Dimensions Of Pain Research Articles

Validation of the Chinese version of the Brief Pain Inventory in patients with knee osteoarthritis

BackgroundKnee osteoarthritis (KOA) primarily presents with symptoms of pain and compromised functionality. Pain is a subjective manifestation that necessitates the employment of reliable evaluation tools for practical assessment, thereby enabling the formulation of appropriate interventional strategies. The Brief Pain Inventory (BPI) is a widely utilized questionnaire for evaluating the status of chronic pain. The purpose of the present study is to translate the short form of BPI into Chinese version (BPI-CV) and conduct cross-cultural adaptation to evaluate the psychometric characteristics of BPI-CV in KOA patients.MethodsBPI-CV was translated and cross-culturally adapted according to internationally recognized guidelines. A cohort comprising 150 patients diagnosed with KOA successfully completed the demographic questionnaire, BPI-CV, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the EuroQoL Group's five-dimension questionnaire (EQ-5D). Internal consistency and test–retest analysis were used to evaluate the reliability. The internal consistency of the scale items was evaluated by calculating the Cronbach's α value (> 0.7). We chose to employ two scales commonly used in the evaluation of KOA patients: the disease-specific WOMAC scale and the universal EQ-5D scale. Construct validity was determined through Pearson correlation analysis, comparing BPI scores with those obtained from the WOMAC and EQ-5D scales. Exploratory factor analysis was used to structural validity.ResultsThe BPI-CV was well accepted with no ceiling or floor effect. Cronbach's α for assessing internal consistency was 0.894. Test–retest reliability was excellent with an ICC of 0.852 (95%CI 0.785–0.905). The BPI-CV showed moderate to strong correlations with the pain dimension (r = 0.496–0.860) and the functional interference dimension (r = 0.517–0.712) of the WOMAC and the EQ-5D (r = 0.527–0.743). Three factors resulted using exploratory factor analysis: pain severity, activity interference, and emotional interference, accounting for 79.0% of the total variance. Standard error of measurement was 0.539.ConclusionBPI-CV has good feasibility, reliability, and validity. It can be recommended for KOA patients in mainland China.

Total hip arthroplasty versus hemiarthroplasty in the treatment of active elderly patients over 75 years with displaced femoral neck fractures: a retrospective study

BackgroundFemoral neck fractures are associated with substantial morbidity and mortality for older adults. Total hip arthroplasty (THA) and hemiarthroplasty (HA) are widely used in elderly patients with displaced femoral neck fractures (DFNF), but there is still controversy refering to the optimal chose for the management of DFNF in active elderly patients.MethodsThis is a retrospective cohort study that incorporates medical record review with an outcomes management database. 73 patients who underwent HA and 66 patients who underwent THA were identified from January 2015 to December 2017. Data of age, gender, BMI, comorbidity status, operation time, blood loss, hospitalization time, in-hospital complication were collected and analyzed. Clinical follow-up and radiographic examinations were performed at approximately five years, and hip complications, Harris Hip Score (HHS) and EuroQol-5 Dimensions (EQ-5D) were assessed.ResultsPreoperative general data of sex, age, BMI and charlson comorbidity score of THA group(n=55) has no statistically significant difference with that of HA group. Patients treated by THA had significantly longer operation time (105.5 vs 76.7 minutes; P < 0.001), more blood loss (524.1 vs 350.1 ml; P < 0.001) and longer hospitalization time (15.8 vs 13.8 days; P < 0.001). There was no significant differences between two groups in complications (32.7% vs 25.8%, P=0.432). No patients died during the hospitalization. After five years, only 33 patients in the THA group and 34 patents in the HA group were still alive, and the fraction surviving were not statistically significant between two groups (60.0% vs 54.8%, P> 0.05). The differences in hip function in favor of THA appeared to increase after the five-year follow-up, and the difference was significant in terms of the total Harris hip score (81.3 vs 73.1, P < 0.001) as well as in the dimensions of pain (38.9 vs 35.9, P=0.033), function (33.7 vs 29.2, P=0.001), absence of deformity (4.0 vs 3.9, P=0.023) and range of motion (4.6 vs 4.2, P=0.008). There was no significant differences between groups in hip dislocation rate (6.1% vs 0.0%, P=0.239). The erosion rate of hip joint in the THA group was significantly lower than that of the HA group (0.0% vs 26.5%, P=0.002). The health-related quality of life, according to EQ-5D index score, was found to be higher (0.69 vs 0.63, P= 0.001) in the THA group than the HA group after five years.ConclusionTHA may be a preferred management option for active elderly patients over 75 years. The more extensive surgery of THA is not associated with higher in-hospital complication rate or mortality rate. These patients can benefit from THA in terms of hip function and quality of life.Trial registrationNo.

A Nutritional Supplement as Adjuvant of Gabapentinoids for Adults with Neuropathic Pain following Spinal Cord Injury and Stroke: Preliminary Results.

Gabapentinoids are first choice drugs for central neuropathic pain (CNP) despite limited evidence of efficacy and side effects affecting therapy outcomes. Nutraceuticals could improve their efficacy and tolerability. Our aim is to investigate the effect of NACVAN®, in addition to gabapentinoids, on pain symptomatology in CNP patients. The effect of 6 weeks of treatment of NACVAN® was preliminary observed among 29 adult inpatients with spinal cord injury (SCI) or stroke-related CNP recruited to the experimental group. Pain intensity, neuropathic pain, and quality-of-life were measured at baseline (T0) and after 3 (T1) and 6 weeks (T2). Change in each outcome over time was assessed through a repeated measures analysis of variance or Wilcoxon matched-pairs test. Preliminary results show a significant reduction in pain intensity (T0 → T1, p = 0.021; T0 → T2, p = 0.011; T1 → T2, p = 0.46), neuropathic symptoms (T0 → T1, p = 0.024; T0 → T2, p = 0.003), and evoked pain (T0 → T2, p = 0.048). There were no significant reductions in other neuropathic pain dimensions and in quality-of-life components. No side-effects were detected. NACVAN® could have a beneficial adjuvant effect when used as an add-on to gabapentinoids in patients suffering from CNP due to SCI or stroke, with no adverse effect. Future analysis on a larger sample, compared with a placebo condition, could confirm these preliminary results.

Psychological intervention for grief in caregivers of adults diagnosed with intellectual disabilities

The objective of this pilot study was to adapt and provide preliminary data of the efficacy of an intervention aimed at family caregivers of adults with intellectual disability to provide them with different coping resources to better cope with their role as caregivers, as well as to reduce the psychological overload and pain associated with the diagnosis. A total of 24 caregivers participated, of which 14 were assigned to an intervention group (IG) and 10 to a control group (CG) through simple randomization. Variables of overload, mental health and feelings of grief produced by the diagnosis were measured. Linear models for repeated measures were used to evaluate the effect of the program. After the intervention, significant differences (p&lt; .5) were found in the dimensions of emotional pain, relational loss and acceptance of loss, and feelings of grief brought on by the diagnosis. In conclusion, it is necessary that this type of program be given early to these caregivers in order to avoid the pathological and chronic grief into which they frequently end up.

Different logics of pain: the gendered dimension of chronic pain in a relational setting

This study aims to increase our understanding of the gendered dimension of living with chronic pain within a relational context. The empirical setting for this study is Sweden, a country widely recognised for its long history of gender equality. Interview responses from 21 women and 12 men were analysed using the feminist notion of the marriage contract, outlining the terms for women and men living together in a relationship. The result shows how living with chronic pain leads to processes of grief and altered priorities. Respondents emphasize the importance of equality. However, men and women apply different logics when deciding which tasks to prioritise. Although there is no distinct pattern regarding whether or not couples share housework equally, the allocation of responsibilities appears to follow a particular pattern: men tend to prioritise their rehabilitation to become good fathers, women are grateful and prioritise the family before her own well-being. The study indicates that while attitudes and the allocation of household chores may have changed in the past few decades, the marriage contract still restricts women from employment and rehabilitation.

Quality of life related to periodontal disease in diabetic patients under the health subsidized regime in Manizales

Introduction: quality of life related to oral health is a relevant topic that involves the relationship of dentistry with chronic noncommunicable diseases such as diabetes, given its bidirectional relationship. This study emphasizes the importance of reviewing the impact of periodontal alterations on the quality of life of diabetic patients. The objective of this study was to establish the quality of life related to periodontal status in diabetic patients belonging to the subsidized regime of Manizales. Methods: 90 diabetic adults belonging to the diabetes program of the subsidized regime were observed by means of a structured interview, application of the OHIP-14 instrument (Oral Health Impact Profile on Quality of Life) and direct observation of periodontal status, to establish the index of periodontal extension and severity, description of the OHIP-14 index, establish its relationship with sociodemographic variables and with periodontal health status. Results: we found a prevalence of impaction according to OHIP-14 of 44.4%, extent of impaction with an average of 1.58 (CI: 1.0-2.1) and severity of impaction of 6.7 (CI: 6.2-7.8). When consolidating the OHIP-14 results by dimension, it was observed that the greatest impact corresponded to the physical pain dimension, with a percentage of 81.1%. The lowest percentage was presented in the dimensions of Social Incapacity and Disability or Handicap with 34.4%. Conclusions: although in the population studied, the presence of periodontal disease had a poor impact on quality of life, this was greater in the dimensions of physical pain and psychological discomfort.

Evaluating the Quality of Pain Management Satisfaction Among Oncology Patients in a Hospital Setting: Psychometric Properties of the Arabic Version of Pain Care Quality Survey.

The purpose of this mixed-methods psychometric study was to translate and adapt the Arabic Pain Care Quality (APainCQ) Survey to Arabic and to measure the quality of pain care provided to Arab patients. This study used an iterative, mixed-methods approach that employed cognitive interviews, expert content analysis, and factor analysis to develop the APainCQ Survey. The study was conducted at Dubai Hospital, Dubai Health Authority, United Arab Emirates. Arabic-speaking patients admitted to the oncology/hematology inpatient units with a minimum 24-hour stay were eligible for the study. The sample consisted of 155 patients. The iterative exploratory factor analysis process resulted in the sequential removal of three items. The results of the significant Bartlett test (P < .001) of sphericity and Kaiser-Meyer-Olkin test of 0.93 for both the health care team scale and the nurse scale. The total variance explained was 76.17% for the health care team scale and 60.91% for the nurse scale, which explained 56.51% for factor 1 with 14 items and 4.40% for factor 2. Regarding internal consistency reliability, Cronbach's alpha and McDonald's omega for the health care team scale and nurse scale were high; both values were .95. Internal consistency reliability of pain assessment and pain management subscales of nurse scales were also high, with values of 0.96 and 0.79, respectively. Moreover, there was a moderate correlation (r = 0.66; P < .001) between the two subscales in the nurse scale. This study provides evidence that the APainCQ is a reliable and valid measure of pain dimensions, including pain management and monitoring. This APainCQ scale can potentially expand research and clinical assessment in the Arab world.

Evaluation of the Efficiency of Enzyme-Based Chemomechanical Method in Atraumatic Restorative Treatment of Primary Molars

Aim: To compare clinical and radiographic successes and pain dimensions this chemomechanical agent and traditional Atraumatic Restorative Treatment (ART) method. Material and Methods: Children aged 3-8 years who applied clinic with their parents were included our study (n=38). Teeth included study; Traditional ART method with excavator, enamel chisel and probe and chemomechanical carious tissue removal method with Brix 3000 material were applied. After caries removal methods, restorations were completed with high viscosity glass ionomer cement (YVCIS). After restoration applications, evaluation was made according the Wong Baker Pain Scale. The clinical success restorations was followed up 3, 6 and 12 months according the modified USPHS criteria. Radiographic evaluation was performed 6 and 12 months. In whole study, error value was 5% and load was accepted maintaining the p&lt;0.05 value. Results: 3 and 6 months, there was difference marginal compliance criteria between chemomechanical caries removal and YVCIS restorations applied after traditional ART methods, under surveillance (3rd month p=0.040; 6th month p=0.047). YVCIS restorations applied after chemomechanical caries removal method had Charlie score 2.8% in secondary caries criterion 6th month follow-up. In evaluation made with Wong Baker Pain Scale, facial expression representing no pain expression was preferred most both groups. When all results were evaluated between the two groups, no difference was found when removed (p=0.536). Conclusion: Our study; The chemomechanical caries removal method used non-surgical and acceptable caries removal technique similar the conventional ART method.

Mindfulness-Based Intervention Effect on the Psychophysiological Marker of Self-Regulation in Women With Endometriosis-Related Chronic Pain

Endometriosis is a gynecological disease that involves a broad biopsychosocial compromise with the potential to create a negative vicious cycle. Despite the complexity of factors influencing women's improvement, most interventions investigated target just the peripheral nociceptive sources of endometriosis-related pain. An alternative is intervening in self-regulation, which can potentially influence multiple domains of the illness experience. The present study examines the effect of a brief Mindfulness-Based Intervention (bMBI) on attention and autonomic nervous system regulation in women with endometriosis-related pain. Also, explore the interaction between these self-regulation domains and the affective pain dimension. An exploratory analysis of the secondary outcomes of a pilot randomized controlled trial was performed. The vagally-mediated Heart Rate Variability (vmHRV) at rest, cognitive stress, and recovery was employed to measure autonomic regulation. The Flanker and Stroop tasks were used to estimate the attention domains. Results showed that bMBI (n = 26) significantly improved Flanker accuracy and Flanker and Stroop reaction time compared to the control group (n = 28). bMBI significantly increased vmHRV at rest and recovery after cognitive stress. Attention mediated the bMBI effect on affective pain improvement. Results suggest that bMBI improves self-regulation domains with the potential to develop a broad biopsychosocial benefit in the endometriosis context. PerspectiveThis article demonstrates the positive impact of a brief Mindfulness-Based Intervention on attention and parasympathetic regulation in women suffering from endometriosis-related pain. This mindfulness-induced self-regulation improvement can benefit affective pain and potentially multiple psychophysiological processes relevant to endometriosis.

Stimulation of lateral parabrachial (LPB) to central amygdala (CeA) pituitary adenylate cyclase-activating polypeptide (PACAP) neurons induces anxiety-like behavior and mechanical allodynia

BackgroundAnxiety disorders are the most prevalent psychiatric disorders, and they are highly comorbid with chronic pain conditions. The central nucleus of the amygdala (CeA) is known not only for its role in the regulation of anxiety but also as an important site for the negative affective dimension of pain. Pituitary adenylate cyclase activating polypeptide (PACAP), a neuropeptide whose terminals are abundant in the CeA, is strongly implicated in the stress response as well as in pain processing. Here, using Cre-dependent viral vectors, we explored in greater detail the role of the PACAP projection to the CeA that originates in the lateral parabrachial nucleus (LPB). MethodsWe first performed a circuit mapping experiment by injecting an anterograde Cre-dependent virus expressing a fluorescent reporter in the LPB of PACAP-Cre mice and observing their projections. Then, we used a chemogenetic approach (a Cre-dependent Designer Receptors Activated by Designer Drugs, DREADDs) to assess the effects of the direct stimulation of the PACAP LPB to CeA projection on general locomotor activity, anxiety-like behavior (using a defensive withdrawal test), and mechanical pain sensitivity (using the von Frey test). ResultsWe found that the CeA, together with other areas, is one of the major downstream projection targets of PACAP neurons originating in the lateral parabrachial nucleus (LPB). In the DREADD experiment, we then found that the selective activation of this neuronal pathway is sufficient to increase both anxiety-like behavior and mechanical pain sensitivity in mice, without affecting general locomotor activity. ConclusionIn conclusion, our data suggest that the dysregulation of this circuit may contribute to a variety of anxiety disorders and chronic pain states, and that PACAP may represent an important therapeutic target for the treatment of these conditions.

Effects of Nature-Based Multisensory Stimulation on Pain Mechanisms in Women with Fibromyalgia Syndrome: A Randomized Double-Blind Placebo-Controlled Trial

BackgroundThe term “nature-based sensory stimuli” refers to the sensory information produced by biotic and abiotic agents from natural environments. The literature has reported the beneficial effects of these agents on various pain dimensions in non-clinical populations. AimsTo evaluate the potential analgesic effects of nature-based multisensory stimulation in women with fibromyalgia syndrome. MethodsA randomized, double-blind, placebo-controlled, parallel-group trial with a 1:1 allocation ratio was conducted. Forty-two women with fibromyalgia syndrome interacted with either different plant species with flowers, stones, and soil organic matter or their synthetic imitations for 30 minutes. Outcome measurements were performed before and after the intervention, including clinical pain intensity using the Numeric Rating Scale, cold pain thresholds using the Cold Pressor Test, mechanical hyperalgesia and wind-up using a monofilament, and pressure pain thresholds using a pressure algometer. ResultsAnalyses revealed group × time interactions for clinical pain intensity (F = 7.915, p = .008), cold-water immersion time (F = 7.271, p = .010), mechanical hyperalgesia (F = 4.701, p = .036), and pressure pain threshold (p ≤ .017). Between-group differences were found in clinical pain intensity (p = .012), cold pain thresholds (p = .002), and pressure pain thresholds (p < .05). The experimental group exhibited reduced clinical pain intensity (p = .001) and increased pressure pain thresholds (p ≤ .034). ConclusionsWomen with fibromyalgia syndrome may benefit from multisensory stimulation using biotic and abiotic agents from natural environments for 30 minutes. Interacting with flowering plants and soil components appears to induce analgesic effects.

"Do you Really Believe that There is Something More?" - The Offer of Transcendental Communication by Pastoral Care Workers in German Hospices and Palliative Care Units: A Qualitative Study.

Palliative Care also encompasses the dimension of spiritual pain. Pastoral care workers and chaplains are specialists in the provision of spiritual care. Decreasing religious affiliation and increasing spiritual diversification in modern societies raise the question of the function of pastoral care. The goal of this study is to answer the question of what pastoral care workers can offer to dying residents in hospices and palliative care units. A qualitative interview study was designed to explore the specific perspective of pastoral care workers in a multidisciplinary environment. The study is based on differentiation theory which is particularly well adjusted to reveal differences in perspectives in so called 'holistic' care settings. The reporting follows the COREQ guidelines. Problem centered interviews were conducted at five hospices and two palliative care units. Eight pastoral care workers were interviewed (5 Catholic, 3 Protestant, mean age of 58years). The analysis of the interviews revealed three major themes: (A) Self-positioning in relation to the organization, (B) Offering conversations to patients and relatives, (C) Performing religious rituals. Minor themes were: mediating conflicts between patients, relatives and staff, sensing moods in silence with patients and organizing workshops for staff. In modern hospice care, pastoral care workers routinely address the problem of making death more tangible and of answering the unanswerable question of what comes afterwards. Through this, they support dying residents in hospices and palliative care units in dealing with the inexplicability of death.

Assessment of Health-Related Quality of Life Using EQ-5D-5L Tool With Indian Tariffs Among Reproductive Age Group Women Living With HIV in India

ObjectiveIndia is witnessing declining HIV prevalence because of dedicated efforts by the government. The highly active antiretroviral therapy has improved life span of people living with HIV but bearing many side effects. Women living with HIV (WLHIV) in reproductive age group have additional burden of pregnancy-related issues. This study aimed to estimate the health utility score among WLHIV in India, particularly in context of their contraceptive use, during pregnancy and postpartum period. MethodsA primary cross-sectional study was conducted among 195 WLHIV availing antiretroviral treatment services at public health facilities of Mumbai. The EQ-5D-5L interview-based questionnaire in local language and Indian value set was used to estimate health-related quality of life (QOL) reported as mean (± SD) utility and visual analog scale (VAS) scores. The relationship between utility values and VAS scores was assessed. ResultsThe WLHIV with mean age of 31.6 (6.4) years were on antiretroviral medication for nearly 7 years, and 63% had CD4+ cell count > 500 cells/mm3. Response of “11111,” that is, in full health state, was reported by 66.7%. The mean utility and VAS scores were 0.976 (± 0.0519) and 82.21 (± 15.77). Reduced health-related QOL scores were associated with pain and discomfort dimension. Utility scores among contraceptive users (0.986 [± 0.029]) was higher than nonusers (0.976 [± 0.028]). Currently pregnant WLHIV had least utility score (0.959 [± 0.088]). ConclusionsWLHIV had better QOL while using contraceptives more so when they were sterilized. Pregnancy reduces the QOL. This emphasizes the need to promote effective contraceptive methods among WLHIV and prevent unintended pregnancies.

Pain-related behavioral and electrophysiological actions of dynorphin A (1-17).

Dynorphin A (1-17) (DynA17) has been identified as a key regulator of both sensory and affective dimensions of chronic pain. Following nerve injury, increases in DynA17 have been reported in the spinal and supraspinal areas involved in chronic pain. Blocking these increases provides therapeutic benefits in preclinical chronic pain models. Although heavily characterized at the behavioral level, how DynA17 mediates its effects at the cellular physiological level has not been investigated. In this report, we begin to decipher how DynA17 mediates its direct effects on mouse dorsal root ganglion (DRG) cells and how intrathecal administration modifies a key node in the pain axis, the periaqueductal gray These findings build on the plethora of literature defining DynA17 as a critical neuropeptide in the pathophysiology of chronic pain syndromes.

EFFICACY AND SAFETY OF DR. ORTHO OIL IN THE TREATMENT OF JOINT PAIN, STIFFNESS, AND INFLAMMATION: AN OPEN-LABEL, NON-RANDOMISED CLINICAL STUDY

Background: Joint pain or inflammation is a common complaint among the elderly and is conventionally treated with steroidal or non-steroidal anti-inflammatory drugs (NSAIDs). Because of the adverse effects of these drugs, the present herbal formulation is being developed for the long-term control of pain and inflammation. Objective: The objective of this study was to assess the efficacy and safety of Dr. Ortho Oil in patients with knee pain, low back pain, joint stiffness, sports injuries, and joint inflammations. Methods: This was a single-centre, open-label, non-randomised study. 120 participants were selected based on the inclusion and exclusion criteria. All individuals were instructed to use Dr. Ortho Oil for 60 days. The primary outcome was a change in the frequency of subjects with a significant reduction in joint pain, stiffness, and inflammation. Secondary outcomes were improvements in investigator assessment scale (IAS) and subject self-assessment questionnaire (SAQ) scores at successive administrations compared with the baseline. Results: The study indicated that topical use of Dr. Ortho Oil for 30 days reduced all dimensions of pain. SAQ and IAS scores also decreased significantly.

O-027 Efficacy results from a phase 3, randomized, placebo-controlled trial testing two doses of linzagolix in women with endometriosis-associated pain

Abstract Study question Does once-daily linzagolix for up to 6 months reduce the pain symptoms in women with endometriosis? Summary answer Once-daily oral use of the GnRH agonist linzagolix alone or in combination with combined hormonal add-back therapy (ABT) for 24 weeks improved endometriosis-associated pain symptoms. What is known already Linzagolix is an oral GnRH antagonist under development to treat endometriosis-associated pain (EAP). In the EDELWEISS 3 study linzagolix 200mg+ABT met its co-primary endpoints at 3 months by reducing dysmenorrhea (DYS) and non-menstrual pelvic pain (NMPP) in a clinically meaningful fashion along with a stable or decreased use of analgesics. Linzagolix 75mg significantly reduced DYS but not NMPP. Secondary endpoints were DYS, NMPP, overall pelvic pain, dyschezia, and dyspareunia at 6 months assessed with a numeric and/or verbal rating scale (NRS and/or VRS), and interference of pain with daily activities assessed with the Endometriosis-Health-Profile-30 (EHP-30) pain domain. Study design, size, duration EDELWEISS 3 was a randomized, double-blind, placebo-controlled Phase 3 study, investigating efficacy and safety of linzagolix 75mg and linzagolix 200mg with ABT (1mg estradiol/0.5mg norethindrone acetate) for up to 24 weeks in women with moderate to severe EAP. To qualify, subject had to demonstrate over 2 menstrual cycles at least moderate DYS and NMPP for ≥2 days each and at least moderate overall pelvic pain for ≥5 days. Participants/materials, setting, methods Eligible women with moderate to severe EAP were equally randomized to once daily oral: placebo, linzagolix 75mg or linzagolix 200mg+ABT. Efficacy assessments included DYS, NMPP, dyspareunia (assessed with a 4-point VRS), overall pelvic pain and dyschezia (assessed with an 11-point NRS), and interference of pain with daily activities (assessed with the EHP-30 pain domain). The co-primary endpoint was a responder analysis at Month 3. We present secondary endpoints at Month 6. Main results and the role of chance Participants (n = 484) had a mean age of 35 years, a BMI of 24kg/m2 with 99% of subjects being White. At Month 6, compared to placebo significant improvements in DYS and NMPP (VRS) were observed in the 200mg+ABT group, with an estimated mean change from baseline (CfB) of -1.83 (95%CI: 1.96, 1.70; difference with placebo p &amp;lt; 0.001) and 0.92 (95%CI: 1.03, 0.82; p = 0.002), respectively. For the 75mg group, the mean CfB was 1.10 (95%CI: 1.23; 0.97; p &amp;lt; 0.001) and 0.84 (95%CI: 0.95; 0.73; p = 0.048), respectively. For overall pelvic pain (NRS), marked improvements were observed with an estimated mean CfB of 3.39 (95%CI: 3.74, 3.03; p &amp;lt; 0.001) for 200mg+ABT and 2.84 (95%CI: 3.20, 2.48; p = 0.024) for 75mg. Similarly, dyschezia (NRS) was significantly improved for both groups with a mean CfB of 1.99 (95%CI: 2.29, 1.70; p = 0.012) for 200mg+ABT and -1.98 (95%CI: 2.28, 1.69; p = 0.015) for 75mg. Both doses offered a marked, statistically significant improvement in the interference of pain with daily activities as measured on the EHP-30 Pain Dimension, with an estimated mean CfB of 35.60 (95%CI: 38.73, 32.48; p &amp;lt; 0.001) and -27.37 (95%CI: 30.50, 24.25; p = 0.001) for the 200mg+ABT and 75mg group, respectively. Both doses did not provide significant improvements in dyspareunia. Limitations, reasons for caution We report data of the EDELWEISS 3 study for up to Month 6. An extension study of this trial will provide more information on the sustained effect and potential symptom recurrence after stopping treatment. Wider implications of the findings The linzagolix 200mg+ABT group provided substantial improvement in endometriosis-associated pain symptoms. The 75mg dose was less effective but demonstrated still marked improvements. There exists an substantial need for different treatment regimens in women suffering from endometriosis. Trial registration number NCT03992846

Physical Health-Related Quality of Life Improves over Time in Post-COVID-19 Patients: An Exploratory Prospective Study.

(1) Background: Ongoing symptoms after mild or moderate acute coronavirus disease 19 (COVID-19) substantially affect health-related quality of life (HRQoL). However, follow-up data on HRQoL are scarce. We characterized the change in HRQoL over time in post-COVID-19 patients who initially suffered from mild or moderate acute COVID-19 without hospitalization. (2) Methods: Outpatients who visited an interdisciplinary post-COVID-19 consultation at the University Hospital Zurich and suffered from ongoing symptoms after acute COVID-19 were included in this observational study. HRQoL was assessed using established questionnaires. Six months after baseline, the same questionnaires and a self-constructed questionnaire about the COVID-19 vaccination were distributed. (3) Results: In total, 69 patients completed the follow-up, of whom 55 (80%) were female. The mean (SD) age was 44 (12) years and the median (IQR) time from symptom onset to completing the follow-up was 326 (300, 391) days. The majority of patients significantly improved in EQ-5D-5L health dimensions of mobility, usual activities, pain and anxiety. Furthermore, according to the SF-36, patients showed clinically relevant improvements in physical health, whereas no significant change was found regarding mental health. (4) Conclusions: Physical aspects of HRQoL in post-COVID-19 patients relevantly improved over 6 months. Future studies are needed to focus on potential predictors that allow for establishing individual care and early interventions.

The relationship between women’s sexual function and type of delivery and pelvic organ prolapse: A cross-sectional study

ABSTRACTs The probable relationship between type of delivery and postpartum sexual function is one of the reasons behind women’s tendency to cesarean. This study was performed with 250 women participants. Female Sexual Function Index and examination form were used to determine pelvic organ prolapse and its severity and type based on POP-Q. Our results showed the difference between the mean performance score in the dimensions of desire (p = .19), lubrication (p = .08), orgasm (0.13), pain (p = .08), and satisfaction (p = .06) was not significant in the two groups of vaginal delivery and cesarean, but the difference between the mean score of sexual function in the dimension of total score (p = .002) was significant in the two groups. Regarding the relationship between sexual function and pelvic organ prolapse, the total score of sexual function in women with uterine, cystocele, and rectocele prolapse was significantly lower (p < .001). Researchers should work to provide more evidence on relationship of female sexual function and the type of delivery and pelvic organ prolapse.

Pain in Parkinson disease: mechanistic substrates, main classification systems, and how to make sense out of them.

Parkinson disease (PD) affects up to 2% of the general population older than 65 years and is a major cause of functional loss. Chronic pain is a common nonmotor symptom that affects up to 80% of patients with (Pw) PD both in prodromal phases and during the subsequent stages of the disease, negatively affecting patient's quality of life and function. Pain in PwPD is rather heterogeneous and may occur because of different mechanisms. Targeting motor symptoms by dopamine replacement or with neuromodulatory approaches may only partially control PD-related pain. Pain in general has been classified in PwPD according to the motor signs, pain dimensions, or pain subtypes. Recently, a new classification framework focusing on chronic pain was introduced to group different types of PD pains according to mechanistic descriptors: nociceptive, neuropathic, or neither nociceptive nor neuropathic. This is also in line with the International Classification of Disease-11, which acknowledges the possibility of chronic secondary musculoskeletal or nociceptive pain due to disease of the CNS. In this narrative review and opinion article, a group of basic and clinical scientists revise the mechanism of pain in PD and the challenges faced when classifying it as a stepping stone to discuss an integrative view of the current classification approaches and how clinical practice can be influenced by them. Knowledge gaps to be tackled by coming classification and therapeutic efforts are presented, as well as a potential framework to address them in a patient-oriented manner.

ID: 221649 Sleep and Physical Activity From Wearables as Alternatives to Pain Scales Throughout the Trial-Through-Implant Journey

Pain therapies have traditionally been assessed using subjective rating scales of pain intensity. These rating scales can be influenced by external factors and may not capture improvements in the affective/motivational dimension of pain and related physical, mental, and social well-being [1,2]. Furthermore, the thoughts and behaviors associated with pain are believed to be more influential on disability and quality of life than the perception of pain itself [3]. In this clinical trial, commercially-available wearable biosensors are used to objectively monitor patient physiology and behaviors as alternative outcome measures across the patient’s journey from therapy trial through post-implant use.