Main Cause Of Pain Research Articles

RETROSPECTIVE ANALYSIS OF PATIENTS PRESENTING TO OUR PAIN CLINIC WITHIN ONE YEAR

Objective: This study aims to retrospectively examine the demographic characteristics, main causes of pain, diagnoses and applied treatment methods of patients who applied to a pain clinic. It is expected that these data will contribute to the evaluation of current clinical practices and the development of more effective pain management strategies. Method: The study was conducted with a retrospective design between January 2023 and December 2023 with the approval of the ethics committee numbered B.30.2ATA.0.01.00./. During this period, the medical records of the patients who applied to the pain clinic were examined. The patients' (age, gender), reasons for application (pain localization) and treatment approaches (drug therapies, interventional procedures) were recorded. Results: When demographic characteristics were examined, 56.8% of the 1210 patients included in the study were female, 43.2% were male, and the mean age was determined as 47.42±20.56. When the complaints of the patients were examined, the reasons for application were back pain, leg pain and widespread body pain in order of frequency. In terms of treatment methods, the most frequently performed procedure was the plan block, followed by epidural analgesia. Conclusion: In our study, it was observed that the majority of patients applying to the pain clinic applied due to chronic pain and needed multidisciplinary treatment approaches. These data are important for the development of new strategies for pain management in clinical practices and for increasing patient satisfaction. It is recommended that more studies be conducted, especially on the effectiveness of interventional methods and the role of psychological support.

Prevalence of Asymptomatic Changes in the Groin Region Among Adult Professional Soccer Players and Their Association With Limb Dominance.

To investigate the prevalence of asymptomatic radiologic groin region findings in adult professional soccer players using magnetic resonance imaging (MRI) and examine the influence of age and limb dominance on their occurrences. Cross-sectional trial. Soccer club medical service, private practice. Forty-seven male professional soccer players. Players underwent a groin presigning MRI scan with a magnetic field induction of 1.5 Tesla. Image analysis of their pubic bones was performed according to The Copenhagen Standardized MRI protocol to assess the pubic symphysis and adductor regions of players. The prevalence of various changes in the symphysis, pubic bone, and adjacent areas. Fifty images of pubic bones and adjacent regions (53.2%) highlighted 1 to 4 changes, while another 44 images (46.8%) demonstrated 5 or more changes. The most frequent changes observed in the pubic bone were joint surface irregularities (100%), symphyseal sclerosis (93.6%), pubic bone swelling (56.3%), parasymphyseal high-intensity line (55.3%), fatty infiltration in bone marrow (38.3%), and adductor tendinopathy (34%). When comparing the prevalence of different changes in the dominant and nondominant limbs, no statistically significant differences were found. In adult professional soccer players with no prior groin pain complaints in recent history (12 months), asymptomatic changes are extremely common in the pubic joint and adjacent areas, including those that are very likely to be considered the main cause of pain when investigated in soccer players with groin pain. None of these changes were associated with limb dominance.

Bioinformatic analysis of differentially expressed genes in lung cancer bone metastasis and their implications for disease progression in lung cancer patients.

Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer-related death worldwide. Moreover, it is highly susceptible to distant metastasis, which is the main cause of pain in advanced lung cancer, and frequently occurs in the bone. This study aimed to identify the differentially expressed genes (DEGs) related to metastatic bone disease in lung cancer using bioinformatics methods and to analyze the risk factors influencing the incidence of secondary bone metastasis in lung cancer. Gene expression profiles from the GSE175601 and GSE10799 datasets in the Gene Expression Omnibus (GEO) database were analyzed to screen for the DEGs associated with lung cancer bone metastasis. The STRING database was used to construct a protein-protein interaction (PPI) network, and the MCODE plugin was used to identify the key genes. The expression of these important genes in lung tumor tissues and their correlation with prognosis were validated in The Cancer Genome Atlas (TCGA) database. An examination of clinical data from patients diagnosed with stage IV lung adenocarcinoma treated at the Anhui No. 2 Provincial People's Hospital was conducted. Immunohistochemistry was used to examine the expression of key genes in lung cancer tumor tissues. A binary logistic regression analysis was conducted to examine the interactions in the expression of critical genes associated with bone metastasis in lung carcinoma patients. In total, 59 DEGs were identified in the GSE175601 and GSE10799 datasets through Venn diagram construction. The PPI network analysis revealed two significant modules and eight candidate genes (LAPTM5, LCP2, CD53, ARHGAP25, C1QA, DES, MYH11, and VIM). According to TCGA database analysis, in carcinogenic tissues of the lung, the expression of these eight critical genes is downregulated. Further, only the lung cancer patients who had high expressions of ARHGAP25 had an improved progress-free interval (PFI) (P<0.05), disease-specific survival (DSS), and overall survival (OS). Of the 49 with stage IV lung adenocarcinoma patients included in the study, 27 (55.10%) developed bone metastasis. The immunohistochemical (IHC) results indicated that the expression score of ARHGAP25 was significantly lower in the group with bone metastasis (3.93±2.95) than the group without bone metastasis (6.64±3.62) (P=0.006). The proportion of patients with low ARHGAP25 expression was significantly higher in the group with bone metastasis (70.37%, 19/27) than the group without bone metastasis (31.82%, 7/22) (P=0.007). The binary logistic regression analysis identified serum alkaline phosphatase (ALP) and ARHGAP25 expression levels as independent risk factors for the occurrence of secondary bone metastatic disease in lung carcinoma patients. The key gene ARHGAP25 identified through bioinformatics for lung cancer bone metastasis was significantly downregulated. Its low expression constitutes an independent risk factor for secondary bone metastatic disease in patients with lung carcinoma.

Gynecological Laparoscopic Surgeries under Spinal Anesthesia: Benefits and Challenges.

This prospective study investigated the feasibility of performing laparoscopic pelvic surgery under spinal anesthesia and analyzed the intraoperative side effects, like pain, nausea, and vomitus, of 915 patients. The implementation and performance of laparoscopic surgery under local anesthesia on 915 patients (out of a total of 3212 who underwent laparoscopic pelvic surgery under spinal anesthesia) were analyzed in relation to BMI (body mass index), obesity, pain during surgery, amount of intraperitoneal mmHg CO2 gas pressure, and surgical complications. BMI > 30, intra-abdominal adhesions, increased duration of the operation, bleeding, and increased intraperitoneal CO2 pressure were statistically significant as the main causes of pain during laparoscopic surgery under spinal anesthesia. Underweight patients, on the other hand, had less pain when intra-abdominal pressure increased compared to those of normal weight. The appearance of pain, nausea, and vomitus occurred in 10.3% of patients, and these events were easy to manage and treat. They did not affect the surgeon's work or the course of the operation. In light of these observations, we are proposing spinal anesthesia for laparoscopic surgery as the first choice in patients who have no contraindications. To the best of our knowledge, this clinical study constitutes the largest clinical observation and dataset concerning spinal anesthesia in laparoscopic pelvic surgery. ISRCTN38987, 10 December 2019.

Research Progress of Neural Invasion in Pancreatic Cancer.

Pancreatic cancer is one of the highly malignant gastrointestinal tumors in humans, and patients suffer from cancer pain in the process of cancer. Most patients suffer from severe pain in the later stages of the disease. The latest studies have shown that the main cause of pain in patients with pancreatic cancer is neuroinflammation caused by tumor cells invading nerves and triggering neuropathic pain on this basis, which is believed to be the result of nerve invasion. Peripheral nerve invasion (PNI), defined as the presence of cancer cells along the nerve or in the epineurial, perineural, and endoneurial spaces of the nerve sheath, is a special way for cancer to spread to distant sites. However, due to limited clinical materials, the research on the mechanism of pancreatic cancer nerve invasion has not been carried out in depth. In addition, perineural invasion is considered to be one of the underlying causes of recurrence and metastasis after pancreatectomy and an independent predictor of prognosis. This article systematically reviewed the neural invasion of pancreatic cancer through bioinformatics analysis, clinical manifestations and literature reviews.

Collagen type II solution extracted from supercritical carbon dioxide decellularized porcine cartilage: regenerative efficacy on post-traumatic osteoarthritis model

Osteoarthritis (OA) of the knee is a common degenerative articular disorder and is one of the main causes of pain and functional disability. Cartilage damage is frequently linked to elevated osteoarthritis incidence. Supercritical carbon dioxide (scCO2) decellularized cartilage graft produced from the porcine cartilage is an ideal candidate for cartilage tissue engineering. In the present study, we derived collagen type II (Col II) solution from the scCO2 decellularized porcine cartilage graft (dPCG) and compared its efficacy with hyaluronic acid (HA) in the surgical medial meniscectomy (MNX) induced post-traumatic osteoarthritis (PTOA) model. Dose-dependent attenuation of the OA (12.3 ± 0.8) progression was observed in the intra‐articular administration of Col II solution (7.3 ± 1.2) which significantly decreased the MNX-induced OA symptoms similar to HA. The pain of the OA group (37.4 ± 2.7) was attenuated dose-dependently by Col II solution (45.9 ± 4.1) similar to HA (43.1 ± 3.5) as evaluated by a capacitance meter. Micro‐CT depicted a dose-dependent attenuation of articular cartilage damage by the Col II solution similar to HA treatment. A significant (p < 0.001) dose-dependent elevation in the bone volume was also observed in Col II solution-treated OA animals. The protective competence of Col II solution on articular cartilage damage is due to its significant (p < 0.001) increase in the expression of type II collagen, aggrecan and SOX‐9 similar to HA. To conclude, intra‐articular administration of type II collagen solution and HA reestablished the injured cartilage and decreased osteoarthritis progression in the experimental PTOA model.Graphical

Identification of aging-related genes in diagnosing osteoarthritis via integrating bioinformatics analysis and machine learning.

Osteoarthritis (OA) is one of the main causes of pain and disability in the world, it may be caused by many factors. Aging plays a significant role in the onset and progression of OA. However, the mechanisms underlying it remain unknown. Our research aimed to uncover the role of aging-related genes in the progression of OA. In Human OA datasets and aging-related genes were obtained from the GEO database and the HAGR website, respectively. Bioinformatics methods including Gene Ontology (GO), Kyoto Encyclopedia of Genes Genomes (KEGG) pathway enrichment, and Protein-protein interaction (PPI) network analysis were used to analyze differentially expressed aging-related genes (DEARGs) in the normal control group and the OA group. And then weighted gene coexpression network analysis (WGCNA), the least absolute shrinkage and selection operator (LASSO) regression, and the Random Forest (RF) machine learning algorithms were used to find the hub genes. Four overlapping hub genes: HMGB2, CDKN1A, JUN, and DDIT3 were identified. According to the nomogram model and receiver operating characteristic (ROC) curve analysis, four hub DEARGs had good diagnostic value in distinguishing normal from OA. Furthermore, the qRT-PCR test demonstrated that HMGB2, CDKN1A, JUN, and DDIT3 mRNA expression levels were lower in OA group than in normal group. Finally, these four-hub aging-related genes may help us understand the underlying mechanism of aging in osteoarthritis and could be used as possible diagnostic and therapeutic targets.

Functional Assessment of Patients after Hip and Knee Arthroplasty – Preliminary Studies

Osteoarthritis is one of the main causes of pain and functional disorders in society, one that often affects the performance of everyday activities. The treatment usually consist of physiotherapy and pharmacotherapy, while in advanced stages, surgical treatment is required. The common method to assess the effectiveness of treatment is the physical examination by standardized scales of quality of life, assessment of pain and functioning. More recently, advances in objective assessment tools have been included such as DIERS formetric III 4D, myotometry or bioimpedance. The aim of the study is to evaluate the functional assessment of patients after hip and knee arthroplasty performed due to osteoarthritis. Hip and knee arthroplasty clearly improves the functioning of patients, reduces the intensity of pain and the risk of falls. In addition, changes in muscle tone and stiffness were demonstrated before and after the arthroplasty of the lower limbs.

Lower Extremity Mechanics and Pathomechanics of People with Patellofemoral Syndrome: A Review

Introduction: The purpose of this study was to review the research conducted on biomechanical and pathomechanical variables of the limbs of people with patellofemoral syndrome and also to summarize and present information in a useful framework from past researches. Methods: The present study was systematic review. Keywords included: mechanics, pathomechanics of the lower limb, kinetics, kinematics, center of pressure and Electromyographic activity of lower limbs, patellofemoral syndrome on the sites of Google Scholar, Science Direct, Web of science, PubMed and Magiranwas searched One hundred nine articles were obtained by using the keywords of the study, and according to the intended purpose and removing duplicate articles, 48 articles were obtained, and according to the desired purpose, in the three parts of the patellofemoral joint, Plantar pressure variables and surrounding patellofemoral muscles were classified and analyzed in terms of mechanics, damage, forces on the joint, electrical activity of muscles and equipment used in the research in the form of tables and text. Results: Displacement of the center of pressure in people with patellofemoral syndrome during using orthotics with corrective exercises was reduced. The main cause of pain in patellofemoral syndrome was the delay in the activity of vastus medialis and vastus lateralis muscles relative to each other, which caused the abnormal displacement of the patella to the side and as a result increased the pressure on the patellofemoral joint and eventually caused pain. Closed kinetic chain exercises and biofeedback strengthened the mentioned muscles. Conclusion: Knowledge of the function of patellofemoral joint elements and orthoses and corrective exercises can help the mechanics and pathomechanics of people with patellofemoral syndrome.

Evidence in treatment of trigger finger: a review

Sclerosing flexor tenosynovitis (commonly known as “trigger finger”) is one of the main causes of pain and disability in the hand for which patients attend reconstructive and orthopedic surgery. The pathophysiology of this affectation is based on the presence of repetitive trauma that generates an inflammatory process in the sheath of the flexor tendon of the fingers, which eventually generates an alteration in the hand pulley system and produces all the manifestations characteristics of this disease. First and second author independently searched databases using the following databases: Medline, Cinhal, Pubmed, Cochrane Library, and Clinicaltrials.gov, using the keywords: trigger finger conservative and surgical management. Publications that evaluated the effectiveness and provided comparative and conclusive information on the results of surgical and conservative management for carrying out this work were reviewed and considered. The usefulness of 3 therapeutic methods for managing trigger finger was reviewed, identifying a success rate of 56% with isolated steroid injection and up to 79.6% when used serially; in the use of orthoses, a reduction in the symptom score was identified in all cases, although there is no conclusive evidence on long-term results and complete resolution of the condition; Regarding surgical treatment, it was determined that it represents the best alternative for long-term symptom resolution, with a higher rate of sequelae such as pain within the first week or nerve injury. Intrafascial steroid-based injection represents the initial technique of choice in the management of trigger finger. The use of orthoses may represent an alternative in patients who have no impediment for their use for a fairly long time. Open surgical treatment continues being the therapeutic measure to be overcome, with a high symptom resolution rate 1 year after the procedure.

Essential headaches in developmental age: What is changed before, during and after the lockdown for COVID-19 pandemic. Clinical study.

Essential headache is one of the main causes of pain in children, and has an important impact on their quality of life. In children with essential headaches play an important role in both triggers like stress, excessive use of video terminals, or physical fatigue but also comorbidities like anxiety, depression, and sleep disturbances. CoViD-19 Pandemic was very stressful, especially for children, and amplified all headache triggers and comorbidities. In this work, we studied the aspects concerning the headache,lifestyle, habits, and mental health of children before, during, and after the lockdown and the differences between some categories (selected by age, gender, and headache status before the lockdown). This study was conducted on 90 patients with primary headaches followed at the AOUP Neuropediatrics Clinic from January 2018 to March 2022. Participants answered a questionnaire of 21 questions. For every question, the answer was divided into three periods: before, during, or after the lockdown. All dates have been converted and inserted into a database and we used SPSS technology for statistical analysis. In our study, 51,1% were females and 48,9% were males and there was a prevalence of adolescents (56,7%) compared to children from 5 to 11 years (43,3%). Regarding the headache onset, 77,7% of patients started to suffer from headaches before 10 years, moreover, 68,9% had familiarity with the headache. Using Cohen's K- Concordance Test, we performed a Concordance Analysis, studying the questions in the three periods above mentioned: considering headache characteristics there is poor concordance about the trend of headache; modest concordance (K: 0,2-0,4) about the frequency and the type (migraine or tension headache); moderate concordance (K: 0,41-0,61) about the acute use of analgesic. Analyzing lifestyle the lockdown had a significant impact on sports (practiced much less) and on the use of video terminals (used much more). The pandemic and lockdown aren't events that led to strong and unidirectional responses in patients, there is great variability in the answers about headache, lifestyle, and psychology, and each patient had individualized reactions. However, these considerations are not applied to physical activity and the use of video terminals, because both have been inevitably modified by the pandemic situations and so were not affected by subjective influence.

Idiopathic Tenosynovitis with Rice Bodies: Clinical Case Report

Introduction: Tenosynovitis is the main cause of pain in the upper limbs; it can be originated from infectious and non-infectious causes. 50% of reported cases are tuberculous tenosynovitis. When the rice body formation pathogenesis is uncertain after performing all extension studies, it is called idiopathic tenosynovitis. Clinical Case: A 79- year-old male patient with a pathological history of chronic ischemic heart disease treated with cardiac catheterization with stent placement comes to the Plastic Surgery Office due to the presence of multiple masses on the back of the right hand in zone V, VI and VII with 3 years of evolution, without significant accompanying symptoms. Physical examination revealed the presence of multiple non-painful mobile masses of approximately 4x5cm in the extensor zone V, VI and VII of the right hand. In the surgical exploration for biopsy, within the macroscopic characteristics, multiple converging and interconnected masses were found with granular content infiltrating sheath and tendon itself (II, III, IV and V fingers of the right hand). Posterior capsule of masses is in contact with intrinsic and interosseous muscles of the right hand with the appearance of rice bodies. At the moment, the patient shows a favorable evolution and continues in periodic controls. Conclusions: In this case, having no underlying diseases related to this pathology and having ruled out among the differential diagnoses, it was determined that the occurrence of rice body masses in an infiltrative manner in the tendons is of an idiopathic origin, so our patient will remain on long-term follow-up, but so far with favorable evolution.

Fractional CO2 Laser in the Treatment of Post-Menopausal Vaginal Atrophy

Introduction: Similarly to other parts of the body, the vagina changes over time, and vaginal atrophy is a common condition in women between 45 and 55 years of age. It causes discomfort and psychological suffering, in addition to being the main cause of pain during sexual intercourse. Objective: This study aimed to evaluate the use of intravaginal fractional CO2 laser in the treatment of atrophy of the vaginal mucosa, as well as its effect on symptoms such as itching, irritation, pain, dyspareunia, urinary incontinence, dryness, and loss of mucosal elasticity. Methods: This is a prospective cohort of 14 menopausal women with vulvovaginal symptoms who were evaluated pre- and post-procedure with CO2 laser treatment using the Monalisa Touch® technique. Cytological examination and validated questionnaires were used in the assessment.

Plain Language Summary of the International Collaborative Gaucher Group Gaucher Risk Assessment for Fracture Score in People Living with Gaucher Disease Type 1

What is Gaucher disease? Gaucher disease is a rare, inherited genetic condition. People with Gaucher disease have two non-working copies of a gene called GBA1, which contains the instructions for producing an enzyme called beta-glucosidase. Beta-glucosidase breaks down excess fatty substances called glycosphingolipids, that help maintain our cells in good working order. People with Gaucher disease do not make enough beta-glucosidase, so glycosphingolipids build up in their organs, causing complications. There are different types of Gaucher disease but most people in the Western world with Gaucher disease have type 1 (shortened to GD1). Typical complications in GD1 include having a larger spleen and liver, blood problems, and increased risk of bone problems. Bone problems, including fractures, are one of the main causes of pain and disability for people with GD1, and can impact their quality of life. Treatments such as enzyme replacement therapy (also called ERT) can reduce fracture risk but do not prevent them completely. What was the aim of this study? In this study, researchers looked at a new assessment score called the Gaucher Risk Assessment for Fracture (also known as GRAF). The aim was to evaluate how well the GRAF could predict future fracture risk in adults with GD1 who were receiving ERT. What were the findings of this study? The risk of future fractures in adults with GD1 was higher in women, and among people who had a history of bone pain or had their spleens removed as part of their treatment. Risk was also higher if people had a longer time between being diagnosed and starting treatment, and/or were older when they started ERT. The study also found that the GRAF score performed as well as other fracture risk tools used in the general population. These findings support the use of the GRAF score alongside bone density measurements and other risk factor assessments to help doctors and people with GD1 understand the risk of having a fracture after starting ERT. Clinical Trial Registration: NCT00358943 ( ClinicalTrials.gov )

CLINICAL SYMPTOM COMPLEXIN VERTEBROGENIC LUMBOSACRAL RADICULOPATHY

Vertebrogenic lumbosacral radiculopathy, being a global problem of modern healthcare, occupies one of the leading places among the reasons for visiting doctors of various specialties and disability of people of different age categories. According to modern scientific medical research by a number of authors, an episode of back pain, at least once in a lifetime, is noted by 100% of the able-bodied population of developed countries. The high urgency of the problem of degenerative changes in the spine in the lumbar region is determined by neurological manifestations, changes in psychological and personal characteristics, and a decrease in the quality of life, which attracts close attention of the scientific and medical communities. In particular, it is associated with the peculiarities of the course of the disease, the high frequency of exacerbations and the occurrence in people of the most able-bodied age, unsatisfactory results of treatment and rehabilitation measures, the transformation of the pain syndrome into a chronic form and progressive disability. According to the literature, from 60% to 80% of the population in industrialized countries experience pain of varying intensity in the lower back against the background of dorsopathy, whose share in the formation of neurological syndromes reaches 95%, and pain, including discogenic origin, is considered the most obligate symptom. , occurring in every fifth person over 30 years of age. In the development and progression of dorsopathies, a significant role is given to the disruption of microcirculation processes, which are observed at the stage of clinically developed manifestations both locally - at the level of the affected segment, becoming one of the factors causing acute pain syndrome, and systemically - in the reflex zones and the central nervous system (CNS) , leading to the preservation, deterioration and chronicity of pain in the conditions of transformation of tissue homeostasis, sensitization and functional dissonance of the CNS structures at different levels, determining the formation of negative pain experience and negative psycho-emotional reactions. A large number of authors indicate degenerative lesions and changes in the musculoskeletal apparatus of the spinal column as the main causes of pain in dorsopathy.

Physical and Psychological Strain in Upper Austrian Elementary School Teachers – An observational study

: Musculoskeletal disorders (MSDs) are a main cause of pain leading to high economic burden and psychosocial disadvantages. In addition, psychological stress impacts the overall health as well as the quality of life. Elementary school teachers clearly are a cohort with a high risk of MSDs and stress. The "BelaPrim" study was conducted to determine the physical and psychological conditions of elementary school teachers in Upper Austria and to investigate the influence of physical and psychological parameters on MSDs. Physical and mental strain was determined with the Nordic Musculoskeletal Questionnaire (NMQ) and the 11-item short version of a German work-related behaviour and experience assessment (AVEM), respectively. Despite a high prevalence of MSDs, high scores were found on personality dimensions. Furthermore, qualitative results indicated the need of administrative/pedagogical support. A linear regression model showed that body height (+), work engagement (+), and emotions (-) are predictors for the occurrence of back pain.

A Pain Management through Ayurveda (Viddha Karma) in Gridhrasi (Sciatica) – A Case Report

Gridhrasi (Sciatica) is a musculoskeletal disorder in ayurveda, in which patient walks like gridha (vulture), So named as gridhrasi. In this disease, extreme and radiating pain occurs from the lower back to thighs and legs. In today’s era, vata vyadhi become so much common, not only old people but youngers also start becoming the patient of vata vyadhi. Here, one of them is Gridhrasi (Sciatica). In this article, I am presenting a case study on a 34-year-old patient with the complaints of Ruka (Pain), Toda (Pricking pain), and Stambha (Stiffness) start from Sphik (Buttock) and radiate toward Kati (Lumber region), Uru (Thighs), Janu (Knee joint), and Pada (legs) and left leg SLR positive was treated with ayurveda. Panchakarma is a group of various kind of therapies, which helps in the treatment in ayurveda. It has its own importance as it works on overall aspects of diseased as well as healthy person too. It does purification of body and gives nutrition too. Viddha karma is explained in Sushrut Samhita and it works very good in pain management as it helps in eradication of Avrodha (vata) [Obstruction] in ayurveda avrutta vata is the main cause of pain in Gridhrasi. According to Acharya Sushrut, the site of Viddha karma is 4 angula (finger) above and below the knee crease on the lateral aspect, but it also can be given at the site of the pain. This whole study was completed in 30 days, where Viddha karma was performed on every alternate day in first 7 days and then every 3rd day for 21 days.

Gene expression and molecular aspects in osteoarthritis of the knee - review of literature

Abstract Gonarthrosis is one of the main causes of pain and limitation of physical activity in elderly patients. The diagnosis is established based on the clinical and radiological examination, and the treatment consists of non-surgical measures. The final stage of gonarthrosis is treated surgically and consists of total knee arthroplasty. The molecular study in gonarthrosis aims to identify patients with early stages of arthrosis, with reversible potential, who can benefit from etiological treatment and non-pharmacological measures to slow down the evolution of the disease or even reversibility. Total knee arthroplasty is a surgical intervention with the role of reducing the symptoms and restoring the functionality of the affected joint. Total knee arthroplasty remains the surgical intervention of choice in the case of patients in the final stage of the evolution of the disease with very good functional outcome.

Preliminary comparative study of the Q angle in pregnant and non-pregnant women for the prevention of orthopedic problems

Orthopedic knee problems are the main cause of pain in pregnant women from the third trimester of pregnancy, mainly. The musculoskeletal problems that affect pregnant women can remain after childbirth, therefore, their prophylaxis is a necessity for health care. In this sense, a comparative analysis was performed between the measurements of the Q angle of samples of pregnant and non-pregnant women to verify the changes in this angle to serve as a basis for prophylactic treatments when the angle is increased. Measurements were made following the Q angle measurement protocol, and other data were obtained to verify the relationship of the Q angle with age, height, weight, Body Metabolic Index [BMI], hip circumference, and superior anterior iliac spine measurement up to the patella. These data were compared with the Q angle values for both samples, and subsequently, the angle values were compared between pregnant and non-pregnant women. Statistical data and analysis of absolute values showed that there was an increase in the Q angle of pregnant women compared to non-pregnant women and the comparison of BMI with the Q angle showed a higher r² for pregnant women.

The incidence of pain and its association with quality of life in patients with peritoneal dialysis

Background The aims of this study were to investigate the incidence of pain in peritoneal dialysis (PD) patients and to analyze the correlation between pain and quality of life. Methods PD patients who followed up in our PD center from March 2016 to December 2017 were included. The Short-Form McGill Pain Questionnaire was used to assess pain status. Depression status, sleep quality, quality of life and clinical data were also collected. Results A total of 463 PD patients were included, of whom 153 patients (33.1%) with pain. The main cause of pain was calcium and phosphorus metabolism disorder (51.6%). About 101 patients (66.0%) had multiple sites of pain, and 28 patients (18.3%) with pain were treated with analgesic drugs. Binary Logistic regression analysis showed that older age (OR = 1.026; p = 0.032) and higher intact parathyroid hormone level (OR = 1.043; p = 0.040) were independent risk factors for pain in PD patients. Multivariate analysis showed that score of pain rating index was an independent risk factor for depressive symptoms (OR = 1.100; p = 0.015), the score of Pittsburgh sleep quality index (B = 0.005; p = 0.044) and the score of physical component scale (B= −0.727; p = 0.016) in PD patients. Conclusions The incidence of pain in PD patients was 33.1%. Older age and higher intact parathyroid hormone level were independent risk factors for pain. Pain was independently associated with depressive symptoms, sleep quality and quality of life in PD patients.