Linear Visual Analogue Scale Research Articles

Associations between changes in habitual sleep duration and lower self-rated health among COVID-19 survivors: findings from a survey across 16 countries/regions

BackgroundSelf-rated health (SRH) is widely recognized as a clinically significant predictor of subsequent mortality risk. Although COVID-19 may impair SRH, this relationship has not been extensively examined. The present study aimed to examine the correlation between habitual sleep duration, changes in sleep duration after infection, and SRH in subjects who have experienced SARS-CoV-2 infection.MethodsParticipants from 16 countries participated in the International COVID Sleep Study-II (ICOSS-II) online survey in 2021. A total of 10,794 of these participants were included in the analysis, including 1,509 COVID-19 individuals (who reported that they had tested positive for COVID-19). SRH was evaluated using a 0-100 linear visual analog scale. Habitual sleep durations of < 6 h and > 9 h were defined as short and long habitual sleep duration, respectively. Changes in habitual sleep duration after infection of ≤ -2 h and ≥ 1 h were defined as decreased or increased, respectively.ResultsParticipants with COVID-19 had lower SRH scores than non-infected participants, and those with more severe COVID-19 had a tendency towards even lower SRH scores. In a multivariate regression analysis of participants who had experienced COVID-19, both decreased and increased habitual sleep duration after infection were significantly associated with lower SRH after controlling for sleep quality (β = −0.056 and −0.058, respectively, both p < 0.05); however, associations between current short or long habitual sleep duration and SRH were negligible. Multinomial logistic regression analysis showed that decreased habitual sleep duration was significantly related to increased fatigue (odds ratio [OR] = 1.824, p < 0.01), shortness of breath (OR = 1.725, p < 0.05), diarrhea/nausea/vomiting (OR = 2.636, p < 0.01), and hallucinations (OR = 5.091, p < 0.05), while increased habitual sleep duration was significantly related to increased fatigue (OR = 1.900, p < 0.01).ConclusionsChanges in habitual sleep duration following SARS-CoV-2 infection were associated with lower SRH. Decreased or increased habitual sleep duration might have a bidirectional relation with post-COVID-19 symptoms. Further research is needed to better understand the mechanisms underlying these relationships for in order to improve SRH in individuals with COVID-19.

Visual art on psychological anxiety in film and television animation scene design

BackgroundThe negative emotions of anxiety can cause a decrease in the body’s immune system, and endocrine disorders, and lead to cardiovascular diseases. Therefore, improving psychological anxiety is of great necessity in the current social context.Subjects and MethodsTo explore the impact of visual art on psychological anxiety in the design of film and television animation scenes, 286 random platelet donors were selected and divided into a control group and an observation group. The observation group watched the selected film and television animations during platelet donation, while the control group did not watch the images. During the donation process, the anxiety scores of the two groups were recorded using the State Anxiety Inventory (SAI), and the heart rate and pain values of the two groups were recorded using a desktop sphygmomanometer and a linear visual analog scale (VAS).ResultsThere was no significant difference in physiological and psychological indicators among the control group, with an anxiety score of (42.02 ± 0.40) kPa, a heart rate of (72.46 ± 8.13) beats/min, and a pain score of (2.35 ± 0.66) points. The anxiety score of the observation group was (35.49 ± 7.67) kPa, the heart rate was (70.67 ± 8.46) beats/min, and the pain score was (1.98 ± 2.64) points.ConclusionsThe difference between the two groups was statistically significant (P&lt;0.05). Therefore, visual art in film and television animation scene design has a positive impact on psychological anxiety.

The Effect of Knee Joint Muscles Deep Dry Needling on Pain and Function in Patients After Total Knee Arthroplasty

Objective Osteoarthritis is one of the most common knee joint diseases. It is a multifactorial, inflammatory, and destructive disorder of the joint that involves the synovial tissues and joint cartilage and causes permanent pain, functional limitations, and a decrease in patients’ quality of life (QoL). In advanced cases of the disease, total knee arthroplasty is performed to reduce pain and improve the function of the patients. The presence of pain after this surgery is a major concern that reduces the QoL of these people. One of the causes of pain after surgery is extra-articular pain and involvement of the musculoskeletal system, the most common cause of which is pain caused by active trigger points. Dry needling is one way to deactivate trigger points. This study aimed to investigate the effects of dry needling on the pain intensity and function of patients with active trigger points in the muscles around the knee after total knee arthroplasty. Materials &amp; Methods This research was a before-and-after clinical trial study. In this study, 49 patients aged 55 to 80 years, with at least 3 months past their total knee arthroplasty and still having pain, were included by an orthopedic specialist after reviewing the inclusion and exclusion criteria. After the first researcher considered the inclusion and exclusion criteria and the presence of active trigger points in the muscles around the knee, including the quadriceps, hamstring, and gastrocsoleus, 27 patients were qualified. The amount of pain in these patients before, one week, and one month, after dry needling was measured and compared based on the linear visual analog scale. Also, the performance of the patients was assessed based on the knee injury and osteoarthritis outcome score questionnaire. This study aimed to investigate the short-term effects of dry needling on pain intensity and function of patients with active trigger points in the muscles around the knee after total knee arthroplasty. Results The results of this study show a significant difference (P&lt;0.001) between the amount of pain before dry needling (57.2±8.9) and one week after dry needling (10.8±33.6). Also, there is a significant (P&lt;0.006) difference between the performance of patients before dry needling (47.5±11.9) and one week after dry needling (42.3±10.6). No significant difference was observed regarding pain and performance between one week and one month after dry needling. Conclusion Performing one dry needling session on the active trigger points of the muscles around the knee after total knee arthroplasty reduces pain and improves patients’ performance.

Efficacy and safety of low concentration hydrogen peroxide as nasopharyngeal lavage fluid in the treatment for nasopharyngeal carcinoma radiotherapy: a pilot cohort study.

Purpose: This study aimed to evaluate and analyze the efficacy and safety of low concentration (0.15%) hydrogen peroxide as nasopharyngeal lavage fluid in the treatment for nasopharyngeal carcinoma radiotherapy. Methods: Patients with nasopharyngeal carcinoma from Jiangxi cancer hospital were randomly divided into two cohorts. The training cohort (n= 50) received low concentration (0.15%) hydrogen peroxide as nasopharyngeal lavage fluid in the treatment for nasopharyngeal carcinoma radiotherapy, and the control cohort (n= 50) received 0.02% nitrofurazone lavage fluid. The primary endpoint of the study was result of short-term efficacy. Second endpoints were assessment of the linear visual analogue scale score and the incidences rate of nasopharyngeal radiation related toxicity. Results: All patients had completed the scheduled nasopharyngeal radiotherapy except two patients in control cohort. The complete response, partial response, stable disease and disease objective response of nasopharyngeal primary tumor observed in the training cohort included 18 cases, 23 cases, 9 cases and 41 cases respectively, while in the control cohort 20 cases, 25 cases, 5 cases and 45 cases were recorded, respectively. The study showed a significant discrepancy in the incidence rate of radiation-related mucosa damage between the two. Specifically, Grade 1 and 2 included 37 cases (74.0%) in the training cohort, while in the control cohort the cases were 20 (40.0%). Grade 3 and 4 damage however reported an incidence of 26.0% and 60%, respectively, which clearly constitutes a significant statistical difference (P = 0.002). The assessment of linear visual analogue scale showed that the patients self-conscious comfortable feeling in the training cohort were significantly higher than in the control cohort (P = 0.003). Conclusions: low concentration (0.15%) hydrogen peroxide as nasopharyngeal lavage fluid in the treatment for nasopharyngeal carcinoma patients is effective and safe, and can reduce nasopharyngeal local mucosa radiation related toxicity after radiotherapy.

Covert contrasts and categorical perception: a comparison of two measurement tools

ABSTRACT This study considers adults’ perception of subtle differences in the error productions of /r/ and /l/ in young children. Given that these two phonemes share a common substitution [w], the potential covert contrast between these three sounds was investigated. The utility of two perceptual rating scales was compared: a linear visual analogue scale (VAS) and a triangular scale that considered the possibility of covert contrast among /r,l,w/. Adult listeners rated speech productions from children with cochlear implants (CIs) and speech age-matched children with normal hearing (NH) as they produced VCV or CV productions with /r,l,w/ in syllable-initial position. Mahalanobis distances of the listener ratings for each stimulus on each rating scale were calculated for analysis. Ultimately, there was no difference between the ratings of the two speaker populations. However, there was a significant difference in the amount of variability captured with each scale. The triangular scale reliably captured more variability in the productions than the linear VAS. The significant effect of scale type on the spread of listeners’ responses provides support for the claim that the type of rating system used can capture different aspects of a listener’s perceptions, thereby suggesting that the type of rating system used in a study may significantly influence that study’s findings.

Comparative analysis of visual analog scales for assessing acute pain in women after radical mastectomy

BACKGROUND: Effective quantitative assessment of acute pain as an urgent problem in clinical medicine. One of the solutions to this problem is a color discrete scale (CDS).&#x0D; AIM: To determine the efficacy of the clinical usage of color discrete scale compared with linear visual analog scale to assess acute pain in women after radical mastectomy.&#x0D; MATERIALS AND METHODS: This study includes a prospective, observational, and non-randomized clinical trial. A total of 110 females who underwent radical mastectomy (RM) were interviewed. We used a 100-point linear visual analog scale (lVAS) and CDS with monotonic (mCDS) and random (rCDS) color arrangement. Pain was assessed 2, 6, 12, 24, 48, and 72 h after surgery.&#x0D; RESULTS: Pain scores obtained 2 h after RM were 6 (0; 30), 12 (0; 24), 8 (0; 20) points according to IVAS, mCDS, and rCDS, respectively (p 0.05). Furthermore, the pain scores were gradually reduced on all three scales and had no statistically significant difference (p 0.05). In women who underwent paravertebral blockade (PVB), pain scores were significantly less at 2, 6, 12, and 48 h after surgery (p 0.05). Spearmans correlation coefficient for lVAS and mCDS is 0.90, 0.86 for lVAS and rCDS, and 0.90 for mCDS and rCDS (all p 0.05).&#x0D; CONCLUSIONS: The CDS is an alternative, independent, and sufficient tool for quantifying pain. A strong correlation was found between the pain assessments according to CDS and lVAS. PVB significantly improves the quality of pain relief after RM.

Classification of endonasal HHT lesions using digital microscopy

BackgroundRecurrent spontaneous epistaxis is the most common clinical manifestation and the most debilitating symptom in hereditary haemorrhagic telangiectasia (HHT) patients. To this date, there exist only a classification of HHT patients by different genetic mutations. There is no standard classification for the mucocutaneous endonasal manifestations of HHT. The aim of the present study was to document the variety of endonasal HHT lesions using digital microscopy and to propose a clinical classification.MethodsWe recorded the endonasal HHT lesions of 28 patients using a digital microscope. We reconstructed the 3D images und videos recorded by digital microscope afterwards and classified the endonasal lesions of HHT in two classes: Grade A, presence of only flat telangiectasias in the mucosa level and Grade B, (additional) presence of raised berry or wart-like telangiectasia spots. We investigated also Haemoglobin level by routine laboratory procedures, plasma VEGF level by ELISA, Severity of epistaxis by epistaxis severity score (ESS) and quality of life by a linear visual analogue scale (VAS).ResultsWe found a higher quality of life and a lower severity of epistaxis in Grade A patients in comparison to Grade B patients. No difference in plasma VEGF level and in Haemoglobin between Grad A patients and Grade B patients could be detected. Plasma VEGF levels showed no gender specific differences. It could also not be correlated to the extranasal manifestation.ConclusionThe classification for endonasal manifestation of HHT proposed in this study indicates severity of epistaxis und quality of life. Digital microscopy with the ability of 3D reconstruction of images presents a useful tool for such classifications. The classification of endonasal HHT lesions using digital microscopy allows to evaluate the dynamic of HHT lesions in the course of time independent of examiner. This allows also to evaluate the efficacy of the different treatment modalities by dynamic of HHT lesions. Moreover digital microscopy is very beneficial in academic teaching of rare diseases.

Comparison of pain and proper sample status according to usage of tenaculum and analgesia: a randomized clinical trial.

ObjectiveColposcopic biopsy is a discomfortable procedure. Additionally, it creates negative influence on sexuality. This study aimed to investigate the relationships among tenaculum, pain perception, and biopsy size during colposcopy.MethodsIn total, 228 patients who underwent colposcopy-directed biopsy were included, and randomized into 4 groups based on whether analgesic and tenaculum were used and replaced (tenaculum with n=58/without analgesic n=56, no tenaculum replacement with n=57/without analgesic n=57). Lidocaine hydrochloride (40 mg) plus adrenaline (0.025 mg) was administered in the analgesic groups. The pain was assessed using a linear visual analog scale. The biopsy specimen size was measured in millimeters.ResultsThe mean age of the patients was 42.85±8.88 years. The most frequent colposcopy indications were atypical squamous cells of undetermined significance and human papilloma virus-positive results on cervical cytology (30.2%; n=69). Low- and high-grade intraepithelial lesions were noted in 14.91% (n=34) and 10.96% (n=25) women through colposcopy-directed biopsy results, respectively. Tenaculum replacement increased pain perception in the without analgesic group; however, no statistically significant differences were noted between of the groups with and without tenaculum replacement with analgesic. The size and number of biopsy specimens were not associated with tenaculum replacement and analgesic use.ConclusionAdministration of analgesics decreased discomfort and pain in patients. Tenaculum replacement aided colposcopists in manipulating the cervix. Additionally, administration of analgesics relieved pain in the tenaculum replacement group.Trial RegistrationClinicalTrials.gov Identifier: NCT03279666

Extracorporeal shock wave therapy for treatment of vulvodynia: a prospective, randomized, double-blind, placebo-controlled study.

Currently, there are no effective therapy strategies for idiopathic, non-organic vulvodynia in women. ESWT (extracorporeal shock wave therapy) is a nonsurgical/noninvasive technique widely used to treat musculoskeletal diseases, muscle spasticity and hypertonia, renal and biliary calculi and urological disorders. We examined the effects of ESWT on vulvodynia in women. A prospective, randomized, double-blind, placebo-controlled study was conducted between 2015 and 2018 following a feasibility study. Obstetrics and Gynecology Hospital departments. The study included 62 women with vulvodynia for at least 3 months. The women were randomly assigned to either a treatment group (N.=31) or a placebo group (N.=31). The patients in the treatment group received perineally applied ESWT weekly (3000 pulses each for four consecutive weeks). The energy flux density was 0.25 mJ/mm2, frequency 4 Hz, focus zone 0-30 mm, therapeutic efficacy 0-90 mm, stand-off II. The device used was a standard electromagnetic shock wave unit with a focused shock wave handpiece. The position of the shock wave transducer was changed six times after every 500 pulses. Patients in the placebo group underwent the same treatment procedure, but the handpiece was provided with a placebo stand-off that disabled energy transmission. Subjective pain was self-evaluated by each patient using two tools before and after treatment: a 10 cm linear visual analogue scale (VAS, 0-10) and a cotton-swab test (CST, Goetsch scale 0-4). Follow-ups were done 1, 4, and 12 weeks post-ESWT. In all, 61 women completed the study. We tested for differences in the VAS and CST within and between the treatment and placebo groups. The testing was between before treatment and particular follow-up. We found significant changes in the treatment group. Reductions in VAS (P<0.01) and CST (P<0.01) were observed at all three follow-ups. At all assessments, pain reduction was always >30%. In the placebo group there were no statistically significant changes between before and after treatment. There were no differences between the treatment and placebo groups before treatment but statistically significant differences at all three follow-ups (VAS P<0.01); CST P<0.01). ESWT seems to reduce pain perception in our treatment group. Thus, we are encouraged to explore this technique further. The method is easily replicable, inexpensive, and without known side effects.

The Use of Magnetic Seeds and Radiofrequency Identifier Tags in Breast Surgery for Non-palpable Lesions.

Wire-guided localisation (WGL) remains the most widely used technique to guide surgical excision of non-palpable breast lesions worldwide. However, recent technological advances have led to the advent of less invasive radiation-free localisation methods to overcome the limitations of WGL. This study prospectively evaluated the role of two radiation-free non-wire localisation methods. Magnetic seeds (n=16) and radiofrequency tags (n=6) were deployed under imaging guidance to guide the surgical excision in 19 consecutive patients. The identification/retrieval and migration rates were 100% and 4.5%, respectively. Twenty-one out of 22 (95.5%) cases had clear surgical margins and no complications were observed. All radiologists and the surgeon rated these methods as being much better than wire localisation. Patient satisfaction data were recorded using a linear visual analogue scale (n=10/19). The mean score was 9.7/10 (range=8-10). Our study provides further evidence that radiation-free wireless breast localisation is an effective alternative to WGL.

Five year long term results of total joint arthroplasties in the treatment of trapeziometacarpal osteoarthritis.

Introduction: Trapeziometacarpal (TMC) osteoarthritis is a common disease. Patients with advanced disease who have failed conservative treatment have different surgical options, including total joint prosthesis. The aim of this study was to investigate the long-term outcome and complications of trapeziometacarpal (TMC) total arthroplasty. Materials and Methods: One hundred and forty-seven patients with TMC osteoarthritis were surgically treated with TMC arthroplasty, and one hundred and thirty-seven patients were seen for follow-up (102 women and 35 men). At follow -up patients were asked to complete a visual linearanalogue scale (VAS) for satisfaction with the result of the operation and persisting pain from the thumb, the Spanish validated Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate function of the affected hand.(9) The radiological examination consisted of posterior-anterior and oblique radiographs. In preoperative radiographs Eaton-Little was used, and in postoperative radiographs were assessed with regard to implant loosening and alignment. Results: The subjective outcome was satisfactory in 126 cases (92 %), 14 (12 %) patients would undergo the same procedure in the other hand. The DASH questionnaireswere 19.55 (range 5.6-33,5) on average, and EVA was 1 on average. The mean key pinch strength was 5.8 Kg at 5 years follow-up. The most frequent postoperative complication was De Quervain tenosynovitis (21%), other complications were: Cup loosening (3.6%), traumatic dislocation (3,6%). The prosthesis was removed in nine cases (7%). There were four intraoperative complications. The survival rate for ARPE prosthesis was 92,7% at 60,5 months. TMC total arthroplasty offers a reliable treatment alternative in patients with thumb carpometacarpal joint osteoarthrosis which conservatives’ treatment had failed. Conclusions: The TMC joint prosthesis is an option for patients with TCM osteoarthritis, provides satisfactory outcomes and has a low failure rate.(www.actabiomedica.it)

Clinical Efficacy in Relieving Dentin Hypersensitivity of Nanohydroxyapatite-containing Cream: A Randomized Controlled Trial.

Objective: The study aimed to investigate the effectiveness of Apadent Pro (Sangi) Nanohydroxyapatite (nHAP) dental cream to relieve Dentin Hypersensitivity (DHS), compared with a positive control cream containing 20% pure silica (Silica).Methods:In this double-blind, randomized, parallel-group clinical trial, patients diagnosed with DHS and qualified to participate were randomized into two groups, nHAP (n=25) and Silica (n=26). Subjects’ baseline and posttreatment sensitivity were assessed using two pain scales, a four-point Dental Pain Scale (DPS) followed by a linear Visual Analog Scale (VAS), after the application of ice-cold and air stimuli. Subjects used custom-fabricated trays to apply their respective cream for 5 minutes once daily following brushing with standard fluoride toothpaste. Posttreatment sensitivity (efficacy) was assessed every 2 weeks for 8 weeks. Mean treatment outcomes (percentage change from baseline) at each time point were compared using the Tukey HSD test for multiplicity (P<0.05).Results:With either air or cold stimulus, VAS and DPS indicated a significant (P<0.001) reduction in DHS at each time point with either nHAP or Silica. Comparing pain scales, VAS showed no significant difference in DHS reduction between the products with either air or cold. However, with DPS, DHS reduction was significantly (P<0.05) better with Silica than with nHAP at all time points with cold, and at 2, 4, and 8 weeks with air.Conclusion:Both Apadent Pro nHAP and Silica dental creams are effective at promoting the relief of DHS symptoms. When comparing the efficacy of the two compounds to relieve DHS, results of the two pain scales were conflicting.

Is there still a role for the uniscale assessment of quality of life?

To obtain proof of external validity of the visual analogue scale and re-evaluate the use of this instrument in assessing cancer patients' quality of life. Consecutive patients attending 79 Italian medical oncology and radiotherapy centers over a period of 1 week were asked to fill out both a questionnaire concerning the presence of 19 problems and a 100-mm linear visual analogue scale evaluating their quality of life. Quality of life was rated as "good" and "bad" when given a score of 70-100 and 0-30, respectively. Multifactorial logistic models were used where good and bad quality of life were correlated with explanatory variables including patient and disease characteristics and the presence or absence of the 19 problems. Gender, level of education, treatment setting, Karnofsky performance status, disease extent, and the presence of 12 out of 19 problems were found to be correlated with good quality of life. A similar pattern of correlations was found with bad quality of life. Due to the difficulties in attaining reliable assessment of quality of life using psychometric questionnaires, the further proof of validity obtained in this study allows us to propose the re-evaluation of the role of the uniscale in measuring the quality of life of cancer patients.

BLOCKADE OF THE PERIPHERAL NERVES IN THE ANESTHETIC MANAGEMENT OF NEUROSURGICAL INTERVENTIONS ON THE HEAD

Objective: to evaluate the effectiveness of peripheral nerve blockades innervating the scalp, in combination with general anesthesia in intra- and postoperative analgesia in patients with neurosurgical interventions. Materials and methods. The efficiency of 105 blockages of the peripheral nerves of the scalp in 18 patients with neurosurgical interventions on the head was evaluated. The age of the patients was 47.5 ± 15.5 years. Patients were operated on for intracranial traumatic and non-traumatic hematomas, brain tumors and the need for plastic of postoperative skull defects. The technique of blockade of the nerves of the head is described: supratrochlear, supraorbital, zygomaticotemporal, auriculotemporal, greater auricular, greater and lesser occipital nerves. The technique of ultrasound imaging of the great occipital and auriculotemporal nerves is presented. Results. In all 18 patients, according to intra- and postoperative monitoring, adequate anesthesia was provided. In 2 of 18 patients, an additional fentanyl injection was required to skin incisiondue to an increase in blood pressure and heart rate by 25% of the baseline values, and an increase in CSI until 82 units. The volume of local anesthetic for blockade in one patient was 7.68 ± 1.67 ml of ropivacaine or of bupivacaine. Time for blockade in one patient was 11.4 ± 4.0 minutes. The intensity of pain on a linear visual analog scale in the first day was 0.3-2 points. Conclusion. Blockages of the peripheral nerves of the head were effective in 16 (88.9%) of 18 patients. The safety of blockades was provided by using small volumes (7.68 ± 1.67 ml ) of 0.75-1.0% solution of ropivacaine or 0.5% solution of bupivacaine.

The Analgesic Efficacy of Paracetamol Versus Ketorolac in Day-case Gynaecological Laparoscopic Procedure: A Comparative Study

Background: Gynaecological laparoscopy is a commonly performed procedure. Providing anesthesiafor this can present a challenge, particularly in the day surgery population. Poor analgesia, nausea andvomiting can cause distress to the patient and increased cost for the health system, because of overnightadmission. In this review we discuss anesthetic and analgesic techniques for day case gynaecologicallaparoscopy. Objectives: Our study is undertaken to compare the efficacy of intravenous paracetamol versus ketorolacfor post operative analgesia after gynaecological day case laparoscopic procedures. Method: Sixty (60) female patients 20 – 40 years of age, of ASA I/II were randomized into two equalgroups of 30 patients each. Patients of group A received intravenous paracetamol 1gm and group Breceived intravenous ketorolac 30mg just after induction of general anesthesia. Postoperative pain wasevaluated by standard 10cm linear visual analogue scale (VAS) at different time intervals. When VAS wasmore than 3 rescue analgesic 50mg tramadol intravenously stat was given. Results: In group A that was paracetamol group and group B that was ketorolac group the visual analoguescale (VAS) almost similar but total analgesic consumption in ketorolac group were slightly higher thanparacetamol group. In paracetamol group 4 patients and in ketorolac group 6 patients required rescueanalgesic dose. Conclusion: Our results indicate that IV paracetamol has better analgesic potency than IV ketorolac forpostoperative analgesia after day case gynaecological laparoscopic procedure. JBSA 2017; 30(2): 90-95

Rehabilitation of Eyelid Malpositions Secondary to Facial Palsy.

Objectives:To evaluate patient satisfaction and outcomes of surgical treatment of eyelid malpositions secondary to facial palsy.Materials and Methods:Consecutive patients with facial palsy who underwent surgical treatment by the same surgeon at İzmir Katip Çelebi University Atatürk Training and Research Hospital between Jan 2007 and Dec 2012 were included in the study. Ophthalmic examination findings, surgical approaches, and their outcomes were evaluated. A successful result for upper eyelid position was defined as more than 50% reduction in lagophthalmos and induction of less than 2 mm of ptosis. A successful outcome for lower eyelid position was defined as the lower eyelid residing at or within 1 mm above or below the limbus. Linear visual analog scale 1 (VAS-1) (subjective complaints) and VAS-2 (cosmetic outcome), both ranging from 0 to 10, were used to compare preoperative findings with findings at last postoperative visit.Results:The mean age of the 14 female and 21 male patients was 54.5±19.9 years. Gold weight implantation (n=31), lateral tarsal strip (n=22), tarsorrhaphy (n=15), suborbicularis oculi fat elevation (n=16), hard palate graft (n=14), and eyebrow ptosis repair (n=6) were performed. Average follow-up time was 17.9±16.9 months (range, 2-60). Surgical success rates were 90% for upper lids and 75% for lower lids. Mean lagophthalmos decreased from 7.1±2.7 mm to 1.6±1.6 mm postoperatively (p=0.000). The use of lubricating drops and gels was reduced from average preoperative daily values of 5.3±2.5 drops and 1.3±0.6 gel applications to 4.4±1.4 and 0.6±0.6, respectively (p=0.003, p=0.001).Conclusion:An individualized surgical approach tailored according to each patient’s severity of facial palsy and associated malpositions resulted in both functional and aesthetic improvements in our patients.

Korean version of the Cough Symptom Score: clinical utility and validity for chronic cough

Background/AimsThe Cough Symptom Score (CSS) is a simple, useful tool for measuring cough severity. However, there is no standard Korean version of the CSS. We developed a Korean version of the CSS and evaluated its clinical utility and validity for assessing chronic cough severity.MethodsThe CSS was adapted for Korean use following a forward-backward translation procedure. Patients with chronic cough enrolled from five university hospitals were graded using the CSS and a 100-mm linear visual analog scale (VAS) of cough severity at each visit. Patients completed the Leicester Cough Questionnaire (LCQ) upon presentation and completed the LCQ and Global Rating of Change at follow-up visits after 2 to 4 weeks. The concurrent validity, repeatability, and responsiveness of the Korean version of the CSS were determined.ResultsCorrelation coefficients between the CSS and LCQ, and between the CSS and VAS, were –0.66 and 0.52, respectively. There was a weak correlation between the scores for night and day symptoms (r = 0.24, p = 0.0006). The repeatability of the CSS in patients with no change in cough (n = 23) was high (intra-class correlation coefficient, 0.75; 95% confidence interval [CI], 0.51 to 0.88). Patients who reported an improvement in cough (n = 30) at follow-up visits had a significant improvement in the CSS (median, –2; 95% CI, –3 to –1; p = 0.0003).ConclusionsThe Korean version of the CSS correlated well with other tools for accessing cough severity in chronic cough patients. Therefore, it could be a reliable method for measuring chronic cough severity.

Retrospective evaluation of the effects of periprostatic local anesthesia on recurrent prostate biopsy.

The aim of the study was investigate the pain palliation effect of 2% dose of lidocaine on the periprostatic nerve block in prostate biopsy patients. Extended (12 cores) and saturation (22 cores) biopsy patients were included. The patients were separated into three groups: extended biopsy patients (Group I), saturation biopsy patients (Group II), and control group patients undergoing a biopsy procedure for the first time (Group III). All patients received 2% lidocaine (10 mL) on both the seminal vesicular junction and apex of the prostate with transrectal ultrasonography guidance. Following the procedure, the pain levels of patients were assessed using a 10-cm linear Visual Analog Scale (VAS). Following the procedure, the VAS values of each group were 2.96±1.06, 3.2±1.47, and 2.93±0.94, respectively (p>0.05). While the highest pain score was seen in the saturation group patients (II), the lowest pain level was seen in the control biopsy group (III). However, no statistical di erence was observed among the groups. Herein, we observed that a local injection using 2% lidocaine was effective as local anesthetic in recurrent prostate biopsies. In addition, it was found that the pain level increases as the number of cores taken in recurrent prostate biopsies increases; however, this has not been established statistically.

Results of the First American Prospective Study of IV Iron in Oral Iron Intolerant Iron Deficient Gravidas

▪ INTRODUCTIONHerein we present safety and efficacy results of the first American prospective study of intravenous (IV) iron (Fe) for oral (PO) Fe intolerant patients with iron deficient anemia (IDA) in the 2nd or 3rdtrimester (IND 114696, ClinTrials.gov NCT 02038023). Anemia affects up to 42% of gravidas. Neonatal Fe deficiency (ID) is associated with low birth weight, delayed growth, development and statistically significant increment in cognitive and behavioral abnormalities up to 10 years after Fe repletion. Although PO Fe is simple to use, inexpensive, up to 70% of gravidas to whom it is prescribed report significant gastrointestinal (GI) side effects. The availability of formulations convenient to administer in a brief single setting with favorable side-effect profiles may help decrease rates of anemia in pregnancy and improve hemoglobin (Hb) responses, maternal and fetal outcomes in women intolerant of, or unresponsive to, PO Fe. METHODSWe treated 74 women with a Hb concentration <10.5 g/dl during the 2nd or <11.0 g/dl in the 3rd, with laboratory evidence of IDA (serum ferritin <20 ng/ml and/or % transferrin saturation (TSAT) <16%). A questionnaire with historical questions of metallic taste, gastric cramping, worsening or onset of constipation was administered to document PO Fe intolerance before enrollment. Women diagnosed during the 1st trimester were eligible for inclusion, however due to a lack of published 1st trimester safety, IV Fe infusion was delayed until beginning of 2nd. All received 1,000 mg LMWID (INFeD, Allergan, CA) diluted in 250 ml of normal saline. 15 minutes after a 25 mg test dose administered over 2 minutes, the remainder was infused over the balance of 1 hour. Subjects were observed for 1 hour for signs of acute hypersensitivity and called at 24, 48 hours and 7 days later to assess delayed reactions. Prior to treatment a visual linear analog scale analysis (LASA) for energy and activity was completed. 4 weeks post- infusion or post-partum depending on confinement, a follow-up visit for Hb levels, Fe parameters (TSAT and serum ferritin) and repeat LASA were performed. Paired T-test was used to assess changes in Hb and Fe parameters, and the Wilcoxin Signed-Rank Test for LASA changes. Following accrual of the final subject 58/73 were contacted and questioned for abnormalities in growth or development of their babies. RESULTS73 of 74 enrolled subjects were treated. 1 experienced a minor infusion reaction (facial flushing) and requested treatment on another day. 72 hours later, labor commenced. 2 months post-partum IV Fe was given off study. Follow-up data were available in 58/73 subjects. The mean pre and post treatment Hb concentrations were 9.8 (SD 0.74) and 10.8 (SD 1.30) g/dl respectively (P<0.00001). The mean pre and post TSATs were 11.6 (SD 8.72) and 23.2 and the mean pre and post serum ferritins were 14.2 (SD 22.96) and 129.4 (SD 89.48) ng/mL. respectively (P<0.000001 for both). Data for 58 infants was available; one was low on its growth charts for 11 months after which the curve normalized. The remaining 57, ages 6 weeks to 3 years, were all normal with no evidence of any developmental or growth lag. None were diagnosed with IDA. 6 (8%) experienced minor self-limited infusion reactions consisting of facial flushing or myalgias of the chest or back. All resolved without therapy. 5 of 6 received the planned therapy. 2 developed mild myalgias and headache 24 hours after the infusion, with complete resolution at 48 hours. 85% reported improvements on repeat LASA (P<0.01). DISCUSSIONThe high prevalence of IDA in gravidas and its association with adverse maternal and infant outcomes, with a reported 2-fold increment of preterm labor and 3-fold increase in low birth weight, is concerning. PO Fe, the current standard, is fraught with GI toxicity and poor adherence in up to 70% to whom it is prescribed. Our prospective data corroborate a litany of studies, that IV Fe is a safe, effective and convenient method of Fe repletion. No significant adverse events have been reported. 96% had significant improvements in Hb, and 85% energy and activity. No adverse fetal outcomes were observed. The improved side effect profile of IV formulations allowing Fe repletion in a single, brief visit supports moving IV iron closer to frontline. Compared to PO Fe, IV Fe has fewer side effects and nearly always effective. Our data and those of others call for large prospective studies of IV vs. PO Fe for therapy of maternal IDA. [Display omitted] DisclosuresAuerbach:AMAG Pharma: Consultancy, Research Funding; Pharmacosmos: Consultancy, Research Funding; American Regent/Luitpold: Consultancy.

A Novel Pain Alternative for Patients with Anorectal Pathologies: The Comparison of Transperineal Prostatic Blockage Technique with Periprostatic Nerve Blockage and Rectal Gel Technique in Initial Transrectal Ultrasound-Guided Prostate Biopsy - A Prospective, Randomized Trial

Introduction: The study aimed to compare the efficiency of periprostatic nerve blockage (PPNB) and intrarectal lidocaine gel (PPNB + gel) with a transperineal prostatic block (TPPB) technique during transrectal ultrasound-guided prostate biopsy (TRUS-PBx) in patients with anorectal pathologies. Materials and Methods: A total of 376 patients who underwent TRUS-PBx were randomized into 2 groups. Group-I (n = 198) received TPPB with 10 ml 2% prilocaine, and group-II (n = 178) received intrarectal administration of 10 ml 2% lidocaine gel followed by PPNB with 10 ml 2% prilocaine. A 10-point linear visual analogue scale (VAS) was used to assess the pain arising from probe insertion (VAS-1) and prostate sampling (VAS-2). Results: VAS-1 scores were significantly lower in group-I than group-II (1.7 ± 1.9 vs. 3.9 ± 1.5; p < 0.001). Combining local anesthesia produced superior pain control to TPPB during sampling (2.0 ± 1.2 vs. 2.5 ± 2.4; p = 0.015). Following subgroup analyses with reference to concomitant anorectal pathologies, VAS-1 scores were significantly lower in group-I than group-II (2.0 ± 1.8 vs. 5.5 ± 1.7; p < 0.001). VAS-2 scores were lower in group-II than group-I; however, the difference was not considered significant (2.4 ± 1.3 vs. 3.1 ± 2.8; p = 0.303). Conclusions: In all patients referred for TRUS-PBx, TPPB is a good alternative to PPNB + gel. TPPB can be particularly useful for patients with anorectal pathologies due to its improved pain reduction during probe insertion.