Limitations In Activities Of Daily Research Articles

Essential Oils as an Alternative Treatment for Migraine Headache: A Systematic Review and Meta-Analysis.

Alternative and complementary medicines are widely used to treat migraine headaches. This review aimed to determine the effectiveness of essential oils as an alternative treatment approach. A structured search was conducted to identify randomized trials comparing essential oils with a placebo for migraine headaches, using databases (MEDLINE and CENTRAL) to search for articles published between 1966 and 2021. We included trials involving adult males and females diagnosed with migraine headaches according to the International Headache Society. The outcomes included number of attacks, headache severity, associated symptoms, number of days of limited activity, headache duration, use of analgesics, and adverse effects. Seven trials were included with a total of 558 participants. No difference was observed in the number of migraine headache attacks compared to placebo (mean difference [MD], -1.34; 95% confidence interval [CI], -3.31 to 0.64; I2=94%; P=0.190; four trials, 242 participants; moderate- quality evidence). There was no difference in this outcome between the essential oils treated group and the placebo (MD, -0.38; 95% CI, -1.76 to 0.99; I2 statistics=86%; P=0.580; five trials, 240 participants; moderate-quality evidence). We found no significant difference between the use of essential oils and placebo in managing migraine headaches.

Self-assessed survival probability and supply of medical doctors

ABSTRACT Self-assessed survival probability is a variable crucially affecting subjective wellbeing and individual (consumption, saving, retirement) economic choices. Bridging a gap in the literature we investigate its determinants, finding a positive and significant effect of the density of physicians at national level. The impact is stronger in the subsamples of individuals declaring low self-assessed health status, limitations in daily activities, and shortage of money. Our findings are robust when we instrument our main variable of interest with the parliaments’ political orientation and their dispersion. We show that our empirical results find correspondence in a negative link between the density of medical doctors and amenable deaths as an ‘objective’ health outcome. Our rationale for the emerging relationship is that individuals take physicians’ density as a proxy of the health system’s quality. Our results provide support for the relevance of public policies that address the shortage of medical doctors among those who improve the quality of national health systems.

The association between refractory plantar fasciitis and insertional Achilles tendinopathy and peripheral spondyloarthritis: a report of human leukocyte antigen B-27 investigation and treatment outcome.

This study aimed to determine the presence of peripheral spondyloarthritis and investigate the clinical characteristics of patients with concurrent peripheral spondyloarthritis in those presenting with refractory plantar fasciitis and Achilles tendinopathy by conducting human leukocyte antigen B-27 (HLA-B27) testing. This retrospective study aimed to investigate patients who complained of persistent pain and significant limitations in daily activities due to their respective foot pain, despite receiving conservative treatment for over one year under the diagnosis of plantar fasciitis or insertional Achilles tendinopathy. The study included 63 patients who underwent HLA-B27 testing. The patients were classified into two groups based on the presence or absence of HLA-B27 positivity. The Mann-Whitney U test assessed significant relationships between continuous variables, and the chi-square test was used to compare categorical variables. Among the 63 included patients, HLA-B27 positivity was confirmed in 11 patients (17.5%), which was significantly associated with a lower average age (22.8years versus 31.7years, P = 0.01) and a substantially lower proportion of females compared to HLA-B27-negative patients (9.1% vs. 25.0%, P = 0.001). Ten of the 11 patients initiated treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) combined with oral steroids as the first-line medication after being diagnosed as HLA-B27 positive. Six patients experienced pain relief with the first-line medication (60%). Four patients who did not achieve pain control with the first-line medication received tumour necrosis factor-alpha inhibitors as the second-line medication. Two patients experienced pain relief, while two experienced reduced but persistent pain. Among the patients with "refractory" plantar fasciitis and insertional Achilles tendinopathy, 17.5% were diagnosed with peripheral spondyloarthritis. Patients diagnosed with peripheral spondyloarthritis had a higher proportion of men and relatively younger mean age compared to those without the diagnosis. Approximately 70% of these patients achieved symptom improvement in foot and ankle joints by taking conventional synthetic DMARDs, TNF-α inhibitors, or both appropriate for spondyloarthritis.

Exploring health service utilization among elderly populations in Hungary: A comparison of rural and urban settings in the context of Unhealthy Ageing

Abstract Background The demographic transition presents a significant challenge for health systems due to increasing healthcare needs of ageing population, particularly in Central and Eastern European (CEE) countries. In first step, we aimed to describe the health status and use of health services among elderly living in the most deprived region in Hungary, and to compare the use of health services (including preventive and healthcare services) among older adults living in urban and rural areas. Methods A complex health survey was carried out on randomly selected sample of individuals aged 65 years and older (n = 443) in Northeast Hungary in 2022. Demographic, socioeconomic characteristics and use of health services were analysed by type of residence. Results Generally, 15.3% of elderlies rated their health as poor/very poor (14.9% in rural and 15.7% in urban areas), and 57.8% (63.5% and 52.6%) reported limitation in daily activities. Elderlies living in rural area in comparison with that living in urban area reported lower frequency of visiting a dentist (21% vs. 32.9%; p = 0.006), and specialists (53.4% vs. 63.8%; p = 0.028), having fecal occult blood testing (8.8% vs. 21.7%; p < 0.001), colorectal cancer screening (12.1% vs. 20.9%; p = 0.014), and mammography (16% vs. 26.6%; p = 0.035), and reported higher frequency of blood pressure measurement (90.9% vs. 84.4%; p = 0.042). After adjustment for demographic, socioeconomic and health related factors, urban residence showed positive association with having fecal occult blood testing (OR = 2.72, 95% CI: 1.42-5.22), and negative association with blood pressure (OR = 0.44, 95% CI: 0.23-0.86) and blood glucose measurements (OR = 0.55, 95% CI: 0.33-0.92). Conclusions Our findings suggest the impact of residence on health (especially preventive) service utilization among older adults in Hungary. Further comprehensive studies are needed to describe the health needs of older people to implement policies to promote healthy ageing in CEE countries.

Adverse childhood experiences and age-trajectories of depressive symptoms in older adults from China

Abstract Background Adverse childhood experiences (ACEs) have profound lifelong consequences. Less is known about their impact on outcomes in late life, such as psychological distress in older adults. Moreover, there is a paucity of evidence on associations of ACEs with age-trajectories in depressive symptoms, especially with distinct patterns of trajectories. We investigated associations between ACEs and trajectories of depressive symptoms at mid-to-older ages in a Chinese population sample. Methods We used the longitudinal data from the China Health and Retirement Longitudinal Survey (13846 participants ≥45y). Depressive symptoms were measured by CES-D10 (Centre for Epidemiologic Studies Depression Scale) at four waves (2011-18). A range of ACEs (<17y) were retrospectively reported by participants. Growth Mixture Models were used to identify distinct age-trajectories of depressive symptoms and their associations with ACEs. Results We identified two trajectory groups: (1) persistent high (men 14%; women 19.2%) and (2) low/normal levels of depressive symptoms. Several ACE measures were associated with increased risk of having persistent high levels of depressive symptoms (mid-to-older ages) after adjusting for other ACEs, sex, childhood SES (financial status, parental education, occupation), adult SES (education, financial status, urban/rural residence), health behaviors and limitations in daily activities. For example, adjusted OR was 1.35 (95% CI:1.17,1.55) for physical abuse (28.2%), 1.38(1.19,1.59) for domestic violence (24.3%), 1.48(1.23,1.78) for parental drinking, drug or mental health problems (9.4%), 1.59(1.38,1.84) for those had a bedridden parent (18.7%). Conclusions ACEs have a long lasting effect on trajectories of depressive symptoms in older adults, independent of childhood SES and adult factors, highlighting the need to act early to reduce the long lasting impact on mental health in later life. Key messages • Adverse childhood experiences are associated with persistent high levels of depressive symptoms from mid-to-older ages. • Associations are independent of childhood SES and adult factors.

Older Adult Falls in the Community: Does Unsafe Home Environment Have a Risk Role Through the Mediating Effect of Functional Limitations?

Fall incidents from unsafe home environments are frequent in older-adult homes but the literature is ambiguous whether it is the presence/absence, or the interplay of such conditions and physical functioning that is of salience. We therefore estimated whether unsafe home environment is adversely associated with subsequent falls among older adults and what proportion of this association was mediated through limitations in daily and instrumental activities of daily living (ADL/IADL). Using a nationally representative sample of community-dwelling Medicare beneficiaries (≥65 years) in the 2018-2019 National Health and Aging Trends Study (n = 2,599), we conducted bivariate and multivariable analyses. We examined baseline conditions of home disorders, unsafe bathroom settings, unsafe house/building features, and house disrepairs in 2018 and their relation with subsequent falls in 2019, after controlling for covariates. To assess whether ADL/IADL limitations mediated this relationship, we employed the Karlson-Holm-Breen methodology. In 2019, the self-reported prevalence of falls among older adults was estimated at 34.68%. Although baseline home disorders had both a direct (adjusted odds ratio [aOR]: 1.14, 95% confidence interval [CI]:1.03,1.26) and an indirect effect through limitations in ADL and IADL (aOR: 1.01; 95% CI: 1.00,1.03), the relation between unsafe bathroom settings and subsequent falls was unclear. Unsafe house/building features and house disrepairs were not statistically significantly related either directly or indirectly with subsequent falls. Addressing home disorders through policy and housing assessments to highlight home environmental safety would be essential to address falls among older adults.

Agreement in reporting restrictions in life between children with epilepsy and their parents

BackgroundThis study aimed to determine the parent-child agreement of the Hague Restrictions in Childhood Epilepsy Scale (HARCES) and identify the clinical factors associated with parent-child disagreement and the restrictions. MethodsData come from a clinical sample of 90 children ages 9-17 (mean age = 12.9, SD = 6.9, 54% male) attending a pediatric neurology clinic. Parents completed the HARCES, and children completed a modified child-friendly scale (HARCES-M). The parent-child agreement was assessed using intraclass correlation coefficients (ICC) and paired t-tests to compare parent and child responses. Logistic regression examined clinical factors associated with disagreement > 0.5 standard deviation. Associations between clinical factors and restriction scores were examined using linear regression. ResultsParent-child agreement on the HARCES was poor (ICC = 0.36, 95% CI: 0.03, 0.58), and parents reported fewer restrictions in daily activities (t(89) = 2.45, p = .016) and to attend parties (t(89) = 2.12, p = .038); however, the overall restrictions scores were not different (t(89) = 1.55, p = .125). The presence of convulsive seizures (OR = 0.20, 95% CI: 0.05, 0.75) and longer duration of epilepsy (OR = 1.19, 95% CI: 1.01, 1.41) were associated with parent-child disagreement. No clinical factors were significantly related to either the HARCES or HARCES-M scores. ConclusionsThe disagreement in perceptions of restrictions highlights the need to use child-reported measures along with parental reports to comprehensively understand restrictions on children with epilepsy fully. More research is needed to understand what factors explain parent- and child-rated restrictions due to epilepsy.

COVID-19's Unequal Toll: Differences in Health-Related Quality of Life by Gendered and Racialized Groups.

We examine whether the COVID-19 pandemic was associated with changes to daily activity limitations due to poor physical or mental health and whether those changes were different within and between gendered and racialized groups. We analyze 497,302 observations across the 2019 and 2020 waves of the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System survey. Among White men and women, the COVID-19 pandemic was associated with fewer days of health-related activity limitations and decreased frequent activity limitation (≥14 days in the past month) compared to the prepandemic period. By contrast, Latina and Black women experienced increased days of activity limitation and greater likelihood of frequent activity limitation, and these changes were significantly different than for White women. These findings are robust to the inclusion of structural inequality measures and demonstrate how systemic racism and sexism likely exacerbate a myriad of pandemic-related health problems.

Post-stroke limitations in daily activities: experience from a tertiary care hospital in Ethiopia

BackgroundThe disability of stroke patients remains an important global health problem; yet information on the extent of restriction from basic and instrumental activities of daily living is limited, particularly in lower-and middle-income (LMIC) countries. Therefore, we examined the issue under the caption, since it is the first step in planning several rehabilitation services.MethodA facility-based cross-sectional study was done to assess the magnitude and predictors of post-stroke limitations in basic activities of daily living (BADL) using the Barthel Index (BI) scale and instrumental activities of daily living (IADL) using the Frenchay Activities Index (FAI) scale among patients who visited Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, Neurology Clinic from April-October, 2022. All patients having a diagnosis of stroke for more than six months duration were enrolled. Descriptive and inferential statistical analyses were done, and measures of estimated crude and adjusted odds ratio with 95% CI were constructed and a p-value less than 0.05 was considered statistically significant. The results are presented in figures and tables.ResultsA total of 150 stroke patients were enrolled in the present study. The mean age of participants was 53 (14.9) years with slight male preponderance (51.3%). Ischemic stroke was present in 106 (70.7%) of them, while 44 (29.3%) had hemorrhagic stroke. Of this, 57 (38%) and 115 (79.3%) of them had limitations in basic and instrumental ADL, respectively. Comorbid cardiac disease (AOR = 6.9; 95%CI = 1.3–37.5) and regular substance use (AOR = 11.1; 95%CI = 1.1–115) were associated with limitations in BADL, while an increase in age (AOR = 1.1; 95%CI = 1.04–1.15) was associated with severe limitations in BADL. Initial stroke severity (AOR = 7.3; 95%CI = 1.2–44.7) was associated with limitations in IADL, whereas depression (AOR = 5.1; 95%CI = 1.1–23.2) was identified as a predictor of severe limitation in IADL.ConclusionLimitation in activities of daily living (ADL) after stroke is common among Ethiopian patients. Therefore, screening for post-stroke limitations in daily activities is essential for further management and rehabilitative plans.

Comparative analysis of health status and health service utilization patterns among rural and urban elderly populations in Hungary: a study on the challenges of unhealthy aging

The demographic transition poses a significant challenge for health systems, especially in Central and Eastern European (CEE) countries, where the healthcare needs of aging populations are on the rise. This study aimed to describe and compare the health status and utilization of health services among the elderly residing in urban and rural areas of the most deprived region in Hungary. A comprehensive health survey was conducted in 2022, involving a randomly selected sample of 443 older adults (≥ 65 years) in Northeast Hungary. Multivariable logistic regression models adjusting for age, sex, education, financial status, chronic diseases, and activity limitations were used to investigate the association between type of residence and health service use. Among the study participants, 62.3% were female, 38.3% attained primary education, 12.5% reported a bad or very bad financial situation and 52.6% lived in urban areas. Overall, 24% of the elderly rated their health as very good or good (27.8% in urban and 19.7% in rural areas), while 57.8% (52.6% and 63.5% in urban and rural areas) reported limitations in daily activities. Compared to urban residents, rural residents reported lower rates of dentist visits (p = 0.006), specialist visits (p = 0.028), faecal occult blood testing (p < 0.001), colorectal cancer screening with colonoscopy (p = 0.014), and breast cancer screening (p = 0.035), and a higher rate of blood pressure measurement (p = 0.042). Multivariable models indicated that urban residence was positively associated with faecal occult blood testing (OR = 2.32, p = 0.014), but negatively associated with blood pressure (OR = 0.42, p = 0.017) and blood glucose measurements (OR = 0.48, p = 0.009). These findings highlight the influence of residence on health service utilization among older adults in Hungary. Further comprehensive studies are needed to better understand the health needs of the elderly population and to develop policies aimed at promoting healthy aging in CEE countries.

Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials.

Radiation dermatitis (RD) is the most common side effect of adjuvant whole-breast or chest wall irradiation, majorly impacting quality of life in numerous patients. The use of barrier films (polyurethane dressings such as Hydrofilm® and Mepitel® film remaining on the skin for the duration of the radiation treatment) has been investigated as a prophylactic measure in several prospective trials. Here, we critically appraise the available evidence behind preventive barrier film application in the context of breast cancer treatment. International literature was reviewed and high-quality randomised controlled trials (RCTs) were included in this meta-analysis. The results of 5 RCTs (663 patients; >90% Caucasian) were analysed. Overall, barrier films lead to improved clinician- and patient-reported outcomes: fewer grade ≥2 RD (11% vs. 42%; OR=0.16; p<0.001) and moist desquamation (2% vs. 16%; OR=0.12; p=0.006), as well as less patient-reported pain (standardised mean difference [SMD] -0.51; p<0.001), itching (SMD -0.52; p=0.001), burning (SMD -0.41; p=0.011), and limitations in daily activities (SMD -0.20; p=0.007). Furthermore, barrier films have a high acceptance rate among patients, as well as a favourable cost-benefit ratio. Possible side effects due to its application are mild and mostly self-limiting. Overall, there was a lack of information on the radiation treatment techniques used. The evidence presented in this meta-analysis suggests that barrier films are an excellent tool in the prevention of RD among Caucasian patients receiving whole-breast or chest wall irradiation. Its use should therefore be considered routinely in these patients.

HLA B27-positive ankylosing spondylitis professional soccer player with a successful return to sports

Ankylosing spondylitis (AS) is a disease of young adulthood and without adequate treatment it dramatically reduces physical activity. To present a case with AS that successfully returned to professionally playing sports after treatment. A 19-year-old Eastern European Russian professional male soccer player with AS complained of right ankle joint pain not related to any trauma or injury and gradually intensified. The player's regular medical tests during the preceding years and were unremarkable. He would occasionally complain of discomfort in the ankle joints, sacroiliac area and symphysis but did not limit his regular training activity. He received the standard treatment of sports injuries that included: 14 days of limited physical activity, ibuprofen 200 mg twice/day, cryotherapy and joint taping. Examination revealed mobile joints, regular in shape without any swelling. Erythrocyte sedimentation rate (ESR) was 60 mm/1st hr and C-reactive protein (CRP) 50 mg/dl. AS was diagnosed as he fulfilled the classification criteria. HLA-B27 was positive, left sacroiliitis was present on magnetic resonance imaging (MRI). The Bath AS disease activity index (BASDAI) was 5.9. Treatment also included golimumab 50 mg/month. He improved, returned to regular training and continued playing sports professionally amid supportive therapy. The last BASDAI was 1.5. AS patients with initially high levels of physical activity may restore professionally playing of sports when a proper management plan is provided. Further monitoring is warranted and the creation of a database for athletes with rheumatic diseases is recommended in order to standardize treatment protocols.

97 Handwriting Speed in Juvenile Idiopathic Arthritis Using the Detailed Assessment of Speed of Handwriting

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common cause of arthritis in children. Common symptoms include pain, joint stiffness, joint swelling, fatigue, and decreased physical function. Over 50% of children have hand or wrist involvement and handwriting is the most commonly reported functional limitation in daily activities. To date there has been limited study of the specific limitations of handwriting in children with JIA. Objectives To better understand handwriting limitations in children with JIA, this pilot study aimed to: (a) describe handwriting speed measured by the Detailed Assessment of Speed of Handwriting (DASH), a standardized assessment of handwriting speed; (b) compare the DASH scores with age- and sex-matched normative data; (c) examine the association between DASH scores and active wrist and hand arthritis; and (d) explore associations between DASH scores and grip strength, quality of life, function, and pain. Design/Methods Participants diagnosed with JIA and actively followed by the paediatric rheumatology clinic at a large tertiary care centre underwent physician assessment with active joint count, occupational therapist (OT) assessment including administration of the DASH, and grip strength measurement by a physiotherapist. Participant-reported outcomes included questionnaires on function (Childhood Health Assessment Questionnaire [CHAQ]), pain, and quality of life (QOL). Results A total of 12 participants aged 9-15 years (M = 12.7y) completed the study. The mean DASH score was 35th percentile (SD = 23) for all participants, 58th percentile (SD = 14) with active hand/wrist arthritis, 25th percentile (SD = 19) with history of hand/wrist arthritis, and 24th percentile (SD = 25) with no history of hand/wrist arthritis. Grip strength was low overall (M = 18th percentile, SD = 28), and lower in participants with active hand/wrist arthritis (M = 4th percentile, SD = 5) and history of hand/wrist arthritis (M = 5th percentile, SD = 7). DASH scores were negatively associated with grip strength (r = -.31), and positively associated with QOL (r = .41) and pain (r = .43). There was no relationship between the DASH and the CHAQ. Conclusion Handwriting speed difficulties are common in children with JIA and may not relate to arthritis disease activity, pain, or function. Handwriting speed may be used in the clinic as a screen to identify children who may benefit from a full OT handwriting assessment. In the absence of access to OT, general guidance can be provided to schools to support a child with JIA in the classroom.

Gender-specific results of the Dresden children and adolescents headache program DreKiP

Girls and women are more frequently affected by headache than boys and men. The influence of gender on the effectiveness of headache therapies has so far been hardly investigated. We examined gender differences in the outpatient multimodal Dresden Child and Adolescent Headache Program DreKiP. We treated 140 patients with primary headache in a15-hour structured group program. At baseline (T0) and six (T1) and twelve months (T2) after the end of the program, data on headache-related limitation of daily activities (PedMIDAS) as well as headache frequency, intensity, and pain-related disability (P-PDI) were collected. Retrospectively, these data were analyzed separately for girls and boys. For 91patients (9-19years, median = 15; 71.4 % female) data were available for at least two measurement time points. Girls showed significantly higher headache frequency than boys at all time points (median headache days/last three months at T0: ♀43, ♂20; T1: ♀32, ♂12; T2: ♀28, ♂9) as well as numerically higher headache-related limitation of daily life. There were significant effects over time with a decrease in headache frequency (F(2.88) = 5.862; p = 0.004) and improvement in daily functioning (F(2.92) = 5.340; p = 0.006). There was no gender-specific treatment response. The DreKiP therapy shows effects in girls and boys with primary headache. Higher headache frequencies and everyday life restrictions in girls may have hormonal but also psychosocial causes and should be addressed in educational measures.

Profile of a disabled person with HIV/AIDS 18 years and older from the standpoint of the International Classification of Functioning

The spread of HIV infection continues not only in the Russian Federation, but throughout the world. With the onset of secondary lesions in HIV infection, patients develop persistent dysfunctions of various organs and body systems, leading to a limitation in the main categories. The International Classification of Functioning and Disabilities and Health ICF, as a tool for describing the life of an individual, is gradually being introduced into medical practice, most often used to assess the effectiveness of the rehabilitation process. By now HIV infection/AIDS does not have a basic comprehensive description in terms of the ICF. The authors, in the article, provide an analysis of the existing problems from the standpoint of the ICF in patients and disabled people with HIV infection/AIDS. As a result of the analysis, the authors propose a set of domains that correspond to the most common disorders in patients and disabled people with HIV infection and characterize limitations in daily activities (self-service and domestic life) and in the main areas of life (education, work and employment).

Analysis of the Disadvantages and Advantages of Online Education During the COVID-19 Pandemic

The COVID-19 pandemic has endangered peoples lives and restricted daily activities. To ensure the safety of students and instructors, education institutions were forced to change to online learning. This shift has brought many unknown challenges and significantly disturbed students learning progress. To explore deeper into the impacts on students learning, the main goal of this study is to analyze the potential challenges and opportunities distance learning has through several previous studies. Datasets are collected through both qualitative and quantitative methods such as questionnaires. Both disadvantages and advantages are highlighted to provide a more comprehensive understanding of how online learning affected students. More challenges are reflected by students than advantages and future suggestions on how to overcome obstacles are also discussed. The COVID-19 outbreak has provided people the chance to establish the foundation for the adoption of online learning. This article seeks to offer a thorough analysis of the pandemics impacts on online education and indicate limitations as well as opportunities.

Topical capsaicin 8% patch in peripheral neuropathic pain: Efficacy and quality of life.

Peripheral neuropathic pain (PNP) is one of the most challenging diseases to treat with a significant negative impact on the patients' health-related quality of life (HRQoL). Capsaicin 8% patch has arisen in the last decades as an alternative to oral drugs in the treatment of PNP with fewer side effects and promising results in efficacy. This work aims to evaluate the effectiveness of the topical application of capsaicin in PNP and its impact on patients' HRQoL based on the use of capsaicin in a tertiary hospital of Oporto. This study included 100 patients with localized PNP with poor pain control and without improvement with previous treatments that were treated at least once with an 8% capsaicin patch. Effectiveness on pain relief, number of treatments needed, safety and impact on HRQoL were assessed through a set of questionnaires. Regarding the aetiology of PNP, 67.6% (N = 46) have post-surgery or trauma induced PNP with 64.7% (N = 44) of patients reporting pain in the lower limb. After the treatment, 30.9% (N = 21) felt minimally improved, 22.1 (N = 15) felt much improved and 13.2 (N = 9) felt very much improved. On a scale from 1 to 10, in the week prior to the survey, the median intensity of pain was 6 and the median interference in quality of life was 7. The majority of patients still report limitations in mobility and daily activities and moderate pain. Capsaicin 8% patch is effective in PNP treatment at least in the short term. Repeated applications may be important for long-term analgesia. The low systemic dose and few side effects mean that the treatment is generally well tolerated by patients. Due to the analgesic effect, capsaicin can improve the HRQoL of patients with PNP.

Neurodegeneration and its potential markers in the diagnosing of secondary progressive multiple sclerosis. A review.

Approximately 70% of relapsing-remitting multiple sclerosis (RRMS) patients will develop secondary progressive multiple sclerosis (SPMS) within 10-15 years. This progression is characterized by a gradual decline in neurological functionality and increasing limitations of daily activities. Growing evidence suggests that both inflammation and neurodegeneration are associated with various pathological processes throughout the development of MS; therefore, to delay disease progression, it is critical to initiate disease-modifying therapy as soon as it is diagnosed. Currently, a diagnosis of SPMS requires a retrospective assessment of physical disability exacerbation, usually over the previous 6-12 months, which results in a delay of up to 3 years. Hence, there is a need to identify reliable and objective biomarkers for predicting and defining SPMS conversion. This review presents current knowledge of such biomarkers in the context of neurodegeneration associated with MS, and SPMS conversion.

Small airway disease in post-acute COVID-19 syndrome, a non-conventional approach in three years follow-up of a patient with long COVID: a case report

BackgroundSmall airways disease (SAD), a novel finding described in post-acute COVID-19 patients, should be suspected when respiratory symptoms continue, air trapping persists on expiratory CT scans, and imaging findings fail to improve despite objectively better conventional pulmonary function test (PFT) parameters. The forced oscillation technique (FOT) and Multiple breathing washout (MBW) are both very sensitive methods for detecting anomalies in the peripheral airways.Case presentationWe discuss the case of a 60-year-old Hispanic patient who had severe COVID-19 pneumonia and developed dyspnea, fatigue, and limited daily activity a year later. The PFTs revealed restrictive lung disease, as seen by significant diffusing capacity of the lungs for carbon monoxide (DLCO) decrease, severe desaturation, and poor 6-min walk test (6MWT) performance. The patient was treated with lowering corticosteroids as well as pulmonary rehabilitation (PR). During the 24-month follow-up, the dyspnea and fatigue persisted. On PFTs, 6MWT performance and restricted pattern improved slightly, but MBW discovered significant ventilatory inhomogeneity. FOT revealed substantial peripheral airway obstructive abnormalities. On CT scans, air trapping and ground-glass opacities (GGO) improved somewhat. The patient used a bronchodilator twice a day and low-dose inhaled corticosteroids (160 µg of budesonide and 4.5 µg of formoterol fumarate dihydrate) for nine months. PR sessions were resuming. The restricting parameters were stabilized and the DLCO had normalized after 36 months, with a 6MWT performance of 87% but significant desaturation. The CT scan revealed traction bronchiectasis, low GGO, and persistent air trapping. Without normalization, FOT and MBW scores improved, indicating small airway disease.ConclusionsThe necessity of integrating these tests when detecting SAD is emphasized in our paper. This article lays the foundation for future research into the best ways to manage and monitor SAD in post-acute COVID-19 patients.

Energy efficiency training’s effect on fatigue scores of children with a cancer diagnosis†

Abstract Objective Fatigue is the most common complication of cancer treatment procedure during chemotherapy, leading to limited daily activities, mood swings, and ultimately impaired functional status. This study aimed to determine the effect of energy efficiency training on the fatigue scores of children with a cancer diagnosis. Methods In the present clinical trial study, 30 children with a cancer diagnosis were randomly assigned variously to the control and testing groups. The cancer-related fatigue questionnaire for children with cancer was employed as the data collection tool. The intervention of the testing group was conducted in 4 sessions of 45–60 min of face-to-face interaction, group sessions, and question-and-answer sessions. Meanwhile, routine interventions were employed in the control group. Quantitative variables were reported as mean and standard deviation, and qualitative variables as frequency and percentage. Stata 11 statistical software and a change score approach were used to analyze the data. Results The mean fatigue score of the testing group increased from 72.12 to 77.53. There was a statistically significant difference between the mean fatigue scores of the testing group before and after the intervention (P = 0.013), and the children’s fatigue score decreased. There was a statistically significant difference between the mean fatigue scores of the testing and control groups before and after the intervention (P = 0.001), and the fatigue score of the children in the testing group had decreased compared to the control group. Conclusions Energy efficiency techniques can be employed to increase energy and reduce fatigue during pediatric chemotherapy.