Visual Analogue Scale Assessment Research Articles

Bone fill following secondary alveolar bone grafting for children with cleft of the alveolus in New Zealand.

To investigate the amount of bone fill post-secondary alveolar bone grafting for children with cleft in New Zealand. Retrospective analysis of post-operative intra-oral periapical and upper anterior occlusal radiographs of 45 grafted sites where all grafting was undertaken within the New Zealand public hospital service. A modified Kindelan Index and a 100mm visual analogue scale (VAS) were used to assess the amount of bone fill using intra-oral radiographs by 4 orthodontists experienced in cleft care and who were blind to the patient's identity. Fourteen duplicated radiographs were randomly selected and added to the sample for reliability assessment. The Kindelan Index rated 37.8% Grade 1 (Good), 31.1% rated Grade 2 (Satisfactory), 22.2% rated Grade 3 (Unsatisfactory) and 8.9% Grade 4 (Failure), a combined unsatisfactory/failure rate of 31.1%. The average VAS score was 50mm±24mm, and there was a strong relationship between Kindelan and VAS assessments. Those patients aged 10-11years had significantly better outcomes using both assessments compared to those aged <10 and >11. The VAS assessment found that higher caseload surgeons had better outcomes, although the difference was of borderline statistical significance (mean VAS 56mm vs 44mm P=0.07). Contemporary secondary alveolar bone grafting bone fill outcomes in New Zealand are poor when compared to contemporary international studies. These findings indicate a review of secondary bone grafting is required to improve outcomes for New Zealand children with cleft.

Physical and psychological outcomes of simple sigmoid sinus bony wall repair for pulsatile tinnitus due to sigmoid sinus wall anomalies.

Pulsatile tinnitus (PT) due to sigmoid sinus wall anomalies (SSWA) is a common health disorder. The purpose of this study is to investigate the efficiency of simple sigmoid sinus bony wall repair on tinnitus relief and psychological improvement. Nine cases of PT due to SSWA were retrospectively reviewed. All of these cases had defect of sigmoid sinus bony wall with or without diverticulum in high-resolution CT. The bony defects were repaired by multi-layer materials, i.e., temporalis fascia, bone dust and another layer of bone dust. The assessment of visual analog scale (VAS) of tinnitus and Mandarin version of the tinnitus questionnaire (MTQ) were carried out before operation and at 1week, 3months, 6months and 12months after operation. All of eight cases treated by simple sigmoid sinus bony wall repair reported disappearance or significant relief of PT after operation. The VAS and MTQ scores at 1week, 3months, 6months and 12months after operation all significantly decreased when compared to that before operation (p < 0.05). Simple repair of sigmoid sinus bony wall defects was an effective way to reduce the physical impact as well as the psychological impact of PT due to SSWA. The defect of sigmoid sinus bony wall played a key role in the pathophysiology of PT due to SSWA.

Single Injection of High Volume of Autologous Pure PRP Provides a Significant Improvement in Knee Osteoarthritis: A Prospective Routine Care Study.

Background: Evidence is growing regarding the ability of platelet-rich plasma (PRP) injections to enhance functional capacity and alleviate pain in knee osteoarthritis (OA). However, heterogeneity in common practice regarding PRP preparation and biological content makes the initiation of this activity in a hospital complex. The aim of this study was to document the efficacy of a single PRP injection to treat knee OA and validate a routine care procedure. Methods: Fifty-seven patients with symptomatic knee OA received a single injection of large volume of very pure PRP. They were assessed at baseline and after one, three and six months, by measuring Knee Injury and Osteoarthritis Score (KOOS), Observed Pain after a 50-foot walk test and Visual Analog Scale (VAS) assessments. Magnetic Resonance Imaging (MRI) analysis was performed at baseline and six months after the procedure. The objective was to recover 50% of responders three months after the procedure using OMERACT-OARSI criteria. Results: A single administration of high volume pure PRP provided significant clinical benefit for 84.2% of the responders, three months after the procedure. The KOOS total score significantly increased from 43.5 ± 14.3 to 66.4 ± 21.7 six months after the procedure (p < 0.001). Pain also significantly decreased from 37.5 ± 25.1 to 12.9 ± 20.9 (p < 0.001). No difference was observed on MRI parameters. Conclusion: A single injection of large volume of very pure PRP is associated with significant functional improvement and pain relief, allowing initiation of daily PRP injection within our hospital.

Comparison of the Efficacy between Conventional Moxibustion and Smoke-Free Moxibustion on Knee Osteoarthritis: A Randomized Controlled Trial.

Objective The aim of this study was to investigate the difference of efficacy between conventional moxibustion (CM) and smoke-free moxibustion (SM) for patients with osteoarthritis of the knee (KOA). Methods This is a multicentre, randomized, single blinded, parallel-group clinical trial. Patients with KOA were randomly allocated to CM group (69) and SM group (69) in 7 hospitals of China. Moxibustion treatment in 12 sessions over 4 weeks was administrated at 3 acupuncture points (EX-LE4, ST35, and ST36). Patients completed standard questionnaires at baseline and after 2 weeks, 4 weeks, 8 weeks, and 12 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) from the baseline to 4 weeks. The secondary outcomes include Visual Analogue Scale (VAS) and Patient Global Assessment score (PGA). Results Analyses showed that the WOMAC score improved in pain (95% CI,-0.1[-1.2 to 0.9], p=0.76), stiffness (95% CI,-0.1 [-0.5 to 0.3], p=0.71), and function (95% CI, 2.2 [-1.3 to 5.8], p=0.22) compared between the two groups at 4 weeks, as well as the VAS score (95% CI,0.1 [-0.3 to 0.6], p=0.60). Similar results presented at 8 and 12 weeks. No statistically significant difference was observed between CM and SM groups for outcome measurements. Conclusions It suggested that smoke generated during moxibustion treatment does not affect the efficacy of moxibustion in the treatment of KOA, which should be taken into account to be removed for the sake of reducing environmental pollution or moxa smoke exposure of acupuncturists or patients. This trial is registered with Clinical Trials.gov, NCT02772055.

Factors Influencing Raynaud Condition Score Diary Outcomes in Systemic Sclerosis.

Raynaud phenomenon (RP) in systemic sclerosis (SSc) could be influenced by clinical phenotype, environmental factors (e.g., season), and personal factors (e.g., coping strategies and ill-health perceptions). We studied the relative influence of a range of putative factors affecting patient-reported assessment of SSc-RP severity. SSc patients were enrolled at UK and US sites. Participants completed the 2-week Raynaud Condition Score (RCS) diary alongside collection of patient demographics, clinical phenotype, the Coping Strategies Questionnaire, Pain Catastrophizing Scale, Scleroderma Health Assessment Questionnaire (SHAQ), and both patient/physician visual analog scale (VAS) assessments for RP, digital ulcer disease, and global disease. Environmental temperature data were obtained at each site. A second RCS diary was completed 6 months after enrollment. We enrolled 107 patients (baseline questionnaires returned by 94). There were significant associations between RCS diary variables and both catastrophizing and coping strategies. There were significant associations between RCS diary outcomes and both environmental temperature and season of enrollment. Age, disease duration, sex, disease subtype, smoking, and vasodilator use were not associated with RCS diary outcomes. The best-fitting multivariate model identified the patient RP VAS, SHAQ pain VAS, and SHAQ gastrointestinal VAS subscales as the strongest independent predictors of the RCS. Patient-reported assessment of SSc-RP severity is associated with a number of factors including pain, catastrophizing, and coping strategies. The effects of seasonal variation in environmental temperature on SSc-RP burden has implications for clinical trial design. Treatments targeting SSc-RP pain and the development of behavioral interventions enhancing coping strategies may reduce the burden of SSc-RP.

Test-Retest Reliability of a Modified Visual Analog Scale Assessment Tool for Determining Incidence and Severity of Gastrointestinal Symptoms in Response to Exercise Stress.

Considering the recent growth of exercise gastroenterology research focusing on exercise-induced gastrointestinal syndrome mechanisms, response magnitude, prevention and management strategies, the standardized assessment of gastrointestinal symptoms (GIS) is warranted. The current methodological study aimed to test the reliability of a modified visual analog scale for assessing GIS during exercise, in response to a variety of exertional-stress scenarios, with and without dietary intervention. Recreational endurance runners (n = 31) performed one of the three exercise protocols, which included: 2-hr running at 70% in temperate (24.7°C) ambient conditions, with fluid restriction; 2-hr running at 60% in hot (35.1°C) ambient conditions, while consuming chilled water immediately before and every 15min during exercise; and 2-hr running at 60% in temperate (23.0°C) ambient conditions, while consuming 30g/20min carbohydrate (2∶1 glucose∶fructose, 10% temperate w/v), followed by a 1-hr distance test. GIS was monitored pre-exercise, periodically during exercise, and immediately postexercise. After wash out, participants were retested in mirrored conditions. No significant differences (p > .05) were identified between test-retest using Wilcoxon signed-rank test for all GIS (specific and categorized), within each exercise protocol and the combined protocols. Strong correlations were observed for gut discomfort, total GIS, upper GIS, and nausea (rs = .566 to rs = .686; p < .001), but not for lower GIS (rs = .204; p = .232). Cohen's magnitude of difference was minimal for all GIS (specific δ < 0.14 and categorized δ < 0.08). The modified visual analog scale for assessing GIS during exercise appears to be a reliable tool for identifying incidence and severity of GIS in cohort populations and is sensitive enough to detect exertional and intervention differences.

Application of the Visualization through Stereoscopic Glasses in the Massage Therapy

Objectives The aim of this paper was the investigation of the relaxation effect after sports restorative massage in standard conditions and in conditions with additional impact by relaxing 3D VR video through stereoscopic glasses. According to the hypothesis of the study, the application of the visualization through stereoscopic glasses during the massage therapy will increase the effect of the massage. Methods The contingent of the study was 25 Bulgarian students from the National Sports Academy. The age of the participants was 22-28 years old. The study had three conditions. The first condition included initial registration of the heart rate (HR) of every participant at rest, performance of the massage procedure in standard conditions and final HR fixation. The second condition contained initial HR measurement, combined massage with additional impact of relaxing 3D VR video through stereoscopic glasses and final HR measurement. In the third condition, a musculoskeletal state assessment of the participants was made. On this basis, the contingent for the investigation of the influence of relaxing 3D VR video on the pain symptoms was defined. The measure procedures included HR measurement, skin fold lift test and visual analog scale for assessment of the skin resistance in the affected area and pain sensation survey. Results All of the results were with an extremely statistical significance. The heart rate variation before the massage (74.4bpm), after the massage procedure in normal conditions (65.7bpm), and after the massage with additional 3D VR visualization (57.6bpm) was found. Five participants have been diagnosed with resistance and strong pain in the lumbar spine. After a restorative massage with the additional impact of the audio visualization through the virtual reality glasses, painful symptoms were not observed. Conclusions The analysis of the results proved the correctness of the hypothesis of the study. The investigation found that the applying relaxing 3D visualization through stereoscopic glasses during massage therapy leads to increase of the restorative effect and to the reduction of the pain symptoms. Keywords: Pain symptoms; Relaxing effect; Restorative massage; Skin fold; Virtual reality

Efficacy of balneological outpatient treatment (hydrotherapy and peloidotherapy) for the management of chronic low back pain: a retrospective study

The aim of this study was to evaluate the efficacy of balneological outpatient treatment including hydrotherapy and peloidotherapy on patients with chronic low back pain. In this retrospective observational study, the records (between 2008 and 2016) of patients who have undergone balneological outpatient treatment at the Department of Medical Ecology and Hydroclimatology were analyzed. The patients were examined and assessed by an experienced physician before and after the treatment. Outcome measures were the Pain Visual Analog Scale (VAS), patient's and physician's global assessment (VAS), Health Assessment Questionnaire (HAQ), and the Waddell Disability Index. A total of 139 patients were included in the study. After the treatment, statistically significant improvement in all evaluated outcome measures was found. The detailed analysis showed age, the duration of treatment, and sex did not affect the effectiveness of the treatment. Balneological outpatient treatment may be an effective option for treatment of chronic low back pain patients with the advantages of being integrated into daily routine and not causing any days off by improving pain and increasing the quality of life. Randomized controlled trials are needed to confirm these preliminary results.

Does flatus incontinence matter?

This study aimed to determine whether incontinence to flatus is associated with women's bother in a symptomatic population and with sonographically diagnosed external anal sphincter (EAS) trauma. This is a retrospective study of women attending a tertiary urogynecological unit between May 2013 and November 2015. Baseline evaluation included a standardized interview with St. Mark's Incontinence Score (SMIS) and visual analog scale (VAS) assessment for bother, as well as a physical examination and translabial pelvic floor ultrasound. At least one volume obtained covered the entire length of the EAS. These volumes were analyzed with the reviewer blinded to all clinical data. During the inclusion period, 1104 patients visited the unit. Fifty-three patients were excluded from the study for missing data, leaving 1051 for final analysis. Mean age was 57years (56-58) and mean body mass index (BMI) 29.1kg/m2 (28.8-29.6). The prevalence of any anal incontinence (AI) and flatus incontinence were 16.4% (172/1051) and 13.9% (146/1051), respectively. In the group of patients with AI, mean SMIS was 11.8 (11.0-12.6), and mean VAS for AI bother was 5.4 (5.0-5.9). Significant EAS trauma was detected in 9.8% (103/1051) of patients and was associated with flatus incontinence (p = 0.002). Including a flatus incontinence question in the SMIS questionnaire improved the prediction of patient bother from AI (R2 87.8% versus R2 86.3%, p = 0.04). Flatus incontinence is associated with ultrasound findings of EAS trauma and with higher patient bother from AI.

Outcome of Transforminal Lumbar Thorough Debridement, Decompression, and Spondylodesis Technique in Treatment of 25 Patients with Pyogenic Spondylodiscitis

Lumbar pyogenic spondylodiscitis (LPS) is still a tangled problem in its management, especially with increasing rates of cases who underwent different spinal procedures and in patients with chronic medical disease. One-stage posterior direct transforminal lumbar thorough debridement of septic lesion, decompression, and spondylodesis (TLTDDS) are the main goals in treatment of complicated LPS without additional morbidity of anterior surgery. This is a retrospective assessment of the clinical, laboratory, functional, and radiologic outcomes in 25 patients with LPS who underwent the TLTDDS procedure. Twenty-nine patients with complicated LPS were treated surgically by TLTDDS surgery from January 2014 to August 2017. Complete records of 25 patients were available for evaluation. All patients were examined clinically for back or leg pain using a visual analog scale (VAS) and neurological assessment by the American Spine Injury Association. Perioperative outcome and complications were documented. All patients were serially followed up between 12 and 32 months as regard pain (VAS), functional status by Kirkaldy Willis criteria, and Oswestry disability index, laboratory, and radiologic outcomes (angle of segmental kyphosis, lumbar lordosis correction, and fusion criteria). Definitive solid bony fusion was seen between 6 and 14 months, except in 3 cases, which showed probable fusion. There was significant improvement in VAS, American Spine Injury Association index, laboratory investigations, and Oswestry disability index. One patient (5%) had transient neurological deficit, which resolved completely within 2 months. TLTDDS surgery is an effective procedure in the treatment of symptomatic LPS and allows abscess evacuation with adequate neural decompression, segmental kyphosis correction, and functional improvement.

Scalp block versus subcutaneous infiltration for stereotactic brain biopsy: a randomized controlled trial

Objective The aim of the current study was to compare scalp block and subcutaneous infiltration anesthesia in adult patient during the placement of a stereotactic head frame and taking brain biopsy. Patients and methods The current randomized controlled trial was conducted at the Neurosurgery Department in Ain Shams University Hospitals on patients who were scheduled for stereotactic brain biopsy. The recruited patients were randomly allocated into one of two groups: group A had 40 patients who received subcutaneous infiltration anesthesia and group B included 40 patients who received scalp nerve block. Both groups were compared regarding analgesic efficacy, hemodynamic changes, duration of local anesthetic, need of supplementary subcutaneous injections, need for postoperative analgesia, and postoperative complications. Results A total of 80 patients were recruited in the current trial. The mean values of the 10-cm visual analogue scale for assessment of pain was significantly lower in patients of group B when compared with patients of group A. Conclusion Scalp block with 0.5% bupivacaine reduced pain, heart rate, and mean arterial pressure response during the fixation of stereotaxy frame, the skin incision, and biopsy intake, and it also decreased the need for more local infiltration in comparison with the use of local subcutaneous infiltration. Moreover, the pain intensity was lower after scalp block in the early postoperative period with less incidence of headache in postoperative period.

Reduction of early postoperative pain with laparoscopic sleeve gastrectomy with local bupivacaine: a randomized placebo-controlled study

Introduction Local bupivacaine provides safe, effective, and low-cost anesthesia with good postoperative analgesia. Our aim was to confirm the postoperative analgesic efficacy and safety of bupivacaine for local infiltration in pain relief in laparoscopic sleeve gastrectomy. Patient and methods This prospective, double-blind study was conducted on 70 patients of age 18–50 years, posted for laparoscopic sleeve gastrectomy and randomly allocated into two groups of 35 patients each. Control group (group C) received an injection of 40 ml saline 0.9%: 30 ml intraperitoneal plus 10 ml normal saline injection local infiltration in the three port sites. Group P received 40 ml of bupivacaine: 30 ml intraperitoneal plus 10 ml local infiltration at the port site. Assessment of pain scores visual analog scale in the 24 h after surgery, first need for rescue analgesia, and incidence of various complications were recorded. Results The timing of the first analgesic request in the control group was 102.5±10.3 min, and in group D was 328.8±32.4 min, which is statistically significant (P Conclusion Bupivacaine (intraperitoneal and local infiltration) leads to prolonged postoperative analgesia after sleeve gastrectomy without adverse effects.

Evaluation of retinal nerve fibre layer and ganglion cell complex thickness with optical coherence tomography in migraine patients

Aim: In this study, we aimed to assess thicknesses of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) in patients with episodic migraine and to compare data between from patients with migraine and healthy individuals. Material and Methods: The study included 44 eyes (right) of 44 patients with migraine who presented to neurology outpatient clinic and 54 eyes (right) of healthy individuals. In patients with migraine (with identified subtypes), demographic and clinical characteristics, Visual Analog Scale (VAS) and Migraine Disability Assessment Scale (MIDAS) results were recorded. After detailed ophthalmological examination, RNFL and GCC thicknesses were measured with optical coherence tomography (OCT) (Carl Zeiss Meditec AG, Jena, Germany, software version: 6.5.0.773). The values obtained were compared between groups. The correlation between VAS and MIDAS scores and RNFL and GCC thicknesses were assessed. Results: Mean age was 36.05±8.84 years in migraine group and 32.89±10.89 years in control group. Mean time of follow-up was 5.50±3.42 years in patients with migraine. No significant differences were detected in mean RFNL and GCC thicknesses from all quadrants (p>0.05 for all). It was found that VAS and MIDAS scores were negatively correlated to mean RNFL thicknesses in temporal and inferior quadrants (p0.05). Conclusion: In our study, it was found that migraine did not affect in ocular structures of posterior segment such as RNFL and GCC thickness.Keywords: Migraine; retinal nerve fiber layer; ganglion cell complex; optical coherence tomography.

Effect of patient education on medication adherence of patients with rheumatoid arthritis: a randomized controlled trial.

PurposeThere is a general understanding that patient educational interventions for enhancing medication adherence are important. However, their success at improving adherence is debatable. This study aimed to assess the influence of different modes of patient education on medication adherence in patients with rheumatoid arthritis (RA).Materials and methodsOne hundred and twenty RA patients with non-adherence, defined as pill count ≥80% or medication-taking behavior questionnaire for Thai patient ≥23, were randomized by block randomization and assigned in a 1:1 allocation ratio to two study arms: multi-component intervention group or single intervention group. The multi-component intervention group received 30-minute directed counseling and a disease information pamphlet. The single intervention group received only a disease information pamphlet. The primary outcomes were an improvement in an adherence rate measured by pill count after 12 weeks. The Thai Clinical Trial Registry number is TCTR20171207003.ResultsAfter 12 weeks, the pill count adherence rate increased significantly from baseline in both study groups. In the multi-component intervention group, adherence rate increased from 92.21±14.05 to 97.59±10.07 (P=0.002) and in the single intervention group, it increased from 88.60±19.66 to 92.42±14.27 (P=0.044). However, the mean difference between the multi-component intervention group and the single intervention group was not significant (5.38±12.90 vs 3.18±14.23, P=0.531). Clinical outcomes, including disease activity score 28, EuroQoL-5D, EuroQol visual analog scale, pain score, and physician global assessment were unchanged from baseline in both groups.ConclusionPatient education significantly improved adherence. However, there were no differences between single education intervention and multi-component education intervention in improving medication adherence. Provision of a disease information pamphlet with or without directed counseling can equally enhance medication adherence of patients with RA.

Prevalence and Correlation of Depressive Symptoms with Functional Scores, Therapy and Disease Activity among Croatian Patients with Rheumatoid Arthritis: A Preliminary Study.

Rheumatoid arthritis (RA) is a chronic, autoimmune and disabling disease that significantly affects the quality of life. Additionally, significant number of patients with RA suffer from depressive disorders, which are commonly underrecognised and undertreated. We aimed to estimate the prevalence of depressive symptoms in Croatian RA patients and to assess the relationship between them and clinical correlates. Fifty-four RA patients treated at the Clinic for Rheumatic Diseases and Rehabilitation at the University Hospital Centre Zagreb were prospectively enrolled in the study and evaluated for functional status using the Disease Activity Score 28 (DAS-28), Health Assessment Questionnaire (HAQ), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and Visual Analogue Scale (VAS) for pain and health related quality of life (HRQL) measurement. The depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II) questionnaire. Thirty RA patients (55.6%) had some sort of mood disorder, with 10 (18.5%) patients accounting as depressed. Positive correlation was found between depressive symptoms, higher disease activity and disablity during daily activities (τb=0.385, p=0.001 and τb=0.282, p=0.024 respectively). We found no significant association between depression and disease activity in the whole sample of RA patients, but for postmenopausal patients, the disease activity correlated with postmenopausal patients accounting as depressed (BDI-II score moderate or severe; τb=0.363, p=0.021). The use of biologic therapy correlated negatively with the disease acitivity, pain intensity and worse health related quality of life score (τb=-0.360, p=0.06; τb=-0.310, p=0.07; τb=-0.380, p=0.01 respectively). Considering the high prevalence of depressive sympoms in RA patients and the effect on functional disability and quality of life, we wanted to emphasize the importance of recognizing and optimizing depression treatment through multidisciplinary approach in RA patients.

Evaluation of factors associated with locomotive syndrome in Japanese elderly and younger patients with rheumatoid arthritis

Objectives: We aimed to determine the prevalence of locomotive syndrome (LS) using the 25-question geriatric locomotive function scale (GLFS-25) and identify factors associated with LS in elderly and younger patients with rheumatoid arthritis (RA).Methods: Overall, 390 patients with RA who underwent GLFS-25 measurement, bone mineral density determination, and bioelectrical impedance analysis were enrolled. Factors associated with LS were analyzed by comparing patients with and without LS among both elderly and younger patients with RA.Results: The prevalence of LS was 41.5%, 47.7% and 32.3% in all patients, elderly patients, and younger patients with RA, respectively. Pain visual analog scale (VAS) and Health Assessment Questionnaire Disability Index (HAQ-DI) were associated with LS in both elderly and younger patients. Moreover, in younger patients with RA, disease activity score in 28 joints (DAS28), erythrocyte sedimentation rate (ESR), basal metabolic rate, and legs muscle mass were identified as being associated with LS.Conclusion: This study demonstrated that to prevent LS, we should aim to control pain and maintain a low HAQ-DI in elderly and younger patients with RA, and improve disease activity and maintain a higher basal metabolic rate, and legs muscle mass in younger patients with RA.

Oral sweet solution to prevent pain during neonatal hip examination: a randomised controlled trial.

AimTo determine if oral glucose can have a pain‐relieving effect during routine hip examinations in newborn infants.MethodsIn this randomised controlled study 100 newborn infants undergoing the routine physical examination including the potentially painful hip examination were included between March 2016 and April 2017. Fifty infants were randomised to water (control) and 50 to oral glucose (intervention) before their examination. Pain was assessed using crying time, Astrid Lindgren and Lund Children's Hospital Pain and Stress Assessment Scale (ALPS‐Neo) and Visual analogue scale (VAS).ResultsTotal crying time (p = 0.006), crying time during the hip examination (p = 0.026), ALPS‐Neo (p = 0.004) and VAS (p = 0.006) (when assessed by the physician) were all significantly decreased in the group of infants receiving glucose. VAS assessment made by the parents did not reach statistical significance (p = 0.127).ConclusionOral glucose given before the examination has a pain‐relieving effect during the hip examination in healthy newborn infants.

Shoulder Arthroplasty Outcomes After Prior Non-Arthroplasty Shoulder Surgery.

Background:The purpose of this retrospective study was to compare outcomes and complications in patients with and patients without a history of non-arthroplasty surgery on the ipsilateral shoulder who later underwent total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA). We hypothesized that patients who had undergone prior surgery would have more complications and worse clinical outcomes.Methods:Consecutive patients who had undergone shoulder arthroplasty and had been followed for a minimum of 2 years were evaluated with the American Shoulder and Elbow Society scoring system (ASES), Simple Shoulder Test (SST), and Visual Analog Scale (VAS) assessments and with physical examination, including range-of motion assessments. Complications and outcomes in patients who had undergone prior surgery on the ipsilateral shoulder (PS group) were compared with those in patients without such a history (NPS group).Results:Data on 506 shoulder arthroplasties (263 TSA and 243 RTSA) were available for analysis. A total of 144 patients (28%) had an average of 1.9 ± 1.0 surgical procedures on the ipsilateral shoulder before arthroplasty. The average age in the PS group was significantly younger at the time of arthroplasty compared with the NPS group (61.6 ± 10.2 years compared with 68.2 ± 8.6 years, p = 0.035). At an average follow-up of 42.8 ± 16.4 months, both groups had significant improvements in ASES, SST, VAS, and range-of-motion values (p < 0.05 for all). All outcome scores in the PS group were significantly lower than those in the NPS group (p < 0.001 for all). The PS group also had a significantly higher complication rate than the NPS group (19.4% compared with 4.4%, p < 0.001), and multivariate regression analysis revealed that prior surgery was a significant independent predictor of postoperative complications. There were no differences between the PS and NPS groups in the number of postoperative infections (p = 0.679), reoperations (p = 0.553), or transfusions (p = 0.220).Conclusions:Patients who have a history of prior surgery on the ipsilateral shoulder derive benefit from shoulder arthroplasty, but their magnitude of improvement and final scores are lower than those of patients who do not have such a history. This information can be used to counsel this challenging patient population on expected outcomes following shoulder arthroplasty.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Assessment of quality of life using the EQ-5D-3L instrument for hospitalized patients with femoral fracture in Brazil

BackgroundQuality of life has become a key outcome in assessing the effectiveness of treatments and interventions in health.MethodsAccordingly, this research study aimed to measure quality of life using the EQ-5D-3L instrument for patients from the Jamil Haddad National Institute of Traumatology and Orthopedics (Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad – INTO) with femoral fractures, hospitalized between 11/2015 and 10/2016.ResultsA total of 165 orthopedic trauma patients with femoral fractures, aged 18 years or older, who were hospitalized and operated upon in the INTO were assessed. The assessment instruments were applied at admission and in the first and second follow-up visits to the outpatient clinic. Most study subjects were women and older than 60 years. Proximal femoral fracture was the most commonly found fracture. The Visual Analog Scale (VAS) assessments over the study period showed an increasing gain in self-assessed quality of life. Similarly, the EQ-5D-3L showed significant improvements in quality of life assessed in the five dimensions of the instrument: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.ConclusionThis type of assessment may help in decision-making and cost-utility assessments related to orthopedic trauma.

A Comparison of the Efficacy of Acupuncture and Hypnotherapy in Patients With Migraine

This study investigated the effect of acupuncture, hypnotherapy, and pharmacotherapy in migraine treatments among 90 patients. They were divided into 3 groups of 30 persons each. Group 1, Group 2, and Group 3 were treated with acupuncture, hypnotherapy, and pharmacotherapy, respectively. Changes in the visual analog scale (VAS) and Migraine Disability Assessment (MIDAS) scores from baseline were monitored. Reductions in the percentages of the VAS and MIDAS scores at the end of the third month were significantly higher in the acupuncture and hypnotherapy groups than those of the pharmacotherapy group (p < .01). Acupuncture and hypnotherapy can be developed as treatment options alone as an equivalent to conventional treatment.