing a case of intravenous lidocaine to treat ischemic pain and at emphasizing potential anti-inflammatory action of local anesthetics in scleroderma patients. CASE REPORT: Female patient, clear mulatto 34 years old, nursing assistant, with scleroderma for approximately 8 years, presented with severe continuous, daily pain (numeric scale = 10 in upper and lower limbs, followed by trophic, color and temperature changes, and small ulcers on extremities. Patient was submitted to 1 weekly session of intravenous 2% lidocaine (400 mg without vasoconstrictor for 10 weeks with pain, turgor, skin elasticity and peripheral perfusion improvement. CONCLUSIONS: Pain and other symptoms relief after intravenous lidocaine suggests that local anesthetics are able to modulate inflammatory response in different scleroderma stages.

  1. Kinematic analysis of rugby lineout throws in the Six Nations Tournament. [Análisis cinemático de los saques de lateral en el Torneo de Rugby del Seis Naciones].

    Directory of Open Access Journals (Sweden)

    Ignacio Martín

    2018-04-01

    Full Text Available Abstract This study examines 126 successful, six- or seven-man lineouts of the 2013 Six Nations Tournament. Data were extracted from footage of the competition to calculate kinematic variables along with jumper position. Through cluster analysis, six types of throw were identified according to distance and velocity: short-fast, short-slow, medium short-fast, medium short-slow, medium long and long. Significant differences were detected in all the variables examined depending on the throw category (throw distance P<0.001; Partial eta square η2=0.932, height P=0.032; η2=0.096, flight time P<0.001; η2=0.789, starting angle P<0.001; η2=0.502, initial velocity P<0.001; η2=0.767 and jumper position P<0.001; η2=0.641. In the discriminant analysis, all variables except jumper position were able to correctly classify 100% of the throws. In addition, we differentiated the six participating teams, finding significant differences in throw height (Scotland vs England difference means d=0.32m, Ireland d=0.36m or France d=0.37m, flight time (Italy vs England d=0.34s or Ireland d=0.33s and angle (Italy vs England d=9.72º or Ireland d=8.49º and Scotland vs England d=8.27º or Ireland d=7.04º. Our findings have implications for training and team analysis (own and rival and also provide direction for future investigations. Resumen El presente estudio ha investigado 126 saques de lateral ganados con seis o siete jugadores en el alineamiento del torneo de las Seis Naciones de 2013 La observación se ha realizado a partir del estudio de los videos, por lo que los datos están extraídos en competición real. Un análisis cluster nos ha permitido establecer seis tipos de lanzamientos en función de la distancia y la velocidad: cortos-rápidos, cortos-lentos, mediocortos-rápidos, mediocortos-lentos, mediolargos y largos. Hemos encontrado diferencias significativas en todas las variables estudiadas en función de los tipos de lanzamiento (distancia del

  2. National inventory of anhyd ric carbonic emissions providing of fuels consumption as energy source; Inventario nacional de las emisiones de anhidrido carbonico proveniente del consumo de combustibles como fuente de Energia

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-07-01

    The Convention of the United Nations about Climatic Change, carried out in 1992, and whose ratification this being considerate d at level Parliament in the Republica Oriental del Uruguay, it has as objective to achieve the stabilization of the concentrations of gases of effect hot house in the atmosphere at a level that impedes interferences dangerous antropogenias. The National Direction of environment has carried out and Inventory of the Emissions of gas carbonic anhydride in the execution of the arisen commitments of the mentioned Convention. It being this the first step for the realization of a national inventory, which will not include the rest of the gases of effect hothouse controlled by the Protocols of Montreal. The inventory of the emissions carried out by the Division of Global and Regional Matters, it has been carried out for each one of the years understood in the period from 1987 to 1992 being studied the contribution of each sector of the national activity in the Emissions of carbonic anhydride.The results show that the total emissions estimated for Uruguay reach only the 6655 gigagrames of annual for the year 1992, being a light increase of the emission values among the years 1989 at 1992.

  3. Atypical Odontalgia (Phantom Tooth Pain)

    Science.gov (United States)

    ... atypical facial pain, phantom tooth pain, or neuropathic orofacial pain, is characterized by chronic pain in a tooth ... such as a specialist in oral medicine or orofacial pain. The information contained in this monograph is for ...

  4. Politica Nacional sobre Discapacidad: Un Informe del Progreso, Diciembre 2000-Diciembre 2001 (National Disability Policy: A Progress Report, December 2000-December 2001).

    Science.gov (United States)

    National Council on Disability, Washington, DC.

    This report (written in Spanish) of the National Council on Disability (NCD) describes the nation's progress in advancing public policies to increase the inclusion, empowerment, and independence of people with disabilities in light of the Americans with Disabilities Act of 1990. The report covers December 2000 through December 2001. It reviews…

  5. Supporting Self-management of Chronic Pain

    Science.gov (United States)

    2018-04-04

    Chronic Pain Syndrome; Chronic Pain; Chronic Pain Due to Injury; Chronic Pain Due to Trauma; Chronic Pain Due to Malignancy (Finding); Chronic Pain Post-Procedural; Chronic Pain Hip; Chronic Pain, Widespread

  6. Paediatric pain management

    African Journals Online (AJOL)

    REVIEW. Introduction. Pain is defined by the International Association for the Study of. Pain (IASP) as ... lasts for a short time, whilst chronic pain normally persists for a much longer ..... on a regular time schedule, i.e. 'by the clock', whereby the medicine is .... combination with a non-opioid (from the first step) for severe pain.

  7. Chest Pain: First Aid

    Science.gov (United States)

    First aid Chest pain: First aid Chest pain: First aid By Mayo Clinic Staff Causes of chest pain can vary from minor problems, such as indigestion ... 26, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-chest-pain/basics/ART-20056705 . Mayo ...

  8. Chronic pelvic pain.

    Science.gov (United States)

    Stein, Sharon L

    2013-12-01

    Chronic pelvic pain is pain lasting longer than 6 months and is estimated to occur in 15% of women. Causes of pelvic pain include disorders of gynecologic, urologic, gastroenterologic, and musculoskeletal systems. The multidisciplinary nature of chronic pelvic pain may complicate diagnosis and treatment. Treatments vary by cause but may include medicinal, neuroablative, and surgical treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Pain, emotion, headache.

    Science.gov (United States)

    Bussone, Gennaro; Grazzi, Licia; Panerai, Alberto E

    2012-10-01

    Pain has been considered as part of a defensive strategy whose specific role is to signal an immediate active danger to the organism. This definition fits well for acute pain. It does not work well, however, for chronic pain that is maintained even in absence of an ongoing, active threat. Currently, acute and chronic pain are considered to be separate conditions. What follows is a review of the different theories about pain and its history. Different hypotheses regarding pain mechanisms are illustrated. New data emerging from scientific research on chronic pain (migraine in particular) involving innovative imaging techniques are reported and discussed. © 2012 American Headache Society.

  10. Cancer Pain Physiology

    DEFF Research Database (Denmark)

    Falk, Sarah; Bannister, Kirsty; Dickenson, Anthony

    2014-01-01

    Mechanisms of inflammatory and neuropathic pains have been elucidated and translated to patient care by the use of animal models of these pain states. Cancer pain has lagged behind since early animal models of cancer-induced bone pain were based on the systemic injection of carcinoma cells....... This precluded systematic investigation of specific neuronal and pharmacological alterations that occur in cancer-induced bone pain. In 1999, Schwei et al. described a murine model of cancer-induced bone pain that paralleled the clinical condition in terms of pain development and bone destruction, confined...... to the mouse femur. This model prompted related approaches and we can now state that cancer pain may include elements of inflammatory and neuropathic pains but also unique changes in sensory processing. Cancer induced bone pain results in progressive bone destruction, elevated osteoclast activity...

  11. Peru's national folic acid fortification program and its effect on neural tube defects in Lima Programa nacional del Perú de fortificación con ácido fólico y su efecto sobre los defectos del tubo neural en Lima

    Directory of Open Access Journals (Sweden)

    Daniel J. Ricks

    2012-12-01

    Full Text Available OBJECTIVE: To evaluate the impact of Peru's national folic acid fortification program on folic acid content in wheat flour, and the effect on birth prevalence of neural tube defects (NTDs in Lima, and to compare the program's legislative requirements with international standards. METHODS: Bread was sampled from six sites across Peru and tested for folic acid. Data were obtained from the largest obstetric hospital in Lima on the prevalence of births (live and still with NTDs during both the pre-fortification period (2004-2005 and post-fortification years (2007-2008. RESULTS: Folic acid content in the sampled bread met national legislative requirements but was less than one-half of the level recommended for Peru by the World Health Organization (WHO (2.6 mg/kg wheat flour. Birth prevalence of NTDs was 18.4/10 000 in the pre-fortification period and 20.0/10 000 during post-fortification years. Relative risk for NTDs after fortification was 1.02 (95% confidence interval 0.77-1.35, P = 0.90. CONCLUSIONS: Peruvian legislative requirements for folic acid fortification are below international (WHO recommendations; birth prevalence of NTDs in Lima is higher than international benchmarks; and no decrease in NTDs following fortification of flour with folic acid (according to Peruvian national standards was observed. As increasing the level of folic acid in flour remains the most sustainable way of preventing NTDs, it is recommended that Peru increase its folic acid fortification requirements to meet those recommended by WHO (2.6 mg/kg.OBJETIVO: Evaluar la repercusión que el programa nacional del Perú de fortificación con ácido fólico tiene en el contenido de ácido fólico de la harina de trigo y en la prevalencia de nacimientos de niños con defectos del tubo neural en Lima, así como comparar los requisitos legislativos del programa con las normas internacionales. MÉTODOS: Se hizo un muestreo del pan en seis zonas de Perú y se analizó su

  12. Potencial del Agua del suelo

    Directory of Open Access Journals (Sweden)

    Bustamante Heliodoro

    1986-12-01

    Full Text Available La energía potencial del agua presenta diferencias de un punto del suelo a otro; esas diferencias son las que originan el movimiento del agua de acuerdo a la tendencia universal de la materia en el sentido de moverse de donde la energía potencial es mayor a donde dicha energía es menor. En el suelo el agua en consecuencia se mueve hacia donde su energía decrece hasta lograr su estado de equilibrio. Se desprende entonces que la cantidad de energía potencial absoluta contenida en el agua, no es importante por sí misma, sino por su relación con la energía en diferentes lugares dentro del suelo. El concepto Potencial de agua del suelo es un criterio para esta energía.

  13. Pain in cognitively impaired older persons.

    Science.gov (United States)

    Parmelee, P A

    1996-08-01

    To summarize, there has been shamefully little empirical research directly examining the prevalence and correlates of pain among cognitively impaired older people. Even less is known about techniques for assessing and managing pain in this group. Existing evidence suggests that cognitively impaired older persons may voice fewer complaints about pain, but there is no reason to believe that they are in fact at less risk of pain than their cognitively intact age-mates. Rather, for whatever reason, persons with cognitively deficits appear to be less inclined to report pain than are intact elders of similar health status. This reporting difference may account at least in part for the fact that pain is less likely to be treated aggressively among cognitively impaired individuals. Unfortunately, knowing the reason for this state of affairs does not mitigate its implication: cognitive deficits place frail older persons at risk of unnecessary pain simply because it is not properly identified. Data reviewed in this chapter suggest that accurate assessment of pain in cognitively impaired older persons, far from being impossible, may actually be only slightly more demanding than it is in intact individuals. Even among markedly impaired elders, self-reports should certainly be taken as valid indicators; early evidence suggests promising avenues for developing reliable, clear-cut guidelines for the nonverbal assessment of pain in very severely demented individuals. As the nation grows older and medical care advances, a growing proportion of individuals can expect to live well into their eighth and even ninth decades. Unfortunately, with this extended life span comes increased likelihood of both cognitive impairment and pain. Thus, expansion of our repertoire of techniques for assessing and managing pain among cognitively impaired older persons must be a central priority for research on pain in late life.

  14. Multidisciplinary pain management programs.

    OpenAIRE

    Kaiser, Ulrike; Arnold, Bernhard; Pfingsten, Michael; Nagel, Bernd; Lutz, Johannes; Sabatowski, Rainer

    2013-01-01

    Ulrike Kaiser,1 Bernhard Arnold,2 Michael Pfingsten,3 Bernd Nagel,4 Johannes Lutz,5 Rainer Sabatowski1,61Comprehensive Pain Center, University Hospital “Carl Gustav Carus”, Dresden, 2Department of Pain Management, Klinikum Dachau, Dachau, 3Pain Clinic, University Medicine, University of Göttingen, 4Day Care Unit, DRK Pain Center, Mainz, 5Interdisciplinary Pain Center, Zentralklinik Bad Berka, Bad Berka, 6Department of Anesthesiology and Intensive Care, University ...

  15. Massage application for occupational low back pain in nursing staff Aplicación del masaje para lumbalgia ocupacional en empleados de Enfermería Aplicação da massagem para lombalgia ocupacional em funcionários de Enfermagem

    Directory of Open Access Journals (Sweden)

    Talita Pavarini Borges

    2012-06-01

    Full Text Available This is a clinical trial which aims to evaluate the efficiency of massage in the reduction of occupational low back pain, and its influence on the performance of work and life activities for the nursing team. The sample consisted of 18 employees who received seven to eight sessions after their work period. From the Numerical Pain Rating Scale, significant improvements were found between the 3rd and 1st evaluations (p=0.000 and between the 3rd and 2nd (p=0.004, using the Wilcoxon test. Regarding the Oswestry Disability Index, the paired t test showed a statistical difference (p=0.02 between the baseline, with a mean of 21.33% and the second evaluation (18.78%, which was also seen between the second and third evaluation (16.67%. The score for the Handling and Transfer Risk Evaluation Scale was 18 points (medium risk. It is concluded that massage was effective in reducing occupational low back pain, and provided improvement in activities of work and life. Clinical Trials Identifier: NCT01315197.Se trata de ensayo clínico con el objetivo de verificar la eficiencia del masaje para apocar la lumbalgia ocupacional y su influencia en el desempeño de las actividades laborales y de vida, en el equipo de Enfermería. La muestra fue compuesta por 18 empleados, que recibieron de 7 a 8 sesiones después del plantón. Por la escala numérica de dolor, hubo mejora significante estadísticamente entre la 3ª y 1ª evaluación (p=0,000 y entre la 3ª y 2ª (p=0,004, por la prueba de Wilcoxon. Sobre la evaluación funcional de Owestry, en la prueba T pareado, se observó diferencia estadística (p=0,02 entre el primer momento, con media del 21,33% y el según (18,78%, y se mantuvo entre la segunda y tercera evaluación (16,67%. Fueron encontrados 18 puntos (medio riesgo para escala de evaluación del riesgo en el movimiento y transferencia. Se concluye que el masaje fue eficiente en la disminución de la lumbalgia ocupacional, así como trajo mejoría en las

  16. Imaginarios nacionales latinoamericanos en el tránsito del siglo XIX al XX Latin American nations' imaginary in the transition from the XIX to the XX century

    Directory of Open Access Journals (Sweden)

    Carmen Norambuena Carrasco

    2007-12-01

    Full Text Available Se reflexiona sobre la construcción de los imaginarios que fueron urdiéndose a través del siglo XIX, en países del sur americano: Chile, Argentina, Uruguay y Brasil, en los que se procura instalar una imagen moderna y atractiva de país en el llamado "mundo civilizado". Se procura establecer un marco comprensible en el cual replantear aspectos de nuestra historia común, en este caso, la formación de un imaginario de países prósperos, tan potente que oscurece la visualización de otros imaginarios.This work is a reflection about the construction of imaginaries that took form along the XIX century in the South American countries: Chile, Argentina, Uruguay, and Brazil. These countries intended to install a modern and attractive appearance consistent with the so-called "civilized world." We try to establish an understandable frame for posing again different issues of our common history; in this case, the creation of an imaginary of prosperous countries, so powerful as to hide other possible imaginaries.

  17. Pain perception and modulation in acute and chronic pain states

    NARCIS (Netherlands)

    Oudejans, L.C.J.

    2016-01-01

    This thesis describes the evaluation of pain perception in acute and chronic pain patients and the strength of the endogenous pain modulation system in chronic pain patients. Additionally, pain phenotypes are determined in patients with chronic pain. The ability of patients with acute pain after

  18. Experiences on current national income measures with reference to environmental and natural resources; Esperienze e proposte relative alla correzione in senso ambientale delle misure del reddito nazionale

    Energy Technology Data Exchange (ETDEWEB)

    Franzese, R; Gaudioso, D [ENEA, Casaccia (Italy). Dipt. Ambiente

    1995-06-01

    The environment provides both a source of goods and services and a `sink` for residues of the production and consumption processes. This is not reflected into conventional estimate of GDP (gross domestic product), the most commonly used measure of aggregate income. The purpose of this paper is to explore whether environmentally-adjusted national income measure can be derived. In the first part, the authors discuss both the shortcomings of the current national income measures, with reference to environmental and natural resources, and the debate on this issues; then they analyse the existing experiences to provide environmentally-adjusted indicators of national accounts. In the second part, the authors present an evaluation of the costs of environmental degradation in Italy in the period 1988-1990, based on the methodologies adopted in a pilot study carried out by UNSO (United Nations Statistical Office) and the World Bank for Mexico.

  19. Occupational lifting and pelvic pain during pregnancy:

    DEFF Research Database (Denmark)

    Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Juhl, Mette

    2013-01-01

    OBJECTIVES: Pelvic pain during pregnancy is a common ailment, and the disease is a major cause of sickness absence during pregnancy. It is plausible that occupational lifting may be a risk factor of pelvic pain during pregnancy, but no previous studies have examined this specific exposure. The aim...... of this study was to examine the association between occupational lifting and pelvic pain during pregnancy. METHODS: The study comprised 50 143 pregnant women, enrolled in the Danish National Birth Cohort in the period from 1996-2002. During pregnancy, the women provided information on occupational lifting...... (weight load and daily frequency), and six months post partum on pelvic pain. Adjusted odds ratios for pelvic pain during pregnancy according to occupational lifting were calculated by logistic regression. RESULTS: Any self-reported occupational lifting (>1 time/day and loads weighing >10 kg...

  20. Validação do Inventário de Atitudes frente à Dor Crônica - profissionais Validación del Inventario de Actitudes Frente al Dolor Crónico - Profesionales Validation of the survey of pain attitudes - professionals

    Directory of Open Access Journals (Sweden)

    Dayse Maioli Garcia

    2007-12-01

    Full Text Available Crenças influem no modo de as pessoas interpretarem os eventos e se conduzirem frente a eles. O objetivo deste estudo foi validar instrumento para identificar as crenças/atitudes de profissionais de saúde frente à dor crônica. O Inventário de Atitudes frente à Dor-Profissionais, adaptado do Inventário de Atitudes frente à Dor-Breve (IAD-Breve utilizado para doentes , foi respondido por 75 profissionais de Centros de Dor (idade média = 42,8 anos; tempo médio após graduação = 16 anos; médicos = 58,7% e fisioterapeutas = 42,7%; com especialização com maior grau de formação = 42,7% e mestrado/doutorado = 26,7%. O IAD-Profissionais foi validado com 20 itens e a análise fatorial con-firmou 6 domínios (emoção, controle, incapacidade, solicitude, cura médica e dano físico. A confiabilidade dos domínios variou entre 0,567 a 0,807 (alfa de Cronbach. Disponibiliza-se instrumento que auxiliará na organização de ações educativas.Las creencias influyen en el modo en que las personas interpretan los eventos y se conducen frente a ellos. El objetivo de este estudio fue validar un instrumento para identificar las creencias/actitudes de profesionales de salud frente al dolor crónico. El Inventario de Actitudes frente al Dolor - Profesionales, adaptado del Inventario de Actitudes frente al Dolor-Breve (IAD-Breve utilizado para enfermos, fue respondido por 75 profesionales de Centros de Dolor (edad media = 42,8 años; tiempo medio después del pre-grado = 16 años; médicos = 58,7% y fisioterapeutas = 42,7%; con especialización com mayor grado de formación = 42,7% y maestría/doctorado=26,7%. El IAD-Profesionales fue validado con 20 ítems y el análisis factorial confirmó 6 dominios (emoción, control, incapacidad, solicitud, cura médica y daño físico. La confiabilidad de los dominios varió entre 0,567 a 0,807 (alfa de Cronbach. Está a disposición un instrumento que auxiliará en la organización de acciones educativas

  1. Proceedings of the 21 National seminar on the rational use of energy and exposition of equipment and services. [Selected Papers]; 21 Seminario nacional sobre el uso racional del a energia y exposicion de equipos y servicios. Memoria Tecnica. [Ponencias seleccionadas

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    This document contains the proceedings of the 21 national seminar on the rational use of energy and exposition of equipment and services, organized by the Asociacion de Tecnicos y Profesionistas en Aplicacion Energetica (ATPAE), in Mexico, D.F., from the 14 to the 16 of March of 2001. This Seminar covered subjects such as: Energy saving in the power sector, power efficiency in industrial processes and practical developments, practical cases of energy saving in industry, energy saving in constructions, transport, utilization of renewable energies and the environment. [Spanish] Este documento contiene la memoria tecnica del 21 seminario nacional sobre el uso racional de la energia y exposicion de equipos y servicios, organizado por la Asociacion de Tecnicos y Profesionistas en Aplicacion Energetica (ATPAE), en Mexico, D.F., del 14 al 16 de marzo de 2001. Este seminario trato de temas tales como: Ahorro de energia en el sector energetico, eficiencia energetica en procesos industriales y desarrollos practicos, casos practicos de ahorro de energia en la industria, ahorro de energia en edificaciones, transporte, aprovechamiento de energias renovables y ambiente.

  2. Mesohabitats, fish assemblage composition, and mesohabitat use of the Rio Grande silvery minnow over a range of seasonal flow regimes in the Rio Grande/Rio Bravo del Norte, in and near Big Bend National Park, Texas, 2010-11

    Science.gov (United States)

    Moring, J. Bruce; Braun, Christopher L.; Pearson, Daniel K.

    2014-01-01

    In 2010–11, the U.S. Geological Survey (USGS), in cooperation with the U.S. Fish and Wildlife Service, evaluated the physical characteristics and fish assemblage composition of mapped river mesohabitats at four sites on the Rio Grande/Rio Bravo del Norte (hereinafter Rio Grande) in and near Big Bend National Park, Texas. The four sites used for the river habitat study were colocated with sites where the U.S. Fish and Wildlife Service has implemented an experimental reintroduction of the Rio Grande silvery minnow (Hybognathus amarus), a federally listed endangered species, into part of the historical range of this species. The four sites from upstream to downstream are USGS station 08374340 Rio Grande at Contrabando Canyon near Lajitas, Tex. (hereinafter the Contrabando site), USGS station 290956103363600 Rio Grande at Santa Elena Canyon, Big Bend National Park, Tex. (hereinafter the Santa Elena site), USGS station 291046102573900 Rio Grande near Ranger Station at Rio Grande Village, Tex. (hereinafter the Rio Grande Village site), and USGS station 292354102491100 Rio Grande above Stillwell Crossing near Big Bend National Park, Tex. (hereinafter the Stillwell Crossing site).

  3. Primer informe del género Gambierdiscus (Dinophyceae y otros dinoflagelados bentónicos en el Parque Nacional Isla del Coco, Costa Rica, Pacífico Tropical Oriental First report of the genus Gambierdiscus (Dinophyceae and other benthic dinoflagellates from Isla del Coco National Park, Costa Rica, Eastern Tropical Pacific

    Directory of Open Access Journals (Sweden)

    Maribelle Vargas-Montero

    2012-11-01

    conocer la incidencia de dinoflagelados bentónicos implicados en ciguatera para el Pacífico Tropical Oriental.The Eastern Tropical Pacific is a region reported as free of ciguatera poisoning that causes serious gastrointestinal, neural and cardiovascular problems, even death. But with this study we found a high incidence of benthic microalgae involved in ciguatera poisoning in Isla del Coco National Park (PNIC, from its name in Spanish, Costa Rica. Between 2006 and 2011, during expeditions to PNIC, 420 phytoplankton samples with the interest of finding benthic dinoflagellates involved in the ciguatera poisoning were collected and analyzed. Samples were taken with phytoplankton nets, towed vertically and horizontally or carried by diving, between 5 to 30 m depth, over reef areas, and by direct extraction from benthic macroalgae. We found the dinoflagellates Gambierdiscus spp., Coolia tropicalis, Coolia cf. areolota, Prorocentrum concavum, Prorocentrum compressum, Amphidinium carterae and Ostreopsis siamensis. The quantity of dinoflagellates by macroalgae weight was high, mainly for Gambierdiscus. Ostreopsis and Prorocentrum, the most widely distributed genera throughout the collection sites. Gambierdiscus is a ciguatera producing genus. Two different sizes of Gambierdiscus were found, and comparing our samples with other studies, we conclude that they are different to any previously reported. They possibly represent two new species. Coco Island is an oceanic island and because of its protection status, it is an ideal site for studying the evolution of marine phytoplankton. Also, long-term monitoring is important due to the variety of potentially toxic dinoflagellates living in this marine ecosystem. This is the first study to report benthic dinoflagellates implicated in ciguatera poisoning in other areas of the Eastern Tropical Pacific.

  4. Pain in cancer survivors

    International Nuclear Information System (INIS)

    Mladosievicova, B.

    2017-01-01

    Pain is a common problem among cancer survivors, especially in the first few years after treatment. In the longer term, approximately 5% to 10% of survivors have chronic severe pain. Overall prevalence of all types pain is about 40% in some cancer survivors with previous specific diagnosis. Until recently, impact of pain in cancer survivors have largely been unexamined. This complication can be predicted by type of malignancy, its therapy, time elapsed from completion of anticancer treatment and effectivity of previous pain interventions. As the purpose of this article is to update readers on more recent data about prevalence of pain in cancer survivors and common treatment-related chronic pain etiologies in patients with a history of cancer who are beyond the acute diagnosis and treatment phase, previously known information about acute pain, pain in terminally ill patients. Some new studies in certain subpopulations of cancer survivors will be explored in more detail. (author)

  5. Spinal pain in adolescents

    DEFF Research Database (Denmark)

    Aartun, Ellen; Hartvigsen, Jan; Wedderkopp, Niels

    2014-01-01

    BACKGROUND: The severity and course of spinal pain is poorly understood in adolescents. The study aimed to determine the prevalence and two-year incidence, as well as the course, frequency, and intensity of pain in the neck, mid back, and low back (spinal pain). METHODS: This study was a school......-based prospective cohort study. All 5th and 6th grade students (11-13 years) at 14 schools in the Region of Southern Denmark were invited to participate (N = 1,348). Data were collected in 2010 and again two years later, using an e-survey completed during school time. RESULTS: The lifetime prevalence of spinal pain...... reported their pain as relatively infrequent and of low intensity, whereas the participants with frequent pain also experienced pain of higher intensity. The two-year incidence of spinal pain varied between 40% and 60% across the physical locations. Progression of pain from one to more locations and from...

  6. Riqueza específica de vertebrados en un bosque reforestado del Parque Nacional Nevado de Toluca, México Species richness of vertebrates in a reforested woodland of the Nevado de Toluca National Park, Mexico

    Directory of Open Access Journals (Sweden)

    Jessica Mariana Sánchez-Jasso

    2013-03-01

    Full Text Available Este trabajo documenta la riqueza específica de vertebrados de un bosque reforestado del Parque Nacional Nevado de Toluca (PNNT Estado de México, México. Se identificaron 85 especies totales, de las cuales 24 especies son endémicas de México, 14 especies se encuentran en alguna categoría de riesgo de acuerdo con la NOM-059 (SEMARNAT, 2010 y 3 especies en la lista roja de la UICN. Aun cuando la zona de estudio representa apenas el 0.42% de la superficie total del PNNT, la riqueza de vertebrados encontrada constituye el 11.37% de la riqueza total en el Estado de México, lo cual destaca la importancia de este espacio y una urgente necesidad de establecer estrategias de manejo que garanticen la conservación de las especies y su hábitat.This paper documents the richness of vertebrates in reforested woodlands inside the Nevado de Toluca National Park, State of Mexico, Mexico. A total of 85 species were identified, of which 24 species are endemic to Mexico, 14 species are in some risk category according to NOM-059-SEMARNAT-2010 and 3 species in the IUCN Red List. Even though the study area accounts for 0.42% of the total area of the Nevado de Toluca National Park, the richness of vertebrates in this area includes 11.37% of the total richness in the State of Mexico, highlighting the importance of the area and an urgent need to establish management strategies for its conservation.

  7. Diseño del Monitoreo Nacional de Indicadores Nutricionales (MONIN, Perú 2007-2010 Design of the National Surveillance of Nutritional Indicators (MONIN, Peru 2007-2010

    Directory of Open Access Journals (Sweden)

    Miguel Campos-Sánchez

    2011-06-01

    Full Text Available Objetivos. Describir el diseño y los métodos del monitoreo nacional de indicadores nutricionales (MONIN 2007-2010 conducido por INS/CENAN. Materiales y métodos. El MONIN fue diseñado como una encuesta continua (transversal repetida, por muestreo aleatorio estratificado y multietápico, del universo de niños menores de cinco años y gestantes residentes en el Perú, dividido en cinco estratos geográficos y seis trimestres (semanas permutadas aleatoriamente que fueron 78% del tiempo entre el 19 de noviembre de 2007 y el 2 de abril de 2010. Resultados. La muestra total ha obtenido 3 827 niños en 361 conglomerados terminados. La pérdida ha sido 8,4% en los conglomerados, 1,8% de viviendas, 13,2% de hogares, 4,2% en antropometría, 13,3% en hemoglobina, 21,2% en consumo de alimentos; 55,0% en retinol y 29,9% en yoduria. Conclusiones. El diseño del MONIN es factible y su implementación resulta útil para la estimación de los indicadores de desnutrición infantil.Objectives. To describe the design and methods of the national surveillance of nutritional indicators (MONIN 2007-2010, carried out by INS/CENAN. Materials and methods. MONIN was designed as a continuous (repeated cross-sectional survey, with stratified multi-stage random sampling, considering the universe as all under five children and pregnant women residing in Peru, divided into 5 geographical strata and 6 trimesters (randomly permuted weeks, about 78% of the time between November 19, 2007 and April 2, 2010. Results. The total sample was 3,827 children in 361 completed clusters. The dropout rate was 8.4% in clusters, 1.8% in houses, and 13.2% in households. Dropout was also 4.2, 13.3, 21.2, 55% and 29% in anthropometry, hemoglobin, food intake, retinol and ioduria measurements, respectively. Conclusions. The MONIN design is feasible and useful for the estimation of indicators of childhood malnutrition.

  8. Intensity of musculoskeletal pain and (in ability to work in nursing Intensidad del dolor musculo-esquelético y la (incapacidad para el trabajo en la enfermería Intensidade da dor musculoesquelética e a (incapacidade para o trabalho na enfermagem

    Directory of Open Access Journals (Sweden)

    Tânia Solange Bosi de Souza Magnago

    2012-12-01

    Full Text Available OBJECTIVE: the aim was to evaluate the association between the intensity of musculoskeletal pain and reduction in work ability among nursing workers. METHOD: a cross-sectional study, involving 592 nursing staff in a public university hospital in Rio Grande do Sul, Brazil. The Brazilian version of the Finnish questionnaire for calculating Work Ability Index was used, whose score varies from 7 to 49 points. The score was dichotomized as reduced work ability (7 to 36 points and good/excellent ability (37 to 49 points. The intensity of musculoskeletal pain over the previous week was evaluated, using a numerical pain scale. RESULT: 43.3% of the participants had reduced work ability and 48.8% reported strong to unbearable pain. Even after adjusting for potentially confounding factors (function and length of service in the function, the workers who mentioned strong to unbearable pain were four times more likely to be classified in the group with reduced work ability. CONCLUSION: A positive association was determined between intensity of musculoskeletal pain and reduction in work ability. It is necessary to adopt intervention measures in the organizational structure, so as to promote/restore work ability.OBJETIVO: se objetivó evaluar la asociación entre intensidad del dolor musculo-esquelético y reducción de la capacidad para el trabajo en trabajadores de enfermería. MÉTODO: Estudio transversal, envolviendo 592 trabajadores de enfermería de un hospital universitario público de Rio Grande do Sul, Brasil. Se utilizó la versión brasileña del cuestionario Finlandés para el cálculo del Índice de Capacidad para el Trabajo, cuyo score de los puntos varia de 7 a 49. La puntuación fue dicotómica como reducida capacidad para el trabajo (7 a 36 puntos y buena/óptima capacidad (37 a 49 puntos. Se evaluó la intensidad de dolor musculo-esquelético en la última semana, utilizándose escala numérica de dolor. RESULTADO: De los participantes, 43

  9. Uso da metadona no tratamento da dor neuropática não-oncológica: relato de casos Uso de la metadona en el tratamiento del dolor neuropático no oncológico: relato de casos Methadone to treat non-oncologic neuropathic pain: case reports

    Directory of Open Access Journals (Sweden)

    Jeane Pereira da Silva Juver

    2005-08-01

    , opioide sintético, semejante a la morfina, por vía oral, es referido como alternativa en el tratamiento del dolor neuropático por su acción antagonista no competitiva sobre los receptores NMDA. El objetivo de este estudio es evaluar el uso de la metadona en el tratamiento de pacientes portadores de dolores crónicos de origen neuropático no oncológico, que no mejoraron con los tratamientos clásicos. RELATO DE LOS CASOS: Se presentan siete casos en los cuales la dosis de metadona fue titulada en consultas subsiguientes y los variables resultados de la intensidad álgica según la escala de aspectos, efectos colaterales y mejora de la capacidad funcional fueron analizados en el 1º, 7º, 14º, 30º y 180º días después del inicio del uso de la medicación. Hubo reducción de los resultados de la intensidad álgica y la ocurrencia de efectos colaterales como constipación, sedación, náuseas, cefalea e insomnio. No fueron observados efectos colaterales del tipo euforia, sudoresis, mioclonias, retención urinaria, reducción de la libido y depresión respiratoria. CONCLUSIONES: Los pacientes presentaron respuesta considerada satisfactoria al uso de la medicación, en bajas dosis; control de los efectos colaterales con medidas simples y mejora representativa de la capacidad funcional. La inclusión de la metadona, en las condiciones de este estudio, se mostró una opción eficaz, segura y de bajo valor, para el tratamiento de los dolores de origen neuropáticos no oncológicos.BACKGROUND AND OBJECTIVES: This report includes seven patients with chronic non-oncologic neuropathic pain who have not responded to classic approaches with tricyclic antidepressant and anticonvulsant drugs. Oral methadone, a synthetic opioid similar to morphine, is referred as alternative to treat neuropathic pain due to its non-competitive antagonist action on NMDA receptors. This study aimed at evaluating methadone to treat chronic non-oncologic neuropathic pain patients who have not

  10. Dependencia funcional y dolor crónico asociados a la calidad de vida del adulto mayor/ Functional dependence and chronic pain associated with the quality of life among the elderly

    Directory of Open Access Journals (Sweden)

    Ara Mercedes Cerquera Córdoba

    2017-06-01

    Full Text Available Objetivo: En la medida que la población va envejeciendo, la presencia de enfermedades crónicas, dolores y discapacidades va aumentando; estas afecciones cuentan con un bajo pronóstico de cura, lo cual lleva a complicaciones en el desempeño de las actividades de la vida diaria, dificul- tando la independencia y la autonomía de quien las padece. Actualmente más de 868 millones de personas superan los 60 años. Se habla de casi un 12 % del total de la población mundial, y para el año 2050, se estima que haya un incremento del 21 %, equiparando el porcentaje de los menores de 15 años. Esta proyección supone nuevos retos sociales y una respuesta del sistema de salud, que permita favorecer entre los envejecidos, procesos de adaptabilidad y crecimiento psicosocial. Objetivo: Identificar la asociación existente entre la dependencia funcional entendida como aquella condición de imposibilidad por deterioro físico y cognitivo, que tiene el sujeto para valerse por sus propios medios y el dolor al cual hace referencia, aquella experiencia sensorial y emocional desagradable causada por injuria real o potencial a un tejido. Método: Para el presente artículo se efectuó una búsqueda bibliográfica en bases de datos como Redalyc, Google académico, Ebsco, Medline, entre otras, donde fueron seleccionados 60 artículos que estuviesen incluidos en revistas indexadas. Resultados: Se encuentra una gran prevalencia de estudios que reportan que el envejecimiento asociado al dolor evidencia mayor nivel de dependencia funcional en el adulto mayor

  11. Emergency pulpotomy in relieving acute dental pain among Tanzanian patients

    Directory of Open Access Journals (Sweden)

    Simon Elison NM

    2006-01-01

    Full Text Available Abstract Background In Tanzania, oral health services are mostly in the form of dental extractions aimed at alleviating acute dental pain. Conservative methods of alleviating acute dental pain are virtually non-existent. Therefore, it was the aim of this study to determine treatment success of emergency pulpotomy in relieving acute dental pain. Methods Setting: School of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania. Study design: Longitudinal study. Participants: 180 patients who presented with dental pain due to acute irreversible pulpitis during the study period between July and August 2001. Treatment and evaluation: Patients were treated by emergency pulpotomy on permanent posterior teeth and were evaluated for pain after one, three and six week's post-treatment. Pain, if present, was categorised as either mild or acute. Results Of the patients with treated premolars, 25 (13.9% patients did not experience pain at all while 19 (10.6% experienced mild pain. None of the patients with treated premolars experienced acute pain. Among 136 patients with treated molars 56 (31% did not experience any pain, 76 (42.2% experienced mild pain and the other 4 (2.2% suffered acute pain. Conclusion The short term treatment success of emergency pulpotomy was high being 100% for premolars and 97.1% for molars, suggesting that it can be recommended as a measure to alleviate acute dental pain while other conservative treatment options are being considered.

  12. Facilitated pronociceptive pain mechanisms in radiating back pain compared with localized back pain

    DEFF Research Database (Denmark)

    Vaegter, Henrik Bjarke; Palsson, Thorvaldur Skuli; Graven-Nielsen, Thomas

    2017-01-01

    Facilitated pain mechanisms and impaired pain inhibition are often found in chronic pain patients. This study compared clinical pain profiles, pain sensitivity, as well as pro-nociceptive and anti-nociceptive mechanisms in patients with localized low back pain (n=18), localized neck pain (n=17......), low back and radiating leg pain (n=18), or neck and radiating arm pain (n=17). It was hypothesized that patients with radiating pain had facilitated pain mechanisms and impaired pain inhibition compared with localized pain patients. Cuff algometry was performed on the non-painful lower leg to assess...... threshold (HPT) at the non-painful hand were also assessed. Clinical pain intensity, psychological distress, and disability were assessed with questionnaires. TSP was increased in patients with radiating back pain compared with localized back pain (Ppain or localized low...

  13. Valoración y estrategias no farmacológicas en el tratamiento del dolor neonatal Assessment and non-pharmacological strategies in the treatment of neonatal pain.

    OpenAIRE

    Ruth Pérez Villegas; Eva Villalobos Alarcón; Karen Aguayo García; Mónica Guerrero Faquiez

    2006-01-01

    El neonato desde su nacimiento recibe diversos estímulos dolorosos que provocan alteraciones multisistémicas y psicológicas, lo que contribuye al aumento de la morbilidad y mortalidad neonatal. Las intervenciones ambientales y conductuales, conocidas también como estrategias no farmacológicas, tienen amplia aplicación en el tratamiento del dolor neonatal ya sea en forma aislada o en combinación con intervenciones farmacológicas. El propósito de estas estrategias es incrementar la comodidad, e...

  14. Proyecto Grannacional ALBASALUD para Centro Regulador de Medicamentos Esenciales de los países del ALBA-TCP Grand-national Project ALBASALUD for Regulatory Center of Essential Drugs for the ALBA-TCP countries

    Directory of Open Access Journals (Sweden)

    Celeste Aurora Sánchez González

    2011-09-01

    Full Text Available La Autoridad Reguladora de Medicamentos de Cuba, coordina un Proyecto de la Alianza Bolivariana para los pueblos de América-Tratado de Libre Comercio (ALBA-TCP, dirigido al desarrollo de un Centro Regulador para los países del ALBA como nuevo organismo regional de integración farmacéutica, en aras de contar con un Registro Grannacional válido en todos los países partes, como herramienta para facilitar el acceso a medicamentos esenciales de calidad. Esta investigación tuvo como objetivo diseñar y conducir desde el punto de vista técnico un proyecto para crear las bases legales y metodológicas del futuro centro y sus funciones básicas. Se emplearon técnicas de grupo nominal, puntos de referencia, consultas a expertos y se crearon metodologías específicas para planear y confeccionar los documentos necesarios. Se utilizaron lineamientos de organismos reguladores internacionales, cuadros básicos de medicamentos y reglamentación farmacéutica de los países participantes. Se desarrollaron y aplicaron documentos y estrategias para el trabajo del proyecto durante la etapa de preinversión, se definió el primer listado de medicamentos esenciales del ALBA y se aprobaron las fundamentales disposiciones legales y la reglamentación para las funciones de registro, vigilancia, inspecciones, laboratorios y liberación de lotes. El Proyecto Grannacional ALBASALUD "Centro Regulador de Medicamentos del ALBA-TCP" aplicado ha demostrado su eficiencia y capacidad para alcanzar los objetivos trazados mediante un trabajo científico-técnico con participación colectiva, que ha garantizado las disposiciones y lineamientos requeridos para sus funciones básicas y respaldo legal.The Drug Regulatory Authority of Cuba is coordinating a Project of the Bolivarian Alliance for the Peoples of America- Free Trade Agreement (ALBA-TCP aimed at developing a Regulatory Center that will operate as a new regional body of pharmaceutical integration for the ALBA

  15. Avances y retos en la construcción del sistema nacional de investigación en salud en el Perú Advances and challenges in building the national health research system in Peru

    Directory of Open Access Journals (Sweden)

    Martín Yagui

    2010-09-01

    Full Text Available El objetivo de este artículo es presentar el estado del Sistema Nacional de Investigación en Salud de Perú (SNIS, las lecciones aprendidas en el proceso de construcción, las oportunidades de mejora y los retos. Se hace una descripción de las funciones del SNIS peruano, con relación a la gobernanza, el marco legal, la priorización de la investigación, el financiamiento, la creación y la sostenibilidad de recursos y la producción y utilización de la investigación. Se describe que en Perú se ejerce la gobernanza en la investigación, se cuenta con regulaciones, política y prioridades de investigación, estas últimas desarrolladas en el marco de un proceso participativo e inclusivo. Se concluye que los retos del SNIS peruano son consolidar la gobernanza y desarrollar los mecanismos para articular a los actores involucrados con la investigación, incrementar la asignación de recursos para la investigación e innovación, elaborar e implementar un plan para el desarrollo de recursos humanos dedicados a la investigación, desarrollar las instituciones y competencias regionales para hacer investigación, ligar la investigación para solucionar problemas y hacer sostenibles las políticas nacionales de investigación.The objective of this paper is to present the situational status of the National Health Research System of Peru (NHRS, the lessons learnt during the building process, the opportunities to improve it and the challenges. A description of the functions of the peruvian NHRS is done, in relation to governance, legal framework, research priorities, funding, creation and sustainability of resources and research production and utilization. It describes that in Peru we excert governance in research, we count with regulations, policy and research priorities, these last developed in the framework of a partipatory, inclusive process. The conclusion reached is that the challenges of the peruvian NHRS are to consolidate the governance and

  16. TL dosimetry in the new Tandetron ion accelerator site of the National Institute of Nuclear Research (ININ); Dosimetria TL en el area del nuevo acelerador de iones Tandetron del ININ

    Energy Technology Data Exchange (ETDEWEB)

    Valdovinos A, M.; Gonzalez M, P.R. [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

    2000-07-01

    The National Institute of Nuclear Research (ININ) acquired a positive ions accelerator type Tandetron 2 MV of the dutch company High Voltage Engineering, Europe B.V., which was finished its installation this year (2000) in an already existing building in the Dr. Nabor Carrillo Flores Nuclear Centre, where it was prepared for the following purposes: the accelerator will be used to realize research through X-ray emission induced by charged particles, Rutherford backscattering analysis, nuclear reaction analysis, gamma ray emission induced by charged particles, resonant dispersion analysis, elastic backward detection analysis and by particle canalization analysis. The accelerator consists of an injection system with two ion sources, ion accelerator tank with voltage in terminal at 2 MV, recovery and recirculation system of charge interchange gas, iman selector analyzer system and with high energy focussing, control system through computer and management and recovery of isolator gas system. For the realization of operation tests of this accelerator, it was had the license authorizing by the National Commission of Nuclear Safety and Safeguards (CNSNS). During the test stage Tl dosemeters were arranged in the Tandetron accelerator area, and also in direction to the beam outlet. In this work, are presented the obtained results of the measurement of radiation levels, as in the area as in the beam outlet. (Author)

  17. del alcoholismo

    Directory of Open Access Journals (Sweden)

    Rodrigo Arias Duque

    2005-01-01

    Full Text Available Desde el punto de vista farmacológico, es importante comprender qué es el alcohol y cómo actúa en el organismo. No existe una causa simple, sino una interacción complicada de factores neuroquímicos, fisiológicos, psicológicos y sociales que originan y desarrollan esta grave enfermedad fármaco-dependiente. La acción psicofisiológica y farmacodinámica del alcohol es fundamentalmente depresiva, por la reducción de la transmisión sináptica en el sistema nervioso humano. Es un hecho conocido que el consumo excesivo de alcohol causa una disfunción aguda y crónica del cerebro, produciendo trastornos en el sistema nervioso central, presentando alteraciones en la memoria y en las funciones intelectuales como cálculo, comprensión y aprendizaje. A nivel hepático tiene lugar, en su mayoría, el metabolismo del alcohol, produciéndose un hígado graso alcohólico, aumentando el tamaño, terminando en necrosis e inflamación grave del hígado; esto se llama hepatitis alcohólica, y si se sigue consumiendo alcohol se desarrollará la cirrosis. El alcohol también ha estado relacionado con alteraciones del miocardio; se ha constatado en animales de experimentación sanos que tanto la velocidad de contracción del músculo cardiaco y su máxima tensión disminuyen en presencia del alcohol, como consecuencia, la fuerza de cada contracción y el aumento de presión en el ventrículo izquierdo son menores, perdiendo eficacia el corazón como bomba.

  18. Preliminary study for the National Energy Plan (PEN) uses the Community market as a reference base. El ante-proyecto del Plan Energetico Nacional (PEN) toma referencia basica del mercado comunitario

    Energy Technology Data Exchange (ETDEWEB)

    1991-11-01

    The National Energy Plan (PEN) for the period 1991 to 2000 lays down basic guidelines for a Spanish energy policy. This includes a wide range of economic measures. The PEN is divided into five main sections with two appendices. The sections are: the international situation; energy demand; energy supply; energy and the environment; and R D policy. The appendices are: Energy-saving and energy-efficiency plan; and General plan for radioactive waste. The PEN provides for 4-year research programmes which aim to reduce the environmental impact of energy production and use. General demand for energy during this period will increase by2.4% and investment in power installations and in the gas sector will be some 1.5 thousand million pesetas. 4 figs., 3 tabs.

  19. Chronic Pelvic Pain

    Science.gov (United States)

    ... NSAIDs) are helpful in relieving pelvic pain, especially dysmenorrhea . Physical therapy—Acupuncture, acupressure, and nerve stimulation therapies may be useful in treating pain caused by dysmenorrhea. Physical therapy that eases trigger points may give ...

  20. Eldercare at Home: Pain

    Science.gov (United States)

    ... or "heaviness" or “misery.” Look for behavior or body language that looks like a response to pain. An ... to communicate about pain in words. Behaviors or body language to look for include facial expressions such as ...

  1. Magnets for Pain Relief

    Science.gov (United States)

    ... NCCIH NCCIH At a Glance Mission and Vision Organizational Structure Director's Message Strategic Plans & Reports Budget & ... © Matthew Lester Magnets are often marketed for different types of pain, such as foot or back pain ...

  2. Perspectives in Pancreatic Pain

    Directory of Open Access Journals (Sweden)

    A. S. Salim

    1997-01-01

    Full Text Available This review describes some of the mechanisms which are thought to be important in the causation of pain in chronic pancreatitis. Both medical and surgical techniques for treating this pain are described.

  3. Diclofenac Topical (osteoarthritis pain)

    Science.gov (United States)

    ... gel (Voltaren) is used to relieve pain from osteoarthritis (arthritis caused by a breakdown of the lining ... Diclofenac topical liquid (Pennsaid) is used to relieve osteoarthritis pain in the knees. Diclofenac is in a ...

  4. Physiotherapists' knowledge of pain

    African Journals Online (AJOL)

    To investigate the pain knowledge of sports and orthopaedic manipulative physiotherapists ... may enable more effective treatment and management of clinical ... A person may have severe pain, but appear calm and rational at the same time.

  5. Persistent idiopathic facial pain

    DEFF Research Database (Denmark)

    Maarbjerg, Stine; Wolfram, Frauke; Heinskou, Tone Bruvik

    2017-01-01

    Introduction: Persistent idiopathic facial pain (PIFP) is a poorly understood chronic orofacial pain disorder and a differential diagnosis to trigeminal neuralgia. To address the lack of systematic studies in PIFP we here report clinical characteristics and neuroimaging findings in PIFP. Methods...... pain 7 (13%), hypoesthesia 23 (48%), depression 16 (30%) and other chronic pain conditions 17 (32%) and a low prevalence of stabbing pain 21 (40%), touch-evoked pain 14 (26%) and remission periods 10 (19%). The odds ratio between neurovascular contact and the painful side was 1.4 (95% Cl 0.4–4.4, p = 0.......565) and the odds ratio between neurovascular contact with displacement of the trigeminal nerve and the painful side was 0.2 (95% Cl 0.0–2.1, p = 0.195). Conclusion: PIFP is separated from trigeminal neuralgia both with respect to the clinical characteristics and neuroimaging findings, as NVC was not associated...

  6. Block That Pain!

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Block That Pain! Past Issues / Fall 2007 Table of ... contrast, most pain relievers used for surgical procedures block activity in all types of neurons. This can ...

  7. Science of pain

    National Research Council Canada - National Science Library

    Basbaum, A. I; Bushnell, M. Catherine

    2009-01-01

    "The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage...

  8. Interstitial cystitis: painful bladder syndrome

    Directory of Open Access Journals (Sweden)

    R F Sholan

    2018-02-01

    Full Text Available Interstitial cystitis, or painful bladder syndrome, is a chronic inflammatory disease of a bladder of unknown etiology. It negatively affects the quality of life, causes depressive disorders, anxiety, and sexual dysfunction. Despite numerous studies, the etiology of interstitial cystitis is still unclear and it’s considered as painful bladder syndrome with multifactorial origin. According to the US National Health and Nutrition Examination Survey, 470/100 000 people (60/100 000 men, 850/100 000 women are diagnosed with interstitial cystitis. Diagnosis of the disease is difficult and is substantially based on clinical symptoms. Pelvic pain, urinary urgency, frequency and nocturia are the basic complaints in this pathology. The diagnosis requires exclusion of diseases with similar manifestations. So interstitial cystitis is frequently misdiagnosed as urinary tract infection, overactive bladder, urethral obstruction or diverticulosis, chronic prostatitis, bladder cancer, vulvodynia, endometriosis, and chronic pelvic pain. Etiopathogenesis of the disease is uncertain, which makes etiologic treatment impossible. Currently scientific discussions on the causes of disease continue as well as different treatment regimens are offered, but are often ineffective, palliative and temporary. The treatment for intersticial cystitis should focus on restoring normal bladder function, prevention of relapse of symptoms and improvement of patients’ quality of life. The literature review presents current view on the terminology, epidemiology, diagnosis and treatment of interstitial cystitis.

  9. Longer sitting time and low physical activity are closely associated with chronic low back pain in population over 50 years of age: a cross-sectional study using the sixth korea national health and nutrition examination survey.

    Science.gov (United States)

    Park, Sang-Min; Kim, Ho-Joong; Jeong, Hyunseok; Kim, Hyoungmin; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S

    2018-04-17

    There is increasing evidence supporting an association between sitting time and low back pain (LBP). However, the degree of the association between the total daily sitting time and LBP in the general population is poorly understood. (1) To analyze the association between the duration of sitting time and LBP, and (2) to examine this association according to the degree of physical activity in population over 50 years of age with a nationally representative sample of Korean adults. A cross-sectional study PATIENT SAMPLE: Data from version VI-2, 3 of the Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2014 and 2015. Multiple logistic regression was performed to find the rates of association between chronic LBP, level of sitting time, and physical activity. Nationwide Health surveys and examinations were conducted in general Korean representative populations (n = 7,550 in 2014, n = 7,380 in 2015). Chronic LBP was defined as self-reported LBP lasting for more than 30 days during the past 3 months in a health survey. Sitting time and daily physical activity were evaluated using the long version of the international physical activity questionnaires (IPAQ). The duration of sitting time was divided into 2 categories according to the median value (7 hours), and further divided into 4 categories using quartiles. Physical activity was also divided into low and high physical activity according to duration of mid- to high-intensity activities. There were no sources of funding and no conflicts of interest associated with this study. On multiple logistic regression analysis, sitting time more than 7 hours/day was significantly associated with LBP (adjusted odds ratio, aOR: 1.33, pphysical activity, the duration of sitting time showed more positive association with LBP than that in all the participants and participants with high levels of physical activity. Longer duration of sitting time is a risk factor for LBP. Furthermore, long duration of sitting

  10. La maxilectomía en las neoplasias del macizo facial. Sistema de clasificación del Instituto Nacional de Oncología y Radiobiología (INOR The maxillectomy in cases of neoplasms of facial area: Classification system of National Institute of Oncology and Radiobiology (NIOR

    Directory of Open Access Journals (Sweden)

    Miguel Azcue Bilbao

    2010-06-01

    Full Text Available La maxilectomía es una de las intervenciones quirúrgicas indicada para el tratamiento de las neoplasias de la región facial. Esta técnica comprende la resección del maxilar y de algunas estructuras anatómicas adyacentes. Se encuentran una gran variedad de términos para definir tipos y subtipos de maxilectomía que conllevan a mucha confusión. Al no existir una herramienta única y normada internacionalmente, aún hoy presupone un reto el procedimiento de clasificación y tratamiento. En las clasificaciones actuales de la maxilectomía se encuentran autores que defienden tratamientos muy radicales y otros los tratamientos conservadores o parciales. El objetivo del trabajo es presentar el sistema de clasificación para la maxilectomía utilizado en el Instituto Nacional de Oncología y Radiobiología (INOR. Se realizó una actualización del tema y se presenta la propuesta de clasificación para la maxilectomía. Se concluyó que siempre que la resección del tumor sea completa y se logre un buen margen de seguridad, se puede plantear que no existe diferencia en los resultados entre el tipo de maxilectomía realizada y el intervalo libre de enfermedad y que sin una norma internacional, la decisión terapéutica se apoya más en las convicciones y resultados personales de los grupos de investigadores, que en un consenso global.The maxillectomy is one of the surgical interventions prescribed for the neoplasms treatment of facial area. This technique involves the resection of maxilla and of some adjacent anatomical structures. There are many terms defining the types and subtypes of maxillectomy creating confusion. Since there is not only tool and worldwide standardized, nowadays the classification and treatment procedure is still a challenge. In current classification systems of maxillectomy there are authors advocating very radical treatments and other favoring the conservative or partial treatments. The aim of present paper is to present a

  11. Pain in Down's Syndrome

    Directory of Open Access Journals (Sweden)

    Federica Mafrica

    2006-01-01

    Full Text Available Pain is a homeostatic mechanism that intervenes to protect the organism from harmful stimuli that could damage its integrity. It is made up of two components: the sensory-discriminative component, which identifies the provenance and characteristics of the type of pain; and the affective-motivational component, on which emotional reflexes, following the painful sensation, depend.There is a system for pain control at an encephalic and spinal level, principally made up of the periaqueductal grey matter, the periventricular area, the nucleus raphe magnus, and the pain-inhibition complex situated in the posterior horns of the spinal cord. Through the activation of these pain-control systems, the nervous system suppresses the afference of pain signals. Endogenous opioids represent another analgesic system.In the course of various studies on pain transmission in Down patients, the reduced tolerance of pain and the incapacity to give a qualitative and quantitative description emerged in a powerful way. All of these aspects cause difficulty in evaluating pain. This is linked to several learning difficulties. However, it cannot be excluded that in these anomalies of pain perception, both the anatomical and the neurotransmitter alteration, typical of this syndrome, may hold a certain importance.This fact may have important clinical repercussions that could affect the choice of therapeutic and rehabilitative schemes for treatment of pathologies in which pain is the dominant symptom, such as postoperative pain. It could influence research on analgesics that are more suitable for these patients, the evaluation of the depth of analgesia during surgical operation, and ultimately, absence of obvious pain manifestations. In conclusion, alterations of the central nervous system, neurotransmitters, pain transmission, and all related problems should be considered in the management of pain in patients with Down's syndrome, especially by algologists and

  12. Pain Examination and Diagnosis.

    Science.gov (United States)

    Curtin, Catherine

    2016-02-01

    Pain is a clinical challenge to health care providers who care for hand disorders. Pathologic pain that prevents recovery leads to dissatisfaction for both patients and providers. Despite pain being common, the root cause is often difficult to diagnose. This article reviews the examination and diagnostic tools that are helpful in identifying pathologic and neuropathic pain. This article provides tools to speed recognition of these processes to allow earlier intervention and better patient outcomes. Published by Elsevier Inc.

  13. Ketogenic Diets and Pain

    Science.gov (United States)

    Masino, Susan A.; Ruskin, David N.

    2014-01-01

    Ketogenic diets are well-established as a successful anticonvulsant therapy. Based on overlap between mechanisms postulated to underlie pain and inflammation, and mechanisms postulated to underlie therapeutic effects of ketogenic diets, recent studies have explored the ability for ketogenic diets to reduce pain. Here we review clinical and basic research thus far exploring the impact of a ketogenic diet on thermal pain, inflammation, and neuropathic pain. PMID:23680946

  14. Ketogenic Diets and Pain

    OpenAIRE

    Masino, Susan A.; Ruskin, David N.

    2013-01-01

    Ketogenic diets are well-established as a successful anticonvulsant therapy. Based on overlap between mechanisms postulated to underlie pain and inflammation, and mechanisms postulated to underlie therapeutic effects of ketogenic diets, recent studies have explored the ability for ketogenic diets to reduce pain. Here we review clinical and basic research thus far exploring the impact of a ketogenic diet on thermal pain, inflammation, and neuropathic pain.

  15. Education in radiation protection in the National Customs of Paraguay; Educacion en proteccion radiologica en la Direccion Nacional de Aduanas del Paraguay

    Energy Technology Data Exchange (ETDEWEB)

    Bordon, Oscar, E-mail: obordon@aduana.gov.py, E-mail: obordon@yahoo.com [Direccion Nacional de Aduanas, Departamento de Seguridad Radiologica, Administracion de Aduana de Gical, Mariano Roque Alonso (Paraguay)

    2013-07-01

    According to the IAEA-TECDOC-1312, as it is required by international agreements, the displacement of radioactive material within and among States should be subject to strict regulatory, administrative, safety and technical controls to ensure conditions of technological and physical safety. The Customs Office is one of the institutions responsible for monitoring shipments crossing international borders. Increasing illicit trafficking of radioactive materials, the use of ionizing radiation generating equipment for checking loads, and trade in radioactive substances have informed the need for education in radiation protection of customs officials. Thus, based on a course on radiation protection for Customs officials, organized by the International Atomic Energy Agency, in March 2008 was initiated a course of radiation protection, of 30 hours Carrera Tecnica del Centro de Formacion y Capacitacion Aduanera de Paraguay, which highlights the basic chapters and for transporting, nomenclature, new equipment emitting ionizing radiation and smuggling. Since then, to date, at least 10 groups have completed the training. Within the training program for customs officials, was incorporated a course for radiation protection of operators of baggage scanners with a four-hour program. Finally, since from 2011 and periodically, at various country customs, a workshop on Illicit trafficking of radioactive and nuclear materials is performed. The results of these courses have been very positive, as well as know the proper procedures for dealing with ionizing radiation has increased the safety culture within the institution.

  16. [Levels of dissatisfaction of external users of the Instituto Nacional de Salud del Niño (National Institute of Child Health) in Lima, Peru].

    Science.gov (United States)

    Shimabuku, Roberto; Huicho, Luis; Fernández, Danitza; Nakachi, Graciela; Maldonado, Ruth; Barrientos, Armando

    2012-01-01

    To determine the changes in the levels of dissatisfaction of the external users of the Instituto Nacional de Salud del Niño, in Lima, Peru. Observational study based on a software to evaluate surveys completed by health care users (Software de Evaluación de Encuestas de Usuarios en Salud - SEEUS). The population consisted of every person accompanying external users to outpatient visits, inpatient visits or emergency treatment in the years 2008, 2009 and 2010. To calculate the sample size, last year's proportion of users dissatisfied with each service was used, with an estimated error of 5% at a 95% confidence level. A sample of 2051 people was obtained, which revealed a decreasing trend in the levels of dissatisfaction with outpatient visits, and an increased dissatisfaction in the medical capabilities dimension for hospitalization and emergency services. In addition, a dissatisfaction index lower than 0.20 was registered in the medical capabilities dimension for outpatient visits. In contrast, the highest dissatisfaction indexes were registered in the hygiene dimension for 2009 (0.25) and 2010 (0.25), and in the others dimension for emergency services in 2009 (0.25). The dimensions showing an increase in the dissatisfaction index were tangible aspects, hygiene and others for hospitalization and emergency services. On the other hand, the medical capabilities dimension for outpatient visits showed a decrease in the level of dissatisfaction over the evaluated period.

  17. The influence of children's pain memories on subsequent pain experience.

    Science.gov (United States)

    Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H

    2012-08-01

    Healthy children are often required to repeatedly undergo painful medical procedures (eg, immunizations). Although memory is often implicated in children's reactions to future pain, there is a dearth of research directly examining the relationship between the 2. The current study investigated the influence of children's memories for a novel pain stimulus on their subsequent pain experience. One hundred ten healthy children (60 boys) between the ages of 8 and 12 years completed a laboratory pain task and provided pain ratings. Two weeks later, children provided pain ratings based on their memories as well as their expectancies about future pain. One month following the initial laboratory visit, children again completed the pain task and provided pain ratings. Results showed that children's memory of pain intensity was a better predictor of subsequent pain reporting than their actual initial reporting of pain intensity, and mediated the relationship between initial and subsequent pain reporting. Children who had negatively estimated pain memories developed expectations of greater pain prior to a subsequent pain experience and showed greater increases in pain ratings over time than children who had accurate or positively estimated pain memories. These findings highlight the influence of pain memories on healthy children's expectations of future pain and subsequent pain experiences and extend predictive models of subsequent pain reporting. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  18. Intervenções não farmacológicas no controlo da dor em cuidados intensivos neonatais Intervenciones no farmacológicas en el control del dolor en cuidados intensivos neonatales Non-pharmacological interventions in pain management in neonatal intensive care

    Directory of Open Access Journals (Sweden)

    Luís Manuel Cunha Batalha

    2010-12-01

    ón del RN, entrevista a padres y enfermeros prestadores de cuidados y análisis retrospectivo seriado de los registros intermitentes efectuados en el proceso clínico. La intensidad del dolor fue medida a través de la escala Echelle Douleur et d’Inconfort du Nouveau-Né (EDIN. Resultados: En ocho horas de observación, las 844 observaciones realizadas mostraron una elevada prevalencia de dolor (94,8%, predominando el dolor ligero (72,7%. Las intervenciones no farmacológicas fueron utilizadas en un 88,7% de las observaciones, con incidencia en las posturas, masajes y técnicas de confort. Conclusiones: Los enfermeros usan con frecuencia y eficacia las medidas no farmacológicas de confort, masaje y postura pero otras técnicas deberían ser añadidas, como el uso de sacarosa, glucosa o amamantamiento materno.Background: Although it has been recognized that most of the pain experienced by the newborn can be prevented or substantially relieved, several studies continue to show an inadequate treatment. Aims: To determine the prevalence and severity of the pain experienced by newborns receiving intensive care, as well as the effectiveness of non-pharmacological therapeutic measures. Methods: At a Neonatal Intensive Care Unit of a University Hospital, 170 newborns were studied during one year, resulting in 844 observations. Data were collected based on newborn observation, an interview with parents and nurses who provided care, and a retrospective analysis of the clinical records. Pain intensity was measured using the EDIN scale (Echelle Douleur et d’Inconfort du Nouveau-Né. Results: During 8 hours of observation, 94.8% of the 844 observations showed a high prevalence of pain, mostly mild pain (72.7%. Non-pharmacological interventions were applied in 88.7% of the observations, especially related to positioning, massage and comfort techniques. Conclusions: Nurses use non-pharmacological measures of comfort, massage and positioning often and effectively, but other

  19. Costo institucional del paciente con incapacidad temporal para el trabajo por lumbalgia mecánica. [Institutional cost of the patient with temporary inability to work due to mechanical low back pain

    Directory of Open Access Journals (Sweden)

    María del Carmen Ponce Martínez

    2013-10-01

    Full Text Available In­tro­duc­ción La lumbalgia afecta de manera frecuente a la población económicamente activa. Es la primera causa de pérdida de días laborales en trabajadores menores de 55 años de edad y la segunda de ausentismo laboral. Objetivo Determinar el costo institucional del paciente con incapacidad temporal para el trabajo por lumbalgia mecánica. Material­ y­ métodos Se realizó un estudio de costos de expedientes de trabajadores con lumbalgia de 20 a 60 años con incapacidad temporal para el trabajo. El tamaño de la muestra (228 pacientes se calculó con la fórmula de promedios para población infinita con nivel de confianza del 95%. La técnica muestral fue por cuota empleando como marco muestral el listado de pacientes con incapacidad temporal para el trabajo y diagnóstico de lumbalgia mecánica. las variables estudiadas fueron las características sociodemográficas, el perfil de uso, costo unitario y costo promedio de los servicios otorgados. El análisis estadístico incluyó porcentajes, promedios, intervalo de confianza y proyección. Resultados El costo total promedio por paciente con lumbalgia mecánica es de 1744,08 uSD, la incapacidad es el costo más elevado (1083,71 uSD, seguido de los estudios de gabinete (394,89 uSD, las consultas (180,52 uSD, los medicamentos y el laboratorio. Conclusión El costo institucional del paciente con incapacidad temporal para el trabajo con lumbalgia mecánica resulta en miles de dólares y, proyectado a una población de pacientes, el costo se incrementa a millones.

  20. Acute pain guidelines

    African Journals Online (AJOL)

    identified the fact that pain is badly managed in all parts of the world, but .... Physiological pain is the activation of nociceptors in response to a noxious ... postsynaptic neuron. ... The basic afferent pain pathway is outlined in Figure 2. 3.2 Neurotransmitters ..... “Crying” is characterised by an utterance of emotion accompanied.

  1. 13. Sacroiliac joint pain

    NARCIS (Netherlands)

    Vanelderen, P.; Szadek, K.M.; Cohen, S.P.; Witte, J.; Lataster, A.; Patijn, J.; Mekhail, N.; van Kleef, M.; van Zundert, J.

    2010-01-01

    The sacroiliac joint accounts for approximately 16% to 30% of cases of chronic mechanical low back pain. Pain originating in the sacroiliac joint is predominantly perceived in the gluteal region, although pain is often referred into the lower and upper lumbar region, groin, abdomen, and/ or lower

  2. Complex Regional Pain Syndrome

    Science.gov (United States)

    Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. It may happen ... move the affected body part The cause of CRPS is unknown. There is no specific diagnostic test. ...

  3. Knee pain (image)

    Science.gov (United States)

    The location of knee pain can help identify the problem. Pain on the front of the knee can be due to bursitis, arthritis, or ... synovial fluid) that forms behind the knee. Overall knee pain can be due to bursitis, arthritis, tears in ...

  4. [Pain in edentulous patients

    NARCIS (Netherlands)

    Baat, C. de

    2006-01-01

    In daily social life, orofacial pain is strongly associated with teeth. However, edentulousness is no lifetime guarantee of being pain-free in the orofacial region. Common oral pains in edentulous people are caused by denture misfits or occlusal errors, by alveolar ridge atrophy, by (sharp)

  5. 21. Phantom pain.

    NARCIS (Netherlands)

    Wolff, A.P.; Vanduynhoven, E.; Kleef, M. van; Huygen, F.; Pope, J.E.; Mekhail, N.

    2011-01-01

    Phantom pain is pain caused by elimination or interruption of sensory nerve impulses by destroying or injuring the sensory nerve fibers after amputation or deafferentation. The reported incidence of phantom limb pain after trauma, injury or peripheral vascular diseases is 60% to 80%. Over half the

  6. Medicines for back pain

    Science.gov (United States)

    ... You may need to be watched for side effects. NARCOTIC PAIN RELIEVERS Narcotics , also called opioid pain relievers, are used only for pain that is severe and is not helped by other types of painkillers. They work well for short-term relief. Do ...

  7. Pain: Hope through Research

    Science.gov (United States)

    ... in drugstores. Chiropractic care may ease back pain, neck pain, headaches, and musculoskeletal conditions. It involves "hands-on" ... together. The peripheral nervous system refers to the cervical, thoracic, ... or dysfunction (such as pain) travel from the brain to the spinal cord ...

  8. Crenças em dor crônica: validação do Inventário de Atitudes frente à Dor para a língua portuguesa Creencias en dolor crónico: validación del Inventario de Actitudes frente al Dolor para la lengua portuguesa Chronic pain beliefs: validation of the survey of pain atittudes for the portuguese language

    Directory of Open Access Journals (Sweden)

    Cibele Andrucioli de Mattos Pimenta

    2006-09-01

    Full Text Available Este estudo validou o Inventário de Atitudes frente à Dor - versão reduzida (IAD-breve para a língua portuguesa. Sessenta e nove pacientes brasileiros foram avaliados. Os pacientes foram mulheres (71%, a idade média foi 50,8 anos (±15,4, a escolaridade média 7,4 anos (±4,8, e as dores mais freqüentes foram de etiologia musculoesquelética (39,1%, relacionadas ao câncer (34,8% e neuropáticas (20,3%. A análise fatorial resultou em sete domínios (Controle, Dano-físico, Incapacidade, Cura Médica, Emoção, Medicação e Solicitude, como no instrumento original. A consistência interna, avaliada pelo µ Chronbach, variou de 0,55 a 0,89, valores considerados moderados e bons. A versão em português apresentou equivalência conceitual à versão em inglês. A disponibilidade do IAD-breve, em português, pode contribuir para a melhoria da pesquisa e prática clínica em pacientes com dor crônica.En este estudio se validó el Inventario de Actitudes frente al Dolor - versión reducida (IAD-breve para el idioma portugués. Fueron evaluados sesenta y nueve pacientes brasileños. Los pacientes fueron mujeres (71%, la edad media fue de 50,8 años (±15,4, la escolaridad media 7,4 años (±4,8, y los dolores más frecuentes fueron de etiología músculo esquelética (39,1%, relacionadas al cáncer (34,8% y neuropáticas (20,3%. El análisis factorial resultó en siete dominios (Control, Daño físico, Incapacidad, Cura Médica, Emoción, Medicación y Solicitud, como en el instrumento original. La consistencia interna, evaluada por el µ Chronbach, varió de 0,55 a 0,89, valores considerados moderados y buenos. La versión en portugués presentó equivalencia conceptual a la versión en inglés. La disponibilidad del IAD-breve, en portugués, puede contribuir en la mejoría de la investigación y la práctica clínica en pacientes con dolor crónico.This study validated the Survey of Pain Attitudes - brief version (SOPA for the Portuguese

  9. Painful Intercourse Is Significantly Associated with Evoked Pain Perception and Cognitive Aspects of Pain in Women with Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Meryl J. Alappattu, DPT, PhD

    2015-03-01

    Conclusions: Differences in local pain ratings suggest that women with pelvic pain perceive stimuli in this region as more painful than pain-free women although the magnitude of stimuli does not differ. Alappattu MJ, George SZ, Robinson ME, Fillingim RB, Moawad N, LeBrun EW, and Bishop MD. Painful intercourse is significantly associated with evoked pain perception and cognitive aspects of pain in women with pelvic pain. Sex Med 2015;3:14–23.

  10. Children's pain perspectives.

    Science.gov (United States)

    Esteve, R; Marquina-Aponte, V

    2012-05-01

    Previous studies on children's pain perspectives remain limited to English-speaking populations. An exploratory cross-sectional descriptive design was used to investigate the developmental progression of children's pain perspectives, including their pain experience, its definition and attributes, causality and coping. The Children's Pain Perspectives Inventory was applied to 180 healthy Spanish children. A coding system was developed following the content analysis method. Three age groups were compared: 4-6 years, corresponding to the Piagetian pre-operational stage of cognitive development; 7-11 years, corresponding to stage of concrete operations; and 12-14 years, corresponding to the period of early formal operations. In children between 4 and 6, the predominant narratives related to physical injuries, the notion of causality and the definition of pain. In children between 7 and 11, the predominant narratives were those in which pain was described as a sensation in one part of the body. The view of pain as having an emotional basis significantly increased with age and was more frequent in adolescents. In contrast, children between 4-6 and 7-11 indicated that pain occurs spontaneously. The denial of any positive aspects of pain significantly decreased with age; some children between 7 and 11 referred to the 'possibility of relief', while the view that pain is a 'learning experience' was significantly more frequent among adolescents aged between 12 and 14 years. The use of cognitive strategies to control pain significantly increased with age. Between 12 and 14 years of age, adolescents communicate pain by non-verbal behaviour and reported that they do not express demands for relief. There was a progression from concrete to more complex notions of pain as age increased. These results may be of use to health professionals and parents to understand how children at various developmental stages express and cope with pain and to develop tools that effectively assess and

  11. Culturas del Mundo

    DEFF Research Database (Denmark)

    Benwell, Ann Fenger; Costa, Alberto; Waehle, Espen

    2006-01-01

    ’Culturas del mundo. Colecciones del Museo Nacional de Dinamarca’ with Ann Fenger Benwell in Culturas del Mundo. Colecciones del Museo Nacional de Dinamarca, ed. Silvia Sauquet, Fundación "la Caixa", Barcelona 2006, pp. 31-39......’Culturas del mundo. Colecciones del Museo Nacional de Dinamarca’ with Ann Fenger Benwell in Culturas del Mundo. Colecciones del Museo Nacional de Dinamarca, ed. Silvia Sauquet, Fundación "la Caixa", Barcelona 2006, pp. 31-39...

  12. Pain-related worry in patients with chronic orofacial pain.

    Science.gov (United States)

    Davis, C Ervin; Stockstill, John W; Stanley, William D; Wu, Qiang

    2014-07-01

    Pain-related worry is distinct from, but related to, pain catastrophizing (PC) and anxiety. Worry and its relationship with other variables have been studied in people with chronic pain but not in people with chronic orofacial pain. The authors explored the prevalence of trait, general and pain-related worry and the association of worry with higher pain levels and other variables. The authors assessed people who had a diagnosis of chronic orofacial pain by using nonpain-related trait worry, state anxiety, trait anxiety, PC and pain measures. The participants' answers to an open-ended question about what they were most worried about led to the identification of worry domains, including worry about pain. The authors found that worrying about pain was related significantly to worst and least pain levels, pain interference and pain duration, as well as moderated trait worry in predicting pain interference. Although trait worry was not correlated directly with pain, when moderated by PC, it made substantial contributions in predicting pain interference. Participants with chronic orofacial pain reported experiencing substantial levels of trait worry, anxiety, PC and worry about pain that related to pain ratings directly and indirectly. Clinicians should assess pain-related worry in patients with chronic orofacial pain to understand the effects of worry on pain and functioning. Clinicians could treat these patients more effectively by helping them reduce their levels of pain-related worry and focusing on improved coping.

  13. Dancing in pain: pain appraisal and coping in dancers.

    Science.gov (United States)

    Anderson, Ruth; Hanrahan, Stephanie J

    2008-01-01

    This study investigated the relationships between the type of pain experienced (performance pain and injury pain), the cognitive appraisal of pain and pain coping styles in dancers. Fifty-one professional ballet and contemporary dancers (17 males and 34 females), with the mean age of 25.9 years, completed a general pain questionnaire, the Pain Appraisal Inventory, the Survey of Pain Attitudes Control Subscale, and the Sports Inventory for Pain. Multivariate analyses of variance indicated that both the cognitive appraisal of the pain and pain coping styles did not differ according to the type of pain experienced or the pain severity. However, it was found that dancers with performance pain of either low or high severity were more likely to dance in pain than dancers experiencing injury pain. Multiple regression analyses indicated that the appraisal of pain as threatening was predictive of the use of avoidance and catastrophizing pain coping styles. Overall, results indicated that dancers may not differentiate between performance pain and injury pain, or modify their appraisal and coping strategies according to the characteristics of the pain experienced. The study highlighted an opportunity for increased education for dancers in recognizing the difference between pain considered to be a routine aspect of training and pain which is a signal of serious injury.

  14. Neuropathic pain in primary care

    African Journals Online (AJOL)

    The operative difference is that neuropathic pain represents a delayed, ongoing response to damage that is no longer acute ... Postsurgical pain (including post- mastectomy and phantom limb pain). Spinal cord injury pain ... Management of neuropathic pain. Neuropathic pain tends to exhibit a relatively poor response.

  15. Multidisciplinary pain management programs

    Directory of Open Access Journals (Sweden)

    Kaiser U

    2013-05-01

    Full Text Available Ulrike Kaiser,1 Bernhard Arnold,2 Michael Pfingsten,3 Bernd Nagel,4 Johannes Lutz,5 Rainer Sabatowski1,61Comprehensive Pain Center, University Hospital “Carl Gustav Carus”, Dresden, 2Department of Pain Management, Klinikum Dachau, Dachau, 3Pain Clinic, University Medicine, University of Göttingen, 4Day Care Unit, DRK Pain Center, Mainz, 5Interdisciplinary Pain Center, Zentralklinik Bad Berka, Bad Berka, 6Department of Anesthesiology and Intensive Care, University Hospital “Carl Gustav Carus”, Dresden, Germany

  16. Institutional effectiveness of energy efficiency national programs: Brazil, Chile, Mexico and Uruguay cases; Eficacia institucional de los programas nacionales de eficiencia energetica: los casos del Brasil, Chile, Mexico y el Uruguay

    Energy Technology Data Exchange (ETDEWEB)

    Ruchansky, Beno [Division de Recursos Naturales e Infraestructura de la CEPAL (Chile); De Buen Rodriguez, Odon [Energia, Tecnologia y Educacion, S.C., ENTE, S.C. (Mexico); Januzzi, Gilberto; Romero, Andres

    2011-05-15

    This work describes the experience of four Latin American countries in the area of energy efficiency (EE), with particular emphasis on the creation and effectiveness of institutional systems needed to develop policies, programs and mechanisms to promote EE. The wide variety of situations presented in the study of national cases in Brazil, Chile, Mexico and Uruguay, as well as the wealth of their experiences may provide significant contributions to the promotion of EE in the region. Brazil stands out because of its long and rich history in the field of promoting EE, in particular, for work conducted in 1985 by PORCEL, a federal program with its base of operations at ELETROBRAS, which served as the national coordinator of EE activities in the electric sector during a large part of the period and was responsible for the successful implementation of activities to foster EE in various areas. While PROCEL and CONPET continue to fulfill an important role, other actors have become involved over time in the activities related to EE, with a gradual transfer over recent years of the activities of these programs to the primary agencies in the sector, particularly MME, ANEEL, ANP and EPE. Currently, Brazil has an extensive network of public and private institutions involved in the area of EE, as well as norms that encourage EE with sufficient resources and regulatory mechanisms to finance and guide these activities. Although a large variety of initiatives have been implemented, they do not yet constitute a national EE policy. Thus, the need is seen for greater institutional coordination that allows for improving the convergence of results, utilizing economies of scale and creating opportunities to develop a national EE policy. Along the lines of the perspective described, the development is underway of a National Energy Efficiency Plan (PNEf, Spanish acronym), coordinated by the MME, that should include the basic elements needed to define an EE policy. Chile has relatively

  17. Institutional effectiveness of energy efficiency national programs: Brazil, Chile, Mexico and Uruguay cases; Eficacia institucional de los programas nacionales de eficiencia energetica: los casos del Brasil, Chile, Mexico y el Uruguay

    Energy Technology Data Exchange (ETDEWEB)

    Ruchansky, Beno [Division de Recursos Naturales e Infraestructura de la CEPAL (Chile); De Buen Rodriguez, Odon [Energia, Tecnologia y Educacion, S.C., ENTE, S.C. (Mexico); Januzzi, Gilberto; Romero, Andres

    2011-05-15

    This work describes the experience of four Latin American countries in the area of energy efficiency (EE), with particular emphasis on the creation and effectiveness of institutional systems needed to develop policies, programs and mechanisms to promote EE. The wide variety of situations presented in the study of national cases in Brazil, Chile, Mexico and Uruguay, as well as the wealth of their experiences may provide significant contributions to the promotion of EE in the region. Brazil stands out because of its long and rich history in the field of promoting EE, in particular, for work conducted in 1985 by PORCEL, a federal program with its base of operations at ELETROBRAS, which served as the national coordinator of EE activities in the electric sector during a large part of the period and was responsible for the successful implementation of activities to foster EE in various areas. While PROCEL and CONPET continue to fulfill an important role, other actors have become involved over time in the activities related to EE, with a gradual transfer over recent years of the activities of these programs to the primary agencies in the sector, particularly MME, ANEEL, ANP and EPE. Currently, Brazil has an extensive network of public and private institutions involved in the area of EE, as well as norms that encourage EE with sufficient resources and regulatory mechanisms to finance and guide these activities. Although a large variety of initiatives have been implemented, they do not yet constitute a national EE policy. Thus, the need is seen for greater institutional coordination that allows for improving the convergence of results, utilizing economies of scale and creating opportunities to develop a national EE policy. Along the lines of the perspective described, the development is underway of a National Energy Efficiency Plan (PNEf, Spanish acronym), coordinated by the MME, that should include the basic elements needed to define an EE policy. Chile has relatively

  18. Pain Management: Road Map to Revolution.

    Science.gov (United States)

    George, Steven Z

    2017-02-01

    Lindblom Young Investigator Award for Clinical Sciences from the International Association for the Study of Pain, the Florida Physical Therapy Association's Award for Scholarly Impact on Practice, and APTA's Jules M. Rothstein Golden Pen Award and Eugene Michels New Investigator Award. In 2014, George's innovative knowledge contributed to being identified by Expertscape as the 10th-ranked world expert for scholarly contributions to the understanding and treatment of back pain. Expertscape's ranking, based on the quantity and quality of peer-reviewed clinical research publications in the National Library of Medicine's MEDLINE database, highlights George's status as a visionary in the profession. For his advocacy toward conducting meaningful research, expertise on pain management, and profound impact beyond published works, APTA is pleased to honor Steven Z. George as the 2016 John H.P. Maley Lecturer. © 2017 American Physical Therapy Association

  19. Escarabajos coprófagos (Coleoptera, Scarabaeoidea del Parque Nacional Los Estoraques (Norte de Santander, Colombia Coprophagous scarab beetles (Coleoptera, Scarabaeoidea of Los Estoraques National Park (Norte de Santander, Colombia

    Directory of Open Access Journals (Sweden)

    Jesus Orozco

    2008-01-01

    Full Text Available En este trabajo se presenta información sobre los escarabajos coprófagos del Área Natural Única Los Estoraques (ANUE, Departamento de Norte de Santander, Colombia. Los muestreos fueron realizados durante los meses de febrero a diciembre del año 2002 en cuatro sitios con diferente grado de intervención, suministrando la captura de 10,538 individuos. Los sitios muestreados correspondieron a bosque seco premontano y bosque montañoso húmedo con diferentes grados de intervención. 16 especies de Scarabaeinae conformaron el 89% de las ejemplares colectados, el 11% restante (3 especies fue conformado por Hibosóridos. La totalidad de las especies se completo en el quinto muestreo. Se registró diferencia significativa en la riqueza y abundancia entre los sitios (P Information on the diversity and abundance of the coprophagous scarab beetles of Los Estoraques National Park (ANUE in Colombia is presented. Beetles were collected monthly from February to December 2002 with pitfall traps baited with human excrement. Four environments where sampled including montane dry forests and montane humid forests with different degrees of disruption. A total of 10,538 specimens representing 19 species were collected. All the species were collected by the fifth month. The Scarabaeinae represented 89% of the collected species (16; the remaining 11% were in Hybosoridae (3. An ANOVA analysis showed significant differences in richness and abundance between some of the sites. No correlation between precipitation and abundance was found for any of the sites sampled. For Norte de Santander, seven species are recorded for the first time, and the known altitudinal distribution in Colombia is expanded for four species.

  20. Estimation of charges for services of transmission of electrical energy between regions of the national electrical system; Estimacion de cargos por servicios de transmision de energia electrica entre regiones del sistema electrico nacional

    Energy Technology Data Exchange (ETDEWEB)

    Inda Ruiz, Adrian; Flores Alba, Dora Elia [Instituto de Investigaciones Electricas, Cuernavaca, Morelos (Mexico); Escobar Lopez, Akihito [Comision Federal de Electricidad (Mexico)

    2002-07-01

    In order to facilitate the answer of the Comision Federal de Electricidad (CFE) to the requests of services of transmission of authorized or potential licensees, this organism devised the construction of matrices of charges that allow in a fast and direct way for specific transactions, to know the charges in which different types of transmission services incur classified by transport levels and by tension levels in which the service is asked for. These tables could be published in the media that might be judged advisable, in order that the applicant licensees have access to a preliminary estimation of the charges for the required services, without the need of going, for one first estimation, directly to the CFE for their calculation. This article presents the results of the development of a calculation tool that allows estimating, in a fast and efficient way, charges for transmission services between regions of the national electrical system. [Spanish] Para facilitar la respuesta de la Comision Federal de Electricidad (CFE) a las solicitudes de servicios de transmision de permisionarios autorizados o potenciales, esta ideo la construccion de matrices de cargos que permitan de manera rapida y directa para transacciones especificas, conocer los cargos en que incurren diferentes tipos de servicios de transmision clasificados por niveles de transporte y por niveles de tension en los que se solicita el servicio. Dichas tablas podran ser publicadas en los medios que se juzguen convenientes, con el fin de que los permisionarios solicitantes tengan acceso a una estimacion preliminar de los cargos por los servicios requeridos, sin necesidad de acudir, para una primera estimacion, directamente a la CFE para su calculo. Este articulo presenta los resultados del desarrollo de una herramienta de calculo que permite estimar, de manera rapida y eficiente, matrices de cargos por servicios de transmision entre regiones del sistema electrico nacional.

  1. Efeitos do tratamento prévio com lidocaína, paracetamol e lidocaína-fentanil por via venosa na dor causada pela injeção de propofol: estudo comparativo Efectos del tratamiento previo con lidocaína, paracetamol y lidocaína-fentanil intravenosos en el dolor causado por la inyección de propofol: estudio comparativo Effect of pretreatment with lidocaine, intravenous paracetamol and lidocaine-fentanyl on propofol injection pain: comparative study

    Directory of Open Access Journals (Sweden)

    Khaled M. El-Radaideh

    2007-02-01

    ón venosa fue hecha después de 60 segundos, siendo seguida de la administración intravenosa de propofol, 2,5 mg.kg-1 a una velocidad de 0,5 mg.s-1 a través de un catéter de 20G insertado en la vena del dorso de la mano. La evaluación del dolor fue hecha durante la inyección de propofol. Ella incluyó movimientos de la mano, expresión verbal espontánea de dolor, muecas y gemidos durante la inyección de propofol. RESULTADOS: Lidocaína-fentanil (70% sin dolor y lidocaína (68% sin dolor fueron más eficaces en la reducción del dolor causado por la inyección de propofol que el paracetamol (54% sin dolor y el placebo (36% sin dolor (p BACKGROUND AND OBJECTIVES: Performed a randomized, double blind study to assess the efficacy of intravenous (IV pretreatment with lidocaine, IV paracetamol (Perfalgan® or lidocaine mixed with fentanyl in reducing propofol injection pain. METHODS: Immediately after venous occlusion with a rubber tourniquet on the patient's arm IV lidocaine 1% 4 mL (Group L, n = 50, IV paracetamol (Perfalgan® 4 mL (40 mg (Group R, n = 50, lidocaine 2% mixed with 100 µg fentanyl (Group LF, n = 50 or normal saline 4 mL (Group P, n = 50; as placebo control was given to 200 adult patients. The release of the venous occlusion was done after 60s and followed by intravenous administration of propofol 2.5 mg.kg-1 at rate of 0.5 mg.s-1 through a 20G catheter inserted in hand dorsum vein. Pain assessment was made during the propofol injection. This included movement of hand, spontaneous verbal expressions of pain, frowning, and moaning during the injection of propofol. RESULTS: Lidocaine-fentanyl (70% pain free, and lidocaine (68% pain free significantly reduced propofol injection pain more than paracetamol (54% pain free and more than placebo (36% pain free (p < 0.05. The difference in reducing the incidence of propofol injection pain between lidocaine and lidocaine-fentanyl did not reach statistical significance. There was a significant superiority of

  2. Impacto económico-social del Programa Nacional de Control de la Tuberculosis (PNCT en la población cubana Economic and social impact of the National Tuberculosis Control Program (NTCP on the Cuban population

    Directory of Open Access Journals (Sweden)

    Edilberto González

    2000-09-01

    Full Text Available Las estrategias de control de la tuberculosis (TB poseen un costo/efectividad muy favorable. Se describen y valoran los impactos del programa de control, utilizando las series temporales de casos nuevos y fallecidos notificados por TB en 1964-91 y 1992-96. Se estimaron los casos evitados y años potenciales de vida ganados; gastos por quimioterapia, hospitalizaciones y prestaciones sociales ahorrados, valorados sobre la base del número de casos nuevos, definiciones y casos esperados estimados. Entre 1965-1991, la incidencia estimada de TB se redujo en 94,6% (4% por año, se evitaron unos 86.500 casos nuevos; hubo una ganancia potencial de 166.439 años de vida. Se estimó un ahorro de 2.831.625,3 pesos solo por costo de tuberculostáticos dejados de aplicar. Se redujeron los pagos por subsidio salarial de trabajadores enfermos por TB con 82 millones de pesos ahorrados. El total ahorrado estimado asciende a 494.919.631,3 pesos. Estos impactos son muy importantes y avalan la efectividad de las estrategias aplicadas bajo las circunstancias sociopolíticas del país, favoreciendo los enfoques para un programa de eliminación.Tuberculosis (TB control strategies provide one of the greatest cost/effectiveness results. To assess the impact of the national TB control program on the Cuban population, the time series of new TB cases and death reports, potential years of life lost, and the numbers of beds for TB case hospitalization in the entire country during 1964-91 and 1992-96 were described by common simple calculation on the basis of estimated expected values. The reduction in new TB cases and deaths, potential years of life saved, and savings in expenditures for treatment, hospitalization, and unemployment compensation were estimated. >From 1965 to 1991 new case reports were reduced by 94.6% (4% per year; 86,500 cases were avoided; 166,439 potential years of life were saved; 2,831,625 million pesos were saved on tuberculostatic drugs; 82.7 million

  3. «We have ceased to be a nation in retreat». Margaret Thatcher e gli usi strategici del conflitto

    Directory of Open Access Journals (Sweden)

    Lidia De Michelis

    2015-03-01

    Full Text Available This essay explores Margaret Thatcher’s political agency and leadership style in terms of her reliance on discursive and media strategies which thrived on the “confusion” of gender stereotypes and her ability to play with multiple, long-established archetypes of women in power, characterized by violent and aggressive femininity. Thatcher’s frequent self-projection as a “masculine” character, the “honorary man” of British politics, and her special grip on British public opinion and fantasies, were never disjointed from her ability to don, exploit, subvert and redirect “motherly’ (or at least “womanly” performances at will, in order to serve her political agenda. Focusing on her strategic deployment of a rhetoric and discourses of aggression, divisiveness, conflict and war, the essay highlights Thatcher’s ability to re-create and keep alive the idea of a national community always under siege, where extraordinary economic, disciplinary and defence measure were required in order to resist and overcome domestic and foreign “enemies”. The Falklands War will be taken as case study, for it provides an outstanding example of Thatcher’s powerful revision of female political authority against the backdrop of the conventionally masculine, heroic imaginary of war. Her masterly and coterminous performances as war leader and “super-mother” of the nation allowed for a complex and hybrid self-projection which still acts as an empowering model whose disciplinary subtext entails a nostalgic investment in imperial national history.

  4. Exposition and evaluation of scenarios for the planning of the national power sector; Planteamiento y evaluacion de escenarios para la planeacion del sector energetico nacional

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez R, Ranulfo; Flores L, Marco P; Gonzalez Santalo, Jose M; Sanchez H, Laura E; Castrejon B, David; Porras L, Gladys L; Lopez A, Esmeralda; Lima R, Deytia [Instituto de Investigaciones Electricas, Cuernavaca, Morelos (Mexico)

    2006-07-01

    In this article the Model of Optimization of Provision and Distribution of Electricity and Fuels is described, which is the analysis tool used by the responsible national organisms to cover the national demand of fuels and electricity for the accomplishment of studies that provide support elements in the exposition of policies covering the national demands, simultaneously diminishing the cost and reducing the environmental impact. This tool determines the combination of technologies and fuels that imply the smaller cost for the country at the time of covering the energy demands. This document extends on the analytical resources and planning that serve as a base to the Model and on its complements, such as risk estimations facing each investment alternative. All this with the purpose of providing more reliable information to the decision maker group in the matter of energy policies. [Spanish] En este articulo se describe el Modelo de Optimizacion de Suministro y Distribucion de Electricidad y Combustibles, que es la herramienta de analisis empleada por los organismos nacionales responsables de cubrir la demanda nacional de combustibles y electricidad para la realizacion de estudios que proporcionen elementos de apoyo en el planteamiento de politicas que cubran las demandas nacionales, al mismo tiempo que minimicen el costo y reduzcan el impacto ambiental. Esta herramienta determina la combinacion de tecnologias y combustibles que impliquen el menor costo para el pais al momento de cubrir las demandas de energeticos. Este documento amplia sobre los recursos analiticos y planeaciones que sirven de base al modelo y sobre sus complementos, como estimaciones de riesgo frente a cada alternativa de inversion. Todo esto con el fin de suministrar informacion mas confiable al grupo que toma las decisiones en materia de politicas energeticas.

  5. Nutraceuticals and osteoarthritis pain.

    Science.gov (United States)

    Wang, Angela; Leong, Daniel J; Cardoso, Luis; Sun, Hui B

    2018-02-24

    Arthritis is a chronic disease of joints. It is highly prevalent, particularly in the elderly, and is commonly associated with pain that interferes with quality of life. Because of its chronic nature, pharmacological approaches to pain relief and joint repair must be safe for long term use, a quality many current therapies lack. Nutraceuticals refer to compounds or materials that can function as nutrition and exert a potential therapeutic effect, including the relief of pain, such as pain related to arthritis, of which osteoarthritis (OA) is the most common form. Of interest, nutraceuticals have recently been shown to have potential in relieving OA pain in human clinical trials. Emerging evidence indicates nutraceuticals may represent promising alternatives for the relief of OA pain. In this paper, we will overview OA pain and the use of nutraceuticals in OA pain management, focusing on those that have been evaluated by clinical trials. Furthermore, we discuss the biologic and pharmacologic actions underlying the nutraceutical effects on pain relief based on the potential active ingredients identified from traditional nutraceuticals in OA pain management and their potential for drug development. The review concludes by sharing our viewpoints that future studies should prioritize elucidating the mechanisms of action of nutraceuticals in OA and developing nutraceuticals that not only relieve OA pain, but also mitigate OA pathology. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Fantom pain: Case report

    Directory of Open Access Journals (Sweden)

    Marić Sanja S.

    2017-01-01

    Full Text Available Background Phantom limb pain is a common problem after limb amputation (41-85%. It is described as an extremely painful sensation in the missing part of the body that can last for hours, days or even years. It is considered to arise from cortical reorganization, although many factors can increase the risk of phantom limb pain: pain before surgery, age and sex of the patients, the time elapsed since surgery, stump pain, inadequate prosthesis. Phantom limb pain therapy is very complicated. Case report We reported a case of 80-year-old patient suffering from phantom limb pain and phantom sensation 25 years after the amputation of his left leg due to the injury. The patient has pain at the site of amputation, sensation that he has the leg and that it occupies an unusual position and almost daily exhausting phantom limb pain (6-9 visual analogue scale - VAS with disturbed sleep and mood. We managed to reduce the pain under 4 VAS and decrease the patient suffering by combining drugs from the group of coanalgetics (antidepressants, antiepileptics, non-pharmacological methods (transcutaneous electroneurostimulation - TENS, mirror therapy and femoral nerve block in the place of disarticulation of the left thigh. Conclusion Phantom limb pain therapy is multimodal, exhausting for both the patient and the physician and it is often unsuccessful. The combination of different pharmacological and non-pharmacological modalities can give satisfactory therapeutic response.

  7. Ketamine for pain

    Science.gov (United States)

    Jonkman, Kelly; Dahan, Albert; van de Donk, Tine; Aarts, Leon; Niesters, Marieke; van Velzen, Monique

    2017-01-01

    The efficacy of the N-methyl-D-aspartate receptor antagonist ketamine as an analgesic agent is still under debate, especially for indications such as chronic pain. To understand the efficacy of ketamine for relief of pain, we performed a literature search for relevant narrative and systematic reviews and meta-analyses. We retrieved 189 unique articles, of which 29 were deemed appropriate for use in this review. Ketamine treatment is most effective for relief of postoperative pain, causing reduced opioid consumption. In contrast, for most other indications (that is, acute pain in the emergency department, prevention of persistent postoperative pain, cancer pain, and chronic non-cancer pain), the efficacy of ketamine is limited. Ketamine’s lack of analgesic effect was associated with an increase in side effects, including schizotypical effects. PMID:28979762

  8. The Pain of Labour

    Science.gov (United States)

    Labor, Simona

    2008-01-01

    Labour is an emotional experience and involves both physiological and psychological mechanisms. The pain of labour is severe but despite this its memory diminishes with time. Labour pain has two components: visceral pain which occurs during the early first stage and the second stage of childbirth, and somatic pain which occurs during the late first stage and the second stage. The pain of labour in the first stage is mediated by T10 to L1 spinal segments, whereas that in the second stage is carried by T12 to L1, and S2 to S4 spinal segments. Pain relief in labour is complex and often challenging without regional analgesia. Effective management of labour pain plays a relatively minor role in a woman's satisfaction with childbirth. PMID:26526404

  9. Pain emotion and homeostasis.

    Science.gov (United States)

    Panerai, Alberto E

    2011-05-01

    Pain has always been considered as part of a defensive strategy, whose specific role is to signal an immediate, active danger. This definition partially fits acute pain, but certainly not chronic pain, that is maintained also in the absence of an active noxa or danger and that nowadays is considered a disease by itself. Moreover, acute pain is not only an automatic alerting system, but its severity and characteristics can change depending on the surrounding environment. The affective, emotional components of pain have been and are the object of extensive attention and research by psychologists, philosophers, physiologists and also pharmacologists. Pain itself can be considered to share the same genesis as emotions and as a specific emotion in contributing to the maintenance of the homeostasis of each unique subject. Interestingly, this role of pain reaches its maximal development in the human; some even argue that it is specific for the human primate.

  10. Back Pain in Children

    Directory of Open Access Journals (Sweden)

    Sadi Kayiran ; Sinan Mahir Kayiran;

    2011-02-01

    Full Text Available Contrary to popular knowledge, back pain is quite frequently seen in children. While very rare in the pre-school age group, frequency reaches 30% in the adolescent period. In many cases, the causes of back pain in childhood cannot be exactly determined and the pain disappears by itself in a short time. It should be remembered that back pain that persists for more than two weeks may be associated with organic causes. Whether or not there have been disruptions in neurological functions should be definitely probed in the medical history. Keeping in mind that back pain could be a part of a systemic disease, a systemic examination should be carried out in cases where there has been long-term back pain. The complaint of childhood back pain should be assessed with a thorough history, a careful physical examination and advanced testing tools. [TAF Prev Med Bull 2011; 10(1.000: 115-118

  11. Avicenna's concept of pain

    Directory of Open Access Journals (Sweden)

    Osama A. Tashani

    2010-09-01

    Full Text Available Ibn Sina (Latin name – Avicenna, 980–1037 is a famous Muslim physician who wrote The Canon of Medicine. Pain-related writings within The Canon were identified and analysed and compared to Galen and Modern Pain Theory. We found evidence in The Canon that Avicenna challenged Galen's concept of pain. Galen insisted that injuries (breach of continuity were the only cause of pain. In contrast, Avicenna suggested that the true cause of pain was a change of the physical condition (temperament change of the organ whether there was an injury present or not. Avicenna extended Galen's descriptions of 4 to 15 types of pain and used a terminology that is remarkably similar to that used in the McGill Pain Questionnaire.

  12. [Physiotherapy and physical therapy in pain management].

    Science.gov (United States)

    Egan, M; Seeger, D; Schöps, P

    2015-10-01

    Patients attend physiotherapy and physical therapy (PT) due to pain problems and/or functional impairments. Although the main focus for therapists has traditionally been physical examination and treatment of tissue structures and biomechanics, over the last few decades a growing body of research has highlighted the importance of central nervous system processing and psychosocial contributors to pain perception. Treatment with PT aims to reduce disability and suffering by reducing pain and increasing tolerance to movement. In Germany, pain management conducted by physiotherapists is currently undergoing major changes. Firstly, PT education is transitioning from a vocational to a degree level and additionally new concepts for improved multidisciplinary treatment approaches are being developed. However, there still remain substantial differences between therapists working in multidisciplinary pain clinics and those following medical referral in private practices. This article provides information on how national and international impulses have contributed to the development of different concepts of passive therapies and active/functional pain rehabilitation in Germany. In the future PT will need to provide more evidence about efficiency and modes of actions for different treatment options to selectively reason the application to patients with acute, subacute and chronic pain.

  13. Chronic female pelvic pain

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2013-01-01

    Full Text Available Chronic pelvic pain (CPP is defined as nonmalignant pain perceived in the structures related to the pelvis that has been present for more than 6 months or a non acute pain mechanism of shorter duration. Pain in the pelvic region can arise from musculoskeletal, gynaecological, urologic, gastrointestinal and or neurologic conditions. Key gynaecological conditions that contribute to CPP include pelvic inflammatory disease (PID, endometriosis, adnexa pathologies (ovarian cysts, ovarian remnant syndrome, uterine pathologies (leiomyoma, adenomyosis and pelvic girdle pain associated with pregnancy. Several major and minor sexually transmitted diseases (STD can cause pelvic and vulvar pain. A common painful condition of the urinary system is Interstitial cystitis(IC. A second urologic condition that can lead to development of CPP is urethral syndrome. Irritable bowel syndrome (IBS is associated with dysmenorrhoea in 60% of cases. Other bowel conditions contributing to pelvic pain include diverticular disease,Crohn′s disease ulcerative colitis and chronic appendicitis. Musculoskeletal pathologies that can cause pelvic pain include sacroiliac joint (SIJ dysfunction, symphysis pubis and sacro-coccygeal joint dysfunction, coccyx injury or malposition and neuropathic structures in the lower thoracic, lumbar and sacral plexus. Prolonged pelvic girdle pain, lasting more than 6 months postpartum is estimated in 3% to 30% of women. Nerve irritation or entrapment as a cause of pelvic pain can be related to injury of the upper lumbar segments giving rise to irritation of the sensory nerves to the ventral trunk or from direct trauma from abdominal incisions or retractors used during abdominal surgical procedures. Afflictions of the iliohypogastric, ilioinguinal, genitofemoral, pudendal and obturator nerves are of greatest concern in patients with pelvic pain. Patient education about the disease and treatment involved is paramount. A knowledge of the differential

  14. Back pain and low back pain

    International Nuclear Information System (INIS)

    Cotta, H.; Niethard, F.U.

    1983-01-01

    In patients with back pain there is only a poor correlation between clinical and radiological symptoms. Therefore the interpretation of radiological findings is only possible with respect to the natural history of the disease. Indication for radiological examination is given for early diagnosis and treatment of malinformation of the spine; diagnosis and treatment of functional disturbances of the spine with back- and low back pain and diagnosis and treatment of diseases which affect the stability of the vertebrae. (orig.)

  15. Maintenance of Pain in Children With Functional Abdominal Pain.

    Science.gov (United States)

    Czyzewski, Danita I; Self, Mariella M; Williams, Amy E; Weidler, Erica M; Blatz, Allison M; Shulman, Robert J

    2016-03-01

    A significant proportion of children with functional abdominal pain develop chronic pain. Identifying clinical characteristics predicting pain persistence is important in targeting interventions. We examined whether child anxiety and/or pain-stooling relations were related to maintenance of abdominal pain frequency and compared the predictive value of 3 methods for assessing pain-stooling relations (ie, diary, parent report, child report). Seventy-six children (7-10 years old at baseline) who presented for medical treatment of functional abdominal pain were followed up 18 to 24 months later. Baseline anxiety and abdominal pain-stooling relations based on pain and stooling diaries and child- and parent questionnaires were examined in relationship to the persistence of abdominal pain frequency. Children's baseline anxiety was not related to persistence of pain frequency. Children who, however, displayed irritable bowel syndrome (IBS) symptoms at baseline maintained pain frequency at follow-up, whereas in children in whom there was no relationship between pain and stooling, pain frequency decreased. Pain and stool diaries and parent report of pain-stooling relations were predictive of pain persistence but child-report questionnaires were not. The presence of IBS symptoms in school-age children with functional abdominal pain appears to predict persistence of abdominal pain over time, whereas anxiety does not. Prospective pain and stooling diaries and parent report of IBS symptoms were predictors of pain maintenance, but child report of symptoms was not.

  16. Pain after earthquake

    Directory of Open Access Journals (Sweden)

    Angeletti Chiara

    2012-06-01

    Full Text Available Abstract Introduction On 6 April 2009, at 03:32 local time, an Mw 6.3 earthquake hit the Abruzzi region of central Italy causing widespread damage in the City of L Aquila and its nearby villages. The earthquake caused 308 casualties and over 1,500 injuries, displaced more than 25,000 people and induced significant damage to more than 10,000 buildings in the L'Aquila region. Objectives This observational retrospective study evaluated the prevalence and drug treatment of pain in the five weeks following the L'Aquila earthquake (April 6, 2009. Methods 958 triage documents were analysed for patients pain severity, pain type, and treatment efficacy. Results A third of pain patients reported pain with a prevalence of 34.6%. More than half of pain patients reported severe pain (58.8%. Analgesic agents were limited to available drugs: anti-inflammatory agents, paracetamol, and weak opioids. Reduction in verbal numerical pain scores within the first 24 hours after treatment was achieved with the medications at hand. Pain prevalence and characterization exhibited a biphasic pattern with acute pain syndromes owing to trauma occurring in the first 15 days after the earthquake; traumatic pain then decreased and re-surged at around week five, owing to rebuilding efforts. In the second through fourth week, reports of pain occurred mainly owing to relapses of chronic conditions. Conclusions This study indicates that pain is prevalent during natural disasters, may exhibit a discernible pattern over the weeks following the event, and current drug treatments in this region may be adequate for emergency situations.

  17. Chronic Abdominal Wall Pain.

    Science.gov (United States)

    Koop, Herbert; Koprdova, Simona; Schürmann, Christine

    2016-01-29

    Chronic abdominal wall pain is a poorly recognized clinical problem despite being an important element in the differential diagnosis of abdominal pain. This review is based on pertinent articles that were retrieved by a selective search in PubMed and EMBASE employing the terms "abdominal wall pain" and "cutaneous nerve entrapment syndrome," as well as on the authors' clinical experience. In 2% to 3% of patients with chronic abdominal pain, the pain arises from the abdominal wall; in patients with previously diagnosed chronic abdominal pain who have no demonstrable pathological abnormality, this likelihood can rise as high as 30% . There have only been a small number of clinical trials of treatment for this condition. The diagnosis is made on clinical grounds, with the aid of Carnett's test. The characteristic clinical feature is strictly localized pain in the anterior abdominal wall, which is often mischaracterized as a "functional" complaint. In one study, injection of local anesthesia combined with steroids into the painful area was found to relieve pain for 4 weeks in 95% of patients. The injection of lidocaine alone brought about improvement in 83-91% of patients. Long-term pain relief ensued after a single lidocaine injection in 20-30% of patients, after repeated injections in 40-50% , and after combined lidocaine and steroid injections in up to 80% . Pain that persists despite these treatments can be treated with surgery (neurectomy). Chronic abdominal wall pain is easily diagnosed on physical examination and can often be rapidly treated. Any physician treating patients with abdominal pain should be aware of this condition. Further comparative treatment trials will be needed before a validated treatment algorithm can be established.

  18. Statistical study of the activity developed in the Unit of Environmental Dosimetry and Personnel of the Radioprotection Service of the National Center of Environmental Health; Estudio estadístico de la actividad desarrollada en la Unidad de Dosimetría Ambiental y Personal del Servicio de Radioprotección del Centro Nacional de Sanidad Ambiental

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Gimeno, G.; Moracho, J.; Sánchez, L.; Ballesteros, G.; Medina, P.; Castro, J.

    2016-07-01

    The service of radiation protection of the National Center for Environmental Health, which belongs to the Institute of Health Carlos III, began its activities in the 80’s. This study shows the dosimetry data of professionals working in the fields of health, research and/ or education, and the industry in radioactive installations controlled by the unit between 1992 and 2013. This work presents the different kinds of dosimeter and the evolution of the number of controlled people in the diverse activity fields during these 22 years, the trend of the average annual doses and the highest received doses, as well as the effect of the administrative doses. Finally a summary of the conclusions from these data is presented. [Spanish] El Servicio de Radioprotección (SRP) del Centro Nacional de Sanidad Ambiental, perteneciente al Instituto de Salud Carlos III, inició sus actividades en la década de los 80. Este estudio contiene los datos dosimétricos de los profesionales, que desarrollaron su actividad en instalaciones radiactivas controladas dosimétricamente por la unidad desde el año 1992 hasta 2013, dentro de los campos sanitario, de investigación y/o docencia, e industrial. En él se presenta los tipos de dosímetros utilizados y la evolución durante estos 22 años del número de personas controladas en las distintas ramas de actividad, la tendencia de las dosis individuales medias anuales y las dosis más altas recibidas, así como la incidencia de las dosis administrativas. Finalmente se hace un resumen de las conclusiones obtenidas a partir de estos datos.

  19. Cambios en las propiedades del suelo, posteriores a un incendio en el Parque Nacional Natural de Los Nevados, Colombia Soil changes after a fire event in a páramo ecosystem: Los Nevados Natural National Park, Colombia

    Directory of Open Access Journals (Sweden)

    Juan Carlos Camargo-García

    2012-04-01

    Full Text Available En 2006 ocurrió un incendio en el Parque Nacional Natural de Los Nevados, Colombia, que afectó aproximadamente 2400 ha de ecosistema de páramo de sectores aledaños a la laguna del Otún (4 ° 46' 58.4" N y 75° 24' 26.8" O. Teniendo en cuenta la posible afectación de algunos servicios ecosistémicos proveídos por el suelo y la necesidad de encontrar variables que puedan ser utilizadas como indicadores del estado de este recurso, se realizó una evaluación de las propiedades físicas y químicas de los suelos en áreas afectadas (AA y no afectadas (NA por el incendio. Las evaluaciones se tuvieron inmediatamente después del evento (2006, dos años (2008 y tres años (2009 después. Se incluyeron áreas donde se implementaron estrategias de restauración y dos posiciones en el relieve: valle (turberas y laderas. Para identificar diferencias en las características del suelo evaluadas entre sitios afectados y no-afectados, posiciones topográficas y los tratamientos de restauración, se hizo una prueba no-paramétrica de Kruskall-Wallis. Posteriormente, para verificar relaciones entre variables, se realizó un análisis de correlación usando el coeficiente de Sperman. En general, la posición de valle mostró los cambios más drásticos en el suelo a través del tiempo de evaluación. Allí, más del 50% de la materia orgánica se perdió, generando cambios también en algunas propiedades físicas como la densidad aparente y la estabilidad estructural, que después de tres años, y a pesar de las actividades de restauración, muestran evidentes problemas de degradación. Con los resultados obtenidos ha sido posible definir variables indicadoras de las condiciones del suelo, que podrían ser usadas en programas de monitoreo de este recurso. Así mismo, se evidencia que los procesos de restauración en este ecosistema son lentos y se requiere un tiempo prolongado para generar cambios positivos en las propiedades de los suelos afectados, que

  20. Suministro de antirretrovirales en Argentina: Programa Nacional de Lucha contra los Retrovirus del Humano, SIDA y ETS Antiretroviral drug supply in Argentina: National Program to Combat Human Retroviruses, AIDS, and STDs

    Directory of Open Access Journals (Sweden)

    Marisel Colautti

    2009-01-01

    Full Text Available OBJETIVOS: Evaluar el circuito de suministro de antirretrovirales (ARV dentro del Programa Nacional de Lucha contra los Retrovirus del Humano, SIDA y ETS, mediante indicadores de desempeño, y recuperar la perspectiva de actores involucrados en el circuito de provisión. Se busca mejorar las acciones programáticas satisfaciendo las necesidades de los pacientes. MÉTODOS: En el servicio de farmacia de dos hospitales de Rosario, Argentina, de abril a septiembre de 2005 se llevó a cabo una investigación evaluativa con un abordaje cuantitativo, mediante indicadores y basado en fuentes secundarias, y otro cualitativo, con entrevistas semiestructuradas. RESULTADOS: Los indicadores revelan el impacto de las interrupciones en la provisión de ARV desde el Programa (nivel central y la acumulación de stock en el nivel local para paliar esas faltas. Los cambios de tratamiento con ARV representan más de 50% de las prescripciones. El cumplimiento en el retiro de ARV se aleja del valor de referencia. Los entrevistados describieron estrategias alternativas para superar dificultades de comunicación entre niveles, acumular stock, garantizar disponibilidad y acortar tiempos de espera; se establecieron acuerdos informales ante la falta de normativas y la escasez de recursos humanos; las instancias jurisdiccionales (central, intermedia y local o municipal suman dificultades, y se reconocen esfuerzos del nivel local para mejorar la gestión. CONCLUSIONES: Estos hallazgos pueden ser el punto de partida para la construcción de propuestas que involucren equipos de trabajo afectados en el circuito de provisión en su totalidad, a fin de lograr una descentralización efectiva, en congruencia con el papel rector que le corresponde necesariamente al Programa.OBJECTIVES: To evaluate the supply cycle of antiretroviral (ARV drugs, overseen by the National Program to Combat Human Retroviruses, AIDS, and STDs, through its order fulfillment indicators, and to obtain input

  1. Impact of Undertreated Sickle Cell Pain in the Caribbean

    Directory of Open Access Journals (Sweden)

    PD Shah

    2014-09-01

    Full Text Available Objective: Undertreated pain around the world includes the acute and chronic pain caused by sickle cell disease (SCD. In collaboration with a Caribbean association that aims to provide assistance to those diagnosed with SCD, we surveyed adults with SCD about pain management and impact of SCD pain. Methods: Participants were recruited from a group of 55 adults with SCD. A survey was administered to those who agreed to participate. Questions centred on their self-assessed level of pain due to SCD, the extent to which that pain interferes with daily activities, and how they seek and obtain pain relief. Results: Responses were received from 39 participants (female: n = 28, 72%, male: n = 11, 28%; mean age: 31.6 (SD ± 13.7 years. Sickle cell disease pain significantly disrupts participants’ daily activities (62%, mood (72%, work (64% and sleep (69%. Prescription medicine was ineffective for 41% and about half (n = 19 sought alternate means of relief. Conclusion: Sickle cell disease pain is undertreated in the Caribbean, disrupts daily activities and affects quality of life by impinging on education, employment and marital status. Sickle cell disease and other types of pain can be clinically managed safely, effectively and inexpensively. By failing to palliate and overcome the problem of undertreated pain, healthcare systems and providers contribute to socio-economic amongst other repercussions for sufferers, their families and caregivers, and their nations.

  2. Persistent facial pain conditions

    DEFF Research Database (Denmark)

    Forssell, Heli; Alstergren, Per; Bakke, Merete

    2016-01-01

    Persistent facial pains, especially temporomandibular disorders (TMD), are common conditions. As dentists are responsible for the treatment of most of these disorders, up-to date knowledge on the latest advances in the field is essential for successful diagnosis and management. The review covers...... TMD, and different neuropathic or putative neuropathic facial pains such as persistent idiopathic facial pain and atypical odontalgia, trigeminal neuralgia and painful posttraumatic trigeminal neuropathy. The article presents an overview of TMD pain as a biopsychosocial condition, its prevalence......, clinical features, consequences, central and peripheral mechanisms, diagnostic criteria (DC/TMD), and principles of management. For each of the neuropathic facial pain entities, the definitions, prevalence, clinical features, and diagnostics are described. The current understanding of the pathophysiology...

  3. Spiritual pain and suffering.

    Science.gov (United States)

    Brunjes, George B

    2010-01-01

    Spiritual pain/suffering is commonly experienced by persons with life-limiting illness and their families. Physical pain itself can be exacerbated by non-physical causes such as fear, anxiety, grief, unresolved guilt, depression and unmet spiritual meets. Likewise, the inability to manage physical pain well can be due to emotional and spiritual needs. This is why a holistic, interdisciplinary assessment of pain and suffering is required for each patient and family. The mind, body and spirit are understood in relationship to each other and, in those cases, in relationship to a deity or deities are important to understand. Cultural interpretations of pain and suffering may conflict with the goals of palliative care. Understanding the spiritual framework of the patient and family can help to assure that the physical and spiritual suffering of the patient can be eliminated to provide a peaceful death. Spiritual practices may help in the management of physical pain.

  4. [Cannabinoids in pain medicine].

    Science.gov (United States)

    Karst, M

    2018-06-07

    The endocannabinoid system (ECS) controls a large number of vital functions. Suboptimal tone of the ECS in certain regions of the nervous system may be associated with disorders that are also associated with pain. Pain and inflammation processes can be modulated by the exogenous supply of cannabinoids. Low-to-moderate pain-relieving effects and in individual cases large pain-relieving effects were observed in randomized, controlled studies of various types of chronic pain. People with chronic neuropathic pain and stress symptoms seem to particularly benefit. The therapeutic range of cannabinoids is small; often small doses are sufficient for clinically significant effects. The "Cannabis-als-Medizin-Gesetz" (cannabis as medicine law) allows the prescription of cannabis preparations under certain conditions. Available data indicate good long-term efficacy and tolerability. However, there is little systematic long-term experience from clinical studies.

  5. CHRONIC UNEXPLAINED OROFACIAL PAIN

    Directory of Open Access Journals (Sweden)

    Aleš Vesnaver

    2002-04-01

    Full Text Available Background. Chronic unexplained orofacial pain is frequently the cause of prolonged suffering for the patient and an unsolvable problem for the therapist. Pathophysiology of the onset of this type of pain is virtually unknown. Still, it is possible to divide chronic orofacial pain into several separate categories, according to its onset, symptoms and therapy. All forms of this type of pain have a strong psychological component.Methods. A retrograde review was conducted, in which patients’ records, treated in 1994 for chronic unexplained orofacial pain, were followed through a 5 year period. The modalities of treatment then and at present were compared.Conclusions. Except for trigeminal neuralgia, where carbamazepine remains the first choice drug, treatment of chronic facial pain has changed considerably.

  6. Orofacial pain conditions

    DEFF Research Database (Denmark)

    Pedersen, Anne Marie Lynge; Forssell, Heli; Grinde, Bjørn

    2016-01-01

    Pain of the oral mucosa is a common accompanying symptom of various oral mucosal lesions caused by local and systemic diseases. Pain of the oral mucosa is usually associated with a known cause of tissue damage, e.g. mucosal ulcer or erosion, and it generally responds to adequate treatment...... and dissolves after healing. Chronic pain, on the other hand, persists months and years after apparent tissue healing, and attempts to alleviate pain are challenging. Neuropathic pain occurs due to damage neurogenic structures in the peripheral and/or the central nervous system. It may occur in the absence...... of any obvious noxious stimuli, and in the oral mucosal, the pain is often described as tingling and burning. In the oral cavity, burning mouth syndrome (BMS) is presently considered to have neuropathic background. It is important for dental practitioners to have a clear understanding of the various...

  7. Thoracic spine pain

    Directory of Open Access Journals (Sweden)

    Aleksey Ivanovich Isaikin

    2013-01-01

    Full Text Available Thoracic spine pain, or thoracalgia, is one of the common reasons for seeking for medical advice. The epidemiology and semiotics of pain in the thoracic spine unlike in those in the cervical and lumbar spine have not been inadequately studied. The causes of thoracic spine pain are varied: diseases of the cardiovascular, gastrointestinal, pulmonary, and renal systems, injuries to the musculoskeletal structures of the cervical and thoracic portions, which require a thorough differential diagnosis. Facet, costotransverse, and costovertebral joint injuries and myofascial syndrome are the most common causes of musculoskeletal (nonspecific pain in the thoracic spine. True radicular pain is rarely encountered. Traditionally, treatment for thoracalgia includes a combination of non-drug and drug therapies. The cyclooxygenase 2 inhibitor meloxicam (movalis may be the drug of choice in the treatment of musculoskeletal pain.

  8. Neonatal pain management

    Directory of Open Access Journals (Sweden)

    Tarun Bhalla

    2014-01-01

    Full Text Available The past 2-3 decades have seen dramatic changes in the approach to pain management in the neonate. These practices started with refuting previously held misconceptions regarding nociception in preterm infants. Although neonates were initially thought to have limited response to painful stimuli, it was demonstrated that the developmental immaturity of the central nervous system makes the neonate more likely to feel pain. It was further demonstrated that untreated pain can have long-lasting physiologic and neurodevelopmental consequences. These concerns have resulted in a significant emphasis on improving and optimizing the techniques of analgesia for neonates and infants. The following article will review techniques for pain assessment, prevention, and treatment in this population with a specific focus on acute pain related to medical and surgical conditions.

  9. Mental Pain and Suicide

    DEFF Research Database (Denmark)

    Verrocchio, Maria Cristina; Carrozzino, Danilo; Marchetti, Daniela

    2016-01-01

    ideation than depression. Conclusion: Mental pain is a core clinical factor for understanding suicide, both in the context of mood disorders and independently from depression. Health care professionals need to be aware of the higher suicidal risk in patients reporting mental pain. In this regard......Background: Mental pain, defined as a subjective experience characterized by perception of strong negative feelings and changes in the self and its function, is no less real than other types of grief. Mental pain has been considered to be a distinct entity from depression. We have performed...... a systematic review analyzing the relationship between mental pain and suicide by providing a qualitative data synthesis of the studies. Methods: We have conducted, in accordance with PRISMA guidelines, a systematic search for the literature in PubMed, Web Of Science, and Scopus. Search terms were "mental pain...

  10. Emprego de soluções adocicadas no alívio da dor neonatal em recém-nascido prematuro: uma revisão integrativa Empleo de soluciones edulcoradas en el manejo del dolor neonatal en recién nacido prematuro: una revisión integrativa Use of sweet solutions for neonatal pain relief in premature newborns: an integrative review

    Directory of Open Access Journals (Sweden)

    Caroline de Oliveira Alves

    2011-12-01

    Full Text Available As experiências dolorosas repetida em recém-nascidos podem ter efeito a curto e a longo prazo, especialmente nos prematuros. Como uma medida de alívio da dor, tem sido recomendado o uso de soluções adocicadas em procedimentos dolorosos. Este estudo objetiva avaliar as evidências do efeito da sacarose e da glicose oral no alívio da dor aguda em recém-nascidos prematuros. Realizou-se uma revisão integrativa, nas bases de dados MEDLINE e LILACS, no período de 2005 a 2010, foram selecionados oito artigos. A análise destes revelou o efeito analgésico da glicose e da sacarose em procedimentos agudos. Nenhum efeito colateral foi encontrado nos recém-nascidos que receberam a glicose/sacarose. Ressalta-se a importância do uso da escala de avaliação da dor que mais se identifique com a população predominante nas unidades neonatais, que seja de fácil aplicação e manuseio pelos profissionais de saúde.Repetidas experiencias dolorosas en los recién nacidos pueden tener un efecto en el corto y largo plazo, especialmente en recién nacidos prematuros. Como una medida de aliviar el dolor, se ha recomendado el uso de soluciones azucaradas durante los procedimientos dolorosos. Así, este estudio tiene como objetivo evaluar la evidencia del efecto de la sacarosa o glucosa oral en el alivio del dolor agudo en niños recién nacidos prematuros. Se realizó una revisión integrativa en las bases de datos: MEDLINE y LILACS en el período 2005 a 2010, habiendo sido seleccionados ocho artículos. El análisis reveló el efecto analgésico de la glucosa y la sacarosa en los procedimientos agudos. No se encontró ningún efecto colateral significativo en los recién nacidos que recibieron la glucosa/sacarosa. Se resalta la importancia del uso de la escala de evaluación del dolor que más se identifique con la población predominante en la Unidad de Cuidados Intensivos Neonatales y que sea de fácil aplicación y manipulación para los profesionales

  11. Assessing ecological restoration potential in Enrique Olaya Herrera National Park Titulo corto: Determinación del potencial de restauración ecológica

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    Diana Carolina Bohorquez

    2013-12-01

    Full Text Available The Enrique Olaya Herrera National Park (c.a. 237 ha is a protected area located in the eastern hills of Bogotá in a strategic ecological location. It forms part of the city’s Main Ecological Structure that maintains valuable landscapes in the region. However, the area is subject to a variety of ecological pressures and constraints that have contributed to its degradation. Based on landscape ecology theories, this study zoned the park according to its restoration potential with the objective of setting base-lines for the planning of restoration projects. Firstly, we characterized the physical, biotic and socio-dynamic components of the territory. Secondly, we selected the variables necessary for the evaluation and spacing of the restoration potential of each of these components. Finally, following the evaluation and weighting of the obtained potentials, and using GIS analysis, we determined which areas have high, medium or low ecological restoration potential, generating a 1:5000-scale cartography for the whole study area. The spacing of these landscape units is one of the main concepts of landscape ecology that allows the identification of priorities in projects that need rigorous planning and investment of technical and human resources. By doing this, it will likely contribute to the success of ecosystem restoration projects.

  12. Research and service capabilities of the National Nuclear Forensic Research Laboratory; Capacidades de investigacion y servicio del Laboratorio Nacional de Investigacion en Forense Nuclear, Lanafonu

    Energy Technology Data Exchange (ETDEWEB)

    Romero G, E. T.; Hernandez M, H.; Flores C, J.; Paredes G, L. C., E-mail: elizabeth.romero@inin.gob.mx [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2016-09-15

    According to the recommendations of the International Atomic Energy Agency, Mexico is taking steps to combat illicit trafficking in nuclear material. The creation of a National Nuclear Forensic Research Laboratory (Lanafonu, acronym in Spanish) has been assigned to the Instituto Nacional de Investigaciones Nucleares (ININ, Mexico) in 2014. The objectives of this Laboratory are: to combat illicit trafficking in nuclear materials, to optimize scientific processes and techniques used to analyze nuclear materials (orphans or radioactive sources), environmental and potential biological sources as a result of the handling, transport and final storage. At present, the Lanafonu facilities are focused on the optimization of emergency and routine protocols for measuring radioisotopes in environmental and biological samples using inductive coupling mass spectrometer with magnetic sector. The main activities are: i) optimization of the methods for measuring the isotopes of Pu by alpha-spectrometry, Icp-SFMS and AMS (accelerator mass spectrometry), ii) development or radiochemical methods for routine situations and nuclear emergencies, iii) participation in the scientific technical commission on nuclear forensic science, iv) participation in international intercomparison exercises to optimize and validate methods, and v) consolidation of Lanafonu in Mexico and the IAEA. (Author)

  13. Vitamin D deficiency is associated with ethnicity and knee pain in a multi-ethnic South-East Asian nation: Results from Malaysian Elders Longitudinal Research (MELoR).

    Science.gov (United States)

    Mat, Sumaiyah; Jaafar, Mohamad Hasif; Sockalingam, Sargunan; Raja, Jasmin; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Abbas, Azlina Amir; Chan, Chee Ken; Hairi, Noran Naqiah; Othman, Sajaratulnisah; Cumming, Robert; Tan, Maw Pin

    2018-05-01

    To determine the association between vitamin D and knee pain among participants of the Malaysian Elders Longitudinal Research (MELoR) study. This was a cross-sectional study from the MELoR study consisting of a representative group of 1011 community-dwelling older persons (57% female), mean age 86.5 (54-94) years; 313 were Malays, 367 Chinese and 330 Indians. Participants were asked if they had knee pain. Levels of serum 25-hydroxy cholecalciferol (25-[OH]D), an indicator of vitamin D status, were measured using routine laboratory techniques. In unadjusted analysis, presence of knee pain was significantly associated with vitamin D deficiency (odds ratio [OR] 1.42; 95% confidence interval (CI) 1.08-1.85, P 0.011). Vitamin D levels were significantly associated with ethnicity differences where Malays (OR 7.08; 95% CI 4.94-10.15) and Indians (OR 6.10; 95% CI 4.28-9.71) have lower levels of vitamin D compared to Chinese. Subsequent multivariate analysis revealed that the association between vitamin D deficiency and knee pain was confounded by ethnic differences. A previous study suggested that vitamin D deficiency was associated with knee pain. This relationship was reproduced in our study, but we further established that the association was explained by ethnic variations. As vitamin D status is dependent on skin tone, diet and sunlight exposure, which are all effected by ethnicity, future studies are now required to determine whether a true relationship exists between vitamin D and knee pain. © 2018 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  14. The Prescription Opioid Pain Medication Overdose Epidemic

    Centers for Disease Control (CDC) Podcasts

    2016-04-19

    Overdose related to prescription opioids has become an epidemic. This podcast discusses the risks of this type of drug sometimes used to treat pain, and how to protect yourself. .  Created: 4/19/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/19/2016.

  15. Chronic whiplash pain.

    Science.gov (United States)

    Seroussi, Richard; Singh, Virtaj; Fry, Adrielle

    2015-05-01

    Although most patients recover from acute whiplash injuries, those with chronic whiplash syndrome develop signs of central nervous system (CNS) amplification of pain and have a poor prognosis. In this context, specific pain generators from acute whiplash have been identified through clinical, biomechanical, and animal studies. This article gives a clinical perspective on current understanding of these pain generators, including the phenomenon of CNS sensitization. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Factores asociados con la dependencia funcional en los adultos mayores: un análisis secundario del Estudio Nacional sobre Salud y Envejecimiento en México, 2001 Factors associated with functional dependence in older adults: a secondary analysis of the National Study on Health and Aging, Mexico, 2001

    Directory of Open Access Journals (Sweden)

    Guadalupe Dorantes-Mendoza

    2007-07-01

    Full Text Available OBJETIVO: Identificar los factores asociados con la dependencia funcional de los adultos mayores para realizar actividades básicas de la vida diaria (ABVD y actividades instrumentales de la vida diaria (AIVD. MÉTODO: Estudio transversal de la información obtenida en la primera vuelta del Estudio Nacional sobre Salud y Envejecimiento en México (ENASEM en 2001. La muestra estuvo compuesta por 7 171 personas de 60 años o más. Mediante el análisis de regresión logística multifactorial se analizó la asociación de la dependencia funcional para realizar ABVD y AIVD con los hábitos de vida y los antecedentes personales sociales, familiares y de salud desde la infancia de los participantes. RESULTADOS: La edad promedio fue de 69,4 ± 7,6 años (de 60 a 105 años; 53,4% eran mujeres. Los grupos de dependientes para realizar ABVD y AIVD tenían en promedio mayor edad (P OBJECTIVES: To identify factors associated with dependence for basic activities of daily living (BADL and instrumental activities of daily living (IADL in elderly adults in Mexico. METHODS: A cross-sectional study of data from the first round of Mexico’s National Study on Health and Aging, 2001, was undertaken. The sample consisted of 7 171 participants, 60 years of age or older. Multifactorial regression analysis was used to identify associations between BADL and IADL dependence and lifestyle, sociodemographics, family background, and health history, from childhood to present. RESULTS: The mean age of the participants was 69.4 ± 7.6 years of age, with a range of 60-105 years; females made up 53.4% of the sample. The BADL- and IADL-dependent groups had a higher mean age (P < 0.01, were predominantly female (P < 0.01, had a greater incidence of illiteracy, and reported a significantly higher number of chronic diseases and greater frequency of pain than did the independent participants. Among the 521 (7.3% BADL-dependent, there was a higher percentage who were single or widowed

  17. 3D Geological modelling of the Monfrague synform: a value added to the geologic heritage of the National Park; Modelo geologico 3D de la estructura en sinforme de Monfrague: un valor anadido al patrimonio geologico del Parque Nacional

    Energy Technology Data Exchange (ETDEWEB)

    Gumiel, P.; Arias, M.; Monteserin, V.; Segura, M.

    2010-07-01

    3D geological modelling of a tectonic structure called the Monfrague synform has been carried out to obtain a better insight into the geometry of this folding structure. It is a kilometric variscan WNW-ESE trending fold verging towards north and made up by a Palaeozoic sequence (Ordovician-Silurian).This structure with its lithology make up the morphology and the relief of the Park. The Monfrague synform is an asymmetrical folding structure showing southern limb dipping steeply to the south (reverse limb) what is well observed in the Armorican Quartzite at the Salto del Gitano. However, northern limb dips gently (less than 40 degree centigrade) to the south (normal limb). 3D geological modelling has been built on the basis of the geological knowledge and the structural interpretation, using 3D GeoModeller. (www.geomodeller.com). In this software, lithological units are described by a stratigraphic pile. A major original feature of this software is that the 3D description of the geological space is achieved through a potential field formulation in which geological boundaries are isopotential surfaces, and their dips are represented by gradients of the potential. Finally, it is emphasized the idea that a 3D geologic model of these characteristics, with its three-dimensional representation, together with suitable geological sections that clarify the structure in depth, represents a value added to the Geologic Heritage of the National Park and besides it supposes an interesting academic exercise which have a great didactic value. (Author)

  18. Submission of Republica Oriental del Uruguay to the Commission on the limits of the continental shelf pursuant to provisions of article 76, paragraph 8, of the United Nations Convention on the Law of the Sea: executive summary

    International Nuclear Information System (INIS)

    Mata Prates, C.; Tajes, J.; Burgos, M.; Caamaño; Lamartheé; Montiel, D.; Preciozzi, F.; De Santa Ana, H.

    2009-01-01

    Pursuant to provisions of article 76 of the United Nations Convention on the Law of the Sea (hereinafter the Convention), and to article 4 of Annex II of same, República Oriental del Uruguay (Uruguay) hereby submits to the Commission on the Limits of the Continental Shelf (the Commission) particulars on the outer limit of its continental shelf, extending beyond 200 nautical miles (M) from the baselines from which the breadth of territorial sea is measured. On December 10, 1982 Uruguay signed the Convention, which was subsequently approved by Uruguayan Law Nº 16,287, and ratified on December 10, 1992. The porvisions of article 76 invoked in Uruguay submission fixed points delimiting Uruguay’s Continental Shelf. There exist, at present, no unresolved disputes over the maritime border with either of Uruguay’s neighbouring countries, Argentina or Brazil. It was received assistance in the elaboration of this Submission April 2008, from member of the Commission and also assistance from other, non-member consultants and institutions from Germany, Brazil, Portugal and Norway

  19. Imaging of painful scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Davies, Alun; Saifuddin, Asif [Royal National Orthopaedic Hospital Trust, Department of Radiology, London (United Kingdom)

    2009-03-15

    Scoliosis is defined as a lateral deviation of the spine from the normal plumb line. Commonly, there is a rotational component and deviation also in the sagittal plane (kyphosis or hyperlordosis). When scoliosis presents in adults, it is often painful. In contrast, back pain in a child is considered rare, and serious underlying pathology should be excluded, particularly since idiopathic scoliosis is typically painless. A painful scoliosis in a child or adolescent, especially if the patient has a left-sided curve, should be examined thoroughly. The aim of this review is to illustrate the causes of a painful scoliosis in children, adolescents and adults. (orig.)

  20. Imaging of painful scoliosis

    International Nuclear Information System (INIS)

    Davies, Alun; Saifuddin, Asif

    2009-01-01

    Scoliosis is defined as a lateral deviation of the spine from the normal plumb line. Commonly, there is a rotational component and deviation also in the sagittal plane (kyphosis or hyperlordosis). When scoliosis presents in adults, it is often painful. In contrast, back pain in a child is considered rare, and serious underlying pathology should be excluded, particularly since idiopathic scoliosis is typically painless. A painful scoliosis in a child or adolescent, especially if the patient has a left-sided curve, should be examined thoroughly. The aim of this review is to illustrate the causes of a painful scoliosis in children, adolescents and adults. (orig.)

  1. Acute pain assessment

    LENUS (Irish Health Repository)

    Clear, Elaine

    2016-05-01

    The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” (IASP, 1997). This definition of pain emphasises that it is neither a sensory nor an emotional experience, but a combination of both. It is a subjective experience influenced by physical, psychological and environmental factors that is assessed from a biopsychosocial perspective. The gold standard in assessing pain however is always what the patient says it is.

  2. Pain in adolescents with spinal muscular atrophy and Duchenne and Becker muscular dystrophy.

    Science.gov (United States)

    Lager, Christina; Kroksmark, Anna-Karin

    2015-09-01

    The purpose of this study was to explore the prevalence, nature and scope of pain in adolescents with spinal muscular atrophy and Duchenne and Becker muscular dystrophy and whether the pain differs between diagnostic groups or between adolescents with different ambulation status. Furthermore to study the consequences of pain and to identify pain-exacerbating and pain-relieving factors. In a national survey, fifty-five adolescents with spinal muscular atrophy and dystrophinopathy completed a questionnaire assessing pain frequency, duration, location using a body map, intensity and discomfort using visual analogue scales, pain interference using a modified version of Brief Pain Inventory and factors exacerbating and relieving pain. Sixty-nine per cent of the adolescents reported pain during the past three months and 50% reported chronic pain. The pain prevalence did not differ significantly between diagnostic groups or between ambulators and non-ambulators. The average pain intensity was graded as mild and the worst pain as moderate. The pain typically occurred weekly, most frequently in the neck/back or legs. General activity and mood were the areas that were most affected by pain. Common pain-exacerbating factors were sitting, too much movement/activity and being lifted or transferred. Pain is a frequent problem in adolescents with spinal muscular atrophy and dystrophinopathy. The assessments used enable an understanding both of the nature and scope of pain and of the impact of pain in everyday life. The study highlights the importance of assessing pain in a systematic manner and offering an individual approach to interventions designed to reduce pain in this population. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  3. Prayer and pain: the mediating role of positive re-appraisal.

    Science.gov (United States)

    Dezutter, Jessie; Wachholtz, Amy; Corveleyn, Jozef

    2011-12-01

    The present study explored in a sample of Flemish pain patients the role of prayer as a possible individual factor in pain management. The focus on prayer as a personal religious factor fits with the current religious landscape in Western-Europe where personal religious factors are more important than organizational dimensions of religion. Our study is framed in the transactional theory of stress and coping by testing first, whether prayer was related with pain severity and pain tolerance and second, whether cognitive positive re-appraisal was a mediating mechanism in the association between prayer and pain. We expected that prayer would be related to pain tolerance in reducing the impact of the pain on patient's daily life, but not necessarily to pain severity. A cross-sectional questionnaire design was adopted in order to measure demographics, prayer, pain outcomes (i.e., pain severity and pain tolerance), and cognitive positive re-appraisal. Two hundred and two chronic pain (CP) patients, all members of a Flemish national patients association, completed the questionnaires. Correlational analyses showed that prayer was significantly related with pain tolerance, but not with pain severity. However, ancillary analyses revealed a moderational effect of religious affiliation in the relationship between prayer and pain severity as well as pain tolerance. Furthermore, mediation analysis revealed that cognitive positive re-appraisal was indeed an underlying mechanism in the relationship between prayer and pain tolerance. This study affirms the importance to distinguish between pain severity and pain tolerance, and indicates that prayer can play a role in pain management, especially for religious pain patients. Further, the findings can be framed within the transactional theory of stress and coping as the results indicate that positive re-appraisal might be an important underlying mechanism in the association between prayer and pain.

  4. Doubling Your Payoff: Winning Pain Relief Engages Endogenous Pain Inhibition

    Science.gov (United States)

    Becker, Susanne; Gandhi, Wiebke; Kwan, Saskia; Ahmed, Alysha-Karima; Schweinhardt, Petra

    2015-01-01

    When in pain, pain relief is much sought after, particularly for individuals with chronic pain. In analogy to augmentation of the hedonic experience ("liking") of a reward by the motivation to obtain a reward ("wanting"), the seeking of pain relief in a motivated state might increase the experience of pain relief when obtained. We tested this hypothesis in a psychophysical experiment in healthy human subjects, by assessing potential pain-inhibitory effects of pain relief "won" in a wheel of fortune game compared with pain relief without winning, exploiting the fact that the mere chance of winning induces a motivated state. The results show pain-inhibitory effects of pain relief obtained by winning in behaviorally assessed pain perception and ratings of pain intensity. Further, the higher participants scored on the personality trait novelty seeking, the more pain inhibition was induced. These results provide evidence that pain relief, when obtained in a motivated state, engages endogenous pain-inhibitory systems beyond the pain reduction that underlies the relief in the first place. Consequently, such pain relief might be used to improve behavioral pain therapy, inducing a positive, perhaps self-amplifying feedback loop of reduced pain and improved functionality.

  5. Chronic pain: One year prevalence and associated characteristics (the HUNT pain study).

    Science.gov (United States)

    Landmark, Tormod; Romundstad, Pål; Dale, Ola; Borchgrevink, Petter C; Vatten, Lars; Kaasa, Stein

    2017-12-29

    Background The reported prevalence of chronic pain ranges from 11% to 64%, and although consistently high, the calculated economic burden estimates also vary widely between studies. There is no standard way of classifying chronic pain. We have repeated measurements of pain in a longitudinal population study to improve validity ofthe case ascertainment. In this paper, associations between chronic pain and demographic characteristics, self reported health and functioning, work Incapacity and health care use were investigated in a sample from the general Norwegian population. Methods A random sample of 6419 participants from a population study (the HUNT 3 Study) was invited to report pain every three months during a 12 month period. Chronic pain was defined as moderate pain or more (on the SF-8 verbal rating scale) in at least three out of five consecutive measurements. Self reported health and functioning was measured by seven of the eight subscales on the SF-8 health survey (bodily pain was excluded). Health care utilisation during the past 12 months was measured by self report, and included seeing a general practitioner, seeing a medical specialist and seeing other therapists. The survey data was combined with information on income, education, disability pension awards and unemployment by Statistics Norway, which provided data from the National Education database (NUDB) and the Norwegian Labour and Welfare Administration (NAV). Results The total prevalence of chronic pain was 36% (95% CI34-38) among women and 25% (95% CI 22-26) among men. The prevalence increased with age, was higher among people with high BMI, and in people with low income and low educational level. Smoking was also associated with a higher prevalence of chronic pain. Subjects in the chronic pain group had a self-reported health and functioning in the range of 1-2.5 standard deviations below that of those without chronic pain. Among the chronic pain group 52% (95% CI 49-55), of participants

  6. Cancer and orofacial pain.

    Science.gov (United States)

    Romero-Reyes, M; Salvemini, D

    2016-11-01

    Cancer pain is a devastating condition. Pain in the orofacial region, may be present as the single symptom of cancer or as a symptom of cancer in its later stages. This manuscript revises in a comprehensive manner the content of the conference entitled "Orofacial Pain and Cancer" (Dolor Orofacial y Cancer) given at the VI Simposio International "Advances in Oral Cancer" on the 22 July, 2016 in San Sebastioan-Donostia, Spain. We have reviewed (pubmed-medline) from the most relevant literature including reviews, systematic reviews and clinical cases, the significant and evidence-based mechanisms and mediators of cancer-associated facial pain, the diverse types of cancers that can be present in the craniofacial region locally or from distant sites that can refer to the orofacial region, cancer therapy that may induce pain in the orofacial region as well as discussed some of the new advancements in cancer pain therapy. There is still a lack of understanding of cancer pain pathophysiology since depends of the intrinsic heterogeneity, type and anatomic location that the cancer may present, making more challenging the creation of better therapeutic options. Orofacial pain can arise from regional or distant tumor effects or as a consequence of cancer therapy. The clinician needs to be aware that the pain may present the characteristics of any other orofacial pain disorder so a careful differential diagnosis needs to be given. Cancer pain diagnosis is made by exclusion and only can be reached after a thorough medical history, and all the common etiologies have been carefully investigated and ruled out. The current management tools are not optimal but there is hope for new, safer and effective therapies coming in the next years.

  7. Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratory.

    Science.gov (United States)

    Hilário, Thamires de Souza; Santos, Simone Marques Dos; Kruger, Juliana; Goes, Martha Georgina; Casco, Márcia Flores; Rabelo-Silva, Eneida Rejane

    2017-05-25

    To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Cross-sectional study with retrospective data collection. Overall, 345 patients were included; 116 (34%) experienced post-procedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. Describir cómo se evalúa el dolor (características, localización e intensidad) y su manejo en la práctica clínica en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterización. Estudio transversal con recolección retrospectiva de datos. En total, se incluyeron 345 pacientes; 116 (34%) experimentaron dolor post-procedimiento; en 107 (92%), no se registraron las características del dolor; la localización del dolor se informó en el 100% de los pacientes, y su intensidad en 111 (96%); el manejo fue en gran medida farmacológico; de los pacientes que recibieron algún tipo de tratamiento (n=71), 42 (59%) fueron sometidos a reevaluación del dolor. La ubicación y la intensidad del dolor se informan bien en la práctica clínica. El manejo farmacológico del dolor sigue siendo frecuente. Se necesitan esfuerzos adicionales para asegurar el registro de las características del dolor y su reevaluación después de las intervenciones.

  8. Health Care Utilization and Costs Associated with Pediatric Chronic Pain.

    Science.gov (United States)

    Tumin, Dmitry; Drees, David; Miller, Rebecca; Wrona, Sharon; Hayes, Don; Tobias, Joseph D; Bhalla, Tarun

    2018-03-30

    The population prevalence of pediatric chronic pain is not well characterized, in part due to lack of nationally representative data. Previous research suggests that pediatric chronic pain prolongs inpatient stay and increases costs, but the population-level association between pediatric chronic pain and health care utilization is unclear. We use the 2016 National Survey of Children's Health to describe the prevalence of pediatric chronic pain, and compare health care utilization among children ages 0-17 years according to the presence of chronic pain. Using a sample of 43,712 children, we estimate the population prevalence of chronic pain to be 6%. On multivariable analysis, chronic pain was not associated with increased odds of primary care or mental health care use, but was associated with greater odds of using other specialty care (OR=2.01, 95% CI: 1.62, 2.47; pcomplementary and alternative medicine (OR=2.32, 95% CI: 1.79, 3.03; pchronic pain were more likely to use specialty care but not mental health care. The higher likelihood of emergency care use in this group raises the question of whether better management of pediatric chronic pain could reduce emergency department use. Copyright © 2018. Published by Elsevier Inc.

  9. Tipificación del síntoma dolor torácico tipo isquémico en la mujer, a la luz de la teoría de los síntomas desagradables Categorization of the sumptom thoracic pain type isquemic in the woman to the light the theory of unpleasant symptoms

    Directory of Open Access Journals (Sweden)

    LUIS ALBERTO CORTÉS CASTRO

    2007-12-01

    Full Text Available La enfermedad coronaria ocupa el primer lugar como causa de mortalidad en la población femenina en Colombia (1 y constituye un problema de salud que implica deterioro de la calidad de vida de esta población. El objetivo del estudio fue tipificar los síntomas del dolor torácico isquémico en la mujer, a la luz de la teoría de los síntomas desagradables. Su diseño fue descriptivo exploratorio con abordaje cualicuantitativo. Información recolectada a través de una entrevista semiestructurada; muestra conformada por la información aportada por 30 mujeres a quienes se les diagnosticó angina inestable o infarto agudo de miocardio en el Hospital San Rafael y en la Clínica San Sebastián de Girardot de julio a noviembre de 2005. Los resultados mostraron mujeres entre 50 y 95 años, la mayoría clasificadas en estrato y nivel de escolaridad bajos. En cuanto al factor fisiológico, los antecedentes patológicos de origen cardiovascular más representativos fueron la hipertensión seguida de la diabetes. Dentro de los factores psicológicos la categoría más representativa en frecuencia fue "lo que la mujeres creen y conocen acerca del síntoma y la enfermedad" y en Factores situacionales "el calor me afecta". En la dimensión de calidad, la categoría destacada fue "gran compromiso del ser". El síntoma fue referido con una intensidad severa en el 93% de los casos, y el promedio en calificación fue 9,48 en escala visual análoga. Dentro de las consecuencias del síntoma la más representativa fue "controlando la actividad física". Los síntomas mas frecuentes fueron "vomito", "mareo" y "dolor de cabeza". Se observa un cuadro sintomático expresado con riqueza lingüística, que muestra procesos concatenados dentro de su experiencia de salud, lo cual permite comprender mejor su situación para dar un cuidado pertinente.Coronary heart disease is the first cause of mortality among Colombia's female population (1 and constitutes a health

  10. Categorization of the sumptom thoracic pain type isquemic in the woman to the light the theory of unpleasant symptoms Tipificación del síntoma dolor torácico tipo isquémico en la mujer, a la luz de la teoría de los síntomas desagradables

    Directory of Open Access Journals (Sweden)

    CORTÉS CASTRO LUIS ALBERTO

    2007-12-01

    Full Text Available Coronary heart disease is the first cause of mortality among Colombia's female population (1 and constitutes a health problem that implies deterioration of the quality of life of this group. The objective of this study was to categorize the ischemic thoracic pain in women in light of the theory Of Unpleasant Symptoms. The study was designed to be descriptiveexploratory with a qualitativequantitative approach. The information was collected by means of a semistructured interview and samples as gathered with information supplied by 30 women who were diagnosed with unstable heart pain or acute heart attack at San Rafael Hospital and at San Sebastián Clinic in Giradot from July to November 2005. The results showed women between 50 and 95 years of age, the majority classified to be within a low social class and level of education. As to the physiological factor, the most representative pathologic background from cardiovascular origin was high blood pressure, followed by diabetes. Within the psychological factors, the most representative category in frequency was "what women believe and know about the symptoms and the disease" and in the situational factors "heat affects me". In terms of the quality dimension, the outstanding category was "major commitment with being a human being". The symptom was referred to a severe intensity in 93% of the cases, and the average grade was 9,48 in a visual analogue scale. Within the consequences of the symptom, the most representative was "Controlling physical activity". The most frequent secondary symptoms were "vomit", "dizziness" and "headache". A symptomatic profile is observed, which is expressed with a linguistic richness and that shows concatenation processes within her health experience that enables us to understand her situation better and consequently to provide adequate care.La enfermedad coronaria ocupa el primer lugar como causa de mortalidad en la población femenina en Colombia

  11. Does pain deteriorate working life expectancy in aging workers?

    Science.gov (United States)

    Lee, Wanhyung; Hong, Kwanyoung; Lim, Sung-Shil; Yoon, Jin-Ha

    2016-11-29

    Many aging workers wish to continue working as long as they can for a better life in the future. However, symptoms of pain are a key obstacle in the continuation of work among older workers. The impact of pain on work is understudied. Thus, we investigated the relationship between pain characteristics (total site and severity) and aging workers' working life expectancy scale (WoLES) in Korea. We included 1,979 participants (1,175 men and 804 women) from a well-established survey of a nationally representative population: the Korean Longitudinal Study of Ageing. A self-questionnaire was used to assess pain characteristics and WoLES. Odds ratios (ORs) and 95% confidence intervals (CIs) for the lower-WoLES group were calculated using multiple logistic regression models. Compared with the absence of pain, ORs and 95% CIs of the lower-WoLES group were increased, as follows: 1 pain site, 1.75 (1.20-2.55); 2 pain sites, 1.99 (1.32-3.03); 3 or more pain sites, 2.28 (1.51-3.42); mild pain, 1.74 (1.32-2.61); moderate pain, 2.02 (1.28-3.22); and severe pain, 2.12 (1.46-3.08). The statistical trend was significant in both total sites and severity of pain (p<0.001). There was a significant association between WoLES and both total pain sites and severity of pain, even after adjusting for potential confounding factors.

  12. Los coleópteros y heterópteros acuáticos del Parque Nacional Calilegua (Provincia de Jujuy, Argentina Aquatic Coleoptera and Heteroptera from Calilegua National Park (Jujuy Province, Argentina

    Directory of Open Access Journals (Sweden)

    Patricia L. M. Torres

    2008-06-01

    Full Text Available Se expone una lista de las especies de Coleoptera y Heteroptera presentes en los cuerpos de agua del Parque Nacional Calilegua. Se registraron 51 especies de Coleoptera incluidas en 28 géneros y cinco familias, y 37 especies de Heteroptera distribuidas en 22 géneros y 10 familias; sólo cuatro especies de Coleoptera y cinco de Heteroptera fueron citadas previamente del parque. Se mencionan por primera vez para la Argentina dos especies de Veliidae (Heteroptera: Rhagovelia trista Gould y Platyvelia brachialis (Stål, así como una especie y un género de Dytiscidae (Coleoptera: Desmopachria chei K. B. Miller y Bidessonotus Régimbart. Además, es la primera ocasión en que se mencionan para la provincia de Jujuy 24 especies y 11 géneros de Coleoptera (Leuronectes Sharp, Bidessonotus, Hypodessus Guignot, Desmopachria Babington, Celina Aubé, Gyrinus Linné, Haliplus Latreille, Hydrocanthus Say, Suphis Aubé, Anacaena Thomson, Derallus Sharp y 19 especies y 12 géneros de Heteroptera (Mesovelia Mulsant & Rey, Hebrus Curtis, Merragata White, Microvelia Westwood, Rhagovelia Mayr, Platyvelia J. T. Polhemus & D. A. Polhemus, Limnogonus Stål, Curicta Stål, Ranatra Fabricius, Centrocorisa Lundblad, Pelocoris Stål, Neoplea Esaki & China.A list of the species of aquatic Coleoptera and Heteroptera occurring in Calilegua National Park is presented. Fifty-one species of Coleoptera included in 28 genera and five families, and 37 species of Heteroptera belonging to 22 genera and 10 families were recorded. Only four species of Coleoptera and five of Heteroptera had been previously cited from the park. Two species of Veliidae (Heteroptera (Rhagovelia trista Gould, Platyvelia brachialis (Stål, along with one species and one genus of Dytiscidae (Coleoptera (Desmopachria chei K. B. Miller, Bidessonotus Régimbart are new records for Argentina. Twenty-four species and 11 genera of Coleoptera (Leuronectes Sharp, Bidessonotus, Hypodessus Guignot, Desmopachria

  13. Physical exercise and pelvic girdle pain in pregnancy

    DEFF Research Database (Denmark)

    Andersen, Linda Kahr; Backhausen, Mette; Hegaard, Hanne Kristine

    2015-01-01

    OBJECTIVE: Pelvic girdle pain is a frequent cause of sick leave among pregnant women in Denmark. Studies regarding prevention of pelvic girdle pain are sparse. The aim of this study was to examine the association between physical exercise and pelvic girdle pain in pregnancy. STUDY DESIGN: A nested...... case-control study within the Danish National Birth Cohort (n = 5304). METHODS: This study used self-reported data on pelvic girdle pain obtained from an interview six months after childbirth. Information on physical exercise was obtained from the pregnancy interview around gestational week 16....... The association was estimated using logistic regression analysis. RESULTS: Physical exercise in pregnancy was associated with decreased risk of overall pelvic girdle pain (OR = 0.87; 95% CI: 0.77-0.99, p = 0.028). Tests for trend indicated decreasing odds for pelvic girdle pain with increasing number of hours per...

  14. Stereotyping and nurses' recommendations for treating pain in hospitalized children.

    Science.gov (United States)

    Griffin, Ruth A; Polit, Denise F; Byrne, Mary W

    2007-12-01

    The purpose of this study was to examine whether nurses' recommendations for managing children's pain were influenced by stereotypes based on children's personal attributes. Three vignettes, in which hospitalized children's sex, race, and attractiveness were experimentally manipulated, were mailed to a national random sample of 700 pediatric nurses; 334 nurses responded. Responses to vignette questions indicated little evidence of stereotyping. Nurses perceived similar levels of pain and recommended similar pain treatments, regardless of sex, race, and attractiveness. Nurses, on average, perceived children's pain at levels consistent with the children's self-reports and recommended assertive analgesic and non-pharmacologic pain management strategies. The results appear consistent with prevailing views on providing adequate pain treatment for children.

  15. Addiction to opioids in chronic pain patients: a literature review

    DEFF Research Database (Denmark)

    Højsted, Jette; Sjøgren, Per

    2007-01-01

    , incidence and prevalence of addiction in opioid treated pain patients, screening tools for assessing opioid addiction in chronic pain patients and recommendations regarding addiction problems in national and international guidelines for opioid treatment in cancer patients and chronic non-malignant pain...... patients. The review indicates that the prevalence of addiction varied from 0% up to 50% in chronic non-malignant pain patients, and from 0% to 7.7% in cancer patients depending of the subpopulation studied and the criteria used. The risk of addiction has to be considered when initiating long-term opioid...... treatment as addiction may result in poor pain control. Several screening tools were identified, but only a few were thoroughly validated with respect to validity and reliability. Most of the identified guidelines mention addiction as a potential problem. The guidelines in cancer pain management...

  16. Competing effects of pain and fear of pain on postural control in low back pain?

    NARCIS (Netherlands)

    Mazaheri, M.; Heidari, E.; Mostmand, J.; Negahban, H.; van Dieen, J.H.

    2014-01-01

    STUDY DESIGN. A cross-sectional, observational study. OBJECTIVE. To determine whether pain and fear of pain have competing effects on postural sway in patients with low back pain (LBP). SUMMARY OF BACKGROUND DATA. Competing effects of pain and pain-related fear on postural control can be proposed as

  17. [Statins and muscle pain].

    Science.gov (United States)

    Yosef, Yoni; Schurr, Daniel; Constantini, Naama

    2014-07-01

    Statins are used for the prevention and treatment of cardiovascular disease. The treatment is quite safe but not free of side effects, particularly muscle pain. Fear of pain may prevent patients from carrying out exercise or diminish their motivation to return and engage in it, even though both the statins and the exercise have a proven benefit in both treatment and prevention, and a synergistic effect enhances this benefit. Prevalence of muscular pain ranges from 1-30%. Pain usually appears at the beginning of treatment, but can occur even after months and under any of the existing agents. The creatine phosphokinase (CPK) enzyme level may rise, but not necessarily. Increases to exceptional values (10 times the upper normal level) are relatively rare and rhabdomyolysis is extremely rare. The risk increases with age, co-morbidities and especially when taken concurrently with drugs that are metabolized in a similar pathway. Pain usually passes within a month after discontinuing treatment, but may persist for six months or more. Studies have examined the effect of statin therapy on the ability to perform physical activity, but results are inconsistent. The increased rise of CPK was observed under statin therapy, a tendency that increased with age. However, it was not accompanied by an increased incidence of muscle pain or rhabdomyolysis. Considering the above we recommend encouraging patients to exercise. However, patients should be instructed to report new or worsening muscular pains. Discontinuation, lowering dose or replacement should be considered when pain is suspected to be related with treatment.

  18. Chronic, unexplained pain

    NARCIS (Netherlands)

    Snijders, T.J.

    2012-01-01

    Chronic, unexplained pain (CUP) is a common clinical problem. The core symptom in this heterogeneous group of patients is pain for which no medical explanation is found. Patients also have many other characteristics (symptoms and psychosocial features) in common. Pathophysiologically, increased

  19. Breakthrough cancer pain

    DEFF Research Database (Denmark)

    Davies, Andrew; Buchanan, Alison; Zeppetella, Giovambattista

    2013-01-01

    Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients.......Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients....

  20. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has...

  1. Attachment Security and Pain

    DEFF Research Database (Denmark)

    Andersen, Tonny Elmose; Lahav, Yael; Defrin, Ruth

    2015-01-01

    The present study assesses for the first time, the possible disruption effect of posttraumatic stress symptoms (PTSS) with regard to the protective role of attachment on pain, among ex-POWs. While secure attachment seems to serve as a buffer, decreasing the perception of pain, this function may...

  2. Belly Pain (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Educators Search English Español Belly Pain KidsHealth / For Kids / Belly Pain What's in this article? All About ...

  3. Pain without nociceptors?

    DEFF Research Database (Denmark)

    Minett, Michael S; Falk, Sarah; Santana-Varela, Sonia

    2014-01-01

    Nav1.7, a peripheral neuron voltage-gated sodium channel, is essential for pain and olfaction in mice and humans. We examined the role of Nav1.7 as well as Nav1.3, Nav1.8, and Nav1.9 in different mouse models of chronic pain. Constriction-injury-dependent neuropathic pain is abolished when Nav1.......7 is deleted in sensory neurons, unlike nerve-transection-related pain, which requires the deletion of Nav1.7 in sensory and sympathetic neurons for pain relief. Sympathetic sprouting that develops in parallel with nerve-transection pain depends on the presence of Nav1.7 in sympathetic neurons. Mechanical...... and cold allodynia required distinct sets of neurons and different repertoires of sodium channels depending on the nerve injury model. Surprisingly, pain induced by the chemotherapeutic agent oxaliplatin and cancer-induced bone pain do not require the presence of Nav1.7 sodium channels or Nav1.8-positive...

  4. Tips for Chronic Pain

    Science.gov (United States)

    ... Don’t let stress compound your pain. • Stress is the result of the way you react to the world, and heightened stress equals heightened pain. Learn relaxation techniques or seek help in reducing your stress level. Get enough sleep. • Practice good sleep habits and get adequate sleep on a ...

  5. Painful Intercourse (Dyspareunia)

    Science.gov (United States)

    ... in sexual pain. Emotional factors include: Psychological issues. Anxiety, depression, concerns about your physical appearance, fear of intimacy or relationship problems can contribute to a low level of arousal and a resulting discomfort or pain. Stress. Your pelvic floor muscles tend to tighten in ...

  6. Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

    Science.gov (United States)

    Uthaikhup, Sureeporn; Prasert, Romchat; Paungmali, Aatit; Boontha, Kritsana

    2015-01-01

    Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold heat pain responses. The pain measures were assessed over the cervical spine and at a remote site, the tibialis anterior muscle. Results Elders with chronic neck pain had lower pressure pain threshold over the articular pillar of C5-C6 and decreased cold pain thresholds over the cervical spine and tibialis anterior muscle when compared with controls (p pain thresholds and suprathreshold heat pain responses (p > 0.05). Conclusion The presence of pain hypersensitivity in elderly women with chronic neck pain appears to be dependent on types of painful stimuli. This may reflect changes in the peripheral and central nervous system with age. PMID:26039149

  7. Ethnic Differences in Cancer Pain Experience

    Science.gov (United States)

    Im, Eun-ok

    2008-01-01

    Background Inconsistent findings on ethnic differences in cancer pain experience suggest the need for further studies on this topic for adequate cancer pain management. Objectives The purpose of this study was to determine ethnic differences in cancer pain experience of 4 ethnic groups in the U.S. Methods A feminist perspective provided the theoretical basis. This was a survey of a multiethnic sample of 480 cancer patients asking questions on sociodemographic characteristics and health/illness status, 3 unidimensional cancer pain scales, 2 multidimensional cancer pain scales, the Memorial Symptom Assessment Scale, and the Functional Assessment of Cancer Therapy Scale. The data were analyzed using descriptive and inferential statistics including ANOVA and hierarchical multiple regression analyses. Results The results indicated certain ethnic differences in types of pain and symptoms that patients experienced. Also, the results demonstrated significant ethnic differences in cancer pain and functional status. The VDS, VAS, FS, MPQ, and BPI scores of Non-Hispanic (N-H) Asian participants were significantly lower than those of Hispanic and N-H White participants (p<.01). The VAS and MPQ scores of N-H African American participants were significantly lower than those of Hispanic and N-H White participants (p<.01). The FACT-G scores of N-H Asian participants were significantly lower than Hispanic participants (p<.01). The findings also indicated that being N-H Asian or not was a significant predictor of the VDS, FS, and BPI scores. Discussion The findings suggest further in-depth qualitative exploration on cultural values and beliefs related to cancer pain in each ethnic group and national-scope studies with a larger number of ethnic minorities on this topic. PMID:17846550

  8. Cancer treatment: dealing with pain

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000827.htm Cancer treatment - dealing with pain To use the sharing features ... test, can cause pain. Treatment. Many types of cancer treatments can cause pain, including chemotherapy , radiation , and surgery. ...

  9. Radiological Approach to Forefoot Pain

    Directory of Open Access Journals (Sweden)

    Sai Chung Ho

    2015-06-01

    Full Text Available Forefoot pain is a common clinical complaint in orthopaedic practice. In this article, we discuss the anatomy of the forefoot, clinical and radiological approaches to forefoot pain, and common painful forefoot disorders and their associated radiological features.

  10. Pain and neuroplasticity

    Directory of Open Access Journals (Sweden)

    Sabine Sator-Katzenschlager, MD.

    2014-07-01

    However, the cerebral processing of hyperalgesia and allodynia is still controversially discussed. In recent years, neuroimaging methods (functional magnetic resonance imaging, fMRI; magnetoencephalography, MEG; positron emission tomography, PET have provided new insightsinto the aberrant cerebral processing of neuropathic pain. Thepresent paper reviews different cerebral mechanisms contributing to chronicity processes in neuropathic pain syndromes. These mechanisms include reorganisation of cortical somatotopic maps in sensory or motor areas (highly relevant for phantom limb pain and CRPS, increased activity in primary nociceptive areas, recruitment of new cortical areas usually not activated by nociceptive stimuli and aberrant activity in brain areas normally involved in descending inhibitory pain networks. Moreover, there is evidence from PET studies for changes of excitatory and inhibitory transmitter systems. Finally, advanced methods of structural brain imaging (voxel-based morphometry, VBM show significant structural changes suggesting that chronic pain syndromes may be associated with neurodegeneration.

  11. Child with Abdominal Pain.

    Science.gov (United States)

    Iyer, Rajalakshmi; Nallasamy, Karthi

    2018-01-01

    Abdominal pain is one of the common symptoms reported by children in urgent care clinics. While most children tend to have self-limiting conditions, the treating pediatrician should watch out for underlying serious causes like intestinal obstruction and perforation peritonitis, which require immediate referral to an emergency department (ED). Abdominal pain may be secondary to surgical or non-surgical causes, and will differ as per the age of the child. The common etiologies for abdominal pain presenting to an urgent care clinic are acute gastro-enteritis, constipation and functional abdominal pain; however, a variety of extra-abdominal conditions may also present as abdominal pain. Meticulous history taking and physical examination are the best tools for diagnosis, while investigations have a limited role in treating benign etiologies.

  12. Back Pain and Modic

    DEFF Research Database (Denmark)

    Manniche, Claus; Jordan, Alan; Mikkelsen, Connie

    Long awaited breakthrough Approximately 25 years ago a few researchers managed to publish an article in the renowned medical journal, The Lancet. The article demonstrated that intensive exercise was most useful for patients with chronic back pain. Many of our colleagues found this difficult...... to accept, nonetheless, intensive exercise has for chronic back pain has spread across the world and has become – in different forms – the most commonly prescribed treatment for back pain patients. Since that time, there has not been much research based progress in back science, however, we have taken...... a significant step forward with the advent of the new back pain diagnosis, ”Modic changes”. During the coming years, thousands of back pain patients will now be given a precise diagnosis as well as a useful treatment in cases where we previously we unable to provide either a diagnosis or a useful treatment...

  13. Methadone for Cancer Pain

    Directory of Open Access Journals (Sweden)

    Eric E. Prommer

    2010-07-01

    Full Text Available Pain is one of the most common and incapacitating symptoms experienced by patients with advanced cancer. Methadone is a potent opioid with strong affinity for the µ opioid receptor. In addition to being a potent µ opioid receptor ligand, methadone blocks the N-methyl-D-aspartic acid receptor and modulates neurotransmitters involved in descending pain modulation. These 3 properties enhance analgesic activity. Methadone’s lack of active metabolites makes it an attractive option when opioid responsiveness declines and renal insufficiency complicates opioid therapy. A lipophilic opioid, methadone can be given by multiple routes. Clinical trial data show equivalence with morphine as an analgesic in moderate to severe cancer pain. Further investigations are needed to define the role of methadone in the management of breakthrough pain and neuropathic pain and to determine whether it is truly superior to morphine, the gold standard of cancer analgesia.

  14. Victimization and pain

    Directory of Open Access Journals (Sweden)

    Małgorzata K. Szerla

    2013-12-01

    Full Text Available Pain has several causes. It can be caused not only by operative trauma or cancer. Some patients suffer from pain as a result of being victims of violence. The aim of the study was to introduce diagnosis and treatment of pain problems in patients who are victims of violence, from a physician’s and a psychologist’s common perspective. Physical pain-related primary effects experienced by the victims of domestic violence go far beyond the results which are noticeable directly and confirmed visually in a forensic examination. In the present paper we introduce an ‘invisible’ group of secondary effects of violence. They appear in time, often after several years, in the form of a variety of psychosomatic disorders. The body is devastated insidiously and the secondary effects are visible as vegetative symptoms, a variety of psychosomatic disorders and pain, difficult to diagnose and treat.

  15. The reliability of measuring pain distribution and location using body pain diagrams in patients with acute whiplash-associated disorders.

    Science.gov (United States)

    Southerst, Danielle; Stupar, Maja; Côté, Pierre; Mior, Silvano; Stern, Paula

    2013-09-01

    The objective of this study was to measure the interexaminer reliability of scoring pain distribution using paper and electronic body pain diagrams in patients with acute whiplash-associated disorder and to assess the intermethod reliability of measuring pain distribution and location using paper and electronic diagrams. We conducted an interexaminer reliability study on 80 participants recruited from a randomized controlled trial on the conservative management of acute grade I/II whiplash-associated disorder. Participants were assessed for inclusion/exclusion criteria by an experienced clinician. As part of the baseline assessment, participants independently completed paper and electronic pain diagrams. Diagrams were scored independently by 2 examiners using the body region method. Interexaminer and intermethod reliability was computed using intraclass correlation coefficients (ICCs) for pain distribution and κ coefficient for pain location. We used Bland-Altman plots to compute limits of agreement. The interexaminer reliability was ICC = 0.925 for paper and ICC = 0.997 for the electronic body pain diagram. The intermethod reliability for measuring pain distribution ranged from ICC = 0.63 to ICC = 0.93. For pain location, the intermethod reliability varied from κ = 0.23 (posterior neck) to κ = 0.90 (right side of the face). We found good to excellent interexaminer reliability for scoring 2 versions of the body pain diagram. Pain distribution and pain location were reliably and consistently measured on body pain diagrams using paper and electronic methods; therefore, clinicians and researchers may choose either medium when using body pain diagrams. Copyright © 2013 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  16. Il dono del racconto

    DEFF Research Database (Denmark)

    Polito, Paola

    1998-01-01

    L'articolo indaga a vari livelli strutturali del romanzo "Il coraggio del pettirosso" (rete metaforica, dialogismo diegetico, dialogismo come fenomeno di voce, strategie discorsive messe in atto dalla voce narrante, stile colloquiale) la complessa realizzazione testuale del genere narrativo...

  17. Alteração na atenção e o tratamento da dor do câncer Alteración en la atención y el tratamiento del dolor de cáncer Alteration in attention and cancer pain treatment

    Directory of Open Access Journals (Sweden)

    Geana Paula Kurita

    2008-03-01

    Full Text Available Os danos à vida diária que a alteração cognitiva pode provocar motivaram a elaboração deste estudo, cujo objetivo foi analisar o impacto do tratamento da dor com opióides sobre a atenção. Os doentes foram divididos em grupos que recebiam (n=14 e não recebiam opióides (n=12. Foram feitas três entrevistas, utilizando-se o Trail Making Test e o Digit Span Test, que avaliam a atenção. Os grupos foram homogêneos nas variáveis sociodemográficas, dor e depressão; não foram homogêneos no índice de Karnofsky e no recebimento de analgésicos adjuvantes. Os doentes sem opióides tiveram melhor desempenho no Digit Span Test - ordem inversa, na segunda avaliação (p=0,29 e não foram observadas diferenças no Trail Making Test. As alterações observadas foram limitadas, mas, enquanto novos estudos não confirmem os achados, doentes, profissionais e cuidadores devem ser alertados dos possíveis efeitos deletérios dos opióides sobre a função cognitiva.Los daños a la vida diaria que la alteración cognoscitiva puede causar motivaron la elaboración de este estudio, cuyo objetivo fue analizar el impacto del tratamiento del dolor con los opioides en la atención. Los enfermos fueron divididos en grupos que recibieron (n=14 y no recibieron opioides (n=12. Fueron realizadas tres entrevistas utilizándose el Trail Making Test y el Digit Span Test, que evalúan la atención. Los grupos fueron homogéneos en las variables sociodemográficas, dolor y depresión; no fueron homogéneos en el índice de Karnofsky y en el suministro de analgésicos adyuvantes. Los pacientes sin opioides tuvieron mejor desempeño en el Digit Span Test - reverse order, en la segunda entrevista (p=0,29 y no se observaron diferencias en el Trail Making Test. Las alteraciones observadas fueron limitadas, sin embargo mientras nuevos estudios no confirmen los resultados, pacientes, profesionales y cuidadores deben ser alertados sobre los posibles efectos deletéreos de

  18. Pain management after lung surgery

    OpenAIRE

    Maria Frödin; Margareta Warrén Stomberg

    2014-01-01

    Pain management is an integral challenge in nursing and includes the responsibility of managing patients’ pain, evaluating pain therapy and ensuring the quality of care. The aims of this study were to explore patients’ experiences of pain after lung surgery and evaluate their satisfaction with the postoperative pain management. A descriptive design was used which studied 51 participants undergoing lung surgery. The incidence of moderate postoperative pain varied from 36- 58% among the partici...

  19. Revisão sobre o uso de gabapentina para controle da dor pós-operatória Revisión sobre el uso de gabapentina para el control del dolor postoperatorio Review of the use of gabapentin in the control of postoperative pain

    Directory of Open Access Journals (Sweden)

    Jefferson Clivatti

    2009-02-01

    . CONTENIDO: Fueron seleccionados todos los estudios clínicos con distribución aleatoria que evaluaron el efecto de la gabapentina en el dolor postoperatorio en humanos entre 2002 y 2007. Se encontraron 26 artículos publicados. En 17 estudios, los pacientes recibieron dosis única preoperatoria que varió entre 300 y 1200mg y entre 30min y dos horas antes de los procedimientos. En los demás estudios, la medicación fue iniciada entre una y 24 horas antes de los procedimientos, y continuada por dos a 10 días en la dosis de 1.200 a 1.800 mg.día-1. Para una medida de intensidad del dolor, fueron utilizadas la Escala Analógica Visual o Numérica. En un 75% entre los que recibieron solamente la dosis pre, los puntajes fueron menores con el uso de la gabapentina y también en un 55,6% entre los que recibieron dosis pre y pos. El consumo de opioide fue menor en un 82,4% de los que recibieron dosis pre y en un 77,8% en los que recibieron pre y pos. En estudios que usaron pre, cuatro no arrojaron efectos adversos; no hubo diferencia en un 52,9%, más náusea o vómito en un 11,8%, más mareos en un 5,9%, más sedación en un 5,9%, menos náusea o vómito en uno y menos retención urinaria en uno. En estudios que usaron pre y pos, cuatro no arrojaron efectos adversos; no hubo diferencia en un 22,2%, más náusea o vómito en 11,1%, más mareo en 22,2% y más sedación en un 11,1%. CONCLUSIONES: La gabapentina usada tanto antes, como antes y después de la operación, promueve la reducción de la intensidad del dolor y de la necesidad de complementación analgésica.BACKGROUND AND OBJECTIVES: Gabapentin has been used as adjuvant in the treatment of postoperative pain with a neuropathic component. It is responsible for the inhibition of central sensitization, decreasing postoperative pain. CONTENTS: All clinical, randomized studies that evaluated the effects of gabapentin on postoperative pain in humans between 2002 and 2007 for a total of 26 studies were selected. In 17 studies

  20. Prevalência e fatores de risco de dores nas costas em adolescentes: uma revisão sistemática da literatura Prevalencia y factores de riesgo del dolor de espalda en adolescentes: una revisión sistemática de la literatura Prevalence and risk factors for back pain in adolescents: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Arménio Cruz

    2012-03-01

    referencia, siguiendo un proceso sistemático desde la selección de los recursos de pesquisa hasta la evaluación crítica de los textos seleccionados. La investigación tuvo como objetivo responder a la pregunta “¿Cuáles es la prevalencia y cuáles son los factores de riesgo del dolor de espalda entre adolescentes con edades entre los 11 e 19 años?” En esta revisión fueron incluidos 24 artículos con una buena y moderada calidad metodológica y, a pesar de la incongruencia respecto al concepto del dolor de espalda, las prevalencias varían a nivel temporal y local. Los factores de riesgo son multidimensionales, entre los cuales el género y la edad emergieron como siendo los más evidentes. Se proponen estudios prospectivos en esta temática y, la información y la educación aparecen como siendo las estrategias más adecuadas para prevenir este problema de salud pública.Spinal complaints are common among adults and have significant individual, social and economic aspects. Some studies report that the source of these problems arises in childhood and adolescence. In this context, we intended to identify the prevalence and risk factors for back pain in adolescence and analyze the scientific evidence currently available. We conducted a systematic literature review between January 2005 and August 2010, with inclusion criteria and pre-defined descriptors using several databases of references, following a systematic process from selection of research resources to the critical evaluation of selected texts. The research question was “What is the prevalence and what are the risk factors for back pain among adolescents aged 11-19 years?”. We included 24 articles of good and moderate methodological quality and, despite inconsistency in the definition of back pain, prevalence rates vary in time and place. Risk factors are multidimensional, and gender and age emerged as the most obvious. Prospective studies are proposed on this issue, and information and education emerge

  1. Multidimensional features of pain in patients with chronic neck pain

    Directory of Open Access Journals (Sweden)

    Fabianna Resende de Jesus-Moraleida

    Full Text Available Abstract Introduction: Chronic neck pain is associated with significant health costs and loss of productivity at work. Objective: to assess pain and disability in individuals with chronic neck pain. Methods: 31 volunteers with chronic neck pain, mean age 29, 65 years, were assessed using the McGill Pain Questionnaire in Brazilian version (Br-MPQ and Neck Disability Index (NDI. The Br-MPQ analysis was performed based on the numerical values associated with the words selected to describe the experience of pain (Pain Rating Index - PRI, and present pain intensity (PPI. NDI was used to evaluate the influence of neck pain in performance of everyday tasks. Finally, we investigated the association between PPI and NDI. Results: PRI revealed that the most significant dimension was the sensory pain (70%, and the number of chosen words was 10 (2,62 out of 20 words. Mean PPI value was 1,23 (0,76 in five points; 40% of participants described pain intensity as moderate. NDI score was 9,77 (3,34, indicating mild disability. There was a positive association between disability and pain intensity (r = 0,36; p =0,046. Pain intensity and duration of pain were not associated. Conclusions: Findings of this study identified important information related to neck pain experienced by patients when suffering from chronic neck pain, moreover, the association between disability and pain intensity reinforces the importance of complementary investigation of these aspects to optimize function in them.

  2. Validade e confiabilidade do Inventário de Atitudes frente à Dor Crônica (IAD-28 itens em lingua portuguesa Validez y confiabilidad del Inventario de Actitudes frente al Dolor Crónico (IAD-28 ítems en lengua portuguesa Validity and reliability of the Survey of Pain Attitudes (SOPA-28 items in the portuguese language

    Directory of Open Access Journals (Sweden)

    Cibele Andrucioli de Mattos Pimenta

    2009-12-01

    Full Text Available Trata-se da reavaliação da confiabilidade e validade do Inventário de Atitudes frente à Dor Crônica-versão breve, (IAD-breve com 183 pacientes com dor crônica não oncológica. O IAD-breve 28 itens avalia as crenças sobre dor crônica relacionadas ao controle, emoção, solicitude, cura médica, dano físico, incapacidade e medicação. A análise mostrou sete domínios e 28 itens. Houve diferenças na alocação de dois itens e, após análises, optou-se por retirá-los. Quatro domínios apresentaram valores de alfa de Cronbach considerados bons (entre 0,74 e 0,85 e em três, foram moderados (entre 0,58 e 0,65. O IAD-breve 28 itens em língua portuguesa é superior à primeira versão.Este estudio trata la reevaluación de la confiabilidad y validez del Inventario de Actitudes frente al Dolor Crónico-versión breve, (IAD-breve con 183 pacientes con dolor crónico no oncológico. El IAD-breve 28 ítems evalúa las creencias en el dolor crónico relacionadas al control, emoción, solicitud, cura médica, daño físico, incapacidad y medicación. El análisis resultó en siete dominios y 28 ítems. Hubo diferencias en la ubicación de dos ítems y, después de análisis, se decidió removerlos. Cuatro dominios presentaron valores de alfa de Cronbach considerados buenos (entre 0,74 y 0,85 y en tres, moderados (entre 0,58 y 0,65. El IAD-breve 28 ítems en lengua portuguesa es superior a la primera versión.This is the re-assessment of reliability and validity of Survey of Pain Attitudes-brief (SOPA-brief version, with 183 chronic non-cancer pain patients. The SOPA-brief assesses the chronic pain beliefs related to emotion, control, solicitude, medical cure, harm, disability and medication. The analysis showed seven domains and 28 items. There were differences in the allocation of two items and after analyses they were excluded. Four domains had good Cronbach's alpha values (between 0.74 and 0.85 and three had moderate (between 0.58 and 0

  3. Las cruces del olvido

    Directory of Open Access Journals (Sweden)

    Carla Fernandes

    2012-08-01

    Full Text Available Les tragiques événements du « mars paraguayen » ont signifié la disparition de l’espoir en la transition démocratique dans laquelle le pays s’était engagé depuis presque une dizaine d’années. Renée Ferrer, poète, dramaturge, auteur de plusieurs recueils de contes et de deux romans, consigne alors le témoignage poétique de ce drame national dans le recueil Las cruces del olvido (2001. Elle a auparavant publié d’autres textes qui peuvent rentrer dans la catégorie de la poésie sociale : c’est le cas en particulier de Viaje a destiempo (1989 dédié aux victimes de la dictature. Las cruces del olvido, dès son paratexte, insiste sur la fonction de témoignage que l’auteur souhaite assigner à ses vers et sur le rôle que ceux-ci peuvent jouer dans la transmission d’une mémoire collective. La voix d’un jeune disparu de ce « mars paraguayen », le dédoublement qu’il subit et travers lequel il évoque son entrée dans la mort et son absence du monde des vivants, rendent possible l’écriture de cette expérience de l’indicible qu’est la disparition.Los trágicos acontecimientos del «marzo paraguayo» significaron la desaparición de la esperanza en la transición democrática que el país está viviendo desde unos diez años. Renée Ferrer, poeta, dramaturga, autora de varios libros de cuentos y de dos novelas, escribe entonces el testimonio poético de ese drama nacional en su poemario Las cruces del olvido (2001. Ya había publicado antes textos que se pueden considerar como poesía social: es el caso de Viaje a destiempo (1989 dedicado a las víctimas de la dictadura. Desde el texto apertural, Las cruces del olvido potencia la función de testimonio que la autora desea conceder a sus versos y el papel que éstos pueden desempeñar en la transmisión de una memoria colectiva. La voz de un joven desaparecido del «marzo paraguayo», el desdoblamiento que sufre y a través del cual evoca su entrada en la

  4. Prevalence and management of pain, by race and dementia among nursing home residents: United States, 2004.

    Science.gov (United States)

    Sengupta, Manisha; Bercovitz, Anita; Harris-Kojetin, Lauren D

    2010-03-01

    Data from the National Nursing Home Survey, 2004. About one-quarter of all nursing home residents reported or showed signs of pain. Nonwhite residents and residents with dementia were less likely to report or show signs of pain compared with white residents and residents without dementia. Nonwhite residents with dementia were least likely, and white residents without dementia were most likely to report or show signs of pain. Forty-four percent of nursing home residents with pain received neither standing orders for pain medication nor special services for pain management (i.e., appropriate pain management). Among residents with dementia and pain, nonwhite residents were more likely than white residents to lack appropriate pain management.

  5. A meta-analysis of fear-avoidance and pain intensity: The paradox of chronic pain.

    Science.gov (United States)

    Kroska, Emily B

    2016-10-01

    The fear-avoidance model of chronic pain has established avoidance as a predictor of negative outcomes in chronic pain patients. Avoidance, or deliberate attempts to suppress or prevent unwanted experiences (e.g., pain), has been studied extensively, with multiple reviews implicating this behavior as a predictor of disability, physical disuse, and depression. Despite hundreds of studies examining the associations between different components of this model (i.e., catastrophizing, fear, avoidance, depression), the association between fear-avoidance and pain intensity has remained unclear. The present study seeks to clarify this association across samples. The present analyses synthesize the literature (articles from PsycInfo, PubMed, and ProQuest) to determine if fear-avoidance and pain intensity are consistently correlated across studies, samples, and measures. Eligible studies measured pain intensity and fear-avoidance cross-sectionally in chronic pain patients. The search resulted in 118 studies eligible for inclusion. A random-effects model was used to estimate the weighted mean effect size. Comprehensive Meta-Analysis software was used for all analyses. Moderation analyses elucidate the variables that affect the strength of this association. Meta-regression and meta-ANOVA analyses were conducted to examine moderating variables. Moderator variables include demographic characteristics, pain characteristics, study characteristics, and national cultural characteristics (using Hofstede's cultural dimensions). Publication bias was examined using the funnel plot and the p-curve. Results indicate a small-to-moderate positive association between fear-avoidance and pain intensity. The results were stable across characteristics of the sample, including mean age, gender distribution, marital status, and duration of pain. Moderation analyses indicate that the measures utilized and cultural differences affect the strength of this association. Weaker effect sizes were observed

  6. The painful shoulder

    International Nuclear Information System (INIS)

    Hartl, P.W.

    1987-01-01

    The painful shoulder syndrome is very common. Diagnosis and differential diagnosis may be difficult. Shoulder pain may be caused by local processes or systemic diseases or can be referred. Periarthritis humeroscapularis (frozen shoulder) is the most common cause of painful shoulder syndrome. Biomechanical factors concerning the rotator cuff are involved in the etiopathogenesis of these pain syndromes. The therapy of frozen shoulder includes physical treatment, antirheumatic drugs, or X-ray treatment. Surgical measures may become necessary. In the course of rheumatoid arthritis the shoulder may be involved. Milwaukee-shoulder-syndrome has been described recently in crystal deposit diseases. Shoulder pain may be referred by mechanical irritations of nerve roots in the course of degenerative lesions of the cervical spine and also in the course of internal diseases of the heart, the lungs, or the gastrointestinal tract. In cases of shoulder pain without pathological data from arthrological, radiological or laboratory studies, one should always consider localized fibromyalgia in the shoulder-neck-region. The precise diagnosis of shoulder pain is an important prerequisite for treatment, the success of which should not be judged as pessimistic as it has been commonly done in the past. (orig.) [de

  7. Efficient conditioned pain modulation despite pain persistence in painful diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Yelena Granovsky

    2017-06-01

    Conclusion:. Pro-nociception, expressed by less efficient CPM and high temporal summation that usually accompanies clinical painful conditions, seems to “normalize” with chronicity of the pain syndrome. This is despite continuing pain, suggesting that pro-nociceptivity in pain syndromes is multifactorial. Because the pain modulation profile affects success of therapy, this suggests that different drugs might express different efficacy pending on duration of the pain in patients with PDN.

  8. Language and the pain experience.

    Science.gov (United States)

    Wilson, Dianne; Williams, Marie; Butler, David

    2009-03-01

    People in persistent pain have been reported to pay increased attention to specific words or descriptors of pain. The amount of attention paid to pain or cues for pain (such as pain descriptors), has been shown to be a major factor in the modulation of persistent pain. This relationship suggests the possibility that language may have a role both in understanding and managing the persistent pain experience. The aim of this paper is to describe current models of neuromatrices for pain and language, consider the role of attention in persistent pain states and highlight discrepancies, in previous studies based on the McGill Pain Questionnaire (MPQ), of the role of attention on pain descriptors. The existence of a pain neuromatrix originally proposed by Melzack (1990) has been supported by emerging technologies. Similar technologies have recently allowed identification of multiple areas of involvement for the processing of auditory input and the construction of language. As with the construction of pain, this neuromatrix for speech and language may intersect with neural systems for broader cognitive functions such as attention, memory and emotion. A systematic search was undertaken to identify experimental or review studies, which specifically investigated the role of attention on pain descriptors (as cues for pain) in persistent pain patients. A total of 99 articles were retrieved from six databases, with 66 articles meeting the inclusion criteria. After duplicated articles were eliminated, the remaining 41 articles were reviewed in order to support a link between persistent pain, pain descriptors and attention. This review revealed a diverse range of specific pain descriptors, the majority of which were derived from the MPQ. Increased attention to pain descriptors was consistently reported to be associated with emotional state as well as being a significant factor in maintaining persistent pain. However, attempts to investigate the attentional bias of specific pain

  9. Characterizing individual painDETECT symptoms by average pain severity

    Directory of Open Access Journals (Sweden)

    Sadosky A

    2016-07-01

    Full Text Available Alesia Sadosky,1 Vijaya Koduru,2 E Jay Bienen,3 Joseph C Cappelleri4 1Pfizer Inc, New York, NY, 2Eliassen Group, New London, CT, 3Outcomes Research Consultant, New York, NY, 4Pfizer Inc, Groton, CT, USA Background: painDETECT is a screening measure for neuropathic pain. The nine-item version consists of seven sensory items (burning, tingling/prickling, light touching, sudden pain attacks/electric shock-type pain, cold/heat, numbness, and slight pressure, a pain course pattern item, and a pain radiation item. The seven-item version consists only of the sensory items. Total scores of both versions discriminate average pain-severity levels (mild, moderate, and severe, but their ability to discriminate individual item severity has not been evaluated.Methods: Data were from a cross-sectional, observational study of six neuropathic pain conditions (N=624. Average pain severity was evaluated using the Brief Pain Inventory-Short Form, with severity levels defined using established cut points for distinguishing mild, moderate, and severe pain. The Wilcoxon rank sum test was followed by ridit analysis to represent the probability that a randomly selected subject from one average pain-severity level had a more favorable outcome on the specific painDETECT item relative to a randomly selected subject from a comparator severity level.Results: A probability >50% for a better outcome (less severe pain was significantly observed for each pain symptom item. The lowest probability was 56.3% (on numbness for mild vs moderate pain and highest probability was 76.4% (on cold/heat for mild vs severe pain. The pain radiation item was significant (P<0.05 and consistent with pain symptoms, as well as with total scores for both painDETECT versions; only the pain course item did not differ.Conclusion: painDETECT differentiates severity such that the ability to discriminate average pain also distinguishes individual pain item severity in an interpretable manner. Pain

  10. Efeito analgésico de antagonistas do receptor da histamina H1 em modelo de dor provocada por formalina em ratos Efecto analgésico de antagonistas del receptor de la histamina H1 en un modelo de dolor provocado por formalina en ratones Analgesic effects of H1 receptor antagonists in the rat model of formalin-induced pain

    Directory of Open Access Journals (Sweden)

    Hazem Adel Ashmawi

    2009-08-01

    sistema nervioso periférico. No queda claro si el efecto analgésico local es de clase específico o un fármaco específico. MÉTODO: Para responder a esa pregunta, utilizamos tres diferentes antagonistas del receptor H1 (pirilamina, prometazina y cetirizina, administrados directamente en la pata del ratón, por vía intraperitoneal o por bloqueo de nervio periférico en modelo de dolor inducido por formalina. Observamos el efecto de los fármacos en el comportamiento del número de elevaciones de la pata. RESULTADOS: En la fase I, la pirilamina local redujo el número de elevaciones de la pata de forma dosis dependiente. En la dosis más alta, la reducción fue de un 97,8%. Para la prometazina, la disminución fue de un 92% y para la cetizirina de 23.9%. En la fase II, la pirilamina redujo el número de elevaciones de la pata en un 93,5%, la prometazina, un 78,2% y la cetirizina un 80,1%. La administración de los fármacos por vía intraperitoneal no alteró el comportamiento doloroso. Cuando se usaron para bloqueo del nervio periférico en la fase I, la pirilamina redujo el número de elevaciones de la pata en un 96,7%, la prometazina en un 73,3% y la cetirizina en un 23,9%. En la fase II, la pirilamina redujo un 86,6%, la prometazina un 64,4% y la cetirizina un 19,9%. CONCLUSIONES: Los resultados mostraron que los antagonistas del receptor de la histamina H1 presentaron efectos analgésicos locales, diferentes del efecto sistémico, siendo uno de ellos antiinflamatorio y clase específico, y el otro específico para la prometazina y la pirilamina, parecido con el efecto clínico anestésico local.BACKGROUND AND OBJECTIVES: Histamine receptors mediate nociceptive pathways, especially in the central nervous system. Some studies have demonstrated the analgesic effects of histamine receptor antagonists in the peripheral nervous system. It is not clear whether the local analgesic effect is class-specific or drug-specific. METHODS: To answer this question, we used three

  11. Low back pain

    DEFF Research Database (Denmark)

    Buchbinder, Rachelle; van Tulder, Maurits; Öberg, Birgitta

    2018-01-01

    Low back pain is the leading worldwide cause of years lost to disability and its burden is growing alongside the increasing and ageing population.1 Because these population shifts are more rapid in low-income and middle-income countries, where adequate resources to address the problem might...... not exist, the effects will probably be more extreme in these regions. Most low back pain is unrelated to specific identifiable spinal abnormalities, and our Viewpoint, the third paper in this Lancet Series,2,3 is a call for action on this global problem of low back pain....

  12. Persistent postsurgical pain

    DEFF Research Database (Denmark)

    Werner, Mads Utke; Bischoff, Joakim Mutahi

    2014-01-01

    The prevalences of severe persistent postsurgical pain (PPP) following breast cancer surgery (BCS), groin hernia repair (GHR), and lung cancer surgery (LCS) are 13, 2, and 4-12 %, respectively. Estimates indicate that 80,000 patients each year in the U.S.A. are affected by severe pain...... duration of surgery, repeat surgery, more invasive surgical techniques, and intraoperative nerve lesion have been associated with PPP. One of the most consistent predictive factors for PPP is high intensity acute postsurgical pain, but also psychological factors including anxiety, catastrophizing trait...

  13. Nonspecific Arm Pain

    Directory of Open Access Journals (Sweden)

    Ali Moradi

    2013-12-01

    Full Text Available Nonspecific activity-related arm pain is characterized by an absence of objective physical findings and symptoms that do not correspond with objective pathophysiology. Arm pain without strict diagnosis is often related to activity, work-related activity in particular, and is often seen in patients with physically demanding work. Psychological factors such as catastrophic thinking, symptoms of depression, and heightened illness concern determine a substantial percentage of the disability associated with puzzling hand and arm pains. Ergonomic modifications can help to control symptoms, but optimal health may require collaborative management incorporating psychosocial and psychological elements of illness.

  14. Nonspecific Arm Pain

    Directory of Open Access Journals (Sweden)

    Ali Moradi

    2013-12-01

    Full Text Available   Nonspecific activity-related arm pain is characterized by an absence of objective physical findings and symptoms that do not correspond with objective pathophysiology. Arm pain without strict diagnosis is often related to activity, work-related activity in particular, and is often seen in patients with physically demanding work. Psychological factors such as catastrophic thinking, symptoms of depression, and heightened illness concern determine a substantial percentage of the disability associated with puzzling hand and arm pains. Ergonomic modifications can help to control symptoms, but optimal health may require collaborative management incorporating psychosocial and psychological elements of illness.

  15. Conditioned pain modulation in patients with nonspecific chronic back pain with chronic local pain, chronic widespread pain, and fibromyalgia.

    Science.gov (United States)

    Gerhardt, Andreas; Eich, Wolfgang; Treede, Rolf-Detlef; Tesarz, Jonas

    2017-03-01

    Findings considering conditioned pain modulation (CPM) in chronic back pain (CBP) are contradictory. This might be because many patients with CBP report pain in further areas of the body, and altered CPM might influence spatial extent of pain rather than CBP per se. Therefore, we compared CPM in patients with CBP with different pain extent. Patients with fibromyalgia syndrome (FMS), for whom CPM impairment is reported most consistently, were measured for comparison. Based on clinical evaluation and pain drawings, patients were categorized into chronic local back pain (CLP; n = 53), chronic widespread back pain (CWP; n = 32), and FMS (n = 92). Conditioned pain modulation was measured by the difference in pressure pain threshold (test stimuli) at the lower back before and after tonic heat pain (conditioning stimulus). We also measured psychosocial variables. Pressure pain threshold was significantly increased in CLP patients after tonic heat pain (P pain modulation in CLP was significantly higher than that in CWP and FMS (P painful areas (0-10) were associated with lower CPM (r = 0.346, P = 0.001) in CBP but not in FMS (r = -0.013, P = 0.903). Anxiety and depression were more pronounced in FMS than in CLP or CWP (P values pain inhibition seem to be more indicated the higher the pain extent.

  16. del cambio

    Directory of Open Access Journals (Sweden)

    Alejandro Canales

    2006-01-01

    Full Text Available El artículo analiza las propuestas y los compromisos en materia de cobertura y de financiamiento en el periodo 2000-2006. En particular, revisa las modificaciones y los ajustes de los tres principales documentos en los que se expresaron las iniciativas: el de la Asociación Nacional de Universidades e Instituciones de Educación Superior, el del equipo de la transición y el programa sectorial. Los resultados muestran que las cifras de atención a la demanda educativa e inversión quedaron lejos de las metas autoimpuestas por el gobierno federal y que será necesario realizar mayores esfuerzos para atender tales desafíos.

  17. Evaluation of pain incidence and pain management in a South ...

    African Journals Online (AJOL)

    Design. A prospective observational study, using the Numerical Rating Scale for pain (NRS pain), Numerical Rating Scale for anxiety (NRS anxiety), the Alder Hey Triage Pain Score (AHTPS), the COMFORT behaviour scale and the Touch Visual Pain Scale (TVPS). All patients were assessed at admission; those who were ...

  18. Predicting postoperative pain by preoperative pressure pain assessment.

    Science.gov (United States)

    Hsu, Yung-Wei; Somma, Jacques; Hung, Yu-Chun; Tsai, Pei-Shan; Yang, Chen-Hsien; Chen, Chien-Chuan

    2005-09-01

    The goal of this study was to evaluate whether preoperative pressure pain sensitivity testing is predictive of postoperative surgical pain. Female subjects undergoing lower abdominal gynecologic surgery were studied. A pressure algometer was used preoperatively to determine the pressure pain threshold and tolerance. A visual analog scale (VAS) was used to assess postoperative pain. A State-Trait Anxiety Inventory was used to assess patients' anxiety. Subjects received intravenous patient-controlled analgesia for postoperative pain control. The preoperative pain threshold and tolerance were compared with the postoperative VAS pain score and morphine consumption. Forty women were enrolled. Their preoperative pressure pain threshold and tolerance were 141 +/- 65 kPa and 223 +/- 62 kPa, respectively. The VAS pain score in the postanesthesia care unit and at 24 h postoperatively were 81 +/- 24 and 31 +/- 10, respectively. Highly anxious patients had higher VAS pain scores in the postanesthesia care unit (P pain tolerance was significantly correlated with the VAS at 24 h postoperatively (P pain tolerance after fentanyl administration (mean, 272 +/- 68 kPa) correlated significantly with morphine consumption in the first 24 h postoperatively (P pain tolerance is significantly correlated with the level of postoperative pain. Pain tolerance assessment after fentanyl was administered and fentanyl sensitivity predicted the dose of analgesics used in the first 24 h after surgery. The algometer is thus a simple, useful tool for predicting postoperative pain and analgesic consumption.

  19. Políticas nacionales de salud y decisiones locales en México: el caso del Hospital Mixto de Cuetzalan, Puebla National health policies and local decisions in Mexico: the case of an intercultural hospital in Cuetzalan, Puebla

    OpenAIRE

    María Beatriz Duarte-Gómez; Viviane Brachet-Márquez; Roberto Campos-Navarro; Gustavo Nigenda

    2004-01-01

    OBJETIVO: Identificar la evolución del hospital del municipio de Cuetzalan a partir de la influencia que diversos elementos del contexto nacional e internacional han tenido sobre ella. MATERIAL Y MÉTODOS: Estudio de caso, realizado en 2000 y 2001 sobre los Hospitales Mixtos en México -el de Cuetzalan, en el estado de Puebla, y el de Jesús María, en el estado de Nayarit-. Durante el trabajo de campo se obtuvo información a través de 72 entrevistas semiestructuradas con terapeutas alópatas e in...

  20. Postamputation pain: studies on mechanisms.

    Science.gov (United States)

    Nikolajsen, Lone

    2012-10-01

    Amputation is followed by both painful and non-painful phantom phenomena in a large number of amputees. Non-painful phantom sensations rarely pose any clinical problem, but 60-80% of all amputees also experience painful sensations (i.e. phantom pain) located to the missing limb. The severity of phantom pain usually decreases with time, but severe pain persists in 5-10% of patients. Pain in the residual limb (i.e. stump pain) is another consequence of amputation. Both stump and phantom pain can be very difficult to treat. Treatment guidelines used for other neuropathic pain conditions are probably the best approximation, especially for the treatment of stump pain. The aim of the present doctoral thesis was to explore some of the mechanisms underlying pain after amputation. Ten studies were carried out (I-X). My PhD thesis from 1998 dealt with pain before the amputation and showed that preamputation pain increases the risk of phantom pain after amputation (I). A perioperative epidural blockade, however, did not reduce the incidence of pain or abnormal sensory phenomena after amputation (II, III). The importance of sensitization before amputation for the subsequent development of pain is supported by study IV, in which pressure pain thresholds obtained at the limb before amputation were inversely related to stump and phantom pain after 1 week. Afferent input from the periphery is likely to contribute to postamputation pain as sodium channels were upregulated in human neuromas (VI), although neuroma removal did not always alleviate phantom pain (V). Sensitization of neurons in the spinal cord also seems to be involved in pain after amputation as phantom pain was reduced by ketamine, an NMDA-receptor antagonist. Another NMDA-receptor antagonist, memantine, and gabapentin, a drug working by binding to the δ2α-subunit of voltage-gated calcium channels, had no effect on phantom pain (VII-IX). Supraspinal factors are also important for pain after amputation as

  1. Sacroiliac joint pain - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000610.htm Sacroiliac joint pain - aftercare To use the sharing features on this page, please enable JavaScript. The sacroiliac joint (SIJ) is a term used to describe ...

  2. Pain and your emotions

    Science.gov (United States)

    ... gov/ency/patientinstructions/000417.htm Pain and your emotions To use the sharing features on this page, ... or hurting yourself What to do About Your Emotions A common type of therapy for people with ...

  3. Physiotherapy for pain

    DEFF Research Database (Denmark)

    Ginnerup-Nielsen, Elisabeth; Christensen, Robin; Thorborg, Kristian

    2016-01-01

    OBJECTIVES: To empirically assess the clinical effects of physiotherapy on pain in adults. DESIGN: Using meta-epidemiology, we report on the effects of a 'physiotherapy' intervention on self-reported pain in adults. For each trial, the group difference in the outcome 'pain intensity' was assessed...... as standardised mean differences (SMD) with 95% CIs. Stratified analyses were conducted according to patient population (International Classification of Diseases-10 classes), type of physiotherapy intervention, their interaction, as well as type of comparator group and risks of bias. The quality of the body...... 'no intervention' or of a sham-controlled design were selected. Only articles written in English were eligible. RESULTS: An overall moderate effect of physiotherapy on pain corresponding to 0.65 SD-units (95% CI 0.57 to 0.73) was found based on a moderate inconsistency (I(2)=51%). Stratified...

  4. Pain Medications After Surgery

    Science.gov (United States)

    ... be used for outpatient procedures or more-involved inpatient surgery. For pain relief lasting several hours, an ... surgical care, such as rest, ice packs, rehabilitative exercises and wound care. Ask to have written instructions ...

  5. Analgesia for acute pain

    African Journals Online (AJOL)

    order to facilitate recovery, prevent chronic pain and accomplish this with minimal ... standard drug or cocktail and a satisfactory patient response is based on targeting ... South African Family Practice 2016; 58(1):11-15 .... and cognitive therapy.

  6. Neuropathic pain - Current concepts

    African Journals Online (AJOL)

    Department of Family Medicine, University of Pretoria and Kalafong Hospital ... The aim of treatment is to assist the patient in managing the pain and to improve function ..... The incidence of true addiction to strong opioids in the management.

  7. Functional abdominal pain syndrome.

    Science.gov (United States)

    Clouse, Ray E; Mayer, Emeran A; Aziz, Qasim; Drossman, Douglas A; Dumitrascu, Dan L; Mönnikes, Hubert; Naliboff, Bruce D

    2006-04-01

    Functional abdominal pain syndrome (FAPS) differs from the other functional bowel disorders; it is less common, symptoms largely are unrelated to food intake and defecation, and it has higher comorbidity with psychiatric disorders. The etiology and pathophysiology are incompletely understood. Because FAPS likely represents a heterogeneous group of disorders, peripheral neuropathic pain mechanisms, alterations in endogenous pain modulation systems, or both may be involved in any one patient. The diagnosis of FAPS is made on the basis of positive symptom criteria and a longstanding history of symptoms; in the absence of alarm symptoms, an extensive diagnostic evaluation is not required. Management is based on a therapeutic physician-patient relationship and empirical treatment algorithms using various classes of centrally acting drugs, including antidepressants and anticonvulsants. The choice, dose, and combination of drugs are influenced by psychiatric comorbidities. Psychological treatment options include psychotherapy, relaxation techniques, and hypnosis. Refractory FAPS patients may benefit from a multidisciplinary pain clinic approach.

  8. Topical Pain Medications

    Science.gov (United States)

    ... Clinic Staff After an especially active weekend of hiking or work around the yard, your joints might ... their arthritis pain, scientific research reveals only modest benefits. Some products work only slightly or no better ...

  9. Shoulder pain in hemiplegia.

    Science.gov (United States)

    Andersen, L T

    1985-01-01

    Development of a painful shoulder in the hemiplegic patient is a significant and serious problem, because it can limit the patient's ability to reach his or her maximum functional potential. Several etiologies of shoulder pain have been identified, such as immobilization of the upper extremity, trauma to the joint structures, including brachial plexus injuries, and subluxation of the gleno-humeral joint. A review of the literature explains the basic anatomy and kinesiology of the shoulder complex, the various etiologies of hemiplegic shoulder pain, and the pros and cons of specific treatment techniques. This knowledge is essential for the occupational therapist to evaluate effectively techniques used to treat the patient with hemiplegic shoulder pain. More effective management of this problem will facilitate the patient's ability to reach his or her maximum functional potential.

  10. Music for pain relief.

    Science.gov (United States)

    Cepeda, M S; Carr, D B; Lau, J; Alvarez, H

    2006-04-19

    The efficacy of music for the treatment of pain has not been established. To evaluate the effect of music on acute, chronic or cancer pain intensity, pain relief, and analgesic requirements. We searched The Cochrane Library, MEDLINE, EMBASE, PsycINFO, LILACS and the references in retrieved manuscripts. There was no language restriction. We included randomized controlled trials that evaluated the effect of music on any type of pain in children or adults. We excluded trials that reported results of concurrent non-pharmacological therapies. Data was extracted by two independent review authors. We calculated the mean difference in pain intensity levels, percentage of patients with at least 50% pain relief, and opioid requirements. We converted opioid consumption to morphine equivalents. To explore heterogeneity, studies that evaluated adults, children, acute, chronic, malignant, labor, procedural, or experimental pain were evaluated separately, as well as those studies in which patients chose the type of music. Fifty-one studies involving 1867 subjects exposed to music and 1796 controls met inclusion criteria. In the 31 studies evaluating mean pain intensity there was a considerable variation in the effect of music, indicating statistical heterogeneity ( I(2) = 85.3%). After grouping the studies according to the pain model, this heterogeneity remained, with the exception of the studies that evaluated acute postoperative pain. In this last group, patients exposed to music had pain intensity that was 0.5 units lower on a zero to ten scale than unexposed subjects (95% CI: -0.9 to -0.2). Studies that permitted patients to select the music did not reveal a benefit from music; the decline in pain intensity was 0.2 units, 95% CI (-0.7 to 0.2). Four studies reported the proportion of subjects with at least 50% pain relief; subjects exposed to music had a 70% higher likelihood of having pain relief than unexposed subjects (95% CI: 1.21 to 2.37). NNT = 5 (95% CI: 4 to 13). Three

  11. Chronic orofacial pain.

    Science.gov (United States)

    Renton, T

    2017-07-01

    The issues specific to trigeminal pain include the complexity of the region, the problematic impact on daily function and significant psychological impact (J Dent, 43, 2015, 1203). By nature of the geography of the pain (affecting the face, eyes, scalp, nose, mouth), it may interfere with just about every social function we take for granted and enjoy (J Orofac Pain, 25, 2011, 333). The trigeminal nerve is the largest sensory nerve in the body, protecting the essential organs that underpin our very existence (brain, eyes, nose, mouth). It is no wonder that pain within the trigeminal system in the face is often overwhelming and inescapable for the affected individual. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Hepatitis C: Managing Pain

    Science.gov (United States)

    ... Pain: Entire Lesson Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For Veterans and the Public Veterans and the Public Home Hepatitis A Hepatitis B Hepatitis C Hepatitis C Home Getting ...

  13. Pain in Bali.

    Science.gov (United States)

    Rajagopal, M R; Ito, Kurnia

    2015-01-01

    There is a lot of unrelieved pain in developing countries. Here is a story from Bali, Indonesia, about a woman with advanced malignancy, who is in unbelievable agony. Expensive chemotherapy is available to her. But although the necessary medications for relieving her pain are available in hospitals, they do not reach the patient, in her home, or even when she is admitted to the hospital, because of ignorance of the medical profession about pain management and because of unnecessary regulatory restrictions. The woman's pain affects the whole family, endangering the family's income and the future of her children. The intervention of palliative care during part of her life gives her some relief, only for the agony to be repeated by pointless chemotherapy and neglect of the suffering during admission to the hospital. Whatever relief could be given to her was because of the intervention of a volunteer with no schooling in medicine or palliative care.

  14. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  15. Pain stress and headache.

    Science.gov (United States)

    Panerai, Alberto E

    2012-05-01

    The association between pain and stress is an old one, but still it is not really clear who comes first. Pain induces stress, and stress induces pain. Pain is part of our homeostatic system and in this way is an emotion, i.e., it tells us that something is out-of-order (control), and emotion drives our behavior and one behavior is stress response. Stress comes from ourselves: the imagination we have or would like to have of us, from the image others give of us, from the goals we assume it is necessary to reach for our well-being or the goals others want us to fulfill. Stress comes from our social condition and the condition we would like, stress comes from dangerous situations we cannot control. Headache easily fits in the picture.

  16. Managing your chronic pain

    Science.gov (United States)

    ... health. It is not always easy to reduce stress, but it's easier if you are able to ask your friends ... worse. Then try to make changes in your home and work to decrease the causes of your pain. For ...

  17. Conceptualizing suffering and pain.

    Science.gov (United States)

    Bueno-Gómez, Noelia

    2017-09-29

    This article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them (the mind-body dichotomy, Cassel's idea of persons as "intact beings") are critically discussed with such purpose. A philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are found as better definitions of suffering and pain. Pain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one's own attachment to the world (including personal management, or the cultural and social influences which shape it). An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person's life, and the self is the ever-changing sum of these (and other) experiences. The provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding

  18. Toward freedom from cancer pain in Japan.

    Science.gov (United States)

    Otsuka, Kuniko; Yasuhara, Hajime

    2007-01-01

    Life expectancy in Japan is highest in the world. Cancer is the leading cause of mortality in Japan, accounting for about 30 percent of all deaths. Many Japanese cancer patients experience severe pain although they and their families hope to be pain free at the end of their lives. Toward that end, the consumption of morphine in Japan has increased markedly since 1989. The amount of morphine hydrochloride and morphine sulfate consumed in 2001 was 6.1 times that used in Japan in 1989. However, the amount of morphine consumed in Japan is still less than in other developed nations, and was only one-sixth of the amount used in Australia in 2001. As a result, many Japanese cancer patients experience potentially manageable cancer pain, largely because the amount of the drug used by doctors is insufficient for pain control. An increasing number of Japanese doctors now understand that their patients' quality of life is most important in end-of-life care and how to use the three step analgesic ladder of the World Health Organization (WHO). However, other doctors do not understand these issues sufficiently causing some patients to die without good pain control. Both the general population and some medical professionals misunderstand and have prejudice against the use of morphine. Patients often do not participate in decision making about medical treatment because of remaining paternalism in the relationship between Japanese doctors and patients. Thus, cancer pain management in Japan is not as effective as it can be and not all Japanese cancer patients receive appropriate management for their cancer pain. To improve outcomes for Japanese patients, it is necessary for health professional and social work students and practicing professionals to receive contemporary education including an introduction to palliative care and ethics.

  19. Colorectal surgery patients' pain status, activities, satisfaction, and beliefs about pain and pain management.

    Science.gov (United States)

    Brown, Carolyn; Constance, Kristel; Bédard, Denise; Purden, Margaret

    2013-12-01

    This study describes surgical colorectal cancer patients' pain levels, recovery activities, beliefs and expectations about pain, and satisfaction with pain management. A convenience sample of 50 adult inpatients who underwent colorectal surgery for cancer participated. Patients were administered the modified American Pain Society Patient Outcome Questionnaire on postoperative day 2 and asked to report on their status in the preceding 24 hours. Patients reported low current (mean 1.70) and average (mean 2.96) pain scores but had higher scores and greater variation for worst pain (mean 5.48). Worst pain occurred mainly while turning in bed or mobilizing, and 25% of patients experienced their worst pain at rest. Overall, patients expected to have pain after surgery and were very satisfied with pain management. Patients with worst pain scores >7 reported interference with recovery activities, mainly general activity (mean 5.67) and walking ability (mean 5.15). These patients were likely to believe that "people can get addicted to pain medication easily" (mean 3.39 out of 5) and that "pain medication should be saved for cases where pain gets worse" (mean 3.20 out of 5). These beliefs could deter patients from seeking pain relief and may need to be identified and addressed along with expectations about pain in the preoperative nursing assessment. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  20. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has ex...... can be challenging, and misdiagnosis as a psychological problem, overactive bladder, or chronic urinary infection has plagued patients with the problem....

  1. Adaptação cultural e propriedades psicométricas da versão portuguesa da escala Pain Assessment in Advanced Dementia Adaptación cultural y propiedades psicométricas de la versión portuguesa de la Escala de Valoración del Dolor en la Demencia Avanzada Cultural adaptation and psychometric properties of the portuguese version of the Pain Assessment in Advanced Dementia Scale.

    Directory of Open Access Journals (Sweden)

    Luís Manuel Cunha Batalha

    2012-12-01

    Full Text Available As escalas desenvolvidas para a avaliação da dor em idosos não comunicantes estão insuficientemente estudadas para garantir a sua validade e fiabilidade. O objetivo deste estudo foi adaptar culturalmente para o Português a PAINAD e avaliar as suas propriedades psicométricas em doentes idosos (com ou sem demência internados em serviços hospitalares com patologia médica e/ou cirúrgica. Estudo descritivo e transversal com o desenvolvimento de painéis e aplicação da escala de forma simultânea e independente a 99 doentes seleccionados de forma acidental. O processo de validação cultural foi fácil de obter, apesar da necessidade de gerar consenso em relação aos termos: «frigtened», «facial grimacing», «Knees pulled up» e «moan». A análise dos componentes principais revelou um factor com variância explicada de 61,09 %. A consistência interna calculada pelo a de Cronbach foi de 0,84. O nível de concordância variou entre um valor de Kappa de 0,49 e 0,78. O coeficiente de correlação intraclasse foi de 0,89. A versão Portuguesa da escala PAINAD quando utilizada em doentes idosos (com ou sem demência e com patologia médica e/ou cirúrgica internados em serviços hospitalares revela ser válida e fiável. Sugere-se o seu uso por profissionais de saúde com formação específica na aplicação da escala.Las escalas desarrolladas para la evaluación del dolor en ancianos con problemas comunicativos no han sido aún suficientemente estudiadas para garantizar su validad y fiabilidad. El objeto de este estudio fue adaptar culturalmente al portugués la PAINAD y evaluar sus propiedades psicométricas en pacientes ancianos (con o sin demencia ingresados en servicios hospitalarios con patología médica y/o quirúrgica. Estudio descriptivo y transversal con el desarrollo de paneles y la aplicación de la escala de forma simultánea e independiente a 99 pacientes seleccionados de forma accidental. El proceso de validaci

  2. Pain among professional orchestral musicians

    DEFF Research Database (Denmark)

    Nygaard Andersen, Lotte; Roessler, Kirsten K; Eichberg, Henning

    2013-01-01

    Professional musicians experience high rates of musculoskeletal pain, but only few studies have investigated how this pain is accepted by musicians.......Professional musicians experience high rates of musculoskeletal pain, but only few studies have investigated how this pain is accepted by musicians....

  3. Electronic diary assessment of pain-related fear, attention to pain, and pain intensity in chronic low back pain patients.

    NARCIS (Netherlands)

    Roelofs, J.; Peters, M.L.; Patijn, J.; Schouten, E.G.; Vlaeyen, J.W.

    2004-01-01

    The present study investigated the relationships between pain-related fear, attention to pain, and pain intensity in daily life in patients with chronic low back pain. An experience sampling methodology was used in which electronic diary data were collected by means of palmtop computers from 40

  4. Efficient conditioned pain modulation despite pain persistence in painful diabetic neuropathy.

    Science.gov (United States)

    Granovsky, Yelena; Nahman-Averbuch, Hadas; Khamaisi, Mogher; Granot, Michal

    2017-05-01

    Alleviation of pain, by either medical or surgical therapy, is accompanied by transition from less efficient, or pro-nociceptive, to efficient conditioned pain modulation (CPM). Spontaneous decrease or resolution of pain with disease progression is reported for some patients with painful diabetic neuropathy (PDN). To explore whether CPM changes similarly in parallel to spontaneous resolution of pain in PDN patients. In this cross-sectional study, thirty-three patients with PDN underwent psychophysical assessment of pain modulation on the forearm, remote from the clinical pain. Pain duration was not correlated with neuropathic pain intensity, yet, it correlated with CPM efficiency; patients with longer pain duration had same pain level, but more efficient CPM than those with short-pain duration (ρ = -0.417; P = 0.025, Spearman correlation). Patients with pain more than 2 years (median split) expressed efficient CPM that was not different from that of healthy controls. These patients also had lower temporal summation of pain than the short-pain duration patients group ( P < 0.05). The 2 patient groups did not differ in clinical pain characteristics or use of analgesics. Pro-nociception, expressed by less efficient CPM and high temporal summation that usually accompanies clinical painful conditions, seems to "normalize" with chronicity of the pain syndrome. This is despite continuing pain, suggesting that pro-nociceptivity in pain syndromes is multifactorial. Because the pain modulation profile affects success of therapy, this suggests that different drugs might express different efficacy pending on duration of the pain in patients with PDN.

  5. Cannabis for Chronic Pain: Challenges and Considerations.

    Science.gov (United States)

    Romero-Sandoval, E Alfonso; Fincham, Jack E; Kolano, Ashley L; Sharpe, Brandi; Alvarado-Vázquez, P Abigail

    2018-04-10

    The National Academies of Sciences, Engineering, and Medicine has found substantial evidence that cannabis (plant) is effective for the treatment of chronic pain in adults, and moderate evidence that oromucosal cannabinoids (extracts, especially nabiximols) improve short-term sleep disturbances in chronic pain. The paradoxical superiority of the cannabis plant over cannabinoid molecules represents a challenge for the medical community and the established processes that define modern pharmacy. The expanding and variable legalization of cannabis in multiple states nationwide represents an additional challenge for patients and the medical community because recreational and medicinal cannabis are irresponsibly overlapped. Cannabis designed for recreational use (containing high levels of active ingredients) is increasingly available to patients with chronic pain who do not find relief with current pharmacologic entities, which exposes patients to potential harm. This article analyzes the available scientific evidence to address controversial questions that the current state of cannabis poses for health-care professionals and chronic pain patients, and sets the basis for a more open discussion about the role of cannabis in modern medicine for pain management. A critical discussion on these points, the legal status of cannabis, and considerations for healthcare providers is presented. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Los cocodrilos de la Cuenca del Duero

    OpenAIRE

    Jiménez Fuentes, Emiliano; Martín de Jesús, Santiago; Mulas Alonso, Eugenia

    1987-01-01

    [ES]La sala de las tortugas de la Universidad de Salamanca, abre provisionalmente sus puertas con motivo del II Congreso Nacional de Herpetología, posee también una interesante muestra de cocodrilos fósiles, que suelen acompañar a los quelonios en casi todos los yacimientos del Terciario Inferior de la Cuenca del Duero. [EN]The turtle room at the University of Salamanca, opens its doors temporarily to mark the Second National Congress of Herpetology, also has an interesting collection of f...

  7. [Device for quantitative analysis of perception and pain sensation].

    Science.gov (United States)

    Arita, Hideko; Kato, Jitsu; Ogawa, Setsuro; Hanaoka, Kazuo

    2014-07-01

    The article describes an analysing device that measures the perception and intensity of pain quantitatively. While it is not necessarily true that psychological aspect is totally irrelevant to pain measurement, this device is remarkable in that it is capable of measuring the intensity of pain felt by the patient more objectively by using electric stimuli. The feature of this device is that it uses a non-pain heteresthesia for measuring the intensity of pain. The device is compact, light-weight, and portable. Unlike VAS that requires only a scale, the device requires a person to carry out the measurement. Nevertheless, as the National Health Insurance (NHI) coverage has been approved, introduction of the device may be facilitated in terms of budget for the purchase and labor. The device is useful to better understand not only the intensity of pain but also the pathological conditions, resulting in more appropriate treatment, by (1) comparing degree of pain or VAS values taken by a multicenter study with those of a patient; (2) using both degree of pain and VAS; and (3) multiple measurements of degree of pain and VAS in one case.

  8. Prayer and physical pains

    Directory of Open Access Journals (Sweden)

    Nahid Mehran

    2014-06-01

    Full Text Available Background and Objectives: Prayer is one of the most impo