Changes In Pain Levels Research Articles

Does Radiofrequency Ablation Reduce Pain and Improve Maximal Incisal Opening More Effectively Than Electrocautery in Temporomandibular Joint Arthroscopy? A Pilot Study

The study compared the effectiveness of radiofrequency and electrocautery techniques in TMJ arthroscopic surgeries by evaluating changes in pain levels and maximal incisal opening before surgery and throughout a 30-day postoperative period. This prospective, randomized controlled trial included 62 patients with bilateral TMJ disorders classified as Wilkes stages III and IV. Patients were randomly assigned to two groups: Group 1 (n=31) underwent arthroscopy with electrocautery, and Group 2 (n=31) received radiofrequency ablation. Inclusion criteria were patients with Wilkes stages III or IV TMJ disorders. Exclusion criteria included previous TMJ surgery, significant systemic disease, or contraindications to surgery. Pain levels were assessed using the McGill Pain Questionnaire, and maximal incisal opening was measured preoperatively and up to 30 days postoperatively. The sample included 62 subjects with a mean age of 33.5 years, 80.6% female. The electrocautery group showed significantly greater maximal incisal opening at 12 hours, 7 days, and 14 days post-surgery compared to the radiofrequency ablation group. Pain levels did not differ significantly between groups, though the electrocautery group reported higher pain scores on postoperative day 14. Both groups showed similar pain improvement and maximal incisal opening changes over 30 days, with a trend towards more improvement in maximal incisal opening in the radiofrequency ablation group. No significant differences in complications or overall pain improvement were observed. Electrocautery and radiofrequency did not differ in postoperative pain outcomes; however, electrocautery was more effective in improving maximal incisal opening up to postoperative day 14.

Fibro-adhesive Bursitis: A Novel Sonographic Finding in Adhesive Capsulitis Patients and a Proposal of Management.

Adhesive capsulitis, also known as "frozen shoulder," is a debilitating shoulder condition increasingly linked to fibroadhesive bursitis, particularly after COVID-19 and related vaccinations. There is no definitive gold standard for its treatment, the primary therapeutic objectives of which are the reduction of pain and the restoration of shoulder range of motion. The aim of our study was to analyze treatment outcomes based on quantitative measures of shoulder function and symptom relief. Conducted between January 2022 and April 2023, the research involved 45 patients initially diagnosed with adhesive capsulitis and associated fibroadhesive bursitis. After excluding nine patients for other concomitant pathologies (five for calcific tendinopathy and four for rotator cuff injury), 36 patients were randomized into two groups: one group was treated with glenohumeral hydrodistension, the other with glenohumeral hydrodistension combined with bursal injection. Assessments were conducted at baseline and then 2, 4, and 6months after treatment, focusing on changes in pain levels, functional scores, and range of motion in all planes. Each group followed a home-based rehabilitation protocol. Significant improvements were observed in both treatment groups, with the combined hydrodistension and bursal injection group showing notably superior outcomes. Specifically, the range of motion in flexion improved from an initial median of 80° to 155° in the combined treatment group, compared to an increase from 75.5° to 129° in the group treated with hydrodistension alone. This enhancement was statistically significant (p < 0.001). Regarding pain reduction, the combined treatment group demonstrated a dramatic decrease in visual analogue scale (VAS) scores, from a baseline median of 7 to 1 at the 6-month follow-up. In contrast, the hydrodistension-only group showed a reduction from 7 to 3, with these differences also proving statistically significant (p < 0.001). Ultrasound-guided hydrodistension of the glenohumeral joint, if combined with bursal injection and specific exercises, effectively reduces pain, decreases disability, and improves range of motion in patients with second-stage adhesive capsulitis. This study highlights the importance of a combined approach in the management of this complex condition, especially after the histological changes that occurred after COVID-19 and related vaccinations. ClinicalTrials.gov identifier NCT06062654.

Penerapan Abdominal Stretching Exercise Untuk Mengurangi Dismenore Pada Mahasiswi DIII Keperawatan Universitas ‘Aisyiyah Surakarta

Background: Dysmenorrhea is still experienced by many women, menstrual pain appears for several days during menstruation. Dysmenorrhea or menstrual pain can have an impact on teenagers' daily activities. The prevalence of dysmenorrhea in Surakarta is 89.8%. Efforts to reduce dysmenorrhea can be done in two ways, namely pharmacological and non-pharmacological. One non-pharmacological therapy that can be done is abdominal stretching exercise. Objective: To describe the results of applying the Abdominal Stretching Exercise to reduce dysmenorrhea pain in DIII Nursing students at 'Aisyiyah University, Surakarta. Method: This application uses the case study method. This method focuses more on the actions or behavior produced, in this method the variable measured is the level of pain in adolescents with dysmenorrhea who have been given intervention for 3 days. Results: After carrying out the Abdominal Stretching Exercise on two respondents who experienced dysmenorrhea for three consecutive days, it showed a change in pain level, Ms. K's pain scale decreased by 2 and Ms. N's pain scale decreased by 3. Conclusion: The application of Abdominal Stretching Exercise can reduce the level of dysmenorrhea pain in DIII Nursing students at 'Aisyiyah University, Surakarta.

A Comparative Study of the Impact of the Covid-19 Pandemic on Mental Health, Healthcare Access, and Pain Levels of Patients with Chronic Pain from Spring 2020 to Spring 2021.

The short-term impact of the Covid-19 pandemic on patients with chronic pain has been under the microscope since the beginning of the pandemic. This time-lag design study aimed to track changes in pain levels, access to care, mental health, and well-being of Greek chronic pain patients within the first year of the Covid-19 pandemic. 101 and 100 chronic pain patients were contacted during the Spring of 2020 and 2021, respectively. A customized questionnaire was used to evaluate the perceived impact of the pandemic on pain levels and healthcare access. Psychological responses, personality characteristics, and overall well-being were evaluated using the Depression, Anxiety, and Stress Scale (DASS-42), the Ten-Item Personality Index (TIPI) and the Personal Wellbeing Index (PWI). The perceived effect of the pandemic and the Covid-related restrictions affected significantly access to healthcare, pain levels and quality of life. Differences were detected in the PWI sub-scales regarding Personal Safety, Sense of Community-Connectedness, Future Security, Spirituality-Religiousness, and General Life Satisfaction. Marital status, parenthood, education and place of residence were associated with differences in pain levels, emotional and psychological responses. Changes in chronic pain levels, emotional responses, and overall well-being took place throughout the year. Also, an evident shift took place in the care delivery system. Both tendencies disclose an ongoing adaptation process of chronic pain patients and healthcare services that needs further monitoring.

Seven tesla knee MRI T2*-mapping detects intrasubstance meniscus degeneration in patients with posterior root tears.

Medial meniscus root tears often lead to knee osteoarthritis. The extent of meniscal tissue changes beyond the localized root tear is unknown. To evaluate if 7 Tesla 3D T2*-mapping can detect intrasubstance meniscal degeneration in patients with arthroscopically verified medial meniscus posterior root tears (MMPRTs), and assess if tissue changes extend beyond the immediate site of the posterior root tear detected on surface examination by arthroscopy. In this prospective study we acquired 7 T knee MRIs from patients with MMPRTs and asymptomatic controls. Using a linear mixed model, we compared T2* values between patients and controls, and across different meniscal regions. Patients underwent arthroscopic assessment before MMPRT repair. Changes in pain levels before and after repair were calculated using Knee Injury & Osteoarthritis Outcome Score (KOOS). Pain changes and meniscal extrusion were correlated with T2* using Pearson correlation (r). Twenty patients (mean age 53 ± 8; 16 females) demonstrated significantly higher T2* values across the medial meniscus (anterior horn, posterior body and posterior horn: all P < .001; anterior body: P = .007), and lateral meniscus anterior (P = .024) and posterior (P < .001) horns when compared to the corresponding regions in ten matched controls (mean age 53 ± 12; 8 females). Elevated T2* values were inversely correlated with the change in pain levels before and after repair. All patients had medial meniscal extrusion of ≥2 mm. Arthroscopy did not reveal surface abnormalities in 70% of patients (14 out of 20). Elevated T2* values across both medial and lateral menisci indicate that degenerative changes in patients with MMPRTs extend beyond the immediate vicinity of the posterior root tear. This suggests more widespread meniscal degeneration, often undetected by surface examinations in arthroscopy.

Angiogenic Precursor Cell Treatment of Critical Limb Ischemia Decreases Ulcer Size, Amputation and Death Rate: Re-Examination of phase II ACP NO-CLI Trial Data

Introduction: Critical limb ischemia has a prevalence in the US of 1.33%, with mortality 15-20% and major amputation 10-40% per year. Stem cell treatment has emerged as a treatment option for the 45% of patients for whom revascularization procedures are not possible. Objective: This study re-examines the data of the Phase II clinical treatment of no option Critical limb ischemia with Hemostemix’ angiogenic cell precursors, focusing upon ulcer wound healing, amputation and death rate of this cohort. Methods: Primary endpoints were changes in ulcer size and major amputation or death within one year of treatment. The secondary endpoint was change in pain level. Results: From 2015 to 2021, 67 patients with no option Critical limb ischemia were allocated to treatment with ACP-01 (46/67) or placebo (21/67). From this data, only patients who presented with wound ulcers before administration of ACP-01 were reviewed (21 treatment, 8 placebo). Ulcer size in the treated group decreased from a mean of 1.46 cm2 to 0.48 mm2 (p = 0.01) by 3 months. There was no significant decrease in the size of the ulcers of the placebo group (p &lt; 0.54). At one year there were no complications related to treatment. The treatment group had one amputation (4.8%) and one death (4.8%); the placebo group had 2 amputations (25%) and 1 death (12.5%). Change in pain was not significant in either group at 3 months, but at 1 year was improved in the placebo group (p = 0.01). Conclusion: The administration of ACP-01 within a program of careful patient follow up is safe and associated with reduced ulcer size and decreased rate of amputation and death. Consideration should be given to re-administration of stem cell treatments every 3-6 months to optimize improvement of Critical limb ischemia. Further studies, more appropriately powered, are warranted.

Assessment of pharmacologic pain management modalities for patients on hemodialysis

Objective: The aim of this project was to assess the change in pain level for hospitalized patients on hemodialysis when using non-opioid medications alone compared to opioid medications alone to establish support for a clinical pain management model that would provide acute pain management guidance for patients on hemodialysis.Methods: This was a non-interventional survey completed at an acute care hospital in Chicago, IL. Patients over the age of 18 on hemodialysis reporting acute pain completed the Short Form McGill Pain Questionnaire-2 on day one and day three of hospitalization to assess pain levels over a three-day period. Results: The results demonstrate a decrease in total pain for patients using non-opioid medications and opioid medications; however, there is no statistically significant decrease in total pain scores between participants using non-opioid medications alone versus opioid medications alone (p = .743).Conclusions: Patients in the non-opioid group perceived their pain management to improve between day one and day three; however, their pain management did not improve to the degree that opioid medications provided. Care should be taken when dosing opioid medications for patients on hemodialysis given the patients’ decreased renal function.

Global pain levels before and during the COVID-19 pandemic

Physical pain has trended upward globally over the last decade. Here, we explore whether the COVID-19 pandemic modified this alarming trend. We used data from 146 countries worldwide (510,247 respondents) to examine whether pain levels changed during the COVID-19 pandemic. Adjusted regressions across countries revealed that 33.3% of people were in pain in 2019, 32.8% in 2020, 32.5% in 2021, and 34.1% in 2022. The change in pain from 2019 to each of the pandemic years was not statistically significant. This suggests that, on average, there was no significant change in pain during the pandemic. However, from 2019 to 2020 there was a significant decline in pain among individuals over 55 years of age, those who were widowed, and those without children in the household. On a global scale, the COVID-19 pandemic was not associated with a significant change in pain levels. The concerning pre-pandemic elevation in global pain continued during this challenging period.

S11: Digital Health and Artificial Intelligence (AI) in Psychogeriatrics: Opening Multiple Frontiers

Symposium OverviewOverall Abstract:The past decade has seen an explosion in the growth of technologies in mental health. Particularly, the scaled adoption of virtual care catalyzed by the COVID-19 pandemic has opened up new frontiers in how digital tools can be incorporated into psychiatry. No area of mental health care is as ripe for digital innovation as psychogeriatrics. In this session, an international group of clinicians and researchers will demonstrate how digital health in psychogeriatrics represents multiple cutting edges of innovation.Our symposium will include 4 presentations, that represent original research from the USA, Ecuador, Norway, Kosovo and Australia. We will highlight clinical applications of these digital tools and aligned issues such as improved care access in low- and middle-income countries, the ethics of digital data collection and the potential for creating new liabilities.We will focus on four distinct technologies and applications. Dr. Ipsit Vahia will discuss passive environmental sensing supported by signal processing and artificial intelligence (AI) in guiding treatment decision making, especially in dementia care. His presentation will include discussions on how AI can be incorporated into care while also preserving autonomy. Dr. Kreshnik Hoti will discuss the application of AI on voice-based signals to determine changes in pain levels and psychopathology. His presentation will include research conducted in collaboration between teams based in Australia and Kosovo and through a public-private partnership with a digital health startup. Dr. Ana Trueba will focus on digital interventions, specifically virtual reality (VR). She will present data from two studies, one from McLean hospital In the US, and the other from Ecuador that explore how VR can deliver evidence-based non-pharmacologic interventions. Dr. Bettina Husebø will present data from a project she oversees in Norway. Her talk will discuss how care in nursing homes can be improved by incorporating a range of digital approaches into nursing home care paradigms. A particular focus will be on the relationship between pain and behavior symptoms and dementia among nursing home dwelling older adults.Thus, the symposium will address diagnostics, treatment and systems level care and how New technologies are shaping the evolution of psychogeriatrics worldwide.

The Effects of Progressive Muscle Relaxation in Reducing Neuropathic Pain in Type 2 Diabetes Patients

Neuropathic pain in DM sufferers can be reduced by providing non-pharmacological therapy by providing relaxation or by providing education such as providing music therapy, relaxation and guided imagery. Physical exercise with relaxation that can be applied to DM patients includes Progressive Muscle Relaxation. The movements in PMR exercises aim to tighten and relax the muscles in one part of the body at a time to provide a feeling of physical relaxation. Relaxation can calm the nervous system so that the sufferer's body relaxes. This study aims to determine the effect of PMR in reducing neuropathic pain in patients with type 2 diabetes mellitus. The research design used the Quasy Experiment One Group Pretest – Posttest Control Group Design. The population in this study were all type 2 DM patients who experienced neuropathic pain. The sampling technique used was purposive sampling. Progressive Muscle Relaxation was given once a day for 7 days, and the pain scale was measured using the Visual Analog Scale (VAS) before and after administering PMR. The results of the study showed that the average pain level in the pre-test control group was 6 and post-test 5, while in the intervention group the average pre-test was 6 and post-test 4.81. The results of the Wilcoxon test in the control group showed a p value of 0.187 so there was no change in pain levels in the control group, while the intervention group showed a p value of 0.0001. The conclusion of this study is that there is a change in pain levels before and after PMR, so PMR can reduce neuropathic pain in patients with type 2 diabetes mellitus.

Effectiveness of community pharmacist-led interventions in osteoarthritis pain management: A cluster-randomized trial

BackgroundCommunity pharmacists contribute in osteoarthritis management via evidence-based pain management services. However, their roles and impacts on osteoarthritis management in low- and middle-income countries have yet to be explored. ObjectiveThis study aims to evaluate the effectiveness of community pharmacist-led educational intervention and medication review among osteoarthritis patients. MethodsA 6-month cluster-randomized controlled study was conducted in 22 community pharmacies of Nepal. Patients clinically diagnosed with osteoarthritis, aged 18 years and above, with a poor knowledge level of osteoarthritis and pain management were enrolled in the study. The intervention groups were educated on osteoarthritis and pain management, and had their medications reviewed while control group received usual care. Primary outcomes evaluated for the study were the change in pain levels, knowledge, and physical functional scores at 3 and 6 months. Repeated analyses of covariance were performed to examine the outcomes. ResultsA total of 158 participants were recruited for the study. The intervention group reported improvements in pain score (mean difference 0.473, 95 % CI 0.047 to 0.900) at 3 months and the end of the study (mean difference 0.469, 95 % CI 0.047 to 0.891) as compared to control. Similarly, improvement in knowledge scores were observed in the intervention group at 3 months (mean difference 5.320, 95 % CI 4.982 to 5.658) and 6 months (mean difference 5.411, 95 % CI 5.086 to 5.735). No differences were observed in other outcomes, including physical functional score, depression, and quality of life. ConclusionCommunity pharmacist-led intervention improved patients’ knowledge of osteoarthritis and pain management. While pain scores improved, physical functional score, depression, and quality of life score remained unchanged. Trial registrationClinicalTrials.gov identifier: NCT05337709.

The Effects of Calcium Silicate- and Calcium Hydroxide–based Root Canal Sealers on Postoperative Pain: A Randomized Clinical Trial

IntroductionThis study aimed to compare the postoperative pain level changes resulting from using calcium silicate- (EndoSeal MTA) and calcium hydroxide–based (Sealapex) root canal sealers in mandibular first and second molar teeth with symptomatic apical periodontitis. MethodsA total of 60 patients with symptomatic apical periodontitis in their lower molar teeth were randomly allocated into 2 groups according to sealer type (n = 30). Demographic data, including gender, age, and smoking habit, and preoperative pain measures were recorded. Root canal treatments were performed in a single visit. Postoperative pain measurements and analgesic intake were measured at 6, 12, 24, and 48 hours and after 3, 5, and 7 days using the visual analog scale. The data were statistically analyzed using a chi-squared test (to compare gender, age, smoking habit, analgesic intake, and sealer extrusion), the Mann-Whitney U test (to compare pain levels), Friedman tests (for the evaluations of the reduction in pain levels over time), and Spearman's correlation test (to analyze the relationships of age, gender, smoking habit factors with postoperative pain) (P = .05). ResultsThe statistical analysis showed no significant differences between the groups in postoperative pain and analgesic intake at any of the time intervals evaluated (P > .05). ConclusionsPatients treated with calcium silicate– and calcium hydroxide–based root canal sealers experienced similar postoperative pain and no statistically significant differences were observed in analgesic intake.

Penerapan Teknik Relaksasi Genggam Jari Terhadap Penurunan Skala Nyeri Pasien Post Op Sectio Caesarea di RSIA Sitti Khadijah Kota Gorontalo

Bacground Sectio caesarea is a procedure that involves cutting the uterine and abdominal walls to deliver a fetus. This study aims to determine the application of hand-held relaxation techniques to reducing the pain scale of post-section caesarea patients at RSIA Sitti Khadijah Aisyiyah, Gorontalo City. Method : The method used is descriptive analytic with a case study approach on 4 Post sectio caesarea patients with pain at RSIA Sitti Khadijah Aisyiyah Gorontalo City which includes nursing assessment, nursing diagnosis, nursing intervention, nursing implementation and nursing evaluation. The process of applying this finger-held relaxation technique is carried out for 1 day. Measurement of the pain scale was carried out before and after the hand-held relaxation technique was carried out and using a Numeric Rating Scale (NRS) pain scale measuring instrument. Result : So the results obtained before and after the relaxation technique was carried out, the pain intensity decreased. This case study shows that after finger grip relaxation was performed in patients I, II, III, and IV who experienced postoperative sectio caesarea pain, the result was a change in the pain scale from a moderate pain scale to a mild pain scale. Conslusion : There is a significant effect of the application of finger grip relaxation techniques in post op section caesarean patients for changes in pain levels.

Manajemen Fisioterapi Pada Atlet Dengan Osgood-Schlatter’s Disease – Sebuah Studi Kasus

Background: Osgood-Schlatter (OSD) Including the most common injuries that occur during productive age, this condition occurs due to inflammation of the patellar tendon insertion at the tuberosity of the tibia. Osgood Schlatter usually occurs in children and adolescents who are active in sports, usually occurs in male adolescents aged 13-14 years and female adolescents aged 10-11 years. Purpose: Reducing pain in the right knee, reducing edema, maintaining muscle strength and increasing muscle mass M.Quadriceps, M.Hamstrings, M.Gastrocnemius, M.Gluteus, M.Adductor hip, M.Pectineus, M.Adductor longus, M. Adductor brevis, M. Adductor magnus, M. Gracilis. evaluated with 8 items sport scale. Methods: This study involved boys aged 12 years who experienced Osgood-schlatter. The exercise program was carried out for 3 weeks. Results: In this study, patients were followed up every week. The patient underwent physiotherapy sessions for 3 weeks. Patients are given measurements for muscle strength, increase in LGS, changes in segment circumference, and are obtained from the patient's ADL. Conclusion: In this study it can be concluded that after being given intervention for 3 weeks there were still no changes in Pain Level, Muscle Strength Level, Range of Joint Motion, Segment Circumference and Activity Daily Living in patients with the Osgood- Schalatter condition.

Analisis Praktik Klinik Keperawatan Penerapan Intervensiterapi Finger Hold Terhadap Tingkat Nyeri Pada pasien Cedera Kepala Ringan

Introduction: Head injury is a traumatic disorder of brain function that does not result in a disconnection of brain continuity and can occur with or without interstitial hemorrhage of the brain substance. Purpose:Acute pain is one of the nursing problems experienced by patients with head injuries. To analyze the application of finger hold therapy interventions in reducing pain in patients with mild head injuries. Research methods: is Pre Experimental, which is a design with a One group pre test post test design approach, when this study was carried out from December 21, 2022 to January 23, 2023, with a sample of 6 patients. Research Results: The frequency of patients who experienced moderate pain levels before treatment was 4 patients (66.7.7%), and severe pain levels were 2 patients (33.3%) while the distribution of psien frequency who experienced mild pain levels after treatment was 3 respondents (50.0%), moderate pain levels were 1 patient (16.7%) and berst pain levels were 2 patients (33.3%). This shows that there is no change in pain levels in patients with severe pain scales, because finger hold terap cannot be applied to patients with severe pain levels.Conclusion :This study showed that there is an effect of finger hold therapy in reducing pain in patients with mild head injuries

The Effects of Self-Aromatherapy Massage on Pain and Sleep Quality in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial

BackgroundRheumatoid arthritis is the most common form of inflammatory arthritis and can lead to pain, joint deformity, and disability, resulting in poor sleep quality and lower quality of life. The efficacy of aromatherapy massage on pain levels and sleep quality among rheumatoid arthritis patients remains unclear. AimsTo investigate the effects of aromatherapy on pain and sleep quality among rheumatoid arthritis patients. MethodsThis randomized controlled trial enrolled 102 patients with rheumatoid arthritis from one regional hospital in Taoyuan, Taiwan. Patients were randomly assigned to the intervention (n = 32), placebo (n = 36), or control groups (n = 34). The intervention and placebo groups underwent self-aromatherapy hand massage guided by a self-aromatherapy hand massage manual and video for 10 minutes 3 times a week for 3 weeks. The intervention group used 5% compound essential oils, the placebo group used sweet almond oil, and the control group had no intervention. Pain, sleep quality and sleepiness were measured by using the numerical rating scale for pain, the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale at baseline and at 1, 2, and 3 weeks after the intervention. ResultsThe intervention and placebo groups had significantly decreased sleep quality and sleepiness scores from baseline to 3 weeks after aromatherapy massage. Compared with the control group, the intervention group showed statistically significant improvement in the sleep quality scores in the first weeks after aromatherapy massage (B = -1.19, 95% confidence interval [CI]: -2.35, -0.02, P =.046), but no statistically significant differences were found in the changes in pain levels from baseline to the three time points. ConclusionsAromatherapy massage is effective in improving sleep quality in rheumatoid arthritis patients. More studies are needed to evaluate the effects of aromatherapy hand massage on the pain levels of rheumatoid arthritis patients.

Efficacy and Long-Term Safety of Ibuprofen Gargle for Oral Lichen Planus: A Study Protocol of Randomized Crossover and Long-Term Extension Trials

Oral lichen planus (OLP) is a type of chronic and refractory stomatitis characterized by abnormal keratinization, which is often painful. There is no consensus regarding treatment options for OLP, particularly in the presence of pain. The current study protocol focuses on the short-term efficacy and long-term safety of an ibuprofen gargle for pain management in patients with OLP. Patients (n = 24) with painful OLP will be enrolled. During a crossover study period, patients in the ibuprofen-placebo (IP) group will receive an ibuprofen gargle (0.6%) on day 1, a placebo gargle on day 2, and an ibuprofen gargle on days 3-5 at least once daily. Patients in the placebo-ibuprofen (PI) group will receive a placebo gargle on day 1, an ibuprofen gargle on day 2, and an ibuprofen gargle on days 3-5 at least once daily. The primary endpoint of the crossover study period is the change in pain level as measured by a visual analogue scale score from before gargle administration to 5 min after gargle administration on days 1 and 2. The primary endpoint of the long-term extension study is assessment of long-term safety. The results of this study may support existing evidence regarding the effectiveness of ibuprofen rinses in treating OLP.

Comparative assessment of osteopathy technique with manual therapy associated with biofeedback in patients with the lumbar spine pain

Introduction: The aim of the study is to assess the impact of physiotherapy containing elements of osteopathy on the change of pain level of the lumbar spine of patients in comparison to traditional management using orthopedic manual therapy combined with biofeedback. Material and methods: The study included 60 people qualified for outpatient rehabilitation. Patients were divided into two groups (research and control) consisting of 30 people. The mean age of patients was 52.75 ± 11.58 years. Patients were examined before and after the implementation of the rehabilitation process, pain scale (VAS) and Oswestry Disability Index were used for the study. Rehabilitation lasted every day for four weeks. The control group used orthopedic manual therapy combined with biofeedback, while the research group used a series of treatments based on osteopathy techniques. In addition, both groups of patients underwent a standard physical therapy program. Results: The study showed the effectiveness of manual therapy combined with biofeedback and osteopathic therapy in patients with lumbar spine pain syndrome. A decrease in pain was noted in patients of both groups, however a greater decrease was noted in the research group. In the assessment using the Oswestry Disability Index, a comparable level of quality of life was noted in both treatment groups. Conclusions: The introduced therapeutic programs show an improvement both in terms of reducing pain and improving functioning in everyday life, however, the rehabilitation process based on osteopathic techniques is more effective in reducing pain.

Comparison of open versus minimally invasive surgery in the treatment of thoracolumbar metastases

IntroductionMinimally invasive surgery (MIS) techniques have been developed for the surgical treatment of thoracolumbar spinal metastases to reduce the morbidity associated with the operation. The purpose of our study was to compare the mean length of stay, change in pain levels, neurological symptoms, complications and survival after open versus MIS surgery. Material and methodsThis is a single-center retrospective study based on a register of patients treated for vertebral metastases between January 2014 and October 2016. The collection included demographic data, cancer-related data, clinical data, the characteristics of the surgery, the length of stay, assessment of pain and the occurrence of death. These data were compared between open and MIS surgery groups. ResultsOut of 59 patients, 35 were treated with open surgery and 24 were treated with MIS surgery. The two groups were comparable in terms of age, gender and body mass index. Breast, kidney, prostate and lung cancers were the most frequent primary tumors. Prognostic and instability scores were comparable. Short- and medium-term pain assessment showed comparable results. Median survival was 208 days in the open surgery group and 224days in the MIS group (p=0.5299). ConclusionMIS techniques aim to limit the surgical approach and allow a faster introduction of adjuvant treatments than after open surgery. Our study did not find any differences between open and MIS surgery in terms of pain, neurological evolution or survival time in patients treated for thoracolumbar spinal metastases. Level of evidenceIV; retrospective study.

Intravenous ibuprofen versus sodium valproate in acute migraine attacks in the emergency department: A randomized clinical trial

ObjectiveSodium valproate and ibuprofen are drugs with known efficacy in the treatment of headache associated with acute migraine attacks. In this study, our aim was to compare the efficacy of these two drugs in the treatment of acute migraine attacks when administered as a single intravenous (IV) dose in the emergency department. Materials and methodThis study was designed as a prospective, randomized controlled, double-blinded study and included patients aged 18 to 65 years who presented to the emergency department with acute headache and met the criteria of ‘migraine without aura’ according to the International Classification of Headache Disorders. The patients were randomized into two groups and given a single dose of 800 mg sodium valproate or 800 mg ibuprofen in 150 mL of normal saline by IV infusion over five minutes. Changes in pain levels were assessed using the Numerical Rating Scale (NRS) for pain over a two-hour period. ResultsNinety-nine patients (49 patients in the sodium valproate group and 50 in the ibuprofen group) completed the trial, and their data were included in the statistical analysis. The mean decrease in the post-treatment delta NRS values was statistically significantly higher in the sodium valproate group than in the ibuprofen group. The mean differences were 1.69 [confidence interval (CI): 1.02–2.37, p<0.001], the mean difference between N0 and N2 was 3.61 (CI: 2.96-4.26, p < 0.001), the mean difference between N0 and N3 was 4.11 (CI: 3.54-4.67, p < 0.001), and the mean difference between N0 and N4 was 3.92 (CI: 3.67-4.46, p < 0.001). The number of patients who achieved the primary endpoint of pain relief was significantly higher in the sodium valproate group than in the ibuprofen group (p < 0.001). According to the Kaplan-Meier analysis showing the rates of reaching the targeted endpoint, there was a significant difference in the efficacy of the two-treatment group (χ2 = 79.98, CI: 80.35-99.65; p = 0.000).